Starter set of masks

I was just diagnosed with severe sleep apnea a few days ago at a hospital in Bangkok, where I live. As it happens, I am due to travel to the US next week, so my doctor kindly suggested I buy the necessary equipment online at cpap.com and have it delivered to my hotel in the US, since the Thai price is over twice the online US price. I don't go the the US often and I have had problems sending medical stuff in the post through Thai customs, so this is effectively a one-time opportunity to buy everything I need at a reasonable price.

I have been busy reading up on machines and masks to try and decide what to buy. Unfortunately before my sleep test, I knew nothing about sleep apnea or CPAP, and so when they decided to connect me to a CPAP machine in the middle of the night, I wasn't very motivated to persist with it, and ended up taking it off after only 15 minutes or so. I believe the mask they used on me was ResMed Mirage SoftGel: the mask itself was OK, from what I remember, but I found it difficult to breath and to keep my mouth shut.

I would like to get a sanity check from all the experienced folks here on what I am planning to buy.

On the machine, the choice seems reasonably straightforward: an S9 Autoset (my doctor recommended this, although the reason she gave was that it looked nice (!)).

On masks, I suspect I am not going to have an easy time, so I would like to have a selection to try. My current thinking is to stick with ResMed and buy the latest version of each of the main types of mask ie Quattro Air, Mirage FX and Swift FX, on the basis that if the latest versions work for me, they are probably the best choice. However, I am concerned that each of these three masks is relative light weight. At the moment I sleep on my side and move about a lot -- that was in fact the main motivation for doing the sleep test -- and I worry that these lightweight masks may not stay put. On the other hand, my movement is almost all hypopnea-related, so maybe if I am on a CPAP machine I will not move about so much. So I am wondering whether I should add a Mirage Activa LT or Mirage SoftGel (or maybe the Convertable Pack that has both of them). I am paying for this out of pocket, but fortunately I have the budget to buy whatever is going to help me succeed with this treatment.

Maybe I am overthinking all of this. Any words of wisdom appreciated.

Resmed has one sizing paradigm; other companies have others.
Nasal pillows, which are usually easiest to fit, usually come in multi-size packs, as do some others. (like my Wisp)
You can print out the sizing gauges for different masks, cut them out, and check rough sizing beforehand.

Hi bkkjames,

You mentioned three masks. Of those, I have had experience with the Resmed Mirage FX and the Swift FX. Both worked for me. The Swift FX was much more likely to stay in place without leaks when turning on my side than the Mirage FX. I'm finding the TAP PAP to be even better about staying in place when I turn -- it might be a mask for you to consider for that reason.

chunkyfrog's suggestion of trying sizing gauges ahead of time is wise. Does your doctor or lab have a selection they'd let you try? While the Swift FX (and TAP PAP) come with a set of three sizes in the package to take home, if you find out quickly which size is best you'd also have a chance to order a replacement set of the nasal pillow size which is best for you.

You mention difficulty in keeping your mouth shut. Picking up two varieties of chin straps might be a good idea. I've used the Airway Management Chinstrap (with Tube Management Loop) to go along with my TAP PAP mask, but I find it gets too loose sometimes in the middle of the night. I've had better experience with the Puresom Ruby Adjustable Chinstrap Manufactured by CareFusion, but I see it has been discontinued, perhaps the suggested replacement does just as well.

Best wishes to you as you obtain your equipment, and enjoy your trip to the U.S.A.

--SleepyCPAP

Lighter weight doesn't always mean a mask will move around a lot with tossing and turning in bed.
I use a nasal pillow mask (and used the Swift FX for over 2 years until my recent change to another brand nasal pillow mask) and the Swift FX didn't move very much and I do a lot of tossing and turning still yet (back pain issues cause the need for movement in bed).

It's more about the fit of any mask as to how well it withstands movement in bed...also look at the hose management systems...Keep the hose up overhead and it doesn't really matter all that much what you do in bed in terms of tossing and turning.

See this thread for ideas...you can make your own or buy one (and there are lots to choose from).
viewtopic.php?t=10640

The Swift FX is a great mask..main minor drawback is that for some people the back strap likes to crawl up the back of the head.
A non issue for me and there are ways to limit the crawl if it does happen.

Check out the Tap Pap...that's what I changed to.....those nasal pillows simply won't move and there is no headgear to crawl.

Hi, I suggest that if you can afford it, get at least one well fitted full face mask (vs just a chinstrap which can still let air out thru lips) for times when e.g. you have a cold with stuffy nose, or your pressure, if high-ish, forces air out through your mouth, etc. whatever other masks you might get... what about also trying a Hybrid (if you're comfortable with nasal pillows but want your mouth covered)?

I and others have found that sizing templates have limitations as facial structure is so varied, so don't go by those alone...

Let us know how things go , and good luck.

Remember to send them a copy of your prescription!

So far ... I still like ResMed's Mirage Quattro full face mask!

With a prescription from Thailand, can cpap.com legally ship equipment
to the US?

jdm2857 wrote:With a prescription from Thailand, can cpap.com legally ship equipment
to the US?

The Prescription FAQ includes this:

Will you accept a prescription from a doctor in my country?

Yes. If you have a valid international prescription we will ship your order to any US state except Texas, or to your country of residence, on receipt of the prescription. If it is not written in English the entire prescription must be translated into English on the original document.

Fortunately I am not travelling to Texas. I don't know the legal reasoning behind this, but presumably cpap.com have done their legal homework.

I have a variety of masks myself:

Swift FX
Mirage Swift II
Mirage Activa LT
Mirage SoftGel
Mirage Quattro FFM

For me, the Swift II stays in place better than the FX. From my brief experience hose management is more important with pillows as the added weight of the hose can easily contribute to leaks. Also find some Lansinoh if your nose is a little sensitive.

For me the Activa LT works the best. It seals even with my facial hair and stays put when I move around. The only leaks I notice are during REM which is common IIRC.

So I would suggest a safe bet would be either the Swift FX or Swift II, Activa LT, and the Quattro FFM for when nothing else works..

I haven't tried the new Quattro air yet so I can't comment on that one.

Controlling leaks are much more difficult with full face masks but sometimes there's no other option. You may want to look at the pad-a-cheek anti-leak strap if you go with the Quattro.

I personally don't use a chin strap, but I'm sure it would help on occasion.. I also use the heated tubing and make sure to keep a spare as well as a spare humidifier chamber and extra filters.

I have received a mask and a machine from Cap.com. I live in Texas.

Thanks for the helpful replies. It's nice to come across a web board where everybody is so pleasant and supportive.

I am going to be in the US for a fortnight, and cpap.com offers return insurance for masks -- even for free on some of the models I'm interested in. So I decided to buy a larger selection and hope that within the fortnight it will become clear which I should keep (and possibly buy parts for) and which I should return.

I ended up ordering the following:

Nasal: Mirage FX, Mirage SoftGel/Activa LT Combo
Pillow: Swift FX, TAP PAP
Full face: Quattro Air, Mirage Quattro

I'm guess I'm still missing a hybrid, but hopefully I should be able to make things work with some of those I've ordered.

Any suggestions for which order I should try them in? The big question in my mind is whether I will be able to avoid mouth breathing. I bought a selection of chinstraps to help with this.

I am sure I will have many more questions next week when I get to the US and start using them.