YIKE!!--Back to Being a Newbie Again~~

I need some help. I've been using my back-up Ultra Mirage FFM for the past couple of weeks to try to "get it right" for effective therapy, in case I ever really need it.

The good news: After about a week, I found the right seating of the thing so that the cushion was not crushed flat against my face to seal it. The light marks on my face disappear after about an hour now, which is great. And I actually like the feel of it. No problem sleeping on my side with this mask, using either my new PurSleep buckwheat pillow or my PaPillow. It's a great mask! (I use the Shallow one)

The not-so-good news: I still have to fiddle with the mask for about 5-10 minutes to get it right at that fine-margin point of being loose enough for the cushion to inflate a bit, without creating those blasted leak places. Worse, is that my AHI has gone from consistently below 1.0 for many months with my Swift LT, to now being anywhere from 2.0 to a shocking 4.5 !! AARRGHHH!

Nothing major is happening in the leak-department. I stay steady at 36 with pressure of 10. Had some trouble feeling like I wasn't getting enough air (that's new to me), so I upped my pressure to 10.5 for the past few nights. Leak rate at 36 for 90% of the night, going up to max of 42 at times for as much as an hour or two with no big spikes. I tried going to 11 for a few nights, but could not get the leaks under control, and my AHI hit the higher levels.

Do any of you who have used this style mask have suggestions? I've been using pressure of 10 for most of the past 9 months with my Swift LT. Still using constant cpap, which has been best for me. Is it normal to need .5 or even greater increase in pressure when changing from nasal pillow to a FFM? Is it typical to have to poke at the cushion & fiddle with it every night to seat it properly and get rid of the tiny leak places?

Hi, I use an UM FF, but beyond having to tighten, or retighten the straps every few wks or so, don't fiddle excessively with it. I will pull it down a cm. or 2 on occasion if it seems to be needed, or readjust the forehead thingy but don't need to fiddle to any extent every night. Are you sure you have the right size? I take a 'funny' one - small shallow, which is both small, but slightly wider ... I can't even remember where, but it accommodates me much better than regular smalls do (as does the Respironics small-wide size for the odd time I use a nasal Comfort Select + tape for a change). Don't depend on the online template for sizing - it once told me that the UMFF (or the Comfort Select) was not recommended, yet it was in fact a mask I'd been wearing and one of the few that did fit well! It's paper and can't possibly account for all of us.

Thanks for your thoughts, Julie. I actually got this FFM from my sleep lab for their cost--had plenty of time and good help with proper fitting--and it felt by far the best of the 5-6 different ones I tried (some for a couple of nights). I'm hoping that others can respond to the questions I have noted above. The fiddling is to get the silicone to "tuck in" and stay put without having the mask so tight it mashes that cushion flat. Ugh.

Pir66 says - Is it typical to have to poke at the cushion & fiddle with it every night to seat it properly and get rid of the tiny leak places?

Hi

I have often read of people suggesting wearing it during the day on normal pressure, and getting out the kinks that way.

I have used 2 different FF masks, and once I have got it right ( just a few seconds of fiddling about) it is usually OK for about a week (then I have to adjust because of my beard). Putting the mask on my face from zero touching to an immediate 100% contact seems to be the best way for me to get a good fit. Fiddling around with one part seems to disturb another part which had already bedded.

So unless your face changes for some reason, like mine does, I would think that once you have got it right, it should be right for a while.

Also, perhaps it is simply that you have to get used to the new mask, and that might take a while and a bit of fiddling around.

Good fitting.

cheers

Mars

Hi again. If when the pressure comes on, you hold the mask away from your face by just a cm. for a second til it all inflates, then just let it sit back on your face, it should be seated properly, i.e. you shouldn't be tucking and poking at it (except to scratch ).

Mars & Julie, I thank you both for your responses to help me with this! I have indeed found that once I have a tiny spot leak & try to fiddle with it, the process just has to go on & on. Shall try to do as you both suggest, by repeating the lifting and re-seating the cushion contact all at once.

Still wondering if anyone can comment on the difference in pressure which may be required when using FFM as contrasted with nasal pillows. I never did get my AHI below 2.4 with the FFM (even after increasing the pressure from 10 to 10.5)-----when my AHI with the old Swift LT & taping routine has been below 1.0 for many months.

I don't think its too surprising that a different mask give different results -- One possible explanation is that with a FFM you let your mouth drop open. An open mouth changes the airway architecture, any make may you more prone to apneas.
O.

I found that using my swift over the FFM type of mask I would need about 1.5 cm less pressure using the swift. Because of the lesser pressure mouth leaks is less of a problem. I also get a bit less rebreathing of CO2 with the swift because of less dead air space in the mask. However I have friends that will do better with a FFM mask. What works best for you is the correct mask.