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I lay down first. Then I put on the mask liner. I then smooth it out to remove any wrinkles. THEN I put the mask in place. That way I don't need to tug on the mask liners. Whenever I do that, it seems to cause the mask to leak like a sieve. As a result, I end up having to do it all over from the beginning.

Hope that helps. It's what I do every night. It works. But it does take time to develop a good process that will work for you.

JohnBFisher wrote:Agreed that major leaks cause problems. But so do the famous face fart leaks .. And an ASV unit will leave you crying in an effort to sleep when it start pushing that pressure over about 15cm H2O .. Leaks happen no matter what you try to do. That's why I recommend mask liners for ASV users. It does not eliminate the leaks but it makes them more tolerable.

Hi John: when you say 'pressure' are you referring to mask pressure? Can you please explain more about mask pressure and what it does and doesn't do for us.

Thanks for all of the suggestions!

I cut out my own mask liner using thicker material than the sample liners I was given. I worked really hard to get it in place so that I would not tug on it to change the locations once on. I made sure to put it on the bridge of my nose first (FX) then flip down to my chin. Took me something like 6-8 times cuz it was too high and then the material was poking me in the eye etc. My leak rate last night was MUCH better and more in line with the previous mask (actually better leak rate wise). Yay!!!! I slept 'ok' too. Not well, just ok. No insomnia like the night before.

Now I'm not sure how to know if I should keep this mask or think about switching back to the first one and use a liner for that one. I've got fairly deep lines on my face all over the side that I slept on even with my cpap pillow. And my eye (the one that is 'down') right eye slept on my right side mostly, is puffy still even tho I didn't have many leaks into my eyes.

I don't consider myself a vain person, but I don't like lines on my face nor do I care for puffy eyes or one eye puffiness. If it is not caused by leaks, what causes the puffiness?

new-to-BiPAP wrote:If it is not caused by leaks, what causes the puffiness?

Most of the time puffiness is related to fluid retention from sleeping position and possibly mask and/or mask strap constriction on the soft tissues. So a combination of things really.
I used to get puffy eyes (especially the lower lid) when I was using the Swift FX mask...especially on the side of my face that was down on the pillow. Combination of gravity and the cheek straps restricting circulation.
I never get it now with my new mask. There is no head gear or straps laying on my cheeks to restrict circulation.

MagsterMile wrote:

JohnBFisher wrote:Agreed that major leaks cause problems. But so do the famous face fart leaks .. And an ASV unit will leave you crying in an effort to sleep when it start pushing that pressure over about 15cm H2O .. Leaks happen no matter what you try to do. That's why I recommend mask liners for ASV users. It does not eliminate the leaks but it makes them more tolerable.

Hi John: when you say 'pressure' are you referring to mask pressure? Can you please explain more about mask pressure and what it does and doesn't do for us.

By pressure I mean the pressure the ASV unit is producing above normal air pressure that should be delivered to your airway via your mask. There can be some variation (due to a long hose, or leaks in the airway). Thus, researchers talk about the pressure at the mask versus from the unit. However, for all intents and purposes, it is the same.

The major difference with ASV therapy is that the pressure jumps pretty quickly and quite dramatically. This helps sustain respiration when we stop breathing during a central apnea. It's not as much pressure as is needed by a full respirator. But it helps enough to break the normal cycles that contributes to central sleep apnea. These frequent changes to address central apneas puts causes more problems with leaks than other xPAP therapies, since it the pressure changes are so dramatic.

Hope that helps.

new-to-BiPAP wrote:… Is a constant leak better than ups and downs? Is below a certain number considered "good" for an ASV machine?…

In a prior thread, I hypothesized why I think it is impossible to have a constant horizontal leak line on ASV and a discussion ensued:

viewtopic/t89387/ASV-Leak-GraphsImpossi ... ontal.html

If you are using ResScan, you will see a red line imposed onto the Leak chart, and staying below that as much as possible is good. And on their Statistics page, you will be able to see whether your 95% Leak rate is at or below the magic "24" number.

But I concur with the advice already given you by the experts here that comfort and sleep is your prime goal.

Regards, Nate

JohnBFisher wrote:

MagsterMile wrote:

JohnBFisher wrote:Agreed that major leaks cause problems. But so do the famous face fart leaks .. And an ASV unit will leave you crying in an effort to sleep when it start pushing that pressure over about 15cm H2O .. Leaks happen no matter what you try to do. That's why I recommend mask liners for ASV users. It does not eliminate the leaks but it makes them more tolerable.

Hi John: when you say 'pressure' are you referring to mask pressure? Can you please explain more about mask pressure and what it does and doesn't do for us.

By pressure I mean the pressure the ASV unit is producing above normal air pressure that should be delivered to your airway via your mask. There can be some variation (due to a long hose, or leaks in the airway). Thus, researchers talk about the pressure at the mask versus from the unit. However, for all intents and purposes, it is the same.

The major difference with ASV therapy is that the pressure jumps pretty quickly and quite dramatically. This helps sustain respiration when we stop breathing during a central apnea. It's not as much pressure as is needed by a full respirator. But it helps enough to break the normal cycles that contributes to central sleep apnea. These frequent changes to address central apneas puts causes more problems with leaks than other xPAP therapies, since it the pressure changes are so dramatic.

Hope that helps.

Wow! Thanks for the info. It really helps a lot. I reviewed my 'pressure' from last night and everything is less than 15.0. I will seriously consider the mask liners now based on your recommendation.

Having trouble with Remzzs liners. I tried a single one and got a lot of leaks and felt terrible the next morning. So I tried 2 Remzzs liners and it is better, but I still have leaks and feel groggy this morning. If I make my own out of thicker material the leak is better. But the insurance will pay for the remzzs on the months that I don't get a new mask and it is difficult for me to make my own. The Sleep tech suggested the Pad-a-cheek kind of reusable ones but they don't have one out for the Quattro Air yet, plus I was hoping to be able to try it at my sleep study to see if it works first, but that is next week. So, for now I will have to make my own, I suppose. Last night I even tried the gecko pad with the 2 Remzzs and I still got leaks (better, but still, a constant low level leak for 2 hours). I suspect I get more leaks when I roll onto my back when I fall asleep. But I have medical issues that make putting a tennis ball in a backpacked of a shirt not very advisable to try and get to not roll on my back. Might have to try putting a bunch of pillows behind me to see if that helps. Not sure what else to try.

Off to make some new liners.

new-to-BiPAP wrote:The Sleep tech suggested the Pad-a-cheek kind of reusable ones but they don't have one out for the Quattro Air yet, plus I was hoping to be able to try it at my sleep study to see if it works first, but that is next week.

Send Karen at Padacheeks a note and ask about the liner for the new Quattro Air. I think she has been making them on an individual basis for now but just hasn't got it up to full production and available on her website just yet.

Thanks, I'll do that!