Masks - Are they evil by design?

BiPAP definitely works for me. What is becoming tough is the mask issue.

For my 30 day report I took the card out of my Remstar and delivered the card to my DME. I spoke with my R/T after she'd downloaded the information and said I've got very good results and then very bad results.

She asked questions and determined that in order to improve the performance of BiPAP(great results one night, horrible the next) that I should use ONE mask for a month, not rotate masks as I had been doing, and let the information tell her what can be improved.

R/T says that I'm having leaks like crazy, but one night there will be no leaks and the next it's leak city. So - try one mask and we'll go from there.

Makes sense to me - so, I've put the Breeze (which was killing my nares and leaking like a sieve, even after multiple pillow adjustments) in the drawer and have been using the Ultra Mirage almost exclusively.

The Mirage Activa mask will "collapse" several times a week. I'll wake up, the mask will be like a limp, deflated balloon on my face and the BiPAP will be blowing air like crazy. It wakes my wife up. And - oh by the way - the Ultra Mirage makes me drool like an idiot. No kidding.

I tried the Breeze for two nights in a row after suffering one of these "deflated mask" episodes with the M/A. The first night went famously - but the second night I had to take the Breeze off, it felt more like some torture device than a mask.

I'm going to try two other masks before giving up and living with the limp balloon on my nose.

As I explained to the R/T, some nights I will wake up with the Mirage Activa limp on my face, almost like it's bloated and "worn out".. the air from the machine will be blowing but it's not helping me breath. The air will be just blowing.

I have no idea what to do other than continue to fight with these damned masks and hopefully it will work itself out by monitoring and eliminating masks. Some mornings I wake up feeling great - other mornings I don't want to get out of bed.

What's interesting is that the first 10 days I had the machine, I'd wake up and be "raring to go". Does one become used to the machine - as in, does the effect wear off after a month?

Too many questions - and the R/T here at my DME is wonderful but she's not as informed on equipment & challenges as the experts on this board.

Thanks for listening. The glass is indeed half full! However, I seem to be regressing a bit at this point due to mask issues.

Their are some good masks to try, the Activa, the Swift, and apparantly the Aura, though I have not tried that one so I can't speak for experience there. I love the Swift but don't like the Breeze. The Activa, kept clean, does not leak very easy and has the highest conformance IMO and Lori really seems happy with the Aura. It's a shame that we have to spend so much money trying so many to find the one that works. Maybe we need NASA to so one for the Astronauts so they can get one right.

I've got a Breeze/Pillows setup and a Mirage Activa.. I keep calling that Activa an "ultra mirage" but it's not.

A fellow here is going to sell me a Comfort Curve that has been used once. If that doesn't work then I believe I'll try and Aura. If neither of those work then I'm going to have to be happy with the Mirage Activa.

Or maybe try a Swift... ....

OSR, my brother, (you and I share a lot of the same experiences with our OSA treatment when it comes to masks) my Activa used to do the same exact thing on me. Did you try adjusting the top adjustment by the forehead that angles the seal? Sometimes if you angle it differently from above, it can help. But I had the same thing happen. Once I did that, I didn't do it anymore. The angularity sometimes makes a big difference.

Yes, I agree that you do not feel that rarin' to go feeling as much after awhile, but I think it's because when you felt that way, it was a new and exciting thing. You kind of get used to anything in life, even when it's great. I can't speak for being filthy rich and how that would feel every day to wake up knowing you don't have to work and can just jet around the world, hitting all the hot spots, buying anything your heart desires, but I'll bet even that may get a little mundane after awhile (though I'd love to put it to the test).

When your DME said you are leaking a lot, do you mouth breath? Experiment you can try is patching your mouth shut for a week, noting when you did it and seeing if that makes a difference. If you live close enough to the DME, maybe they will allow you to bring in your card and see if that was the cause of your leaks, not necessarily the mask.

In any event, please consider either the Swift or the Aura. Yes, they are expensive to play trial and error with, but I'm not suggesting you do anything I haven't done. The way I explain it to my friends who say, "Didn't you just buy a mask recently," I tell them that I'm willing to pay the price if it means a more comfortable sleep, which makes being compliant and staying healthy an easier task.

I am truly smitten right now with the Aura as I side sleep. But if you can believe this, for the first time IN MY LIFE, I have been waking up on my back. It's almost like my body got trained to do that because it was tired of worrying all night about dislodging the barrel on the Swift when I turned on my side. I can't believe that I am back sleeping now, too.

OSR, you seem like a real wonderful person and have been a pleasure to talk with since you came aboard. I really, truly wish you success in finding the RIGHT mask. So far, you haven't found it in either the Breeze or the Activa. Don't feel bad, neither did I. But it's out there. If it takes a little more $$$ out of pocket to find it, it will be worth it when you do. I know, it's not my money I'm telling you to spend, but I did practice what I'm preaching here and am so much better for it. Good luck and keep us posted.

Lori, you're definitely a huge help and "bright light"!

Tell me please, what do you use to seal your mouth with? I've got duct tape, US Mail Priority Tape and Superglue... ....

Seriously though, what do you use? I'll give it a try this evening!

Lori get's the prize!

Keep in mind that the air will take the path of least resistance. Do you feel stuffed up? Are you using a humidifier? Your nasal passages may be getting plugged and as a result you open your mouth to breathe (you do need to breathe) You might try using a nasal spray like nasonex (prescription) to open your nasal passages. I have found for myself that using the max heat setting on my heated humidifier does the trick.

I hope you can find a solution, because the aternative is to switch to a Full Face mask... I wouldn't wish that on anyone.

Thank you both for the nice words. Just trying to help. I hope it does.

Anyway, OSR, I use what I consider the best method as per Rested Gal's advice (no wonder, right?). I buy the Tegaderm patches. Unlike tape, it more or less PEELS off rather than having to rip adhesive like a Band Aid that you end up doing with the medical tape. They are a bit more expensive if you go that route. One trick I have found is when you put the patch on, turn your lips inward so that you almost don't see them and then put the patch over your mouth that way. It helps to keep any leaks you may have had trying to break through inside your lips, harder to get past. If you buy the larger ones, you can use them cut in two. When I use the smaller/regular size, I end up cutting another in half and sealing the vertical edges on the sides of my mouth to prevent any breakthrough air. It has happened to me before.

OR...you can train yourself, hopefully, to keep the tip of your tongue behind the top of your front teeth. If you experiment with it, you will see if you hold your tongue there, you won't be able to mouth breathe. But what happens after you fall asleep is anyone's guess. I tried it last night just because I got tired of taping and I did just fine. I'm going for it again tonight. If it doesn't work, I'll go back to my Tegaderm but at least I'll have had a break from it all for a couple of nights.

In the meantime, OSR, try adjusting the top adjustment on the Activa to see if it can make a difference in the deflation department, if you haven't already tried that. R&R had a great suggestion, too, if you can stand the smell of vinegar, which I don't mind at all, which is to soak the seal in 3 to 1 parts water and vinegar (I believe that's the right ratio) and it brings the seal back to its full size and takes off the oils. I did it and it helped. You just have to be able to tolerate the smell after it's on your face till it fades.

Good luck with your endeavors tonight and let us know how you did. Hang in there...it will get better again, I'm sure.

Wading, thank you for your questions! I don't have any issues breating through my nose. I do have the old Flonase handy for when my allergies bother me but these days, allergies aren't a problem. As for the humidification, I have that set on "2" less I get rain in the mask.

Lori, I'll look and see what we've got in the house. I've got a Van Dyke type goatee so hair is an issue. I guess duct tape is out, eh? .

I did take the time to clean my mask this evening; We'll see if that makes any difference. After reading all of the different information on this forum I settled on using warm water and just a tablespoon of Borax (20 Mule Team stuff) to about a gallon of water. I then rinsed the mask out with warm vinegar water and set on paper towels to dry.

I taped mine with a mustache and I had a goatee last spring and I did fine. Now it can't be duct tape It needs to be of the type that they use on wounds that won't stick to the flesh. It was not a joy to take it off, but left hairs intact.

OSR,

Let us know how you did last night, please.

Also, in answer to your question in the subject line of this thread, "Masks - Are they evil by design," I would say, the masks aren't, no. It's the people who DESIGN the masks that are .

I was wondering if any cpap company had expirimented making a customized mask. For example, we can get customized insoles by submitting a mould of our foot, and customized teeth whitening or anti-grinding mouth guards with a mould of our mouth and jaw.

Why not make a mould of our face, then use this to make a cast, which then serves as a mould for the plastic and silicone components of the mask? Might cost 1k or so, but I'll bet many of us spend that much when you add up all the masks we have tried and failed. The cast could also be kept on file for us at the manufacturer, ensuring customer loyalty when replacement is needed because of age. Even doing a customized mould of our nares for nasal pillows (which should be a lot cheaper) would be a huge improvement over the current three sizes fits all approach. (I'm still fighting blisters and sores after 2 months.)

Sleepybarb,

One of my DMEs told me that Hans Rudolph does. Now, is that true or not, I don't know. Just repeating what he said.

Sleepybarb,
That guest was me. Have to remember to log back in when I clear my cache and temp. internet files...

This is probably the "custom" mask the DME had in mind, Lori:

Hans Rudolph E2-DigiMask

Doesn't impress me because, as we all know, it doesn't matter how well a mask fits a person's face sitting up... it's when you lie down and turn from side to side that the face's geometry, the shifting of skin and tissues, musculature, etc. change subtly or dramatically enough to cause some masks to leak.

Gravity just will do its thing. As will the slightest pushing of a head pillow against the edge of a mask.

Far more important, imho, than the "fit" of mask to face in a static position, is whether a CUSHION is designed to "go with the flow", so to speak, when head and face are moved about during sleep. The ResMed Activa is the best, imho, at sealing well throughout the dynamics of sleeping position, contact of head pillow with the mask, etc.

In the HR PDF brochure, the drawing and cursory description of the "Skin Interface - E2 DigiSkin" doesn't look like it could handle anything other than lying perfectly still. Looks can be deceiving though...might be the best thing since sliced bread.

I'd rather spend my money on a backup of one of my favorites than take a chance on that one.

I'd rather spend my money on a backup of one of my favorites than take a chance on that one.

You, take a chance ? We all know you'd just come up with some new lab ratting tecnique to fix whatever was wrong with it, so there is no chance it wouldn't work for you. May take you some hard work and ingenuity, but I have faith that you'd make it work.