Leaky mask driving me nuts

Den, excuse the "indelicate" question, but how do you control those "obscene" noises one hears when the mask is too loose. What causes them? It seems the only way to eliminate them is to make the straps pretty snug. Any tips? Dori

KSMike,

In the same boat on the mask here. I can usually fiddle with them a bit and get a pretty good fit. Right now, I've got the top strap fairly loose and the angle set at 1 notch from full straight up and down. I'm still needing the lower straps tighter than I'd like, but I'm working on it. Cleaning the seal daily helps with the seal so be sure to give that a try.

Off topic -
For those of you who have used CPAP.com's sizing guide - How accurate is it? My wife helped to take the measurements and it says I should have the medium mask instead of the large that I have. If I knew the medium would work better, I'd switch. The problem is that Friday is the only day they (DME) are open that I can make it in there. If I swap out and it doesn't work, I'm stuck fighting with it for a week before I can swap back.

David

With the Quattro FF mask I'm finding that where the top sits on the bridge of my nose will affect how it leaks and air to the eyes or a sore nose bridge. It can't be too high or too low and finding that just right spot takes me a few tries each night. I also find that the top control is vital for top leaks and is a fine line for me, one turn from flat and no more or else it starts to leak into my eyes. If you sleep on your side, I found that I need to get the pillow to not push the mask up, down or sideways, so I took a long bread knife (electric carving knife works better on foam), and cut out spots on my pillow so I could side sleep and not have the mask or closing clips pushed upon. Finally, this has only worked for me up to pressures of 11 cms. Pressures above that may require more or tighter straps? I'm afraid to find out as tighter straps are not enjoyable nor am I used to high pressures. I'm still trying to figure out the correct pressure for good therapy, no mask leaks, comfort and sanity.

I WAS FIRST DIAGNOSED WITH OSA IN JULY 2008 AND LIKE EVERY ONE ELSE WHO HAS THIS DIAGNOSES,IS WAS TOLD ABOUT THE GOLD STANDARD.EVERY APNEA WEBSITE THAT I GO TO YOU READ THE SAME THING.FIRST OF ALL I AM NOT IN DENIAL,I HAVE APNEA AND IT CAN KILL ME.FOR SOME PEOPLE THEY ARE TOLD OVER AN OVER AGAIN THAT CPAP IS THE ANSWER.APNEA PATIENTS ARE BRAIN WASHED INTO THINKING THAT THERE IS NO THERAPY BUT CPAP.AT TIMES I THINK THAT MOST SLEEP DOCTORS HAVE A LOT OF STOCK IN THE CPAP COMPANIES AND THE DME'S.AND MAY BE GETTING KICK BACKS FROM THOSE COMPANIES.THE DOCTORS AND THE DME REPS TELL YOU JUST GET USED TO HAVING HURRICANE KATRINA STRAPPED ON THEIR FACE.JUST GET USED TO THE OVER PRICED MASKS THAT LEAK AND THE 50 LBS OF TIGHTNESS ON THEIR STRAPS JUST TO HOLD THE THING ON YOUR FACE THEN THEY TELL YOU THAT THE PERFECT MASK IS JUST AROUND THE CORNER.IT REMINDS ME OF THE SCENE IN THE FIRST ALIENS MOVIE WHEN THE HALF SQUID AND HALF CRAP CLIMBS ON TO YOUR FACE.FIRST OF ALL CPAP'S ARE OBSOLETE.THEY TELL YOU YOU WILL GET USED TOTHE RESISTANCE OF YOU LABORED BREATHING OUT AGAINST THE INCOMING PRESSURE. YOU KNOW WHAT I MEAN,IT'S LIKE BREATHING INTO A BALLON ALL NIGHT LONG.I AM A AIRCRAFT MECHANIC i KNOW ALL ABOUT OXYGEN MASK REGULATORS. PILOT DO NOT HAVE TO BREATH AGAINST 300 LBS OF PRESSURE.THERE IS ABSOLUTLY NO REASON THAT YOU HAVE TO ACCEPT THAT YOU CAN'T EXHALE NORMALLY. THIS IS THE 21ST CENTURY.BIPAS AND CFLEX ARE OPTIONS FOR A LOT OF PEOPLE.THEN YOU HAVE PEOPLE LIKE ME,THAT EVEN THOUGH YOU HAVE A HUMIDIFIED FISHER AND PAYKIIL AND A HUMIDIFIER IN YOUR BED ROOM.YOUR RINITUS MAKES YOU APNEA THROUGH YOUR NOSE.THEN THEY TELL YOU THAT THEY HAVE TO CUT OUT YOUR SEPTUM AND PACK YOUR NOSE COMPLETELY WITH GAUZE FOR THE NEXT 6 WEEKS SO YOU CAN'T BREATH. THE ONLY REASON THAT I AM WRITING THIS IS TO SAVE YOU FROM WHAT I HAD TO GO THROUGH.I DECIDED TO GO THE ORAL APPLIANCE ROUTE AND I AM SURE GLAD THAT I DID. SINCE I HAVE NO TEETH A TAP WILL NOT WORK FOR ME BECAUSE I CAN NOT MOVE MY JAW FORWARD. AND THEN A DENTIST IN COLUMBUS OHIO FOUND A SOLUTION FOR ME. iT IS CALLED AVEO tsd AND IT IS MADE IN NEW ZEALAND BUT IS APPROVED BY THE FDA. APNEA IS SIMPLE MECHANICS. YOUR TONGUE BLOCKS YOUR AIRWAYS. THE TOUNGE STABILIZING DEVICE THROUGH SUCTION HOLDS YOUR TONGUE OUT.IT REALLY WORKS.100% COMPLIANCE FROM THE FIRST DAY THAT YOU USE IT.iT COST THE SAME AS ONE CPAP MASK $150.YOU JUST HAVE TO GO TO A DENTIST AND YOUR SLEEP DOCTOR CAN FIND A GOOD ONE FOR YOU. BUT IF YOU STILL WANT TO BELIEVE THAT YOU HAVE TO ACCEPT CPAP GO AHEAD AND KEEP TELLING YOURSELF THAT IS IS THE ONLY THING THAT WORKS OUT THERE.kEEP LISTENING TO THE BULL THAT YOU WILL JUST GET OVER IT

KSMike wrote:That's very helpful Den. So - the target is to have your leak number come as close as possible to the published number for the mask at a given pressure (based on the above referenced charts)? What's the theory behind those published numbers? That the design of mask X at pressure Y dictates that Z leaks per hour are "normal," and that Z is a compromise for the amount of comfort or functional features that are included in the design? Just trying to get educated on leaks in general.

Am I typing as though I haven't slept?

The stated/published "Leak Rate" is actually called the "Vent Flow Rate" in some of the user manuals. That's the stated rate for the the air flow for that mask to exhaust the CO2 and make sure you're getting an adequate (hopefully) supply of air to breathe. Typically, we call anything higher that that stated number as "Leak". Due to normal moving around during the night, it can be difficult to hit that ideal number, but it can happen.
For my pressure of 12 cm., the typical rate is around 40. There are nights when my machines have recorded less than that but more often it's slightly to somewhat more than that......depending on what kind of night it was. I've hit numbers in the neighborhood of 50, but not necessarily on a consistent basis. If it looks like a trend is developing, I try to snug up the bottom straps a bit and/or wash the mask and headgear. Keep in mind that the mask and headgear I'm using has been used almost continuously for nearly four years. (I'm endurance testing it)
A couple of weeks ago, I had this situation and by snugging up the bottom straps a bit, I got the number from the mid to upper 40's to around 39 - 40. And, the leak line in my reports went from rather erratic to almost a straight, flat line.

DoriC wrote:Den, excuse the "indelicate" question, but how do you control those "obscene" noises one hears when the mask is too loose. What causes them? It seems the only way to eliminate them is to make the straps pretty snug. Any tips? Dori

Oh.....you mean "mask farts"? Actually, I don't hear them......I'm asleep, I guess.....if I actually have any. Occasionally a little leakage from a area of the seal will wake me up, but I usually bury the side of my head into the pillow and use the weight of my head to get the seal back. Sometimes I may have to use my hand to do a little readjusting.
I'm a side sleeper and flip over several times during the night, so being able to keep the mask perfectly sealed during the whole night isn't a guaranteed thing. But, I don't sweat the small stuff.

Den

THE HARD TRUTH wrote:I WAS FIRST DIAGNOSED WITH OSA IN JULY 2008 AND LIKE EVERY ONE ELSE WHO HAS THIS DIAGNOSES,IS WAS TOLD ABOUT THE GOLD STANDARD.EVERY APNEA WEBSITE THAT I GO TO YOU READ THE SAME THING.FIRST OF ALL I AM NOT IN DENIAL,I HAVE APNEA AND IT CAN KILL ME.FOR SOME PEOPLE THEY ARE TOLD OVER AN OVER AGAIN THAT CPAP IS THE ANSWER.APNEA PATIENTS ARE BRAIN WASHED INTO THINKING THAT THERE IS NO THERAPY BUT CPAP.AT TIMES I THINK THAT MOST SLEEP DOCTORS HAVE A LOT OF STOCK IN THE CPAP COMPANIES AND THE DME'S.AND MAY BE GETTING KICK BACKS FROM THOSE COMPANIES.THE DOCTORS AND THE DME REPS TELL YOU JUST GET USED TO HAVING HURRICANE KATRINA STRAPPED ON THEIR FACE.JUST GET USED TO THE OVER PRICED MASKS THAT LEAK AND THE 50 LBS OF TIGHTNESS ON THEIR STRAPS JUST TO HOLD THE THING ON YOUR FACE THEN THEY TELL YOU THAT THE PERFECT MASK IS JUST AROUND THE CORNER.IT REMINDS ME OF THE SCENE IN THE FIRST ALIENS MOVIE WHEN THE HALF SQUID AND HALF CRAP CLIMBS ON TO YOUR FACE.FIRST OF ALL CPAP'S ARE OBSOLETE.THEY TELL YOU YOU WILL GET USED TOTHE RESISTANCE OF YOU LABORED BREATHING OUT AGAINST THE INCOMING PRESSURE. YOU KNOW WHAT I MEAN,IT'S LIKE BREATHING INTO A BALLON ALL NIGHT LONG.I AM A AIRCRAFT MECHANIC i KNOW ALL ABOUT OXYGEN MASK REGULATORS. PILOT DO NOT HAVE TO BREATH AGAINST 300 LBS OF PRESSURE.THERE IS ABSOLUTLY NO REASON THAT YOU HAVE TO ACCEPT THAT YOU CAN'T EXHALE NORMALLY. THIS IS THE 21ST CENTURY.BIPAS AND CFLEX ARE OPTIONS FOR A LOT OF PEOPLE.THEN YOU HAVE PEOPLE LIKE ME,THAT EVEN THOUGH YOU HAVE A HUMIDIFIED FISHER AND PAYKIIL AND A HUMIDIFIER IN YOUR BED ROOM.YOUR RINITUS MAKES YOU APNEA THROUGH YOUR NOSE.THEN THEY TELL YOU THAT THEY HAVE TO CUT OUT YOUR SEPTUM AND PACK YOUR NOSE COMPLETELY WITH GAUZE FOR THE NEXT 6 WEEKS SO YOU CAN'T BREATH. THE ONLY REASON THAT I AM WRITING THIS IS TO SAVE YOU FROM WHAT I HAD TO GO THROUGH.I DECIDED TO GO THE ORAL APPLIANCE ROUTE AND I AM SURE GLAD THAT I DID. SINCE I HAVE NO TEETH A TAP WILL NOT WORK FOR ME BECAUSE I CAN NOT MOVE MY JAW FORWARD. AND THEN A DENTIST IN COLUMBUS OHIO FOUND A SOLUTION FOR ME. iT IS CALLED AVEO tsd AND IT IS MADE IN NEW ZEALAND BUT IS APPROVED BY THE FDA. APNEA IS SIMPLE MECHANICS. YOUR TONGUE BLOCKS YOUR AIRWAYS. THE TOUNGE STABILIZING DEVICE THROUGH SUCTION HOLDS YOUR TONGUE OUT.IT REALLY WORKS.100% COMPLIANCE FROM THE FIRST DAY THAT YOU USE IT.iT COST THE SAME AS ONE CPAP MASK $150.YOU JUST HAVE TO GO TO A DENTIST AND YOUR SLEEP DOCTOR CAN FIND A GOOD ONE FOR YOU. BUT IF YOU STILL WANT TO BELIEVE THAT YOU HAVE TO ACCEPT CPAP GO AHEAD AND KEEP TELLING YOURSELF THAT IS IS THE ONLY THING THAT WORKS OUT THERE.kEEP LISTENING TO THE BULL THAT YOU WILL JUST GET OVER IT

The AVEO is old news around here. It was being discussed at least a couple of years ago. I think one or two people got one and tried it......and weren't impressed.
Many of us have nasal issues. I do, and CPAP therapy is much preferred to some of the alternatives. Having my tongue sucked out of my mouth during the night wouldn't be something I'd consider (The AVEO) and it still wouldn't have any affect on my nasal passages.
I took charge of my own therapy in the beginning. I don't wear my mask tight and I have C-Flex on my machines so I don't have to breathe out against a lot of pressure. I was prescribed a pressure of 18 cm. but found out I only need about 10 - 12 cm. to have effective therapy.

PS. Quit using all CAPS when you type. In Internet protocol, that's considered SHOUTING! (and it's hard to read)

Good luck with your oral device.

Den

Thanks, Den. I'll play around with it some more tonight with some of this new knowledge and see how it goes.

No joy. I tried loosening the top quite a bit, and loosening the bottom enough to feel very comfortable. I also moved the whole mask up somewhat. Those changes made it much more comfortable and it didn't leak, at least long enough to fall asleep. At about 4am, however, I awoke to the feeling of about 3 different leaks which had been going on for who knows how long. At that point I could not get it even back to where I started, and pretty much went without any real rest the remainder of the morning. In my exhausted blur, all I could think was, "I'm SO done with this; I feel worse now than I ever did before CPAP."

Intellectually I know things may be improving. I've had low SpO2 for years, usually running in the low 90's during the day, and in the few days since starting CPAP my spot checks have all been 95% or higher. But that's little consolation in the middle of the night when you can't sleep.

KSMike wrote:No joy. I tried loosening the top quite a bit, and loosening the bottom enough to feel very comfortable. I also moved the whole mask up somewhat. Those changes made it much more comfortable and it didn't leak, at least long enough to fall asleep. At about 4am, however, I awoke to the feeling of about 3 different leaks which had been going on for who knows how long. At that point I could not get it even back to where I started, and pretty much went without any real rest the remainder of the morning. In my exhausted blur, all I could think was, "I'm SO done with this; I feel worse now than I ever did before CPAP."

Intellectually I know things may be improving. I've had low SpO2 for years, usually running in the low 90's during the day, and in the few days since starting CPAP my spot checks have all been 95% or higher. But that's little consolation in the middle of the night when you can't sleep.

Baby steps.......
What kind of bed pillow do you use? I've been using a Chiroflow water-based pillow for years.....even several years before I started therapy. There are also other pillows designed for XPAP users.
Late last summer, my wife got some new "regular" bed pillows and I was curious as to how one of them would work now that I had been on CPAP for several years. It was HORRIBLE! I was having lots of leaking problems and gave up after one night.


Den

Of course there's always a possibility that it's just not the right mask for me, but something tells me I just don't know how to adjust it properly. If it does turn out to be the wrong one, how do you go about finding the right one? I bought the return insurance, but it seems like there has to be a better way than just buying and returning over and over.[/quote]

I've had the same mask for years and for me it's a delicate balance of tension of the upper and lower straps and the position of the forehead piece. If it hurts, I know it's TOO tight.

I have very oily skin so I make sure to wash up and use Sea Breeze (the wife's astringent) before retiring and in the AM I take the mask into the shower with me to give it it's daily clean (along with myself!). The forhead cushion is particularly oily in the AM.

At the same time I must agree with the other posts that the mask may not be the right size or right for your facial contours.

Good Luck!

SLEEP WELL

Standard pillow. I do have a xpap pillow that I have not tried yet, but so often it seems like I can be on my back, think I finally have it adjusted fine, and then make just the slightest head movement and the leaking starts. In that scenario I wouldn't think the pillow would be a factor. I don't have anything to lose by trying it, though.

Today I took the seal off and just held it up to my face in front of a mirror, hoping to get a better idea of how well the size matches my face. It appears to me to be perfect. When the bridge of the seal crosses my nose directly between my eyes (at the eye line), the bottom of the seal runs just below my lower lip. Of course that doesn't tell me anything about the contour match, which may be the problem based on how it feels.

KSMike wrote:Standard pillow. I do have a xpap pillow that I have not tried yet, but so often it seems like I can be on my back, think I finally have it adjusted fine, and then make just the slightest head movement and the leaking starts. In that scenario I wouldn't think the pillow would be a factor. I don't have anything to lose by trying it, though.

Today I took the seal off and just held it up to my face in front of a mirror, hoping to get a better idea of how well the size matches my face. It appears to me to be perfect. When the bridge of the seal crosses my nose directly between my eyes (at the eye line), the bottom of the seal runs just below my lower lip. Of course that doesn't tell me anything about the contour match, which may be the problem based on how it feels.

You'd be surprised. At least I was when I tried to switch.

Den

Here's how I've been dealing with this very same issue on my Quattro but the principle probly
applies to the UMFF. The past 5 nights or so have been my best as far as a straight leak line goes.
I'm sure all this has been beaten to death but this works pretty well for me anyway.

1. Wash mask membrane seal with Dawn Ultra dishwash liquid. I used to use baby shampoo but
I noticed it was leaving a slight hazy residue. The Dawn liquid leaves the seal noticeably clearer and squeaky
clean.

2. Wash face with Ivory plain bath soap. I was mistakenly using a soap with Aloe in it or something.

3. Put mask on and adjust.

4. Put on Deluxe chinstrap by cpapdotcom. What was happening is I realized after I fell asleep
that my jaw would drop. This would seem to be no big deal but as my jaw dropped I would get
leaks out of both sides on the lower part of the mask....fairly big leaks. The chinstrap would
keep my jaw closed so there would be no more leaks when my jaw tried to drop.
As an added benefit though the elastic chinstrap would hug the mask mounting straps and pretty
much keep it from sliding around which I think in my case was making the leaks worse. The mask stays
pretty much stable on my face. I'm not crazy about wearing a FFM AND a chinstrap but it is relatively
comfortable...it is the one about 3 inches wide.

That's where I'm at now...



Bill

Well, there's another idea I hadn't thought of. You're wearing the strap over the mask's headgear it sounds like? I have to be honest, it sounds uncomfortable, but it might be worth a try.

Yup.....chin strap over headgear. I think they're around 20 bucks. I don't use the extra little
straps that come with it I just fasten the top toward the upper back of my head and it is juuussst
long enough (I have a big head LOL ! ). When I fasten the chin strap it has a tendency to hug
the mask support straps and tighten them down a bit. So I just have to fiddle a bit pulling the mask
straps out a little bit cause they're clamped down if you know what I mean. Actually I think I'm going
to modify it a little and lengthen it about 1 1/2 inch. I'll have to get some wide velcro. As I said,
I'm not fond of wearing a chin-strap but this is what I'm doing for now.
Hope that helps.



Bill