Help me get back on the Wagon

Hello all. Long time, no post. I wonder if any of you remember me.

In any event, It's been about 9 months since I last used my CPAP. Prior to that I had been using it for about 9 months with decent success. Here's the story.

Diagnosed with mild OSA (29) and given CPAP. Started CPAP with a RemStar Pro and a bunch of masks. Did it for about 9 months until a combination of weight loss reducing my AHI and chronic mask issues just made me to give it up all together.

The masks:

Opus 360
Swift II
Swift LT
Ultra Mirage II
Mirage Liberty

I had most success with the Liberty. It's issues: tough to fit without Macks. And that got old, FAST. Used Macks on both the mouth and the pillows. Also, the air blowing across my mouth dried out my lips FIERCE.

Next most comfy was the Swift LT. Problems....disturbed by pillow / mask contact and also mouth venting. I got really tired of my wife waking me up saying "you're farting again" as my lips would flap in the breeze.

The Opus never seated well, which was too bad as it was COMFY.

I hated the UM II. I did not like the face support, it hurt my nose and I had pretty bad leaks around the nose / cheek.

I am using a home-made hose management system to keep the hose up and away from me, similar to those made on here.

So...any new masks which could help? I tolerate nasal prongs & pillows well. I was thinking of a Hybrid as a way of getting around the Mack's issue with the Liberty. However, will that stop the air blowing on my lips? Dunno.

Help me get back on the wagon!!

Thanks all.

Sure do remember you.

If you try a Hybrid, here are some tips viewtopic.php?t=14422&highlight=

I have used the mask exclusively for over three years and after the initial startup problems, I have very little trouble with it. I even sleep on my tummy about half of the night with the mask pressed partially into the mattress.

Make a commitment to CPAP and get in the trenches with us.

Needsdecaf wrote:I was thinking of a Hybrid as a way of getting around the Mack's issue with the Liberty. However, will that stop the air blowing on my lips? Dunno.

Help me get back on the wagon!!

Thanks all.

Nope, it won't. Any FFM is going to blow air over your lips. I use the Hybrid and, even though I almost exclusively breathe through my nose with it, I put a little Lansinoh on my lips before I mask up, and my lips are always moist in the morning. (Even on the occasions when I do mouth-breathe, my lips stay moist.) You might try that, with any FFM.

I'm glad you're getting back into using your machine, and I wish you the best.

BleepingBeauty wrote:

Needsdecaf wrote:I was thinking of a Hybrid as a way of getting around the Mack's issue with the Liberty. However, will that stop the air blowing on my lips? Dunno.

Help me get back on the wagon!!

Thanks all.

Nope, it won't. Any FFM is going to blow air over your lips.

To BB and Needs,I don't understand that problem. The air that is "blowing over your lips" is coming from where and going to where?

rooster wrote:

BleepingBeauty wrote:

Needsdecaf wrote:I was thinking of a Hybrid as a way of getting around the Mack's issue with the Liberty. However, will that stop the air blowing on my lips? Dunno.

Help me get back on the wagon!!

Thanks all.

Nope, it won't. Any FFM is going to blow air over your lips.

To BB and Needs,I don't understand that problem. The air that is "blowing over your lips" is coming from where and going to where?

I'm not sure what's confusing you, rooster. The air comes from the hose, of course. Where it goes from there depends on whether I'm breathing through my nose or my mouth. But in either case, my lips stay moist with the Lansinoh.

Maybe I'm not understanding what you're asking.

I use both a quatro & the hybrid and I have never had problems with my lips. If they are dry from outside (like cold frigid wind) then I use lip balm.

Pardon my ignorance--what are "Macks"?

rubymom wrote:Pardon my ignorance--what are "Macks"?

They're moldable silicone earplugs (like you'd use for swimming). Some people roll the material into a thin rope and stick it to the seal of the mask wherever they're experiencing a leak.

BleepingBeauty wrote:
I'm not sure what's confusing you, rooster. The air comes from the hose, of course. Where it goes from there depends on whether I'm breathing through my nose or my mouth. But in either case, my lips stay moist with the Lansinoh.

Maybe I'm not understanding what you're asking.

With a properly operating CPAP system, the air flow in or out of the mouth or nose is no greater than normal breathing without CPAP.

CPAP only provides an increased air pressure, not an increased air flow, compared to normal breathing. So I am still at a loss to what you two are describing as "air flow over the lips".

Welcome back, I don't remember you because I joined around the time you made your last post. I had all kinds of problems finding a mask because I was at such a high pressure. But I had good luck with a quattro and got the Hybrid to fit but my pressure of 21/17 blew thie pillows right out of my nose.

Their are lots of people on here who hate the quattro. It looks like you either love or hate the quattro, that mask doesn't really have an in between.

I also noticed that for a majority of the people who have not had much luck with other masks the quattro works.

I tried many of the ideas people listed on this site and putting wax or anything else didn't work to help prevent leaks.

If you have a DME that will let you try on masks, try a hybrid and the quattro out. Then if they will loan then to you give them both a try.


Best of luck. Gerry

rooster wrote:
With a properly operating CPAP system, the air flow in or out of the mouth or nose is no greater than normal breathing without CPAP.

CPAP only provides an increased air pressure, not an increased air flow, compared to normal breathing. So I am still at a loss to what you two are describing as "air flow over the lips".

When I breathe in, the air rushes over my partially opened lips. Since the air is at pressure, it's a higher volume, which means increased irritation of the lips.

I used to wake up with my lips and mouth dry and cracked, feeling like I had "cotton mouth" of a hangover.

I used to run about 2 on the humidifier, but anything more than that gave me rainout.

Thanks to all those who replied, and howdy rooster!

rooster wrote:

BleepingBeauty wrote:
I'm not sure what's confusing you, rooster. The air comes from the hose, of course. Where it goes from there depends on whether I'm breathing through my nose or my mouth. But in either case, my lips stay moist with the Lansinoh.

Maybe I'm not understanding what you're asking.

With a properly operating CPAP system, the air flow in or out of the mouth or nose is no greater than normal breathing without CPAP.

CPAP only provides an increased air pressure, not an increased air flow, compared to normal breathing. So I am still at a loss to what you two are describing as "air flow over the lips".

I disagree. With nasal and full-face masks (not pillows, cannulas, etc.), there's constant airflow inside the mask's shell. That's the "airflow over the lips" that I'm describing with my FFM. I feel the air moving inside the mask constantly when the machine is running. The air isn't passive (as it is when I'm breathing normally without xPAP). Doesn't matter if my mouth is open or closed; if I don't put some kind of moisturizer on my lips, the constantly-moving air inside the mask dries them out.

Perhaps you have your humidifier up really high and this isn't an issue for you.

Needsdecaf wrote:
When I breathe in, the air rushes over my partially opened lips. Since the air is at pressure, it's a higher volume, which means increased irritation of the lips.

Thanks to all those who replied, and howdy rooster!

If the CPAP is running at a pressure of 20 cm (very high) the air is compressed by only about 2% compared to normal air at sea level. So I maintain the volume of air moving across the lips with a properly working CPAP is neglibly higher volume than during normal breathing.

Now there is a volume of air that moves from the input hose to the exhaust ports that is not existent with normal breathing. This flow will go from the input hose direct to the exhaust ports. With the full face masks I have, this flow does not travel over the lips.

I can understand dry mouth. On nights when I have nasal congestion, I tend to mouthbreathe a good bit of the night and that will make the mouth dry. Of course, someone not using CPAP tends to get dry mouth if they spend a considerable amount of time mouthbreathing. Dry lips may be a side effect of this. I quite often use lip balms also.

It seems to be a common misunderstanding that CPAP blows a lot of air around, when it is only creating a pressure. The action of our lungs is what determines the flow of air.

But anyway, that is just an academic discussion and you are right to focus on the practical aspects of getting your therapy working at this point.

Good luck.

Although I am a near-total noob, I will weigh in on the moisture discussion. With a full face mask and decent (high-ish) humidity, my mouth -- including my lips -- is less dry than my pre-CPAP days.

If the only problem with higher humidity is rainout, perhaps the solution is to deal with that, with a hose insulator or hose warmer.

As full-face masks go, I have personally had my best luck so far with the F&P Forma, though I understand that the Quattro and Ultra-Mirage have higher success rates overall.

Anyway, welcome back into the fold.

Try to tackle one or two problems at a time and you will work through them. If you try to tackle everything at one you won't get anywhere.
You have a hose management system, now lets get that hose covered so the chances of rainout are reduced. You can buy a cover for the hose or make one. Try to find an old long sleeve shirt and remove the sleeves and make a hose cover out of that. If that works then try a commercially available one or have someone make one for you.

Next get a mask that fits or get the one you have properly adjusted. Either find the directions for it or download them. This worked for me. Read throught the directions a few times on putting the mask on and adjusting the headgear. Next take the mask and instructions and sit in front of a mirror and with the instructions put the mask on and take it off a few times. Then finally just put the mask on and take it off without the instructions unless you run into problems. Then I put the mask on wiht my eyes closed. Kind of a muscle memory thing. This should help you get the mask on and adjusted properly which should result in lower leak rates and the mask being more comfortable.

Some people have picked up a mask put it on and hooked it up to their machine and went to sleep and never looked back. The rest of us had to work at it. I found that one of my biggest problems was getting the mask on properly and the headgear adjusted properly.

Gerry