mask choice question

HI

I am still really new to all this i have had my diagnostic study and titrations study, i have a basic prescription but here the process seems to be a bit different to what you guys experience, our health insurance funds have set rates of what they pay for the machines and equipment, they do not get involved in deciding or approving choice of equipment, prescriptions to DME's are not compulsory but preferred. once we have ascript we see the DME and have a trial of a machine and they feedback the results to the DR, after a trial we then either pay full cost and get a small amount back from health insurance ( mine will give me a whole $500!)

Anyway, when i saw the DME they tried a full face mask first depsite the sleep study saying that it had resulted in big leaks, so then they went to a nasal mask, at present i am using a resmed mirage micro and a chin strap and i do not have any problems with leaks, it is comfortable- this is still loan equipment. My only complain with this mask is that i do sometimes watch tv or read for a while to relax to get to sleep but i am useless without my glasses on! I had wondered about the nasal pillow type of masks that i could still have my specs on. we are still trying to get satisactory readings to work out what machine i finally have and since mask leak hasnot been an issue but my AHI has supposedly jumped to 94 to 98, there is still a lot of work to be done- the one thing that does seem apparent is that i need failry high pressures (this is from the tiration study where they got the AHI down to 17 but what was left were the centrals) the AHI was at 18 to 20. The DME has told me that the nasal pillows are not as good at high pressures and i have not pushed the point til now as the mask choice seemed to be the least of the problems but i would like the views of the folk here as there is a lot great experience here.

as for the other stuff, i know part of the issue is that i do not have access to the data myself at them moment, i only get told my AHI and i am not getting a lot of answers when i ask questions- it seems apparent that people here have a good deal more expertiese than some of the dme staff- one of whom has admitted to me they do not understand all the finer points of how the machines work ( i had ask how it was possible to jump from 17 from the titration study on some kind of straight cpap to over 94 on a respironics bipap auto SV that is set with a back ground resp rate of 16-it did not seem possible especially as i actually feel good in the morning compared with nothing or the titration study)


sorry i am rambling!, basically i am ok with leaving the mask as is while the work the other stuff out but long term i would like to consider the nasal pillow type and i was wondering whether you guys agree that they are not as effective in getting a seal at higher pressures

karen

Karen,

I'm new to this also (Since 12/18) and certainly do not have the expertise that many on this site have. I can only tell you my experiences.

A Mirage Quattro FF was used during my titration and I subsequently tried two different sizes of the mask when I got my equipment. I had terrible problems with the mask leaking. From there I went to the Mirage Swift II Nasal Pillows and then the Opus 360 nasal pillows. I wasn't too fond of the Swift II - it's seem awkard and I had problems with it leaking. The Opus 360 was really light, I liked the way it fit, but to get a good seal I had to tighten it down so much that my nose got sore. This past Monday I went to the mask you are now using, the Mirage Micro, and am finally getting sleep. I have my fingers crossed that the Micro will be THE mask for me. The one thing I've learned (and continue to) is that you just have to keep trying until you get something that works for you. I'm claustrophobic, so the nasal pillows really helped that feeling vs. a full face mask. However, my DME just told me on Monday that nasal pillows are more difficult for people with pressures above 10 - I'm at 13. - which is why I'm now trying the Micro.

My employer changed to a new insurance carrier this year. With my old insurance, the DME would let me try as many masks as I wanted for the first 30 days. My current DME requires that I buy the masks outright. As a result, any future masks I purchase will probably be via the web (cpapauction.com).

Good luck - I hope you find what works the best for you.

Thaks for the feedback, i had wondered whether the nasal pillows would be harder to get a seal at higher pressures and that is what your DME has indicated, i guess expecting to be able to keep my spectacles in place as well as a mask is expecting too much- perhaps i am better leaving the one thing that is working well alone for now- the mirage micro certainly is a good fit, it has a low leak rate and is reasonably comfortable- i felt claustrophobic with the full face mask they tried in the sleep lab and that certainly did not seal well. perhaps once everything else is sorted about what machine i will have software etc- then i may look at masks again

nice to meet another newbie
karen

Few points about masks:

My first nasal pillow mask - the Breeze - is good for up to 30, according to its literature.
I wouldn't trust a DME's info on nansal pillows and masks.
I have no personal exeprience with high pressure - but have read from a number of users that they do fine with high pressure and nasal pillows - GumbyCT comes to mind just now:
viewtopic.php?f=1&t=37420&p=326157&hili ... re#p326157, but others as well.

Last but not least, the Resmed VPAP Adapt SV, which I understand you considering, Karen, is very picky about masks.

O.