Review: Hybrid Universal OSA Interface
Author: cpaptalk.com nickname Minerva
Table of Contents
* Introduction
* First Impressions
* Fitting and Wearing
* Conclusion
* More Information
Introduction
The “Hybrid Universal OSA Interface” was formally released on the market June 19, 2006 by Teleflex Medical. Teleflex is a global distribution company, marketing the Hybrid under their HudsonRCI brand name. The mask was designed and patented by RespCare, Inc., based in Coconut Creek, Florida. RespCare entered into an exclusive agreement with Teleflex to market and distribute the Hybrid worldwide.
Teleflex also sells the Nasal-Aire® II sleep therapy interface, and designs, manufactures and distributes products and services for the aerospace, automotive, marine, industrial and medical markets worldwide. Respcare reports an expected sales revenue in excess of $100 million within the first five years of the Hybrid’s availability.
The release of the Hybrid mask was highly anticipated by the sleep apnea community, as an innovative solution to common difficulties with existing cpap masks, including mouth leaks, mask comfort, and problems with large, unwieldy interfaces. Teleflex was extremely cooperative in providing samples to members of cpaptalk.com for review.
Retail price of the mask varies from $175.00(US) to $225.00(US).
First Impressions
The Hybrid comes in an attractive sky blue zippered case with one set of headgear, three pairs (S-M-L) of nasal pillows and three (S-M-L) mouth seals. The case is quite roomy and bears the Hybrid logo. Included with the mask is a CD and users manual describing how to fit and use the mask.
On visual inspection, the design of the Hybrid shows real ingenuity, combining the best features of a nasal pillows interface and full-face mask. The outer shell of the lower part of the mask, which covers the mouth, is a rigid clear plastic, which receives a soft silicone mouth seal that fits into a groove around the edge of the shell, much like a standard full-face mask. At the top of this mouth seal are two holes that receive the nasal pillows. The pillow sets are simply inserted into these holes and are held in place by friction – no complicated fitting, clips, or other attachment is needed. The pillows have two height settings on each set – adjustment is by simply pushing the pillows further into the holes in the mouth seal or pulling them further out. The nasal pillow sets are connected by a thin strip in the middle. Users with different-sized nostrils can cut this thin strip and use different sizes of pillow for each nostril.
The mouth seal has a soft silicone shelf at the lower edge that fits under the chin, that is slightly more rigid that the rest of the mouth seal. The mask is extremely light. The headgear joins the mask by means of four small flat plastic clips that fit over four small pins that protrude from the face of the mask shell. The headgear is adjustable at all four points via Velcro fasteners.
The hose connection is a 90-degree coupling elbow that swivels 360 degrees, and a small exhaust valve is located at the top curve of the 90-degree angle. A small silicone flap moves freely against the vent with the user’s breathing. The mask also has pinhole washout valves just above where the coupling joins the mask shell, and two supplemental ports that are covered with small silicone caps.
Fitting and Wearing
The CD that is included with the mask is short, well-produced, and easy to understand, showing how to put on the mask and adjust the fit properly. After reading the manual and reviewing the CD, I decided to try the medium mouth seal with medium nasal pillows.
Putting on the mask takes a little practice, but following the directions on the CD, I soon got the hang of it. First, I attached the headgear at the top two connection points, and let it hang down in front of the mask. Then, the pillows are inserted into the nostrils, and the mouthpiece rotates down over the mouth. Holding the mask in place, the headgear is then drawn up and over the head, and the bottom two clips are secured. It took me a few tries to figure out that the clips ‘snap’ into place – without fully securing them, they will fall right off the pins.
I put the mask on in the afternoon and wore it around the house, much to the amusement of my husband and cats, to see how it felt over time. The mask bears mainly between the bottom of the nose and the upper lip, but is not uncomfortable because the silicone seal is quite soft and pliable. By adjusting the straps of the headgear, I was able to get a good seal around the mouth, but the angle of the mouthpiece was such that the nasal pillows pushed forward and tried to pop out of my nostrils. I tried several combinations of mouth seal and pillows before settling on the large size of both, which seemed to work better and was very comfortable.
I hooked up to my machine and took a short nap. It was easy to turn on either side, and the seal of both the mouthpiece and the nasal pillows held well for the two hours I was asleep. I woke up feeling refreshed and comfortable. My nostrils were slightly sore, but not more than what I have experienced with other nasal pillows systems, and the soreness went away after a short time. The mask left no marks or indentations on my face.
That night I again used the large mouth seal and large nasal pillows. After about four hours of sleep, I awoke with a dry mouth and leaks around the nasal pillows. I reseated the mask, which took care of the leaks, and turned up my humidifier a bit. After another hour of sleep, I was again awakened by nasal pillows leaks. I changed out the large pillows for the medium sized pillows, to see if that would help, but could not get them to seal in my nose. Since it was late, I put on my Swift and went back to sleep.
The second night, I tried using the medium mouth seal and the large pillows, but could not get a good seal on either the mouth or the nasal pillows. I went back to the large mouth seal and large nasal pillows. I got the mask on and sealed and fell asleep easily. After a few hours I was awakened by one of the nasal pillows popping out of my nose toward the front. I pushed it back into place and went back to sleep. After another few hours I awakened with extremely sore nostrils and had to take the mask off.
On night three, I gave it another try, even though my nose was still sore. This time I adjusted the pillows down to the lower position, which seemed to help counter their tendency to want to pop out of my nose, but after a few hours I was awakened again with leaks at the nasal pillows. My nose was too sore to try the mask again the following night, so I reluctantly gave up on the Hybrid after three nights.
Conclusion
As I fiddled around with the different mouth seals and nasal pillows, it became clear to me that the problem was geometric disagreement between my face and the mask. My overbite, small chin, and pointy “nordic” (read: big) nose means that in order to get a good seal on the mouth part of the mask, I have to tighten the lower part against my chin, which causes the upper part of the mask to angle forward and push the nasal pillows forward. Since my nose is somewhat turned up, the pillows easily pop out of my nostrils as they are pushed forward. For people who don’t have an overbite, I imagine the pillows will seat correctly and the mask will be comfortable for the full night.
In terms of humidity, it appears that people who use a nasal interface with a humidifier may want to turn up their humidity a bit to prevent dry mouth. I didn’t notice any particular discomfort after adjusting my humidity the first night – I was neither too sweaty nor too dry under the mask.
I did notice that if the coupling is turned up to put the hose overhead, it makes a lot of noise, but this was not a problem for me because I prefer the hose to hang down in front. Noise could be a problem for people who like to route their hose overhead. In a hose-down position the mask is extremely quiet.
Even though the mask did not work well for me, I think it’s really a leap forward in cpap mask design. I liked not having a bunch of straps, hoses and forehead rests in front of my eyes, and the mouth seal/nasal pillows interface is truly ingenious. The only thing that I found difficult to deal with (unrelated to my unfortunate face shape) was the headgear connection to the mask. It’s difficult to manage all four connector points at once in the dark or when sleepy – some type of ‘quick release’ headgear for this mask would be ideal.
More Information
Teleflex home page: http://www.teleflex.com/
Teleflex medical division home page: http://www.teleflexmedical.com/
HudsonRCI home page: http://www.hudsonrci.com/
RespCare home page: http://www.respcare.com/
Hybrid home page: http://www.hybrid-mask.com/
cpap.com Hybrid page: https://www.cpap.com/productpage.php?PNum=2204&PAID=301
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CPAPopedia Keywords Contained In This Post (Click For Definition): cpap mask, humidifier, hose, nasal pillow, cpap.com, swift, CPAP, seal, Nasal Pillows
Hyrbid Review
Hyrbid Review
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| Mask | ||||
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| Additional Comments: Started CPAP June 14, 2006, pressure set at 8.0 | ||||
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sidesleeper
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rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
What a descriptive, clearly written review, Minerva! Very interesting.
Your experience with the Hybrid is much the same as I have had this past week. When I first put it on, using the medium mouth cushion and medium nasal pillows, I thought, "Wow, this is soft, cushy....great!!"
But it didn't take long -- an hour or less into each night, sometimes immediately -- for it to begin leaking at various spots. "Ok", I thought, "I don't mind working with a good mask to get the kinks out."
Try as I might, however, night after night, no matter what combo of mouth/nasal pillows I tried; no matter what adjustments I did to make the straps tighter, looser, route them more up or down, no matter how many times I got up to start from scratch...annoying leaks just kept springing out too many times. Perhaps it's that I turn over several times during the night. Perhaps it's the way I move my head on the pillow while sleeping on my side. If someone stays more or less in one position, perhaps it works better.
Or, perhaps as you surmise, it's that the Hybrid, like any other mask, is simply going to fit some faces better and other faces not so well. I had the same feeling you did that the mouthpiece needs to tilt a bit differently for me. And the same trouble with getting both areas (pillows/mouth) to stay "fitted" at the same time as the night progressed. The "tilt" is something we can change with some other masks, but there's not much way to change the angle on this one. Even raising or lowering the nasal pillows couldn't accomodate the angle not being right for me.
I finally tried using one of my ubiquitous pantyhose tights straps over the front to stabilize the thing better against my face. That's helped every mask (except the Comfort Curve, which I never could tame) for me, if the mask needed a little leak control or stabilizing of the headgear. No joy. Leaks kept springing out here and there. I'd get matters under control, and then pretty soon here'd come another leak when I moved my head or turned. The usual pressures my autopap rocks along at most nights is 9 or 10, btw.
The softness of the silicone they used in the mouth cushion and the nasal pillows was very comfortable. However, that initial comfortable feel was negated by my having to crank the thing down tightly to even get a reduction in leaks.
Too many times, the area holding the nasal pillows was being shoved too hard just under my nostrils, regardless of which combo of mouth/pillows I used. I hasten to say, I absolutely love nasal pillows interfaces and have almost never had any soreness or tenderness of the nares themselves from contact with "pillows". However too much mask pressure against the outside just below the nostril openings can quickly make the area where upper lip joins the base of nostrils sore and tender. I had that happen several times too many with the Hybrid.
Not being able to route the main air hose overhead was a major drawback to me. As an active sleeper who turns over several times during the night, I much prefer the freedom of having the hose completely up and out of the way. I could probably figure out a way to route this one up (already was eyeing a spot on the ceiling and/or thinking about getting a longer swivel arm plant hanger for the wall...lol ) but with the on-going leakiness issue, it wasn't worth trying to lab-rat my way around the hose position problem.
Soooo...while I can see how it would suit many, many people and would be a welcome change if other FF masks were gouging the bridge of the nose or jetting air leaks up toward the eyes, it just didn't work well for me.
I'll stick (no pun intended! lol ) with taping my mouth in order to use nasal-pillows-only interfaces that, for me, are much more comfortable...much less leaky. And I'll drag out a traditional FF mask on the rare occasions that I absolutely need to mouth-breathe. They aren't comfortable either, but at least they don't leak as much for me as the Hybrid does, and I can route the hose where I want it to be.
Your experience with the Hybrid is much the same as I have had this past week. When I first put it on, using the medium mouth cushion and medium nasal pillows, I thought, "Wow, this is soft, cushy....great!!"
But it didn't take long -- an hour or less into each night, sometimes immediately -- for it to begin leaking at various spots. "Ok", I thought, "I don't mind working with a good mask to get the kinks out."
Try as I might, however, night after night, no matter what combo of mouth/nasal pillows I tried; no matter what adjustments I did to make the straps tighter, looser, route them more up or down, no matter how many times I got up to start from scratch...annoying leaks just kept springing out too many times. Perhaps it's that I turn over several times during the night. Perhaps it's the way I move my head on the pillow while sleeping on my side. If someone stays more or less in one position, perhaps it works better.
Or, perhaps as you surmise, it's that the Hybrid, like any other mask, is simply going to fit some faces better and other faces not so well. I had the same feeling you did that the mouthpiece needs to tilt a bit differently for me. And the same trouble with getting both areas (pillows/mouth) to stay "fitted" at the same time as the night progressed. The "tilt" is something we can change with some other masks, but there's not much way to change the angle on this one. Even raising or lowering the nasal pillows couldn't accomodate the angle not being right for me.
I finally tried using one of my ubiquitous pantyhose tights straps over the front to stabilize the thing better against my face. That's helped every mask (except the Comfort Curve, which I never could tame) for me, if the mask needed a little leak control or stabilizing of the headgear. No joy. Leaks kept springing out here and there. I'd get matters under control, and then pretty soon here'd come another leak when I moved my head or turned. The usual pressures my autopap rocks along at most nights is 9 or 10, btw.
The softness of the silicone they used in the mouth cushion and the nasal pillows was very comfortable. However, that initial comfortable feel was negated by my having to crank the thing down tightly to even get a reduction in leaks.
Too many times, the area holding the nasal pillows was being shoved too hard just under my nostrils, regardless of which combo of mouth/pillows I used. I hasten to say, I absolutely love nasal pillows interfaces and have almost never had any soreness or tenderness of the nares themselves from contact with "pillows". However too much mask pressure against the outside just below the nostril openings can quickly make the area where upper lip joins the base of nostrils sore and tender. I had that happen several times too many with the Hybrid.
Not being able to route the main air hose overhead was a major drawback to me. As an active sleeper who turns over several times during the night, I much prefer the freedom of having the hose completely up and out of the way. I could probably figure out a way to route this one up (already was eyeing a spot on the ceiling and/or thinking about getting a longer swivel arm plant hanger for the wall...lol ) but with the on-going leakiness issue, it wasn't worth trying to lab-rat my way around the hose position problem.
Soooo...while I can see how it would suit many, many people and would be a welcome change if other FF masks were gouging the bridge of the nose or jetting air leaks up toward the eyes, it just didn't work well for me.
I'll stick (no pun intended! lol ) with taping my mouth in order to use nasal-pillows-only interfaces that, for me, are much more comfortable...much less leaky. And I'll drag out a traditional FF mask on the rare occasions that I absolutely need to mouth-breathe. They aren't comfortable either, but at least they don't leak as much for me as the Hybrid does, and I can route the hose where I want it to be.
RG, what is your personal favorite FF mask? I'm going to order a new mask in Sept and it might as well be a FF one for when I get a cold.
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| Machine: DreamStation Auto CPAP Machine |
| Humidifier: DreamStation Heated Humidifier |
| Additional Comments: Compliant since April 2003. (De-cap-itated Aura). |
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sidesleeper
I have to be able to open my mouth. I didnt have the leak problem I usally have on FF, but it would be nice to wear it over the head. Almost sounds like you wore a different mask. The trick I figured out that worked for me was not to strap it too tight.
And I like the Comfort Curve. I made great non slip pads for mine.
And I like the Comfort Curve. I made great non slip pads for mine.
Reading the various reviews here, I wonder if perhaps this mask is more forgiving for men, because of their different chin alignment (i.e., men's chins seem to stick forward further, which would change the angle of the mask and make the nasal pillows more comfortable/leakproof)? It seems like the people having the most trouble with it are the gals, while most of the men are liking it. Guys, what do you say?
Min
Min
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| Additional Comments: Started CPAP June 14, 2006, pressure set at 8.0 | ||||
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oldgearhead
- Posts: 1243
- Joined: Thu Mar 30, 2006 9:53 am
- Location: Indy
I am not having any problems with the pillows. I can use either the medium mouthpiece with the large pillows, or the large mouthpiece with the medium pillows. The main problem I'm having with the large mouthpiece is I cannot seal it.
As we speak I am applying layers of mole skin to the corners of the large mouthpiece. I plan to use an extensively modified large mouthpiece tonight.
As we speak I am applying layers of mole skin to the corners of the large mouthpiece. I plan to use an extensively modified large mouthpiece tonight.
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Guest
Min, that is a good review. Even though it didn't work for you. It is hard to tell what mask will work for you and what mask won't when you've only been on cpap for three weeks. The adjustment period can take a lot longer than that and sometimes it takes a while for your nose to toughen up. Thanks for the review.
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Sleepless on LI
- Posts: 3997
- Joined: Mon May 30, 2005 6:46 pm
- Location: Long Island, New York
The problem that Minerva and Rested Gal speak of is exactly my problem. It seems the angle of the nasal pillows is just not right and the top of them wants to either pop out or leak, no matter what combination I've tried.
I hate to say this, but I don't think this is made for everyone, and I'm included in the category of the unable-to-use group. I think we are going to soon start to see listings of "gently used" Hybrids up for sale, mine perhaps being one of the first to go. In theory, it's a great idea. However, I think since this is the "Edsel" of Hybrids, we may need to wait until all the kinks are worked out and this mask is modified before more users find it can work for them.
I hate to say this, but I don't think this is made for everyone, and I'm included in the category of the unable-to-use group. I think we are going to soon start to see listings of "gently used" Hybrids up for sale, mine perhaps being one of the first to go. In theory, it's a great idea. However, I think since this is the "Edsel" of Hybrids, we may need to wait until all the kinks are worked out and this mask is modified before more users find it can work for them.
L o R i
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birdiebaby
- Posts: 137
- Joined: Tue Apr 18, 2006 9:34 pm
It's my problem also. I'm not one to easily give up, though, and the combination of raising the pillows and using ponytail holders on the mask straps helped quite a bit last night for me. My leak rate was the lowest of the four days that i've used the hybrid. The downside is that the mask is pretty tight against my face, and it's not quite as comfortable. Still, it beats my UMFF, and I had some serious mouth breathing going on a couple of nights ago that made me very glad for this mask.The problem that Minerva and Rested Gal speak of is exactly my problem. It seems the angle of the nasal pillows is just not right and the top of them wants to either pop out or leak, no matter what combination I've tried.
I'm going to continue tinkering and will present my review next weekend
[quote="Sleepless on LI"]The problem that Minerva and Rested Gal speak of is exactly my problem. It seems the angle of the nasal pillows is just not right and the top of them wants to either pop out or leak, no matter what combination I've tried.
I hate to say this, but I don't think this is made for everyone, and I'm included in the category of the unable-to-use group. I think we are going to soon start to see listings of "gently used" Hybrids up for sale, mine perhaps being one of the first to go. In theory, it's a great idea. However, I think since this is the "Edsel" of Hybrids, we may need to wait until all the kinks are worked out and this mask is modified before more users find it can work for them.
I hate to say this, but I don't think this is made for everyone, and I'm included in the category of the unable-to-use group. I think we are going to soon start to see listings of "gently used" Hybrids up for sale, mine perhaps being one of the first to go. In theory, it's a great idea. However, I think since this is the "Edsel" of Hybrids, we may need to wait until all the kinks are worked out and this mask is modified before more users find it can work for them.