CPAPtalk.com

enghelp wrote:

caffeinatedcfo wrote:Even if you open your mouth before CPAP you may not after you start using it. Getting the air you need through the nose could make your body happy and keep your mouth closed.

YES!

I was a chronic mouth breather. I'd wake up with a dry mouth, plugged up nose, and throat full of sticky, brown chunks. I couldn't imagine ever being able to use a nasal or pillows.

Now I use a Swift FX and am pretty sure I never open my mouth at night. With the whisp I did, and I'd suffocate a bit, but with that air going into my nose with such a great seal...I actually wake up with a clear set of nasal cavities! No more choking up goo until I puke. It's also incredibly comfortable.

The one thing I'd improve with the Swift is the headgear. I can't seem to hook it up like they show in the pictures. Ends up feeling like I'm wearing glasses all night and I wake up with sore ears. But I pushed the top strap forward by quite a bit, tightened it a bit, and loosened the back one and it's more comfortable. Still presses on my ears a bit (the back strap), but not as bad. So research on that would be where I'd go next with the Swift.

Uncle_Bob wrote:

NateS wrote: 1) Mouth breathing. So far, there doesn't really seem to be a good solution for mouth breathing for people unwilling to wear a full face mask. Most chinstraps are rather ineffective.

I disagree. I uses the papCap chin strap which prevents my jaw dropping and mouth leaking, it gets me a 0.0L rate.
I can also use the ruby red but find the papCap more comfortable,

~UB

Uncle Bob,
If I could keep the papCap from 1) sliding down over my eyes and 2) from distorting the angle of the cheekstraps on my Wisp, I would give it another try.

As to the second issue, the Wisp is one of those masks where the cheek straps form a special angle protruding out towards the nose pillow so as to hold it at just the right angle. Sort of like a suspension bridge over a body of water. The velcro strips or straps on the papCap are so bulky that placing them over the mask bends the Wisp cheek straps outward and placing them under the mask bends the Wisp cheek straps inward.

Have you ever had this problem with your mask(s) and overcome it somehow? If so, how?

Regards, Nate

NateS wrote:

Uncle_Bob wrote:

NateS wrote: 1) Mouth breathing. So far, there doesn't really seem to be a good solution for mouth breathing for people unwilling to wear a full face mask. Most chinstraps are rather ineffective.

I disagree. I uses the papCap chin strap which prevents my jaw dropping and mouth leaking, it gets me a 0.0L rate.
I can also use the ruby red but find the papCap more comfortable,

~UB

Uncle Bob,
If I could keep the papCap from 1) sliding down over my eyes and 2) from distorting the angle of the cheekstraps on my Wisp, I would give it another try.

No chin strap has ever kept my lips closed, mostly because my upper jaw and lower jaw seem to belong to two different people and the designer of the covering "fabric" forgot to make things fit properly. The Hybrid works for me because the small mouth piece encircles my generous lips and keeps them together.

enghelp wrote:
Unrelated... Nate, PLEASE TELL ME THAT IS YOUR REAL BEARD!!!!! It is AWSOME!

NateS wrote:Hi, I picked an avatar that somewhat resembles what my mustache and beard looked like at one time in my youth. I don't recall where I got the picture, maybe Tolstoy in his youth. Even if I could get away with it now, I'm not sure I could handle that much of a lush hirsute display now! But it is a fond memory.

As for its relevance to the forum, I neglected to mention that it reminded me of Washington Irving's Rip Van Winkle.

Nate

NateS wrote:What about a sewn-in label telling the patient not to accept the mask unless all 3 sizes are included in the fit pack? Why should the mask companies be facilitating the dishonesty of the DMEs when the patient or his/her insurance company has paid for the entire fit pack with all three trial sizes in it?

Regards, Nate

I don't use pillows, so I don't have that problem.

But, I have a hard time understanding why anyone would just let the DME keep some of the pillows. Just demand all of the pillows you or your insurance is paying for. In fact, I would not even accept an opened package.

Or, am I missing something obvious?

StuUnderPressure wrote:

NateS wrote:What about a sewn-in label telling the patient not to accept the mask unless all 3 sizes are included in the fit pack? Why should the mask companies be facilitating the dishonesty of the DMEs when the patient or his/her insurance company has paid for the entire fit pack with all three trial sizes in it?

Regards, Nate

I don't use pillows, so I don't have that problem.

But, I have a hard time understanding why anyone would just let the DME keep some of the pillows. Just demand all of the pillows you or your insurance is paying for. In fact, I would not even accept an opened package.

Or, am I missing something obvious?

It is done surreptitiously, the patient is not aware more than one size has been provided by the manufacturer. It's a rip.

StuUnderPressure wrote:

NateS wrote:What about a sewn-in label telling the patient not to accept the mask unless all 3 sizes are included in the fit pack? Why should the mask companies be facilitating the dishonesty of the DMEs when the patient or his/her insurance company has paid for the entire fit pack with all three trial sizes in it?

Regards, Nate

I don't use pillows, so I don't have that problem.

But, I have a hard time understanding why anyone would just let the DME keep some of the pillows. Just demand all of the pillows you or your insurance is paying for. In fact, I would not even accept an opened package.

Or, am I missing something obvious?

Yes, you are.

1) It is not an arms-length transaction. Especially if it is setting up someone new to xpap, the DME is placed in the dominant position of a trusted professional, supposedly trained and experienced in his work, whereas the patient is in a learning, submissive position psychologically;

2) Even with someone already on xpap, if a new mask is being considered or introduced for the patient, the DME is expected to open the package in order to assist in demonstrating the proper fitting of the mask, so the package is going to be open or opened as part of the process.

cpaptalkers, especially experienced xpap users, are not a representative group. Terms like "Just demand" and "not even accept" are not in the emotional or working vocabulary of the average consumer being fitted for a life-changing device.

Are ALL consumers entitled to protection from unscrupulous behavior in matters of health care, or just the most assertive segment?

Regards, Nate

NateS wrote: Yes, you are.

1) It is not an arms-length transaction. Especially if it is setting up someone new to xpap, the DME is placed in the dominant position of a trusted professional, supposedly trained and experienced in his work, whereas the patient is in a learning, submissive position psychologically;

2) Even with someone already on xpap, if a new mask is being considered or introduced for the patient, the DME is expected to open the package in order to assist in demonstrating the proper fitting of the mask, so the package is going to be open or opened as part of the process.

cpaptalkers, especially experienced xpap users, are not a representative group. Terms like "Just demand" and "not even accept" are not in the emotional or working vocabulary of the average consumer being fitted for a life-changing device.

Are ALL consumers entitled to protection from unscrupulous behavior in matters of health care, or just the most assertive segment?

Regards, Nate

Thanks for the excellent summation, Nate.

I definitely fell into category 2 there when I switched to my current mask. Even watched the RT steal the large pillows from the pack after he convinced me I was between a small and a medium. Three guesses and $25 plus S&H will get you the size I finally settled on...

The OP's pretty much said it's a dead horse, but why don't the manufacturers get their lobbyists together with the insurance company's lobbyists and require at least one mail-order outlet as "in network?" Heck, in this post-Leegin oligopoly there'd still be plenty of profit left for both sides and the honest DMEs if they ganged up against the less-than-scrupulous DMEs.

Can't keep my mouth shut. Even with a normal chinstrap, I puff air out of my mouth. I'd use a FFM except none fit me well. My nose bridge is narrow and my face is thin. The beating my nose bridge took was brutal and leaks were a problem.

MagsterMile wrote:Enghelp: I too appreciate you being on the site and asking for opinions and suggestions on how to improve mask fit. I liked an earlier suggestion someone had about having the ability to direct the masks venting to where it is most convenient. That would be especially useful in the winter. I would like to see a material other than silicone and gel be tested for usability. My neighbor and myself, who both use the FFM have a skin condition called 'rosacea'. This is a chronic condition and the silicone and gel materials used in masks are not friendly to the skin. I will try a pad-a-cheek liner down the road when I can be reasonably sure that I have found a permanent mask that I want to stick with. It would be nice to not have to take that extra step for comfort.

Try the SleepWeaver mask "ELAN" or 'Advance'. They're good masks and they're fabric masks rather than silicone.

enghelp wrote:Just a reminder guys, like i said, I can't take away solutions, only problems. if you guys throw out solutions we can't use them in products unless we can prove in court that we thought up the idea first.

Sure you can. You can use someone else's idea unless they file for a patent first.

You can probably even patent it. Patents are not for ideas, they're for the implementation of an idea.

Even without that argument, the US is now on a "first to file" patent system, not a "first to invent."

What I would like is a better range of small sized masks and parts. One size fits all may keep production nice and simple, but it doesn't fit all. For instance, I've tried the Wisp and like it, but the headgear is so large that if I want to keep it stable, I need to either not move or figure out just where precisely I need to take it in. For that mask, their only other headgear is even larger.

Not everyone has the giant pumpkin propped atop our necks that the mask manufacturers seem to think we have.

enghelp wrote:LOTS of times they will put people on a full face mask...

My experience has been different. Every time I've gone to a DME, they have attempted to give me the cheapest, crummiest nasal mask available at the time.

I'm in the same category as SleepingUgly - no amount of pursing my lips or keeping my mouth closed will stop air from leaking out my mouth between my teeth, under my tongue, past my cheeks, and out the corners of my mouth at a pressure of 10cm plus. There isn't a nasal mask made that works for me, much though I wish this were the case.

I use the zzz, quattro, umff and the hybrid. All of them as they are designed - even nasal masks - suffer from mask torque. Your head is on the pillow, you spin your face in one direction and the mask stays with the pillow and moves around on your face. Leakage ensues. You wake up and have to re-establish the purchase of the silicone on your face.

The below has probably been said every time students come here. We have yet to see anyone come up with the golden solution. You want to create a winner? Here is your recipe.

First: Design a system of straps, webbing or mesh that stop mask torque, because all of the current methods embraced by the big mask-making companies are next to useless. Turning over basically means waking up almost fully, just to insure your mask isn't going to leak, settling into a new position consciously and then attempting to continue sleeping.
a. Make a solution that does not leave strap marks.
b. Make your strap solution light, easy to don and doff, stretchy where appropriate and unstretchy similarly.
c. Make the head-facing surfaces of whatever you design lined with cotton - not polyester or nylon.
d. Include some real chin stabilization in your solution. Make it a valid solution or don't even try.
d. Make your solution machine-washable. I want to be able to wash it a hundred times and still have it as useful and comfortable as the first night.

Second: Design this full face mask:
a. One that doesn't need one of those obnoxious forehead braces. This isn't just about vanity. All morning long after you wake up you've got two itchy suction cups stamped on your forehead. You may as well tattoo "Loser" there.
b. One that doesn't cause a bloody nose bridge under high pressure or tight straps - not too narrow, not too wide.
c. One that wraps properly around the corners of the mouth, senses when your mouth goes slack and follows your face contours during sleep, or when you smile or laugh in your sleep.
d. While you're at it, find a better alternative to silicone that feels like cotton, or design your solution with washable cotton liners.

Third: Wear your solution for thirty days before expecting someone else to try it. If you can't wear it, chances are nobody else will want to either.

Fourth: Make any solution such that small children don't stare in horror at a grandparent when they see him wake up masked in the morning, or alternatively make masked children feel like they are sick hospital patients.

Fifth: Make it less expensive than any mask system currently on the market while simultaneous more durable.

Now for nasal masks...

NateS wrote: 1) It is not an arms-length transaction. Especially if it is setting up someone new to xpap, the DME is placed in the dominant position of a trusted professional, supposedly trained and experienced in his work, whereas the patient is in a learning, submissive position psychologically;

2) Even with someone already on xpap, if a new mask is being considered or introduced for the patient, the DME is expected to open the package in order to assist in demonstrating the proper fitting of the mask, so the package is going to be open or opened as part of the process.

Yep, I didn't even know that nasal pillow masks came with all three sizes when they gave me my first and second mask with only one set of nasal pillows each (Swift LT and Swift FX) because they did not give them to me in the original package that says that there are all the sizes on it. The DME cleverly didn't mention that, and only offered me the size that they thought fit. As it turns out, I'm now one size up from that, and now I also know which masks come with multiple size pieces in the package.

Later on I saw the bill that they submitted to my insurance company at that time, and they billed them for the full kit of course (for the full package which should have had all 3 sizes of nasal pillows), so they've got a little fraud going on with that one. And I haven't gone back to the DME except to exchange stuff since then, I get stuff from them in the mail so I don't have to see them. Don't really want to see that DME unless I absolutely have to, and at this point there's really no reason.

So it goes.

DreamDiver wrote:

enghelp wrote:LOTS of times they will put people on a full face mask...

...

"c. One that wraps properly around the corners of the mouth, senses when your mouth goes slack and follows your face contours during sleep..."

AMEN! As a mouth breather I now am struggling with nasal pillows, when what I would like to be wearing is one of the two hybrids gathering dust in the closet.

Tipiford