Best Masks for Relatively High Pressure

[barrybd]

I am still struggling a bit with mask problems. I have read on here that some people have had success with nasal masks at higher pressure. That has not been the case for me. What am I missing? My pressure is set to auto with a range from 13 to 18, usually hitting 16 or higher every night. When I mentioned the issues with leaks/noise from leaks to the tech at the sleep Dr, she recommended the Eson Nasal Mask, which I am using mainly. I have a strong preference for nasal pillows, but I also like to sleep. My AHI seems to be under control (usually between 2 and 4, rarely below 2), but I am struggling with sleep issues. The noise/leaks and discomfort from the various masks still seems very disruptive. I am now trying a full face mask and while it seems OK when I go to bed, as the night progresses and the pressure increases, the noise from leaks wakes me up. I have read posts in the past on similar issues, but the solution seems to be eluding me. Looking for some ideas. Thanks!

[avi123]

Most masks on the market should take your pressure which is not hi. Some posters here are using pressures above 20 cm which could be regarded as hi. In your case you just need to experiment with masks. I have tested around 20 different masks and still am not completely satisfied but I do get a good treatment, with minimum leak. The masks that I tried I ordered from those providers on the internet who sent them to me free for 30 days. My only cost was the cost of about $12 for shipping back.

I am still waiting for someone to come up with a mouth lips-closer that I could attached to the frame of my Mirage Softgel mask frame. Something like this:



to go around the lips like this and act like a chinstrap:



No need for tube #62.
As I understand it, nobody came out with such a mask, yet.

[Pugsy]

I use a nasal pillow mask and see pressures over 20 often during the night. Often go from 6 to 20 rapidly with my machine. Leaks aren't an issue.

What is the main problem? Leaking that wakes you up when the higher pressures are reached?
Have you tried fitting the mask at the higher pressure to anticipate the needed change? Or are you fitting it to the lower pressure for seal. If that's the case what seals well at starting minimum pressure doesn't seal so great at higher pressures. Are you using the ramp and starting out even lower?

What happens with the nasal pillow mask?
Have you tried a mask liner with the nasal (over the nose mask) or full face mask? Do you know about mask liners?
http://www.padacheek.com/PAC_Maskliners.html

[JDS74]

My Oracle 2 mask is good to 25 cm H2O with zero leaks.
But ... unless you really need this mask, I don't recommend it.
If you do, though, there is no substitute.

Others with proper adjustment can handle pressures higher than those you are experiencing.
So, find a DME that will help you and handle exchanges until you find YOUR mask.

[barrybd]

Thanks! There must be something I am missing. I have tried several different masks since getting this CPAP in Dec. I clearly prefer the nasal masks and they don't seem to leak until the pressure goes up. I have tried Lansinoh (no help). I have tried the Nasal Mask covers from Padacheek (just caused more leaks). The ESON nasal mask has worked best for me so far at these pressures, but it does leak some and lasts less than a month (then starts to leak badly, even as I tighten the mask straps). The Fisher Paykel masks all seriously rub the bridge of my nose and cause bleeding. To deal with that I have tried using bandaids or medical tape and those silicone nasal protectors (those are so thick, they always cause leaks at any pressure). The medical tape is hard on my skin. The bandaids work well enough. As I said I am now trying the Fisher & Paykel full face mask (recommended by my brother). When I put it on and tighten the straps, there are no leaks and it seems not too uncomfortable to sleep, until I move or move my face muscles just a bit, then loud leaks. I cannot hold still enough to keep it from not leaking. I realize these leaks are not bad enough to impact my AHI, but they really disturb my sleep. The leaks that I am talking about can be a very high pitched whistle noise, although sometimes they just feel like air leaks and someone blowing on my face

With my old brick CPAP, I tried several different full face masks, but never found one that was comfortable enough to sleep through the night. Nasal pillows seemed like a giant improvement, but that was with a constant pressure of 10. I suspect my AHI scores were pretty bad then.

So, I guess I will just keep trying random masks, but would still love to hear what has worked for others. Maybe we should have a field in our profiles for our history of masks.

[JDS74]

It may be that you are fitting the mask at lower pressure and getting leaks at higher pressures.
Have you tried setting the pressure to the top of the range and then adjusting your mask while in the position you use for sleeping? Then resetting the machine back to the prescribed pressures?

That sometimes helps.

[hyperlexis]

Supposedly the older style "gel"-type mask cushions do best for the higher pressures. The older Respironics designs use those. Big, thick blue cushions. That may do the trick.

[barrybd]

JDS74, thanks I will try that.

Superlexus, thanks for your suggestion. I will try one of those masks too.

[avi123]

IMO, the full face and the nasal Fisher & Paykel's masks are inferior to Resmed's similar types masks because those F&P masks don't use the double flap technology in the cushions to minimize leak. Apparently, Resmed holds patent(s) on it. I am also guessing that Respironics is paying royalties to Resmed to using it but F&P and Resmed are sort of enemies, there, down under.

[Bill44133]

I use a BiLevel Cpap with higher pressure of 23 and 19. I have had much luck with the Probasics Zzz-Mask Full Face CPAP Mask. I do well with the leaks and also I like the mask because it does not have the forehead support and also I love the price. It is about half price compared to the Resmed or Respironics masks. The replacement cushions are also cheaper.

I wish you well

[barrybd]

Bill, thanks! Are you talking about the Zzz-Mask Full Face CPAP Mask with Headgear or the SG model? It seems the SG model is a revision that is not as popular.

[Bill44133]

Bill, thanks! Are you talking about the Zzz-Mask Full Face CPAP Mask with Headgear or the SG model? It seems the SG model is a revision that is not as popular.

No not the SG model I think that costs more. I use the cheaper one.. It works good for me..
Worse case is it would be a cheaper experiement. Remember every one is different. What works for for one may not work for the other.

I wish you well

[JDS74]

avi123

Interesting patent.
It is a design open to anyone to manufacture as it has expired.