newbie having terrible time with mask leaks

[vlaugtug]

I am only one month into this process, have tried the quatro fx full face mask, a hybrid mask and nasal pillow mask. I am stuck in the never ending cycle of leaks, causing higher pressure, causing more leaks, causing higher pressure, and the end result is I am awake alot adjusting the mask and trying to sleep over the rather loud noise of the leaks. Not only that, but the "bloat" (nice word for it) is a problem for me at higher pressure, which is around 11. Seems I am swallowing alot of the air that should be going into my lungs. So far, I would call this entire process a failure, as I am more tired and worn out than before! Does anyone have any advice for me on a mask that is most successful in preventing leaks under higher pressure, especially for a thin face? I would love to find one that also would allow me to read with it on. I am ready to give up.

[Julie]

Very sorry to hear of your problems... unfortunately, most of us have gone through similar times and there is no easy answer except to experiment with different masks, sizes, trying them while lying down as if you were at home, jiggling them a bit, not overtightening (doesn't help and can make things worse). Cpap.com has a program where you pay a little insurance to test drive a mask and be able to return it if it doesn't work out, or if you can find a decent local DME to help you get fitted properly that would be great... but you may end up with a drawerful like the rest of us (tho' may also be able to sell those at some time).

Faces (bone structure under our look-a-like chubby cheeks) are so different - no one can say what would really be just right for you. Every mask will leak on the wrong person, but try different styles, rather than just different ones of the same type (such as prongs), just don't give up yet - it's way too early and so important to not let the mask keep you from getting help.

As far as the aerophagia (bloat) goes, some people are able to just nudge their pressure down a little and that works, but check with your MD first, unless you're using software and can see for yourself if it matters much.

[SleepingUgly]

The only compelling reason for a full face mask in my opinion is if you really and truly can't breathe well through your nose. So if you can breathe through your nose, start with nasal pillows or a nasal mask (my first choice would be pillows). The smaller the surface area, the less chance for leaking, so pillows or nasal masks will be easier to get a seal on than a full face mask. If your mouth opens, add a chinstrap (or tape, if you're comfortable with that). Only if you fail nasal interfaces would I go to a full face mask. Repost if you get to that.

[KEQ5]

Well, another question is "where are you leaking"? Nose? Around the sides? Up between the eyes?

[Starlette]

I have four masks that I interchange for different reasons:

Main: Hybrid Full Face CPAP Mask with Nasal Pillows and Headgear. I use because I am a mouth breather. Favorite mask.
Alternate: Swift FX for Her and Aloha. Why? Sometimes I like change.
Mirage SoftGel: I use when both nostrils are stuffy before going to bed.

All four took some nights and I use the "s" after night. Unfortunately, it doesn't happen overnight for most of us. Data looks pretty awesome with both pillows and Mirage SoftGel. The Hybrid still has some leak issues but I'm willing to forgive it as long as it's within its leak range.

With all masks I've used, I follow the same process:
I sit up in bed and put the mask on mildly snug on my face and begin the tweaking process. Holding the mask in place with one hand, I put the other hand on the back of my head. Whatever strap is left over, I remove the mask and restrap until the "extra" strap has disappeared. One thing is key here (I may sound anal, but again its worked for me), after tweaking the straps, I measure out the straps on both sides for the top and for the bottom to make sure they are evenly distributed on both sides. Reason being is that I don't want imbalance where an unnecessary leak might occur.
Now, I turn on the machine while sitting up and listen for leaks. If there are leaks, I turn off the machine and remove the the mask and tweak accordingly. My theory is that If it leaks while sitting up, it will leak laying down.
Then I lay on my pillow and repeat the line above.
Next step, I move my body to the left and to the right and repeat the process again.

That gives me a starting point. As you continue to use the mask nightly, the mask will definitely talk back to you letting you know of leak issues.
vlaugtug, may I suggest keeping a leak journal so that you document and see what is working and not working.
Keep in mind vlaugtug that all our masks are going to leak at some point or another outside of the vent leak rating. We just want minimize them so we get the best nightly therapy possible. It's usually taken me about a week to a week and a half to get the leaks under control.
Key for pillow mask: You don't want to overtighten the straps because the pillows get filled with air which keeps them in place.
Rule of thumb for fitting a mask is to give enough give to the straps so as to slide two fingers in. This will help to night overtighten the mask.

Keep us posted and let us know how things are going.

Starlette

[vlaugtug]

Oh Boy Thanks everyone!!! I am so happy to have found this place. I went to a different DME today and they spent a long time trying different masks on me and fitting me. It was so good to find someone to help. My first DME didn't have a clue. I am going for another sleep study tomorrow to get my machine titrated. I am hoping that a very low pressure will do the trick and that alone will help with leaks, but I know that is just postive thinking. I often have trouble breathing through my nose as I have a deviated septum, so I am settling on trying a swift FX nasal pillow mask and a hybrid mask for those days when I cant breath very well through my nose. The quatro FX is the mask that was causing me alot of leaking problems and I think this happened because I am a side sleeper. I would develope leaks around the bottom and on the side I was sleeping on. The DME wants me to try the mirage quatro because I have a very narrow face. This fact alone has contributed to the leaks. I am going to try this one along with the swift fx and hybrid. I think the swift FX will work well because the side supports on my face are flexible and not rigid and wont move the pillows out of my nose when side sleeping. Hopefully, one of these will provide me a complete night's sleep because I am WAY more tired now than when I started this process!

[cherylgrrl]

If you haven't tried one of the SleepWeaver masks, that would be my first recommendation. You can get them with a 30-day money-back guarantee.

I'm also now trying the Bella Loops, with pretty good results.

Don't give up, the mask trials are the most important part of getting adjusted to xPAP therapy. Once you have that behind you and one or more masks you can tolerate well, it's a cakewalk!

[KEQ5]

One trick that I use when putting the mask on is to tilt my chin downward. On the Quattro FX and Mirage Quattro masks, this loosens them up, making it more likely that they'll leak. When I then raise my chin away from my chest, you can feel the mask straps tighten up.

(Depends on how the straps go around the back of the head, or over the head, or around the ears, etc.)

[AmishApnea]

vlaugtug,I too have been on this air trip for a bit longer than a month and I have been using the Quattro Fx full face.
For me this was much better than the nasal mask I started with, but as a side sleeper the leaks were horrible.
Even when the mask isn't leaking the vent is blowing air across the brow above my nose, still getting used to that.
I stuffed cotton around the straps where they attach to the mask because air from the vent was also getting deflected by them.
My leaks are suprisingly around the eyes and not where my beard is. What has helped me so far is getting a new pillow that has a cutout for the mask.
Now my mask doesn't touch the pillow and get knocked around, keeping its seal.
The rest is readjusting the mask up and down my face during the course of the night.
I would agree with the logic that a smaller surface area would give less chance for leaks, but you have to find something that's comfortable to wear, even without leaks.

[Denial Dave]

my issue is with the quattro Fx mask and what I call "delayed leaks" after ramping

When I turn on the S9, I prefer a 15 minute ramp to allow me to get accustomed to the machine, air flow and to fall asleep.. During that time, I get zero leaks.

Wait 15 minutes for it to reach my Bipap settings of 21 /15 and I can get leaks blowing all over the place, but mostly near the bridge of my nose and across my eyes.

I'm told that mask fit option does not work on s9 with bi-pap.

So my process is to put on the mask, turn on the machine with ramp to zero....check for leaks at full pressure, if all is well, I go back and set ramp for 15 minutes and try to go to sleep.

if there are leaks, 'i work on resolving them...

I've ordered pad-a-cheek liners to see if they help with the issue.

any sugestions for an easier process?

Dave