Fed up with Mirage Liberty at high pressure

Just to preface this post, I'd like to provide a little information from one of my previous posts. This issue is sufficiently different that I thought I'd break it out of that post.
I got a new machine (Resmed VPAP ST with IPAP: 16, EPAP: 12; this is moving from a Resmed Autoset at 8-12). I also got my new Mirage Liberty at the same time. With the increased pressure, I have some issues. If you'd like to read my previous post, here's the link: viewtopic/t95001/ASV-hybrid-mask-leaks- ... ssure.html

Anyway, on to my issue....

Well, I threw my Liberty across the room in frustration last night. I went back to my Swift FX. The reason I went with the liberty to begin with is because air escapes through my lips at night (not a mouth breather; taping/polygrip issue was dealt with in previous posts; regardless, it didn't work for me). It was SOOOO much quieter than the Liberty. I just cannot get the Liberty to seal properly. Even when I tighten it all the way down (bad, I know, but that's the only way I can get it to work at even 60% efficiency), it still leaks like a sieve. But, even with the leaks I have on the Liberty (when it's tightened all the way), they're much lower than I get on the Swift FX (due to air escaping through my lips).

I think the main reason that the Liberty doesn't work for me is because the distance between my upper lip and my nose is fairly small. This causes the top of the mouth piece to be really close to my nose. Since the pillows stick out so far from the mask, they have to be bent just to get into my nostrils. Most of the leaks, however, come from the mouth piece. Especially at the top, right behind the pillows. This has me thinking that if the pillows could be adjusted downward, that might help with the leaks.

This got me thinking about the Innomed hybrid. This thing has 3 sizes each in pillows and the mouth piece. The pillows are also able to be adjusted downward.

Anyone have any similar experience with the Liberty or the Innomed hybrid?

The Liberty didn't fit me either. But the Hybrid works beautifully. And the chin cup keeps my mouth firmly shut.

You don't have any problems with the pressures that you're using?

I have used the Innomed Hybrid for several years. I do mouth breathe at times during the night. Using an auto setting, my pressures range as high as 16 to 20 cm for much of the night. My leak rate is consistently under control.

There is a guy that posted excellent instructions on the forum about how to use the Innomed Hybrid. I lost the link to it but maybe someone else remembers where it is. (I use the ladies tights fix he has in the instructions.)

Thanks for the info. I really don't have a problem with the pillows, other than how they're bent at an angle. Last night was actually the first time that the pillows came loose. That was the last straw. That's when the mask went flying across the room. Luckily, it's still all intact.

I had a Liberty first, then the Hybrid. I couldn't get the Liberty to seal at all. My efforts to make it work gave me TMJ. With the Hybrid, I had problems with the angle of the pillows causing them to stick out too far. It was an easy fix for me and has kept me in the hybrid ever since. I purchased a package of ordinary headbands from the grocery store. They're about 2 inches wide. After I mask up, I put the headband over the pillows. The bottom of the headband rests at the top of the mask (above the vent holes) and the top of the headband curves slightly over the tip of my nose. No extra pressure, but tons of stability. The pillows have never popped out since I donned the headband. BTW, the Hybrid pillows allow you to adjust their height, so you may find the shorter position of the pillows to your liking.

digitalepiphany wrote:I think the main reason that the Liberty doesn't work for me is because the distance between my upper lip and my nose is fairly small. This causes the top of the mouth piece to be really close to my nose. Since the pillows stick out so far from the mask, they have to be bent just to get into my nostrils. Most of the leaks, however, come from the mouth piece. Especially at the top, right behind the pillows. This has me thinking that if the pillows could be adjusted downward, that might help with the leaks.

This got me thinking about the Innomed hybrid. This thing has 3 sizes each in pillows and the mouth piece. The pillows are also able to be adjusted downward.

I would definitely try the Innomed Hybrid in your shoes. It didn't work for me, but I know it works for a lot of people, and I since you can adjust the pillow height, it sounds like it would be a good match for you.

I've never had the pillows pop out on my Mirage Liberty, I've only had leaks around the mouth. So if you're having the trouble you describe, definitely give the Innomed a shot.

I tried the Liberty again last night. No problem with the pillows, but it still leaked way too much on the mouth part behind the pillows. So, I went back to my Swift FX and taped my mouth. The tape didn't last long with my pressures.

I'm gonna try it again tonight using a slightly different order (from the instruction booklet) of putting the mask on. If that doesn't work, I'm going to try the saran wrap trick I found buried in the search results. I'll post it up as soon as I can find it.

Thanks to everyone for your help.

By the way, can you keep your mouth closed when using the hybrid? I've noticed that the Liberty forces your mouth open. Well, it does mine, at least.

I couldn't get it to seal properly again. I tried it out until 4:30 this morning, but I was awake the entire time. About 20 minutes ago, I tried the saran wrap trick. Worked like a charm. It's even quieter than using it normally. I can't wait to go to bed tonight.

I'm still going to see if my DME can get me the Innomed hybrid. I look at the saran wrap trick as a nothing more than a temporary patch. I'd rather have something that works right out of the box.

I've noticed that the Liberty forces your mouth open. Well, it does mine, at least.

Wow! You don't want that. Are you sure you have the mask sized and adjusted properly?

I use the original Innomed Hybrid (ResMed Liberty is a followup copy with some features missing to avoid patent problems) and breathe with my mouth closed until I hit REM.

The curve on the mouthpiece of the Innomed mask is different than the Liberty. It might fit your face better and avoid leaks. I don't think there is any way to find out except trying it.

When you get a mask to work for you, I think you will be very happy with CPAP. I am. Happy and alive!

If I seat the mask the way it's supposed to be seated (according to the instructions), my mouth is open. According to the sizing chart they provided, I'm supposed to be using the large, so who knows?

I put a call in to my DME, so I'll see what he says about the Innomed when I get a call back. Could be a day or so. If I can't get it through them (the VA), then I'll just have to stick with saran wrap and the Liberty.

I've been on CPAP since August, and I'm still waiting to see an improvement. Hopefully, it'll be sooner rather than later.

The Liberty seems to actually fit a smaller range of faces than the original Hybrid.

digitalepiphany wrote:If I seat the mask the way it's supposed to be seated (according to the instructions), my mouth is open. According to the sizing chart they provided, I'm supposed to be using the large, so who knows?

No, your mouth should be closed. But if your chin-to-nose distance is fairly small (as you say your upper-lip-to-nose distance is), it may be that the mouth cushion is too big for you. Or maybe it's just getting pushed down by the pillow height and you're dropping your jaw so that the bottom of the mouth cushion fits?

I have the large, and the cushion is just around the outside of my lips with my mouth closed. It's also flexible enough that if my jaw drops a little, it generally follows (with a fresh cushion...after a month the cushion is too rigid and leaks).

How old are your cushion & pillows?

If the saran wrap worked, try the mask liner as well.

digitalepiphany wrote:If I seat the mask the way it's supposed to be seated (according to the instructions), my mouth is open. According to the sizing chart they provided, I'm supposed to be using the large, so who knows?

Nice that the Innomed Hybrid comes with all three sizes of mouthpiece and three sizes of nasal pillows. Easy to experiment and get the right size.

The Innomed is a lot cheaper than ResMed's knockoff.