Mask fitting

My partner just received a new ResMed UltraMirage full face mask, size medium from Apria. She was not measured, nor trained on how to properly fit the mask. Nor was she even allowed to try on different styles and sizes. The best they did was give her a small mask as an extra that was open, they weren't sure where it had come from.

Not surprisingly, she's had nothing but trouble with it. It's making the bridge of her nose swell painfully and turn read, along with acne breaking out long the sides of her nose. For the swelling they sent a "Gecko", size large, though she has a medium mask. So none of that is quite working together, and she's still breaking out.

Maybe I had the wrong idea of how this process goes. I envisioned that you would meet with a RT, they take some measurements, talk about what you're concerns are, what type of mask you might like. Then they would let you try a variety of masks, and show you how to properly adjust the one that you choose. If you have problems with that one, you come back in, show what is causing the problem, and either help you adjust it, or find you a new piece of equipment.

Do we need to be forceful with Apria, or is there another provider we can see? We have an HMO, so I'm guessing they only have one provider. Should she check back with her sleep specialist doctor and see if he recommends anything in particular for her? This seems like there's too much guess work and nobody wanting to take responsibility.

I guess I'm venting more than anything, we're going to get on the phone tomorrow and try to make things happen. Just wonder if anyone has words of encouragement.

What you envisioned is how it should work. What actually happened is a large part of the reason CPAP has a 50% failure rate. You should probably start by calling her doctor. I've seen several reports of DME's snapping to when a doctor calls to chew them out.

I'd also check with your insurance to see if there is a list of providers that you can see. Sometimes that information is on their website.

Plus there usually are templates online (under the manufacturers websites) to help with fitting. You may have to download, print and cut them out.. but they'll help determine if the size is incorrect.

A large part of getting a correct fit is based on what you tell the technician as they try the mask. If you feel pressure spots that could be uncomfortable later, tell them. If it's a nasal pillow mask and it hurts when you move it about in your nose, it's the wrong fit/size.

It's a lot like trying on shoes. When you get the right size and design, you know it.

Mask problems are probably the number 1 problem with CPAP. Many of us have tried new masks, buying out of pocket at a discount on cpapauction.com (no ResMed products). You can try to be more forceful with Apria. I'm not familiar with them, are they the actual DME providers? In any case the current mask is not working now. There are liners you can try to protect the nose area- Pad-A-Cheek, RemZzzs, and Quietus liners work for some folks. I had a DME who worked very closely with me letting me try many masks. I finally found the FitLife Total Face Mask myself. Since it goes around the face, avoiding contact with the nose area it works well for me. They are often available on the auction at a considerable discount. Good luck. Finding the right mask can be a difficult process for some of us, but it can be done. Be sure when asking about trying another mask that you are precise in descriibing the problems you are having. It also helps to find one helpful tech at your DME who is knowledgeable and work exclusively with that person.

Mag, most of us hose heads have a closet full of mask that we could not use for one reason or other. It is trial and error. Sometimes it takes a long time to find the right one. Some of us use nose pillows and have a full face mask for a back up in case we can not breath through our nose because of sinus trouble.

The trick is to have a DME who will work with you on finding the mask you need. Also keep reading this forum to get ideas that will help your journey down cpap row.

Good Luck.!

I've seen Apria referred to here as Crapria! She should have had a fitting but you can check here for proper sizing. https://www.cpap.com/cpap-mask-sizing.php. Also have you tried adjusting the forehead position? My husband wears the UMFF and after a bit of adjusting it's quite comfortable. He wears a Medium and the bottom of the mask comes just into the indent on his chin with the top resting on the bridge of his nose. Top straps should be worn loosely and bottom straps should be adjusted for leaks tightening only in small increments.

Hello Friends,

My partner Mag, shared my story about my ill-fitting mask. So I have an appointment scheduled with Apria tomorrow for a re-fit and I want this done right. When I received my mask (ResMed Ultra Mirage) The RT never measured me and told me that I wasn't allowed to try on any masks. I found that very odd. He told me to pick out whatever mask I wanted and he held it up to my face. That was my fitting! He never showed me anything about the forehead adjustment or how the straps should feel on my face. So I called Apria today and was told by customer service that I supposed to to be able to actually try on masks. Why would the RT not allow me to try on any masks? I would assume they didn't want open any new boxes because those would not be able to be sold? This is the San Diego office.
So tomorrow, when I attend my re-fit I am going to try on every mask they have! But really, since most of my irritation is on the bridge of my nose (very red and sore) what mask do you recommend? Could I be allergic to the latex? How comfortable should the mask feel? I have read seamless?

I am exhausted and really want this to work. With the last mask every time I woke up it looked as though I had just been in a fight. Tell me your thoughts.

Doctor Deb

Welcome, doctordeb. Are you an MD? What specialty?

Some DMEs are worse than used car salesmen. Some are good. Be polite but insistent. If you're not happy with the service, be sure to make a formal complaint with Apria customer service and your HMO. It may not do any good, but make the effort to help keep others from suffering from the same DME.

You should be able to exchange a new mask for up to 30 days from the time you got that mask.

Don't be malicious on trying on masks. Take the high road, but don't let them run over you, either. Don't give them the satisfaction of letting them know they're getting to you. Sometimes it helps to be so sweet and polite that you put them into a diabetic coma. While still not letting them walk all over you. Visibly taking notes may help, too.

You'll need to ask your HMO if there is more than one DME you can use.

For the breakouts, a lot of trial and error is often necessary. Clean the heck out of the mask. The cushion part that touches your nose comes off. Wash it very thoroughly. I would wash the cushion it by itself in the dishwasher. Wash your face and hands very thoroughly before masking up. Some people use the liners mentioned above. Some take a T-shirt, cut a nose hole, then put that between the mask and the face. Trim the excess. Do NOT block the exhaust vent where the air comes out of the mask.

Here's the manufacturer's advice

Please fill in your equipment on your profile. There's a link at the bottom of this post.

doctordeb wrote:So tomorrow, when I attend my re-fit I am going to try on every mask they have! But really, since most of my irritation is on the bridge of my nose (very red and sore) what mask do you recommend? Could I be allergic to the latex? How comfortable should the mask feel? I have read seamless?

You need a mask that fits, and you need it to be adjusted properly. A real respiratory therapist would help you with that. The guy at Apria who threw masks at you may be an RRT, but he's definitely not any kind of therapist. Hopefully on the second visit, you'll get someone more helpful. If it's a repeat of the previous clown circus, put your foot down. If you still can't get a real fitting, walk out and tell both your doctor and your insurance that Apria repeatedly refused to fit you with a mask.

Moleskin will help with the bridge of your nose. You still need a mask that fits, but the moleskin will help the current damage heal. It helps with leaks too. If the adhesive is too strong for your tenderized nose, stick it somewhere else for half an hour, then peal it off and put it on your nose. Once your skin heals, you could probably use each piece of moleskin twice. That's what I do.

You might also want to go to padacheek.com and look around. Karen has padding for just about everything.

Because you're only irritated in that one spot, I doubt it's an allergy. The skin there just isn't meant to take a load. Nearly everyone who wears a mask gets marks there, and if you looked very closely, you'd see a ghost of the problem you're having on the bridge of most of our noses right now. If the mask is right and you add some sort of padding, though, you won't have to walk around looking like you've just been in a fight for the rest of your life.

I recommend the Respironics EasyLite nasal mask. It's designed to avoid leaks and marks on the face. Resmed do a similar one but i don't know the name - I didn't like theirs cos the mask went up and down as i breathed - very off putting.

As for acne, the reason you would be getting acne is due to oily skin and having something on your face all night causing the pores to block (i'm a skincare consultant). You need a product designed to limit oil production on your face. to treat pimples as they appear, you need one of those gels that works promptly to dry out the pimple. If you are in Australia, I would be able to help you out with all of these products but it doesn't sound like you are?? Be sure to cleanse, tone and moisturise before you put your mask on (allowing time for the moisturisers to obsorb). repeat in the morning.

Good luck and let me know if you have any more acne questions I can help with.