Aloha mask issues

[Papit]

Here's my experience over the first two nights with my new Aloha.

First, I found our host site cpap.com to be a prompt and reliable supplier. Got my mask within 3 days of placing an order and they honored their lower $85 price and free shipping (upon request, even though they raised their price to $99 plus shipping). Their Mother's Day free shipping promotion may still be in effect (then, of course, Father's Day is coming up).

First the Pros. The side straps are much more off to the side than on most other masks, well away from corners of my eyes as compared to the Swift FX which has been my favorite mask by far. The side strap covers feel comfortable against the skin and come standard.
As Nate reported, the lateral position of the pillows is very firm and stable while the vertical position is appropriately flexible for sealing. These two characteristics In combination seem to accommodate head movement and side sleeping much better than by any other mask I’ve tried in terms of comfort and seal stability. The weight of the mask is very light and about the same as for the FX. The optional use upper velcro loop for fastening the short tube overhead is a big plus for me. The FX lacks that and I had to rig my own fastener on the FX by threading wire through the small top neoprene buckle. That worked, but it's a semi-permanent fix whereas the Aloha loop is easily undone as needed.

Now the Cons. Given so many favorable reviews with hardly any criticism, I was surprised that I'm not having much luck with the Aloha, at least not right away. The Aloha head-gear straps apparently must be made more snug than with the FX, a comfort issue. The rear head band rode up on the back of my head as I slept. I use velcro on my FX rear head band and will apply that to the Aloha tonight, my third night. The pillows seal leaked for long periods during the night and I could hear it unmistakably as I arose now and then. I tried different angular pillow adjustments to no avail. On the second night I snugged the straps up noticeably more than I am accustomed to with the FX. While that did seem to correct the leak problem, it resulted in much more pressure against my upper lip and nostrils. So I partially loosened the straps, but clearly velcro is needed on the head band, at least for me.
The design of the pillows angle adjustment feature leaves a lot to be desired imo. The left and right head band prongs hook into the corresponding pillows reservoir channels at only one angular position, the position in which the mask is supplied. Thus, the other three advertised angular positions are not similarly secured or locked in place. The adjustable pillows was of course a nice idea, especially from a competitive marketing standpoint, but this design feature is functionally rather deficient in its ability to firmly hold any user selected position other than the one position in which the mask is delivered. Luckily for me, this is not an issue re. fit or seal because the default (as delivered) angle seems just right for my face. Others may not be so lucky.
On the first night I used Medium size pillows. On the second night I tried the Large. (Maybe I should try the small size too although I have fitted best on Large size pillows on all other masks I've tried in the past. Any views on that?) The sideways dimensions of both the Medium and Large pillows do not fit me quite right. Neither is a perfect fit and their lateral flexibility is nil. In the past, per my earlier threads, I optimized the FX pillows fit with my 'compression clip', got a fantastic seal and never looked back. (Some people use a small rubber band or a short tied loop of dental floss to accomplish a similar improvement.) I'll try that later if needed. Until then, to compensate for a less than perfect pillows fit, I found that the straps must be noticeably more snug than with the FX. That produced moderate discomfort from pressure on my upper lip and against my nostrils. So far the Aloha is not nearly as comfortable as the FX. Does anybody else notice this?
Also, as with the FX before I applied velcro, the rear band of the Aloha tended to ride up during the night; and that loosens up the mask and seal. So I'll apply velcro tonight to the Aloha to better compare the two masks.
Finally, I found the position of the head band prongs in the pillows barrel 'reservoir' to have been shipped already in the best setting for me and firmly held in place (or 'hooked') by a right angle stop in the reservoir channels in which the prongs are inserted. However, other users may not be as lucky. I notice that the other three advertised ("four raised notches" in the prongs) angular positions are not provided with similar right angle stops in the left and right channels; and so there is nothing to secure or lock the prongs in place for those other three angular positions. Looks to me like those other "three" angular positions, if selected, will be prone to slip or slide out of their desired position at night as the user moves around.
I did try the upper front left and right strap slots on the second night and used the rear slots (as delivered) on the first night. I noticed only a minor difference in the pillows angle.
Comments, and suggestions of course, on my critiqued comments are invited.

Thanks.

[Uncle_Bob]

The rear head band rode up on the back of my head as I slept.

Papit

Are you aware that the top headband strap can go through two posisions on the headgear?
Mine shipped with strap through the front positions I had a problem with the ride up with the back strap and having the tightness of fit.
Once i switched to the rear position for the top strap i found the back strap was able to fit much better.

~UB

[Uncle_Bob]

I did try the upper front left and right strap slot on the second night and used the rear slots on the second night, but noticed negligible difference in the pillows angle.

Ahh it looks like you may have already tried that adjustment. And then hopefully re-adjusted the tension of the two straps?
Did it at least stop the rear headband riding up the back of your head?

~UB

[neverbetter]

wow, we've see 100 reviews and finally, someone had a what look like a problem . I have one suggestion. Did you notice there are two positions for the headgear on top? the mask will sit totally different on your head in each slot. Go with the one you like best. It's shouldn't even touch your upper face, never mind your lip. It should only touch your nostrils. The straps can be worn very lose without a leak in one of those two positions. The mask pillows adjusts themselves during the night as you sleep. Our DME confirmed this. You should never break a seal. Also, try the mask both with and without the comfort wraps. Some people don't bother with them ,some love them. Can you please tell me what the wire is sticking out of your swift in your avatar photo?

[nanwilson]

I'm the opposite of Uncle Bob, mine shipped with the strap in the rear position, but I moved it to the front slots and find it fine . I have kept my top strap on the loose side and the back one a bit snugger, so far so good. I have had my aloha for about 10 days now and have settled on the medium pillows, and I use the loop at the top to anchor the little hose. I had to make a hose snuggie for it as I found it flopped around too much, now with the snuggie on it, it stays put. I tried the small and large pillows for one night each, my leak rate went up but found I could in a pinch, use them. Hope this helps...gotta remember one mask is not "all" to everyone, some may not get it to work well for them.

[neverbetter]

Oh, and if the FX works, it's wonderful.
Please tell me what the wire is in your photo? What's the darn wire for?
Was this a lab photo with a sensor thermatestster thingy that reads air pressure? (I'm a pro after doing one family service call)

[ozze_dollar]

The rear head band rode up on the back of my head as I slept.

Papit

Are you aware that the top headband strap can go through two posisions on the headgear?
Mine shipped with strap through the front positions I had a problem with the ride up with the back strap and having the tightness of fit.
Once i switched to the rear position for the top strap i found the back strap was able to fit much better.

~UB

Tried it last night. I put it on back to front to start off. The rear band lifts during the night but thats me sliding on the pillow. I will tighten the top strap tonight foe a tighter fit tonight. So far so good.

[SleepingDVader]

Hello all...When the Aloha mask was first being reviewed in this forum, several people noted that it was too bad there was only one size headband available, and that many found it to be a little too large. Since I wear a papcap/chinstrap, the sizing is just fine for me, but recently I decided to take a nap and not use the papcap. That's when I noticed the problem as well. So I studied the headband a little and found that the adjustable velcro tabs were about 2 1/8" long which I think is pretty substantial overkill. You can easily (at all four locations if needed) cut off up to an inch of each velcro tab and significantly increase the adjustability of this headband. Hope this helps.

[portiemom]

I have been using may Aloha, since April 14, with the exception of 3 days because my DME wanted me to compare it for her with the Opus 360. My Aloha came with the top straps in the front setting, and I found the 3rd ridge to work for me with the pillows. I'm a very restless sleeper and soon found the right side of the pillow automatically slipping every night to the second position, I'm guessing because I do settle more on that side when sleeping. Due to the consistency of this automatic slipping (while I am sleeping) I now just leave it there on that side. 30 days in and I love it!!!
I can NOT get this mask from my DME so anyone who wants to trade let me know!!

[ems]

Tried my new Aloha for the first time last nite. Initially, I thought it was comfortable and liked the fit.

However, after a very few minutes I noticed I was having a really hard time with the side I sleep on... in other words, the strap digging into the pillow or vice versa, resulting in the strap feeling like it was digging into my cheek.

Any and all thoughts are most welcome. I know I can't sleep with it this way.

[Papit]

". . . Please tell me what the wire is in your photo?

It's a 'compression clip' I made a few months ago to optimize the fit and seal of my Swift FX pillows. Others here have used small rubber bands or a short tied loop of dental floss. It serves to either compress or spread the pillows ever so slightly to customize a close-but-not-perfect pillows fit when the next size up or down is worse. It has worked beautifully for me and is adjustable from time to time as discussed in some of my links. I may need to use the same or a similar solution if other approaches I'm offered here by other members don't work out for my Aloha.

Here are some of my earlier links and close up photos and instructions if you'd like to read more about it.
Cpap compression clip for pillows masks:
viewtopic.php?f=1&t=76155&st=0&sk=t&sd= ... 15#p695995
viewtopic.php?f=1&t=76155&st=0&sk=t&sd=d#p696224
viewtopic.php?f=1&t=76155&st=0&sk=t&sd=d#p696357

Let me know if the links don't work and I'll send you the text and images.

[Papit]

". . .The straps can be worn very lose without a leak . . . The mask pillows adjusts themselves during the night as you sleep. Our DME confirmed this. You should never break a seal. . . .

I sure hope I can get to that happy place where you are. I'm going to try everybody's ideas here. Thanks much!

". . . Did you notice there are two positions for the headgear on top? the mask will sit totally different on your head in each slot. . . . "

Yes, I notice that, neverbetter. Also note that by using the front slot, the rear head band gets positioned lower behind your head, which should minimize the upward slipping problem. So use of the front slots may help some of us with this. I think Velcro will also help and I’m trying that tonight.

‘. . . I did try the upper front strap slots . . . (as well as) and the rear slots on the second night, but noticed negligible difference . . .’

“Ahh it looks like you may have already tried that adjustment. And then hopefully re-adjusted the tension of the two straps? Did it at least stop the rear headband riding up the back of your head?

Nope. The rear head band slid up, Uncle Bob, when I tried both the front and rear upper slots. I let my hair grow kind of long between hair cut so that might contribute to this problem. See my comment above re. using the front slot and applying Velcro. I’m going to try two 2 ½” strips of velcro (rough hooks side) tonight, one piece on each side of the center rear buckle on the inner side of the rear head band.

". . . I use the loop at the top to anchor the little hose. I had to make a hose snuggie for it as I found it flopped around too much, now with the snuggie on it, it stays put. . . ."

I noticed the same tendency, Nan, for the short hose to reposition itself by "flopping" both way over to the left and way over to the right side of my face in response to occasional head movements. At first I tightened it somehow to the top head strap and got the hose to stay centered over my face. BUT THEN I decided I actually much preferred the short hose to be allowed to "flop" over to the right-most or left-most position. Here's why.

In those two outer hose positions, as compared to a centered position, the hose is completely out of my field of view. Even though I may not often need to 'see' or look at anything with my mask on, I much prefer to have a wide open unobstructed field of view. Why? Because it gives the whole mask a much better, less-confining feel for me. (This could be especially helpful to any of us who sometimes might feel a bit claustrophobic in our masks. ) So allowing the hose to flop to the far right or far left sides of my face allows me to 'have my cake and eat it too' so to speak; i.e., I can route the hose atop my head AND still have my field of view unobstructed. I get the most "floppiness" by connecting the very end of the short hose to the velcro loop fastener that you mount at the top center of the upper strap. Check it out.

". . . Hello all...When the Aloha mask was first being reviewed in this forum, several people noted that it was too bad there was only one size headband available, and that many found it to be a little too large. . . . I noticed the problem as well. So I studied the headband a little and found that the adjustable velcro tabs were about 2 1/8" long which I think is pretty substantial overkill. You can easily (at all four locations if needed) cut off up to an inch of each velcro tab and significantly increase the adjustability of this headband. Hope this helps.

Good observation and good call, SleepingDVader. I agree, unless the user has a large head, the adjustable velcro head bands are too long and 'in the way' for some of us. I like your idea of simply trimming the ends back by as much as an inch or so if need be. That would still leave almost another inch of velcro at the ends for holding adjustments in the straps.

". . . I can NOT get this mask from my DME so anyone who wants to trade let me know!!"

Mine can’t or wouldn’t get me one either, portiemom. So I bought it direct from our host, cpap.com, and submitted my claim to my medical insurance company (just like the DME does I guess when they provide you a mask). I used the insurance company’s claim form and added a note, as recommended by cpap.com to “Please pay claimant. Out of pocket payment made” and, of course, include the invoice or receipt for the purchase. Alternatively, at the end of the online purchase process, cpap.com enables you to print out a generic insurance claim form, with instructions for filling it out, that you could use. I would think this would work ok if you haven’t bought or been supplied with a mask in the past three months. If I’m wrong on that 3-month period, someone, please jump in and correct me.

[Suzjohnson]

Hi Papit!
I don't know if you wear a chinstrap but I do, the wide Deluxe, velcro on top one. It has a totally removable strap that I use around the back of my head to keep the chinstrap from moving forward. I always put this on first, then the Aloha. Get it all adjusted with the mask upper strap in front of the chinstrap and the rear strap wherever you like it. Then I take the removable chinstrap strap and put it just above the mask rear strap so during the night, that mask strap doesn't move. There is something about having the Aloha over the chinstrap that keeps it extremely stable and results in being able to maintain a good seal without over-tightening. I kind of tug on the mask straps to get them in the right position as they aren't tight at all, and they stay there all night. Very fiddle free. Once I have all the headgear issues resolved, I adjust the angle of the pillow, attach the hose and, waa-laa! I'm ready to start counting sheep. However, if you don't wear a chinstrap, never mind.

Suz

[NateS]

Hi Papit!

If your nose hurts, you have the top head band too tight. I started tightening mine up and that's what happened. When I readjusted it so that the top head band is completely loose, doing nothing but laying loosely on the top of my head, then I don't feel the nasal pillows on at all and I get my lowest AHIs. Sometimes I wonder whether the top band is even necessary. I'm not sure what if anything it is doing when it is this loose, but that seems to be the best way to set it, at least for me.

I have no problem with the back headband riding up as you do, but I think that is because I wear my Ruby under the Aloha. The Ruby has a strap which pretty much rests exactly where the back headband goes, and apparently creates enough friction to keep the Aloha back band in place. Has velcro solved the problem for you?

Regards, Nate

[Papit]

" Hi Papit!. . . Has velcro solved the problem for you?"

I think so! The velcro strips helped a whole lot by reliably holding the rear strap in place, allowing me to loosen the side straps for less pressing against my upper lip and nose. My CAI dropped to an amazing (for me) 0.6 and OAI held at 0.5. Sweet. 96%Leaks increased to 33.6 on SleepyHead (24.0 according to ReScan). Both are set to read mask leak, not total leak including venting holes. Results from last two nights with velcro strips to prevent the rear headband from riding up are shown below plus my first nights experience with the Aloha. With CA events now minimized well below 5 (which I never expected from a change in mask), very little periodic breathing shows up on the graphs. I'll have to see a lot more of this to believe it, but early results are encouraging.

5/18- CA: 0.6, OA: 0.5, Leak:24.0/33.6, AHI: 1.5 Pressure setting: 7-11 >Velcro strips used on rear band
5/17- CA: 1.4, OA: 0.5, Leak:9.6,Tight straps AHI: 2.3 Pressure setting: 7-10 >Velcro strips used on rear band
5/16- CA: 3.3, OA: 1.6, Leak: 37.2,Large Leak AHI: 5.7 Pressure setting:7-10 >Rear head band slid up at night

I'll try adjusting the head bands some more and see if I can loosen them up some. With my doc's ok, I adjusted my Autoset range from 7-10 to 7-11 as some suggested earlier in another thread. Machine pressure then varied during the night from 7 to 10.28.

Leak is now pushing higher: 96% Leak was 9.6 on 5/17 with pressure set at 7-10.
96% Leak was 24.0 (33 on SleepHead) on 5/18 with pressure set at 7-11
Not yet sure what to do about this leak trend. Ideas?