Can't find a APAP mask that works.

[Pamberg]

I was diagnosed with Sleep Apnea, and went and got an APAP machine. I am now on my 4th mask, not counting those I tried in the Home Health office. The nasal ones did not work, it appears I must breathe through my mouth, and I kept waking with a mouth full of air. So Then I have gone to 3 others. Now on the Quatro FX for Her, which I tried last night, and woke up when it was blowing off my face. Tried to tighten it even more, but that did not help keep it in place. I have used a heavier one, which was heavy and cumbersome and uncomfortable and I had to rip off in the night, and another one with some kind of gel cushions inside it, which just slid all over my face. I tighten the straps ,really tight and they give me head pain. WHY am I having so much trouble with a mask? The people at the store are getting tired of trying to find something for me. Now, I do have 1-2 glasses of wine while I watch TV and read at night. I am wondering----does THAT have anything to do with it? I read some people take Lunestra and other sleep aids, so why would wine be different? My 1-2 glasses are the small size glass, not excessive. I am ready to give up and take my chances on heart, stroke, and dementia.

[Stormynights]

I was diagnosed with Sleep Apnea, and went and got an APAP machine. I am now on my 4th mask, not counting those I tried in the Home Health office. The nasal ones did not work, it appears I must breathe through my mouth, and I kept waking with a mouth full of air. So Then I have gone to 3 others. Now on the Quatro FX for Her, which I tried last night, and woke up when it was blowing off my face. Tried to tighten it even more, but that did not help keep it in place. I have used a heavier one, which was heavy and cumbersome and uncomfortable and I had to rip off in the night, and another one with some kind of gel cushions inside it, which just slid all over my face. I tighten the straps ,really tight and they give me head pain. WHY am I having so much trouble with a mask? The people at the store are getting tired of trying to find something for me. Now, I do have 1-2 glasses of wine while I watch TV and read at night. I am wondering----does THAT have anything to do with it? I read some people take Lunestra and other sleep aids, so why would wine be different? My 1-2 glasses are the small size glass, not excessive. I am ready to give up and take my chances on heart, stroke, and dementia.

Mask problems are not a good reason for giving up. Most of us have gone through many masks trying to find the one that will work. If you have a little piece of ribbon try tying that across the bottom straps of the quattro fx and tie it under your chin to help stabilize it. One mask will just never work for everyone. We all finally settle down to favorites but it isn't always an easy process.

[Wulfman...]

I was diagnosed with Sleep Apnea, and went and got an APAP machine. I am now on my 4th mask, not counting those I tried in the Home Health office. The nasal ones did not work, it appears I must breathe through my mouth, and I kept waking with a mouth full of air. So Then I have gone to 3 others. Now on the Quatro FX for Her, which I tried last night, and woke up when it was blowing off my face. Tried to tighten it even more, but that did not help keep it in place. I have used a heavier one, which was heavy and cumbersome and uncomfortable and I had to rip off in the night, and another one with some kind of gel cushions inside it, which just slid all over my face. I tighten the straps ,really tight and they give me head pain. WHY am I having so much trouble with a mask? The people at the store are getting tired of trying to find something for me. Now, I do have 1-2 glasses of wine while I watch TV and read at night. I am wondering----does THAT have anything to do with it? I read some people take Lunestra and other sleep aids, so why would wine be different? My 1-2 glasses are the small size glass, not excessive. I am ready to give up and take my chances on heart, stroke, and dementia.

Sounds like you're using your machine in a range of pressures. I suspect THAT is your problem. You need to set your machine to a single pressure in CPAP mode and try to get things settled down and get some decent sleep.
With a range of pressures, it's hard to adjust a mask to handle the wide variations of pressure. Changing pressures can also disrupt sleep. Drinking alcoholic beverages can affect a person's breathing during the night and cause the APAPs to change pressures. If you're a mouth breather, you need to do some nasal cleansing before bedtime so you CAN breathe through your nose.

See where I'm coming from?


Den

.

[JDS74]

Pamberg

Perhaps If you really can't reliably breath through your nose at night, you might want to think about trying an Oracle 2 oral mask by Fisher-Paykel. Here is a link to my post after 10 months of using just this mask. It's almost 3 years for me now and only once did I use anything else and that was a nasal mask when I spent the night in the ER wihout my own equipment. Then they propped me up so my nose didn't close down as is usual for me when I lie down.

viewtopic/t92105/viewtopic.php?f=1&t=63 ... 32#p589683

[Sheriff Buford]

Mask problems are not a good reason for giving up.

Mask problems are probably the only reason people stop treatment. I went thru 6 masks before I found one that will work for me. I have worked with many folks here that give up because either the mask is uncomfortable, leaks real bad or they just can't stand wearing that conclaption all night. When I started cpap therapy, I asked myself more than once what the heck have I gotten myself in to? And I didn't say heck. When I help someone, I know that the mask will prevent someone from being successful, and that's where I focus my energy.

Sheriff

[robysue]

INow on the Quatro FX for Her, which I tried last night, and woke up when it was blowing off my face. Tried to tighten it even more, but that did not help keep it in place.

The Quattro masks all use air filled cushions to provide the seal. Overtightening the straps---particularly to the point of inducing head pain (which you mention later) is counterproductive: The overtight straps prevent the air-filled cushion from fully inflating and that creates additional leaks. Although JanKnitz's guide is for a different member of the Quattro family of masks, the tips she provides in Taming the Mirage Quattro may help you to better fit this particular mask. Read and re-read her guide a couple of times---particularly the parts about how to insure the air-cushion has had a chance to properly inflate.

I have used a heavier one, which was heavy and cumbersome and uncomfortable and I had to rip off in the night, and another one with some kind of gel cushions inside it, which just slid all over my face. I tighten the straps ,really tight and they give me head pain. WHY am I having so much trouble with a mask? The people at the store are getting tired of trying to find something for me.

Lots of new PAPers have as much trouble as you are having when it comes to finding a mask. Some DMEs know this fact and understand it. Other DMEs? They try to make the new PAPer feel like they are a freak simply because the DME doesn't want to help the new PAPer do any real trouble shooting. Guess which kind of DME you have.

More to the point: Here are some ideas to try with any of the masks you might still have lying around waiting to be tried:

1) Mask liners. For some people a liner really helps with the "it slides all over the place problem"

2) Facial care routine: Make sure you're not using anything greasy or slippery on your face at night. But also make sure that your face is clean and dry before you mask up. You may need to wash the face an hour or so before bedtime to make sure it's had time to completely dry before you put the mask on.

3) Try a different size of one (or more) of the masks. A mask that is too large is going to slide all over the place. A mask that is too small is going to also slide all over the place.

4) Go the the website of the company that makes the mask and see if there are any on-line videos about how to properly fit the mask. Go to youtube.com and search the videos there. There are a large number of "fit a CPAP mask" videos out there. One theme you'll notice if you watch multiple videos, however, is Don't over tighten the straps.

Now, I do have 1-2 glasses of wine while I watch TV and read at night. I am wondering----does THAT have anything to do with it? I read some people take Lunestra and other sleep aids, so why would wine be different? My 1-2 glasses are the small size glass, not excessive. I am ready to give up and take my chances on heart, stroke, and dementia.

Alcohol acts on the body in a different way than Lunestra and other sleep aids. And any given drug affects different people in different ways.

Alcohol is technically a depressant drug rather than a hypontic drug like most prescription sleep meds are. The systemic effects of alcohol are wider than those of typically caused by the standard prescription sleeping medications. And one of those effects is that alcohol is likely to cause more muscle relaxation throughout the entire body. [Alcohol also tends to adversely affect the sleep stages (REM, Light, and Deep sleep) even in a normal sleeper.] Hence it is possible that some of your problems finding a mask that fits all night are being aggravated by the possibility that your glasses of wine are causing your facial muscles to relax more than they otherwise would after you go to sleep.

An important question: How close to bedtime is that last glass of wine? If you are drinking the last glass of wine within an hour or so of bedtime, then you may need to increase the time between finishing the wine and going to bed. (Eating too late affects some people's ability to tolerate the mask as well.)

As for the reading and TV watching: You could use some of that time to practice with the mask. Just drag the machine out to the room where you're reading or watching TV. Mask up and turn the machine on and fiddle with the straps and headgear to find out what tightening here and losing there seems to do while you're watching the tv. Once you think you've got a decent seal (albeit a "sitting up" seal), do some reading and see how long it takes for the seal to become unstable. If possible try to do some of this "wake practice" with the mask while lying down on the couch. Fitting a mask properly is a muscle skill. It takes time to learn and it takes time to perfect. And some of us just can't do that while we're also perfecting the skill of learning to sleep with a hose on our nose.

[BlackSpinner]

I am ready to give up and take my chances on heart, stroke, and dementia.

You obviously are not around people with strokes and dementia much. Before you make that decision I suggest you spend a couple of days helping out at a seniors home. After changing a few adult diapers and dealing with people with dementia you may change your mind. Personally I will jump off a cliff first if I find dementia sneaking up on me. Oh yes, by the way, I have been my mothers care giver for the last 2 years.
There are literally hundreds of masks on the market, as well as mask liners. The job of your providers is to meet the challenge to get you the best care possible. You are not responsible to make their lives easier.

[DoriC]

You might do a search here for Bed Pillows, the right one for you might help with leaks. Also a search for a Hose Management setup should help as well. I'd certainly think more than twice about risking any of those diseases you mention. Keep us posted, you'll find lots of help here.

[hyperlexis]

I was diagnosed with Sleep Apnea, and went and got an APAP machine. I am now on my 4th mask, not counting those I tried in the Home Health office. The nasal ones did not work, it appears I must breathe through my mouth, and I kept waking with a mouth full of air. So Then I have gone to 3 others. Now on the Quatro FX for Her, which I tried last night, and woke up when it was blowing off my face. Tried to tighten it even more, but that did not help keep it in place. I have used a heavier one, which was heavy and cumbersome and uncomfortable and I had to rip off in the night, and another one with some kind of gel cushions inside it, which just slid all over my face. I tighten the straps ,really tight and they give me head pain. WHY am I having so much trouble with a mask? The people at the store are getting tired of trying to find something for me. Now, I do have 1-2 glasses of wine while I watch TV and read at night. I am wondering----does THAT have anything to do with it? I read some people take Lunestra and other sleep aids, so why would wine be different? My 1-2 glasses are the small size glass, not excessive. I am ready to give up and take my chances on heart, stroke, and dementia.

It would help if you listed your machine pressures and equipment info.

Where exactly was the air leaking on the mask? The QFX is actually a very good mask and with practice and adjustment you should be able to get it to work. Definitely do not tighten the mask too much. That is totally counterproductive. Re-watch the ResMed fitting videos online and read the taming the quattro web article (see above). That should help immensely. Remember with the QFX you put it on by first placing the cushion down on at the top of your nose, then swing the bottom of the mask down towards your chin.... Then clip the headgear in place and tighten the straps to slightly snug, but NOT tight.

Also re-check the sizing template to see if your mask is the proper size for your face.

Finally, re-check to make sure the cushion itself is properly sealed all the way around the sealing flange on the hard plastic mask body (the little track the cushion presses into) before you use it. It is problematic on the QFX because its a press-fit seal and sometimes the gasket of the cushion can pop out and leak. The regular old Quattro uses a retainer clip to snap the cushion into place.....

If you still have problems, definitely ask your DME for assistance fitting the QFX. That's what they get paid for. The regular old Quattro and new Quattro Air are great alternatives too.

[sleepy1235]

You have my sympathies though I don't think that helps any.

I use the nasal plugs and wouldn't give them up unless I absolutely had to such as you have had to. I am so thankful that I don't have to wear the face masks.

There are endless postings about these face masks and their problems and creams and this and that which face mask people do to make them work.

My engineering assessment is that there needs to be better work done with face masks. If Apnea patients need to use face masks the current work process needs to be better.

That is there needs to be a systematic assessment of the facial structure, understanding of the mask fitting and mechanical dynamics and the mask should generally work the first time. I get the impression that mask selection is a try this and try that methodology.

I don't read about 3D mapping of faces for face masks. We live in an age of 3D printing and it used for face masks. Correct me if I am wrong on these points.

I work in semiconductor processing and we have face coverings for the ultra clean environment. At one place we had a mouth cover that tended to slip off peoples noses. The problem is that it was designed with the idea that you tended to have a Roman nose, that is a nose that stuck out. Of the work force a majority of the operators manifestly didn't have that type of nose. So we got a new design that didn't rely on hanging on protruding noses.

Sorry if this is just chatter on your thread, but it seems that face mask problems are a real plague for Apnea sufferers based on the postings. I wan't to raise the issue that Apnea face mask technology is not adequate.

Good luck. You just have to keep fighting that is what I did on other issues. Don't be afraid to push your doctor and nurse or change them.

[sleepy1235]

I meant to say I don't read of 3D printing used for face masks.

I don't see the whole concept of customizing a mask for an individual face.

The face mask design idea seems to be is that some jerry-rigged system of straps and cushions will do the job.

As you will note, face mask uses just try and try and try and try face masks until they find one that works. i think they all eventually find one that works, I hope.

[robysue]

My engineering assessment is that there needs to be better work done with face masks. If Apnea patients need to use face masks the current work process needs to be better.

That is there needs to be a systematic assessment of the facial structure, understanding of the mask fitting and mechanical dynamics and the mask should generally work the first time. I get the impression that mask selection is a try this and try that methodology.

I don't read about 3D mapping of faces for face masks. We live in an age of 3D printing and it used for face masks. Correct me if I am wrong on these points.

Sleepy1235,

You've actually identified a major problem for PAP users in general and those who must use FFM in particular. The standard mask comes either two or three generic sizes, whereas patients faces come in many more sizes. Whereas shoes come in literally a dozen or more sizes (some of which are hard to find, but they are still available if you look.)

Even such obvious facial structure such as

• How pronounced is the bridge of the nose?
  How high or bony are the cheekbones?
  How much space is there between the nostrils and the upper lips?
  How much of a receding chin does the person have?

are not directly taken into account in either the fitting at the DME or the mask design stage. In the design stage, I think manufactures are ignoring these issues simply because the manufacturer is trying to make a decent mask that will fit decently on a reasonable percentage of patients with "standard" faces in "standard" face sizes) or the fitting at the DME.

It would be nice if masks could be custom-made at a sufficiently low enough cost so that 3D mapping of facial features could be used for making custom fit masks. Heck, it would be nice if such a thing were available only to patients who've tried at least 3 or 4 masks without finding a "generic" one that works.

Sorry if this is just chatter on your thread, but it seems that face mask problems are a real plague for Apnea sufferers based on the postings. I wan't to raise the issue that Apnea face mask technology is not adequate.

Sometimes the most interesting things happen here when a thread starts to go off topic. And the issue you raise IS an important one.

[sleepy1235]

3D scanning with lasers is now fairly economical.

A lot of other medical treatments use individual dimensioning. People with flat feet have their feet cast for the supports, though it is somewhat expensive.

I don't even read of faces catagorized into types and sub-types.

If you buy a pair of shows they have a system of sizing.

[Stormynights]

I would love to see a mask store where you could go in and try them on similar to a shoe store. I have heard that these do exist but I haven't heard of them very often. I think that would be amazing and people would come from miles away just for a proper fitting by and experienced mask expert.

[PamBerg]

Thank you all so much. I got some very good tips here, and will try them starting tonight. And I will call my DEM provider again tomorrow, despite their attitude that it is me---not them, if I need to get another one.