Custom Fit Mask

Just thinking. Lots of people aren't happy with the fit of their FF or nasal masks. Everyone's facial structure is different, and it's only reasonable that mask manufacturers design their masks to fit customers' features who reside in the middle of the bell curve, as far as facial dimensions go. But what about whose physiognomy resembles, for example, the late Jacques Cousteau? What a schnoz that goy had! Imagine the frustration of a DME rep. trying to fit someone like that! Imagine your frustration if you HAD a beak like that!

How many apneics slip through the cracks and abandon xPAP out of frustration brought on by persistent mask leaks? I wonder if a viable solution might be to take a partial facial impression of the areas a mask would need to seal and use that as a mold to create a custom set of silicone mask cushions. Sort of how a denti$t/orthodonti$t takes dental impressions to make dentures.

Perhaps someone is doing something like that. If that is so, I haven't heard about it. It was just a thought.

That is a wonderful dream. I would bet it would work but at the cost of whom? I would do it myself if that were an option.

I would love a custom fit FF mask. I have a small, short chin. From the top of the bridge on my nose to the crease in my chin, is barely 3 inches. My jaw is misaligned--you can't tell by looking at me, but it makes an impact on my bite and jaw position, which does affect my leak rate.

One type fits all isn't always true.

Slartybartfast, it's too true that many, many cpap users have trouble finding a well-fit mask because of the limited sizes, shapes, and options available. Furthermore it's too bad, because for many it means unsuccessful therapy or even abandonment.

Without digressing from the idea at hand, there is a moldable mask on the market; the shell is a pliable material that can be bent in order to fit the contours of your face. They are made by Sleepnet and both nasal as well as full face options are available. Please PM me if I can be of any help to anyone, or if someone would like more information! Granted, it's not quite the same as getting fit for dentures or orthodontic work, but maybe that's a good thing... those molds taste naaaas-TAY.

It's certainly a fascinating idea that you would go in and have a facial impression made for your cpap mask!(Lying down, of course ... )

Sbf,

There is such a thing.

But it costs AU$ 1400 and you have to go to Australia to have the mold made.

I cannot understand why someone in the US doesn't offer such a product. I'd buy one. $1400 doesn't sound that expensive when you consider that I've already spent $1000 and still don't have a completely satisfactory mask. And I suppose that economies of scale would bring the price down.

http://www.cpapaustralia.com.au/shoppin ... -masks.htm

jromano wrote:Slartybartfast, it's too true that many, many cpap users have trouble finding a well-fit mask because of the limited sizes, shapes, and options available. Furthermore it's too bad, because for many it means unsuccessful therapy or even abandonment.

[snip]
It's certainly a fascinating idea that you would go in and have a facial impression made for your cpap mask!(Lying down, of course ... )

The Comfortgel mask appears to just have a pliable seal. I'm thinking of a truly custom-fit seal that might be used for folks who can't be fit with an off-the-shelf mask. Klingons, for example.

Perhaps something that could be made in the back room of a sleep lab or even a DME. If you Google "lifecasting" you can see how alginate gels, similar to the ones used in dental labs, can be created that quickly form a mold of the body part of your choice.

I have an appointment with my pulmo-Doc/sleep-doc in February. Maybe I'll see if I can talk him out of an old mask or two that I can experiment with. Not that I need yet ANOTHER all-consuming project to devote my limited time to . . .

M.D.Hosehead wrote:Sbf,

There is such a thing.

But it costs AU$ 1400 and you have to go to Australia to have the mold made.

I cannot understand why someone in the US doesn't offer such a product. I'd buy one. $1400 doesn't sound that expensive when you consider that I've already spent $1000 and still don't have a completely satisfactory mask. And I suppose that economies of scale would bring the price down.

http://www.cpapaustralia.com.au/shoppin ... -masks.htm

There it is! I figured someone might have already come up with something along those lines.

I'd settle for simply being able to have an appointment with a technician who knew a lot about fitting masks and who had access to a lot of different styles. This trying to guess what will work for you all by yourself has to be the most inefficient method possible.

Hmmm . . . wonder what the HCPCS code is for the flight to Oz to get fit with one of those . . .

"Inquiring Mind Wants to Know 1 (ontopic semirant)" - topic started by M.D.Hosehead - July 2010
viewtopic.php?p=500864#p500864


"Mask for Sale: $1450.00" - topic started by roster - May 2009
viewtopic.php?p=364894#p364894


"Hans Rudolph" - topic started by FL andy - Dec 2005
viewtopic.php?p=56092#p56092
That was five years -- never have heard any more about that company's digital mapping of the face idea.

__________________________________________

My opinion:
A mask custom made to fit a person's face sounds like a good idea.... IF a person lies motionless in one position all night... with head in same position all night long... same exact position in which the custom fit was made in the first place.

However, facial contours are going to change with every change of position. We won't even get into the problems of how well (or poorly) a mask cushion is designed to withstand CPAP air pressure inside.

Back to just the molding process... I don't think there's any way to create a mold that can handle things that are likely to happen in "real life" sleep:

Pillow smushing against side of face and against side of mask.

Relaxing the jaw or opening/closing the mouth during sleep.

Simply turning the head to one side or the other even if the body is not turned can change the "thickness" of one cheek or the other. Good old gravity.

Here was an interesting topic from Feb 2006 in which Kelly Rudolph (Hans Rudolph -- mask manufacturer) wrote:

We have technology that allows us to send a digital Camera mounted to & calibrated with a small projector to your Dr., Lab, or Homecare Dealer so they can take a photo of your face & then email that jpeg file to us so we can make a custom shell/cone that follows your exact face geometry/curves and therefore allows a leakfree comfortable custom fit.
viewtopic.php?p=56092#p56092

Neversleeps, ozij, and I had doubts.

Never saw any more about it from the Rudolph company.

Never heard much about ia1234's attempt at a custom mask, or "Acurest's" custom mask...at least not from cpaptalk members:
Mask for Sale: $1450.00 - topic posted by roster (rooster) May 01, 2009
viewtopic.php?p=364810#p364810

"Acurest" describes his company's "Logical" mask on page 3 of that thread:
viewtopic.php?p=387067#p387067

Acurest wrote of having the person relax for 30 minutes before the mold is made. That still can't duplicate the total relaxation of muscles during sleep. Nor duplicate the changes in facial contours when a person turns over, say from being on their back to on their side.

For a very still sleeper, perhaps a custom molded mask would work. For a sleeper who moves their head much, or especially one who changes position often -- a toss 'n turn sleeper -- I don't think a custom mask would be much, if any, better than masks off the shelf.

Can be a long, frustrating (and expensive!) quest to keep trying masks until a person finds one that suits. I don't think "custom molded" is necessarily the answer.

Well said, RestedGal. I tend to agree with you.

A mask custom made to fit a person's face sounds like a good idea.... IF a person lies motionless in one position all night... with head in same position all night long... same exact position in which the custom fit was made in the first place.

However, facial contours are going to change with every change of position.

rested gal, great point. It would be difficult at best to take into account subtle facial changes in every position.

Slartybartfast, I would whole-heartedly bring this up to your doctor in February. Best case, it inspires the creativity to flow. Worst case, you both get a hearty laugh. Win-win.

The Comfortgel mask appears to just have a pliable seal. I'm thinking of a truly custom-fit seal that might be used for folks who can't be fit with an off-the-shelf mask. Klingons, for example.

Just in case I misunderstood:
Respironics' Comfortgel mask does have an adjustable seal. However, I was referring to Sleepnet's masks (such as the IQ and the Mojo); it's not just the gel cushion that can be adjusted, but rather the whole shell of the mask can be bent and flexed in order to accommodate varying facial characteristics. There is no personal mold that must be formed, but they are customizable in a unique way.
Now Klingon masks... THERE'S a concept.

I'd settle for simply being able to have an appointment with a technician who knew a lot about fitting masks and who had access to a lot of different styles.

Suetois, such a reasonable request, yet too often (once is too often as far as I'm concerned) not the case.
At least the brilliant folks such as yourself have taken a stand in their own healthcare; advocacy and research does wonders...

RG,

I agree it's wise to be skeptical until there are convincing facts to the contrary. And you have (more than once) listed a number of reasons to be skeptical. I'll even offer one more:

If the Acurest mask is dramatically better than all the off-the-shelf masks, why haven't we heard about it from at least one of the Aussies who regularly post here?

OTOH, I can think of a plausible reason it might work.

Disregard, for the purpose of this discussion, the soft tissues of the face, and consider just the bony structure--which doesn't change with body position or movement. Consider the complex solid angles made by the sides of the nasal bones, their pitch away from the face, and the complex contours where those bones meet the frontal and maxillary bones and orbit of the eye, the curvatures of the frontal bone and maxillary bone beneath the nose. You can trace your own bony anatomy with your finger and notice how complex the shape of your skull is.

And of course, in addition to the angles and curvatures, the dimensions of every bone are highly individual.

Now look at any current mask. No off-the-shelf mask even begins to follow the complexity of human skeletal anatomy. None of them "fits" the face; instead they depend upon soft materials to form a "gasket" to seal against leaks.

In contrast, notice how the custom mask appears to fit, literally, the skeletal coutour of the models here (you have to wait for all the photos to cycle):

http://www.acurest.com.au/

If someone in the US made custom masks, some patients would try them, and then we'd have facts to discuss. And I don't understand why some entrepreneur isn't trying.

suetois~ Threre is a cpap only center in Chantilly. We've been going ther for years! Its great! Fantastic staff.

Clearly there is interest in the custom-made mask concept, and:

Acurest is prooud to announce that our TrueFIT Custom CPAP Mask is now available in the USA!

Please see our website (http://www.acurest.com.au) for how you can access this mask for yourself.

In discussing our mask with doctors and clinics over the years, we find what is to us a surprising reluctance to consider this obvious alternative to the standard-sized mask concept. It's as if the whole industry cannot look beyond "the way we do it now" towards a better future.

Over time, as patients find our mask and then return to their doctors and clinics with great results and feedback, opinions have changed and many Aussie CPAP groups now routinely refer patients to us or discuss the TrueFIT mask as an option. We don't expect to change everyone's mind with a slick marketing campaign; we want the results to speak for themselves. Ultimately, we will be judged by CPAP users in their own beds.

Current mask manufacturers incrementally improve their standard masks and frequently release new models to satisfy the consumers demand (hope?) for something "better". They can continue doing this forever. It is a commercially compelling approach, but it does not put the needs of the user first. Let's face it, if standard mask manufacturers made better masks, they would sell fewer of them. So where does this leave users?

Simple: either the user stays on the CPAP mask merry-go-round hoping that they will one day find the mask that is right for them, or they have a mask made that will do the job today.

Everyone is going to weigh this up differently. But it is important for struggling CPAPers out there to know that there is an alternative nasal mask out there that works without the leaks, noise and discomfort. It is guaranteed to be comfortable and to seal effectively - ask any other manufacturer to make, and stand behind, a guarantee like that!