New to board, seeking help with mask problems

[thesnarkyllama]

Hi all... long-time lurker, new poster. Apologies for the length of my first post, but I"m getting kinda desperate here, and I want to give as many details as I can. Thank you SO much to anyone who reads this!

I've been on CPAP therapy for almost 3 years. Like a lot of us, I went through several masks at the start. The Amara View was the first mask I ever tried; I couldn't get a seal (I tried both S and M). I tried nasal pillows and tape. I finally tried the size small Simplus, and it was as close to perfect as I think most of us ever get. I use combined therapy, as I wear a Herbst appliance at night because I clench and grind my teeth so badly that I've destroyed every other nightguard I've tried. The Herbst definitely distorts the mouth and once I fall asleep, my mouth doesn't stay closed.

I've recently lost ~15 lbs, and now the Simplus and I don't get along. I wake up multiple times a night with it dislodged, air blowing into my eyes or onto my cheeks, or with flapping chipmunk cheeks. I've tried refitting numerous times; no matter how loose or tight, with Padacheek liner or without, it doesn't change. Plus I'm swallowing a lot of air and waking up in pain. Oddly, my AHI is still at most 1-2, and my leak rate (on the machine) shows as 0.

With my DME's help, here are the masks I've tried in the past few months, and the problems I've had:
Airfit F20: small is too small, medium is too big
Dreamwear (all size combinations of mask/headgear): I just cannot get a good seal, and my leak rate shoots up into the high 20s. I got the Padacheek strap covers to see whether I could try tightening the sides, but it wasn't helpful.

DME gave me a Quattro FX with a large seal thinking it would compensate for the Herbst, but it swallows my face so I haven't even tried sleeping with it. He never sent me another size cushion, so I don't know if it would be any better than the Simplus.

I got on live chat with cpap.com, and the person I spoke with said that I've already tried all their most popular masks, that the Simplus was the lightest, and that it's probably just my best bet and I'll have to live with the problems, but I could try changing my sleeping position (???) The only other suggestion they had was a Resmed chin strap, which I ordered. I tried it last night; it made things worse and all I can say is that it just felt like I had way too much stuff on my head and it all kept dislodging.

Edit: just remembered that the cpap.com rep also suggested a total-face mask, but I'm claustrophobic and that sounds terrifying.

I have no idea where to turn next. Do I just start ordering masks with trade-out insurance, and if so, which one(s)? Beg my DME to send me yet another sample? I did try sleeping with only the Herbst, but Spouse says I still snore, and I wake up with terrible headaches, so clearly I'm not breathing all night and still need my machine.

I would be incredibly grateful for suggestions, as all I want (as we all do) is to SLEEP, preferably breathing while I do!

[ChicagoGranny]

Here are three FFMs that I don't find at all confining. The field of vision is not blocked - you could read or watch TV.

https://www.cpap.com/productpage/respir ... dgear.html

https://www.cpap.com/productpage/RespCa ... -Mask.html

https://www.cpap.com/productpage/respir ... -mask.html

[thesnarkyllama]

Thank you for the links. I've already tried both the Amara and the Dreamwear, and neither worked for me. I don't know whether the Hybrid would, as the Herbst appliance distorts my mouth so much, but it might be worth a look.

[ChicagoGranny]

Thank you for the links. I've already tried both the Amara and the Dreamwear, and neither worked for me. I don't know whether the Hybrid would, as the Herbst appliance distorts my mouth so much, but it might be worth a look.

I would like to suggest taking one of the FFMs that has seemed the least problematic. Then, study the fitting and adjusting videos on youtube. Watch two to four videos carefully.

Here are some more general tips:

To reduce unintentional mask leak -

- Make sure the mask is fitted properly. (See mask manufacturer's video.)

- Make sure the headgear is adjusted properly (See mask manufacturer's video.)

- If you use a low ramp pressure or a low minimum pressure, you should fit and adjust your mask at the higher pressures it is operating at for most of the night. You would temporarily change the machine pressure settings while you do the fitting and adjusting. It's best to do this well before bedtime before you are tired and ready for sleep. Don't forget to change your settings back to the ones you prefer.

- Make sure to use good hose management - the hose should not pull on the mask. Notice how your hose is positioned between machine and mask. It should be positioned to minimize any pull on the mask. Hose management is an individual practice. How it is done depends on the mask, the position of the machine, your sleeping position and other factors specific to the individual.

- If you still have problems, learn from the forum what mask liners are available.

- Start a thread in cpaptalk asking for help. Subject: Need Help with Mask xxxxxx

- If your mask still has excessive leak, try other masks. Many people report trying several masks before they find one that works well for them.

Note: Links to just some of the mask manufacturers' instructional videos can be found on the forum host's website - https://www.cpap.com/cpap-masks.php and https://www.youtube.com/

- CG