POLL: Must-have mask features

[archangle]

archangle,
Just a personal opinion, but I believe that many masks will indeed be dishwasher safe in the near future, simply due to the fact that so many people are doing it anyway... time will tell.
Have you found that you're able to wear glasses over a forehead support, or is this strictly either/or?
Replaceable cushions to extend the life of the mask without purchasing a whole new kit and kaboodle?

Even if they're not "officially" dishwasher safe, it's not a bad idea to make them dishwasher safe in fact.

The glasses go between the mask frame and my face, not "over" the forehead support. i.e. I put on the glasses then put on the mask. I wear glasses all the time with my ComfortGel mask with no problem. The forehead support and mask frame have plenty of clearance. Occasionally, the mask cushion and flap do slightly interfere with the bottom of the glasses. Wearing the glasses really helps me because I can put the mask on "just in case" while watching TV or when I wake up in the middle of the night, I can watch a little TV or check the computer without getting out of "CPAP mode" while trying to get back to sleep.

Yes, the replaceable cushions is to extend the lifetime of the mask. No reason buy and throw away mask frames, forehead cushions, nose cushions or flaps just because one part is torn, damaged, icky, or just old. I also think it's beneficial to wash one set of cushions and flaps, use a spare set of masks and cushions and let the just cleaned parts dry for a few days for hygiene reasons. Removable cushions and flaps also contribute to more thorough cleaning. Insurance reimbursement schedules for cushions vs. whole masks are also an advantage to the patient and the mask seller.

[Stormynights]

I'd like to see masks have user adjustable exhaust vents (people sleep in different positions).

I'd like to see all masks that offer each size cushion and/or pillows in the same package also sell the mask to repeat users who only want the size they need inclosed at a reduced price.

Finally, I'd like to see all masks and their parts sold for more reasonable prices. A simple cushion probably is worth a dollar and a half.

You would sell a lot more masks I believe if the price was much lower and I think make even more money in the long run.

[robysue]

robysue,
You're right: easy to clean and reassemble is absolutely an important feature. Duly noted.
You're description of the exhaust valve made me laugh... only because you're spot on.
Do you find that it's more convenient to:
a) Have the air diffused more strongly in one direction such that it could (ideally) be pointed away from all parties or
b) Have air diffused in multiple directions with the intent of minimizing said jet stream?

Choice B for me: I roll around a lot at night. So no matter where you point a jet stream, it remains a jet stream that WILL hit something it's not supposed to hit sometime in the night: Bed partner, your own chest or arm, or---my own current nemises---the bed covers, blankets, or pillows and then bounce back into your face and eyes. There's just no good reason to design the exhaust flow as a forceful, concentrated stream of air in my opinion.

[chunkyfrog]

If it hasn't been mentioned yet; thank you, jromano for this thread.
It means a lot that someone is sensitive to our frustrations.

[napstress]

how about a database which would have 3-D models of masks --especially full-face),
with which patients (or providers) could compare 3-D models of faces, thus eliminating masks which simply will not fit?

Great idea, chunkyfrog! I believe Land's End already used to have something like this. It's a virtual model. You type in your height, weight, and B, W, H, and inseam measurements. You can even choose and eye and hair color. Then you choose your clothing. This was really helpful: I have a tiny waist and very generous hips. Shopping for pants is the biggest freakin' nightmare imaginable. If it fits in the hips, there's all this extra space at my waist. With the virtual model, I typed in my info and it told me straight away that the pair of pants I was interested did not exist in my dimensions. Well, there you go! Same bummer information, without having to go into the dressing room, undress, try on, take off, re-dress, etc., etc., etc.—all with nasty lighting.

It would be cool to have this for the masks.

[chunkyfrog]

As much as the masks cost, I consider it a no-brainer.
The mask designers could use data input when designing new sizes.
--Yes, I did just say 'more sizes',
Our faces are more different than our feet, yet look how many sizes shoes come in.

[McSleepy]

From my experience talking to sleep doctors (3 so far), multiple DME, sleep center staff, and people on forums, it would appear I am the only OSA patient in the world who sleeps strictly in the prone position - flat on my stomach, with my head turned left or right. That makes it so I have found only one mask that would work for me, and only after I have modified it. The Breeze mask is not the only nasal pillow mask but seems to be the only one with a rigid enough support, and one connected to the top of my head via a narrow conduit so that not only it doesn't get in the way but is also supported robustly to keep the pillows planted on my nose, even with the relatively high pressure I am using (up to 20cm at one point). As an example, I can tell you that I have a Swift FX that I tried using but it will simply not stay planted - the weight and rigidity of the hose would make it twist and break the seal. And that's even after modifications.

Among the modifications I made, I guess only one has been corrected: I've heard the new version of this mask (mine was made in 2003, I have two) are made from stronger plastic. I had to reinforce the plastic bridge of mine with epoxy after they broke in multiple places. The other corrections include some additional strapping to keep it tighter on my head and against my nose, but the most important one relates to something that was mentioned earlier in this thread, so I'll emphasize it a bit more.

It is the venting problem. Especially at 20cm, it tends to produce a nice jet-stream that has caused my wife (who is always cold) some trouble. Of course, bearing in mind my sleeping position, it bothers me a lot - to the point where I stated sleeping with a blindfold mask to protect my sensitive face. But that isn't nearly the biggest problem I have with this - it is the fact that as I am sleeping with my face buried in the pillow, the vent would get blocked (a-a-ah, relief from the blowing!) and the exhaled air would have no way of coming out, and I would start breathing some concentrated CO2, and... well, you get the idea.

So, to solve this problem I made a conduit that covers the vent and routes the air back up in parallel with the hose. The way this should be done, addressing all of our problems, is the vent should be terminated into a narrow hose that can then be attached to the main hose - since there is already a hose there, it is an escape route that will not be in the way of anything or bother anyone. It would probably be too much to ask to have the hoses have dual conduits, where you would attach the vent to the secondary one. This way, masks would only need to have a small hose that routes the vented air to the main dual-conduit hose. I don't want to get too sophisticated but you could even make the flow generators accept the secondary hose (as opposed to just venting it somewhere about a foot up the main hose), and effect some control over the exhaled air stream.

Anyway, I just wanted to put this in perspective from the point of view of a stomach sleeper. If someone was actually serious about soliciting design ideas for an actual mask (or even machine) development, I could be very helpful - I am an experienced engineer.

McSleepy

[robysue]

McSleepy,

I'm not a tummy sleeper, but I really, really like your solution to the jet stream of exhaust flow idea. A way of routing it back along the existing hose for some distance to get it out of the way sounds wonderful.

[Rjaye]

Everyone has made good points. I would add my support to making
a surer seal cushion and room for glasses. I use a full face Quattro
and I have been fairly happy with it. I'm not happy with the forehead
piece-because of the glasses-and I would like to see a more user
friendly set of headgear. The neoprene is not very comfortable.
I would like a smaller mask if possible. Thanks!

[sleepyb]

Respironics Easy Life mask has a pretty good vent. It blows almost straight up so it doesn't hit anyone. Unfortunately the mask is a PITA to clean and gets leaks between the two pieces that make up the nose cushion and it can actually start to squeek.
Actually Respironics makes another nose mask that has a swivel vent that blows straight down the hose. I thought the vent was great but the mask didn't fit my face well and didn't need the vent because it leaked so badly everywhere else.

For comfort the swift FX is great but the jet stream is terrible! It either hits my arm and freezes it or it is aimed at my wife, who at 3am is less than a good sport about it.

It would be great to have a FFM that would not leak. The best I found is the liberty but it is a noisy mask and even it leaks too much.
One big issue I have is the straps are not high enough so they rest like glasses on my ears.

[jromano]

nanwilson,
You're story......!!! Oh my goodness - an EXCELLENT example of the need for quick-release clips.
PS. Glad your mask lived to see another day! Hope you got some good sleep last night......

howkim,
Thanks for your input on the quick-release placements. I think obstacles such as the one you encountered are largely unacknowledged. I hope this changes...

jimnsc,
You highlight some important points: the need for individual adjustments, reasonable packaging and bundling options, and fair pricing. All deserve attention.

Wulfman,
This was to include both nasal and full face, although I realize that may have generated unnecessary confusion. It may be easier to separate the two (and all other kinds) in the future - thanks! I appreciate all your input.

archangle,
I see what you mean about the glasses going underneath the forehead support.
Have you ever had dreams that your vision has been miraculously corrected only to realize that you woke up in a fog with your glasses on? I occasionally forget to take my contacts out and its always really disappointing.
You make some good points about the replaceable cushions, especially for hygiene, insurance, and to minimize waste - thank you.

[jromano]

(Opted to break this up instead of posting a dissertation.)

Stormynights,
Fair pricing must be a priority - for the manufacturer, the distributor, and the patient.
Most masks fall somewhere in the $75-$150 range (although we know this can vary GREATLY), and many individuals that either choose to or must pay out of pocket are hit hard with an OSA diagnosis because of the sheer cost.
With the assumption that masks can't be sold for below production costs, what do you think fair pricing looks like? For today's world with all its quirky regulations, who do you consider (if anyone) to be a good example? Anyone's opinions are more than welcome...

robysue,
Thanks for your reply. The exhaust flow deserves more attention, and I agree that McSleepy's solution is fascinating! Which brings me to...

McSleepy,
Thanks for the detailed description of your modifications! You've designed a great system for your (unique? any more strictly stomach sleepers out there?) situation. Your engineering background is apparent.
I do want to stress that we appreciate all the input we receive, and anyone's ideas are always more than welcome.

napstress,
Another idea for this software - let's have it easily available!

Rjaye,
Your input is appreciated. The ability to wear glasses certainly stands out as an important feature.

The neoprene is not very comfortable.

What is it about neoprene that you find uncomfortable? Anyone else have this experience?

sleepyb,
Vent direction, noise, and stream, as archangle pointed out earlier, do seem to have a large influence on CPAP compliance and must be addressed. Thanks for sharing your experiences. And no straps on the ears... got it.

chunkyfrog,
Would you rather have an expanded line of sizes, or fewer options but with customizable features? Your feet example is great - let's run with it. Three pairs of the same heels in different sizes to account for temperature variations and feet swelling, or one pair of summer sandals with all adjustable straps? (Note: the questions is NOT whether you'd wear heels or sandals... )

You - the end users - is what this is all about. May that never be forgotten.

[McSleepy]

A quick comment about neoprene - the only issue I've had with it is that it has a short life. It stretches easily and after a longer period of use it starts disintegrating in a messy fashion. But unless it's a part of an expensive setup and cannot be replaced cheaply, it should be a great material to use. Of course, there have been instances where skin-sensitizing adhesives have been used in neoprene manufacture, so people who might be affected should watch for that.
McSleepy

[bailachel]

Before I settled on the Swift FX, I tried a number of FFMs and nasal masks.. One of the problems that I had with them was that the distance between the the mask and the forehead support wasn't long enough for my face. Therefore when the mask was in the correct position, some of the forehead supports barely cleared the bridge of my nose, sat on my eyebrows and were not comfortable. Perhaps this length could be made adjustable in the same way that mask tilt is adjustable in some models. Or in any other way that works.

[jromano]

McSleepy,
Thanks for the info on neoprene. While it's not used in any of Sleepnet's headgear, I'd still be interested in any outstanding experiences.
Your point about contamination carries a lot of weight, and serves to highlight the importance of consumer education and manufacturer disclosure. I'd be preaching to the choir to tell THIS group that research and advocacy are important... HA!

bailachel,
Distance between the main mask and the forehead support is a measurement that can be easily overlooked.
Would you be more interested in an adjustable mechanism or differently sized static masks?