New user introduction- full face mask fit issue

Hi All:

I am a new APAP user here and I have been lurking for awhile as I start this new therapy. Thanks to all of the great knowledge on this board I think I am off to a good start!

Here's my story- I am a 37 y/o overweight otherwise healthy (BMI >40) male who is also a private pilot. At my last flight physical I was told I needed to do a sleep study, so off to my doc I went. My home sleep study gave me the following stats:
AHI 40
RDI 46
100 desats <90% mostly around 88%, 1 was 81% for about a minute and a half

My sleep doc prescribed an APAP (Airsense 10 Autoset) and I picked both the machine and a F&P Simplus full face mask yesterday. When trying it for the first time I was unsure how it would go, but I have been trying to keep a good attitude because I want to get back in the air asap, and I have also learned through research what a ticking time bomb untreated apnea makes me.

Question for you all/Results:
My results from last night (below) were pretty good but I feel like I am having a bit of a mask fit issue. According to MyAir I got a good seal for a full face mask, but I could still feel a little air at times blowing towards my eyes. I'm a side sleeper and I do have a beard that I keep at approximately 1/4in and 6MM. I am also a mouth breather and I just don't think I can keep my mouth closed unless I tape it shut. Any tips out there for full face mask sealing? Since my air says it is good should I just learn to deal with it? I do feel a lot more refreshed today!

Results from the MyAir app last night:
8:01 hours usage
11M/L leak (good? according to MyAir)
Pressure was averaging 8.8
.3 events per hour
10 mask on/off events (I had trouble initially getting the seal to work)

I'm a data geek at heart so I will definitely be downloading data into Sleepyhead to get the rest of the story..

Very minor leaks the machine can compensate for but if even minor leaks cause sleep disruptions and wake ups or trouble going to sleep we want to avoid them because anything that disturbs our sleep is unwanted.

You might look at mask liners. Sometimes they help diffuse the leak so that it is much less annoying and less likely to cause sleep disturbances.
http://www.padacheek.com/PAC_Maskliners.html

Before you go spending money I woulds suggest you try a homemade mask liner first to get an idea if it would help or not.
An old worn T Shirt is a good candidate to cut up.

First nights are always a bit rough. We haven't mastered the mask fit yet and every little thing is going to be magnified in terms of annoyance. Play with the adjustments...watch the fitting videos and see if you can improve on the seal.

And no...you shouldn't have to "live with it" either. There are too many options out there to try before settling for something that is annoying.

Facial hair does present extra challenges for full face mask users but they aren't challenges that can't be successfully met...they just may require a little more work.
You might also look at a full face mask that doesn't come up on the nose so there's no seal to break to blow into the eyes.
The Respironics Amara View might be a good alternative. Something to think about if it looks interesting to you.
https://www.cpap.com/productpage/respir ... -mask.html

Certainly try the suggestions Pugsy gave on general mask fit. I just wanted to mention I didn't think I could do a nasal or nasal pillow mask, but proved myself wrong on that. So, just keep it in mind as an option you may want to try at some point in the future. Since you've got facial hair (and presumably want to keep it), a nasal pillow might be a great option as the hair has no impact at all on a nasal pillow. You have to conquer the mouth breathing (really , just get it to an acceptable level of leaks), but that's possibly something you can do with a chinstrap, or a mouth guard, or technique with tongue placement. Even with a full face mask, gratuitous mouth breathing has its problems (dry mouth, mask leaking), so you probably will have to do some amount of mouth breathing control anyway. Take that a step further, and you might be able to do nasal pillows.

Due to the shape of my nose (a narrow bridge), I had a hard time getting the simplus to seal around my nose and not blow air into my eyes. I would place the mask a little lower on my nose than what the fitting instructions called for. I would then place two pieces of tape from the mask (around where the bottom of the elbow is) to under my chin to hold it in place.

Okie bipap wrote:Due to the shape of my nose (a narrow bridge), I had a hard time getting the simplus to seal around my nose and not blow air into my eyes. I would place the mask a little lower on my nose than what the fitting instructions called for. I would then place two pieces of tape from the mask (around where the bottom of the elbow is) to under my chin to hold it in place.

Just FYI, an option that can help keep the mask down on the face is the mask stability strap that padacheek sells. http://www.padacheek.com/PAC_MaskStabilizer.html . I had similar issues with FFM riding up. This keeps it in position nicely, and just provides overall better stability of the mask when moving around.

Thanks all for the great tips! I moved the mask down a bit on my nose, and last night I had 0 leak as reported by the machine. 0 events too!

I'm also going to check out that amara view mask, the one thing I don't like about the simplus is the forehead support "splitting" my view reading a book.




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rlentless226 wrote: Question for you all/Results:
My results from last night (below) were pretty good but I feel like I am having a bit of a mask fit issue. According to MyAir I got a good seal for a full face mask, but I could still feel a little air at times blowing towards my eyes. I'm a side sleeper and I do have a beard that I keep at approximately 1/4in and 6MM. I am also a mouth breather and I just don't think I can keep my mouth closed unless I tape it shut. Any tips out there for full face mask sealing? Since my air says it is good should I just learn to deal with it? I do feel a lot more refreshed today!

This is from the Mask Primer I authored.
Mouth Breathing is when you open your mouth and the air pressure from your PAP is venting out your mouth typically showing on your charts as a large leak which can substantially negate the effectiveness of your therapy. It is generally not good. The solution varies depending on the person

How to manage Mouth Breathing, not in any particular order.

Tongue Trick. Place the tongue on the roof of the mouth, Practice during the daytime. The idea is to train the tongue that this is a good place to be, not overnight, but it works for some.

Chin Strap. A chin strap is to manage mouth leaks from a variety of causes. Most result from the jaw dropping or opening either partially or wider. The chin strap is to gently keep the jaw closed. If you have to crank it shut to make it work this is not the correct solution. Note that your jaw is strong enough to open if it wants to.

Cervical collar. A Cervical Collar may also be used to keep the jaw from dropping.

Mouth Guard. The concept here is a closed mouth guard to keep the air from leaking out.

Taping. The purpose of taping is to seal the lips and prevent mouth leaks / mouth breathing. It is not to stop the mouth from opening. I make sure that I can easily open my mouth, when taped, if I need to.

FFM – Full Face Mask or Hybrid Mask. This is a very traditional solution and it is generally effective.

Hope this helps you some.

bonjour wrote:

rlentless226 wrote: Question for you all/Results:
My results from last night (below) were pretty good but I feel like I am having a bit of a mask fit issue. According to MyAir I got a good seal for a full face mask, but I could still feel a little air at times blowing towards my eyes. I'm a side sleeper and I do have a beard that I keep at approximately 1/4in and 6MM. I am also a mouth breather and I just don't think I can keep my mouth closed unless I tape it shut. Any tips out there for full face mask sealing? Since my air says it is good should I just learn to deal with it? I do feel a lot more refreshed today!

This is from the Mask Primer I authored.
Mouth Breathing is when you open your mouth and the air pressure from your PAP is venting out your mouth typically showing on your charts as a large leak which can substantially negate the effectiveness of your therapy. It is generally not good. The solution varies depending on the person

How to manage Mouth Breathing, not in any particular order.

Tongue Trick. Place the tongue on the roof of the mouth, Practice during the daytime. The idea is to train the tongue that this is a good place to be, not overnight, but it works for some.

Chin Strap. A chin strap is to manage mouth leaks from a variety of causes. Most result from the jaw dropping or opening either partially or wider. The chin strap is to gently keep the jaw closed. If you have to crank it shut to make it work this is not the correct solution. Note that your jaw is strong enough to open if it wants to.

Cervical collar. A Cervical Collar may also be used to keep the jaw from dropping.

Mouth Guard. The concept here is a closed mouth guard to keep the air from leaking out.

Taping. The purpose of taping is to seal the lips and prevent mouth leaks / mouth breathing. It is not to stop the mouth from opening. I make sure that I can easily open my mouth, when taped, if I need to.

FFM – Full Face Mask or Hybrid Mask. This is a very traditional solution and it is generally effective.

Hope this helps you some.

Well, is mouth breathing not an issue if I'm using a FFM?
My mouth is getting dry, and I am just not getting the sleep and rest and feeling good, like I was hoping.
Something is still making me wake up, not stay asleep, and not rested like I thought I would.

Sent from my MotoG3 using Tapatalk

You can still mouth breathe (and get dry) with a FF mask on, you just won't lose Cpap air that way, which is a good thing, if uncomfortable. You can try using Biotene before putting the mask on to help prevent the dryness.

mrbreezeet1 wrote:

bonjour wrote:

rlentless226 wrote: Question for you all/Results:
My results from last night (below) were pretty good but I feel like I am having a bit of a mask fit issue. According to MyAir I got a good seal for a full face mask, but I could still feel a little air at times blowing towards my eyes. I'm a side sleeper and I do have a beard that I keep at approximately 1/4in and 6MM. I am also a mouth breather and I just don't think I can keep my mouth closed unless I tape it shut. Any tips out there for full face mask sealing? Since my air says it is good should I just learn to deal with it? I do feel a lot more refreshed today!

This is from the Mask Primer I authored.
Mouth Breathing is when you open your mouth and the air pressure from your PAP is venting out your mouth typically showing on your charts as a large leak which can substantially negate the effectiveness of your therapy. It is generally not good. The solution varies depending on the person

How to manage Mouth Breathing, not in any particular order.

Tongue Trick. Place the tongue on the roof of the mouth, Practice during the daytime. The idea is to train the tongue that this is a good place to be, not overnight, but it works for some.

Chin Strap. A chin strap is to manage mouth leaks from a variety of causes. Most result from the jaw dropping or opening either partially or wider. The chin strap is to gently keep the jaw closed. If you have to crank it shut to make it work this is not the correct solution. Note that your jaw is strong enough to open if it wants to.

Cervical collar. A Cervical Collar may also be used to keep the jaw from dropping.

Mouth Guard. The concept here is a closed mouth guard to keep the air from leaking out.

Taping. The purpose of taping is to seal the lips and prevent mouth leaks / mouth breathing. It is not to stop the mouth from opening. I make sure that I can easily open my mouth, when taped, if I need to.

FFM – Full Face Mask or Hybrid Mask. This is a very traditional solution and it is generally effective.

Hope this helps you some.

mrbreezeet1 wrote:Well, is mouth breathing not an issue if I'm using a FFM?
My mouth is getting dry, and I am just not getting the sleep and rest and feeling good, like I was hoping.
Something is still making me wake up, not stay asleep, and not rested like I thought I would.

Sent from my MotoG3 using Tapatalk

Julie wrote:You can still mouth breathe (and get dry) with a FF mask on, you just won't lose Cpap air that way, which is a good thing, if uncomfortable. You can try using Biotene before putting the mask on to help prevent the dryness.

OK, I will need to google it.
I don't know Julie, I hope I can adjust to this %$%^ thing. and start getting some rest-full sleep!
I still want to get my collar too!
I got up I guess after about 5 0r 6 hours, cane out for a while, went back to bed, and DID use the mask.
But the problem besides Dry mouth, is Today and yesterday, (But today was worse) I fell like My neck is/was all Bunched up.
I guess in the defense of the strap and mask, and hose, the orthopedic doctor , not unlike my knees, my one shoulder is almost bone on bone, so that is causing the muscle over from my shoulder to hurt. He said something like it's trying to hold my shoulder up, or something like that.
This dr. "floored me" cause I said, "well, dr, it don't hurt at ,my Shoulder, he said, "NO, and he grabs my neck ,over near the shoulder(if that make sense) and said, "It hurts here" I was Like Wide Eyed, and said, OMG, Yes. So he apparently knows what he is talking about.
I'm going to also post this in my original thread, so that I should keep it all together too.
I do have to say,I am very Very Disappointed thus far. Although I do have to say In spite of my neck area and shoulder, and waking up all "Bunched up" feeling,
I'm "Starting " to feel 1/4 decent.
Thing is too tho, I think maybe Im using a little too much water, Can I over fill that chamber a Tad?

Yes you can overfill the tank - there's a line that shows the correct level on it.

BUT - get a proper collar (not a homemade one that won't do the job right).

Make sure your neck strap isn't too tight or use a piece of fleece, towel, etc. under it so you don't get neck issues.

Julie wrote:Yes you can overfill the tank - there's a line that shows the correct level on it.

BUT - get a proper collar (not a homemade one that won't do the job right).

Make sure your neck strap isn't too tight or use a piece of fleece, towel, etc. under it so you don't get neck issues.

the homemade one was temporary.
I mean I think The Machine is Consuming more water than it should.
And is it OK IF I Over Fill it Just a Hair, (About an 1/8") So IT don't run out?...............LOL
Sorry for the confusion.
I still have to order one I guess.
Please try to understand, Things are very hard for me right now. I have been through a lot the past 3 years or so.
I went downhill fast. I am here alone, and never have any help,
don't have any friends, except "fair weather friends" And also have trouble staying focused on what I want and need to do.
I am trying to move, I am having trouble with my landlord, always running out of money before the month is over.
and on top of all this, very seldom get a proper nights rest.

My usual question is why are you using a full face mask instead of a nasal mask. However, you seem to be doing well, so I won't argue with success.

The biggest mistake newbies make is to make the mask too tight. The next biggest mistake is too loose. Most masks inflate like a balloon to form a seal, and making it too tight can defeat the seal. Also, the relative tightness of the upper and lower strap is very important.

D.H. wrote:My usual question is why are you using a full face mask instead of a nasal mask. However, you seem to be doing well, so I won't argue with success.

The biggest mistake newbies make is to make the mask too tight. The next biggest mistake is too loose. Most masks inflate like a balloon to form a seal, and making it too tight can defeat the seal. Also, the relative tightness of the upper and lower strap is very important.

I don't think I'm doing well.
I'm not sleeping through the night, two or three nights I got up and took the mask off and don't know why.
I'm using a FFM, cause the girl at the sleep study insisted it was the best..

mrbreezeet1 wrote: Please try to understand, Things are very hard for me right now. I have been through a lot the past 3 years or so.
I went downhill fast. I am here alone, and never have any help,
don't have any friends, except "fair weather friends" And also have trouble staying focused on what I want and need to do.
I am trying to move, I am having trouble with my landlord, always running out of money before the month is over.
and on top of all this, very seldom get a proper nights rest.

not getting proper sleep can make everything seem more difficult. most of us here absolutely understand that. i've only recently started CPAP and frankly i've not had much luck feeling better, but my data shows i'm finally getting sleep like i've not had for easily a decade or more.

i do understand your frustration, most of us here do. i've been struggling for almost a decade with symptoms that have essentially put my life on hold. i've had extreme fatigue, memory and concentration issues, blurry vision, depression, anxiety, motor skill and balance issues, etc. etc. i've gone from doc to doc for almost a decade with zero help. they have diagnosed me with depression, adhd, anxiety, and chronic fatigue, and it's been suspected i may have ms or als or parkinsons. my life has been extremely frustrating for the last 5-7 years in particular. finally a new neuro had me do a sleep study and i found out i have fairly severe OSA.

it was the best news i had in almost 10 years. at least now i have something i CAN treat....and you can too.

it won't be fixed overnight...but if you can stay focused and positive, you will see results. you've already stated that you have felt better. that is great news...it means the CPAP will help you sleep better and over time, you will start feeling like your old self again.

this board is an excellent place for advise, people here are experienced and friendly...and they will do all they can to help you in your treatment.

now, in regards to the masks...it seems to be one of the main hurdles to jump when you first start CPAP treatment.

i've been experimenting with masks to find one that feels comfortable and keeps a seal all night. i'm still in the process. it can be frustrating, indeed.

i had a beard, usually kept it fairly close cropped, 1/8-1/4" but i did find that i had issues getting any mask to seal right with my facial hair.

once i shaved, my amara view sealed perfectly the first night.

it does seem that facial hair can make things more difficult, though i have talked to many people with full beards who have no issues with their masks sealing.

i've also been told that a mask liner such as the padacheek liners can help with the seal as well as protect your nose from becoming red and irritated.

so far i've tried quite a few masks and i've found 2 that seem to work fairly well so far, the resmed airfit F20 and the amara view. the view seems to be the best for me so far. now that i have started shaving every day again, it seals nicely. i have had a few nights where it lost seal, i sleep on my side and with my face in pillow...so it's understandable. i'm working on that right now.

the F20 seals very nice, but i think i need slightly larger headgear as the top straps seem to pull the top of the mask into my nose too much, which causes the bottom to come unsealed at times.

it's going to be a process to find the perfect mask, but i know i will get there. you will too. you may need to try a few different full face masks to find the ideal one for your face. they are all a little bit different. what works perfectly for one person may not work best for another.

just hang in there...keep trying it. maybe consider trying some of the mask liners like the padacheek liners.

definitely download the sleepyhead software and start tracking your data. follow the primer up there in the pinned posts on the first page of this forum and you can upload some of your nights of data here and people will help you evaluate it and help you with any issues.

i wish you the best of luck.