Leaks Leaks Leaks! Is There Any Hope?

I'm looking for some more suggestions for leak-free FF-mask usage with ASV. Folks here have offered some advice which has helped some, but it's just not enough yet.

I've moved to a FF-mask with S9 VPAP Adapt ASV due to problems with chronic nasal congestion. It is terrific but for one thing - the leaks! I was using S9 APAP with pressures of 7.5 to 12 and a nasal mask before. When I could breathe freely (less than half the time) all night through my nose, that worked really well - AHI of like .8 on average.

I've moved to the ASV with FF mask after a titration in January, and the pressures are much higher - can max out at 25. At those higher pressures, none of the FF masks I have tried (Quattro, Amara, Fisher-Paykel FlexiFit) can withstand the higher pressures without leaking like crazy. Though SleepyHead reports pretty decent AHIs around 5.0, I wake up 15 or 20 times during the night due to the "face-farts" and thin streams of air blowing into my eyes, etc.

Based on the suggestions I've gotten here, I purchased the Pad-a-Cheeks mask liner and anti-leak strap. That has helped for sure. I'm having issues with the strap staying high enough on my head, but Karen has kindly offered to tailor it for me with more velcro to help secure it. I'm hoping that will help a little more.

But I'm really thinking I need more of a "nuclear" option - possibly a FF mask that has been specifically designed to withstand high pressures. Does anyone have any knowledge that might help?

I truly believe this is the "final frontier" for me - that if I can solve this leak problem, I will finally, after 14 years on PAP, be able to reliably use PAP therapy all night every night.

Thanks!

Ken

I got higher pressures than most here and the Quattro FFM with pad a cheek liners work awesome for me...

Have you read the "taming the Mirage Quattro" blog yet?

http://maskarrayed.wordpress.com/taming ... e-quattro/

it has numerous tips for solving leaks that work with all FFM's

Dave

I assume the leaks are waking you up often???
If they are then of course they need to be prevented.
If you are sleeping right through them...just how bad are they?

Ken, you might want to try the F&P Simplus. Like you, leaks disturb my sleep and I've yet to find a mask that didn't leak, and I've tried a bunch.
Typically, my leaks are less than 24 L/m and my AHI is low, but even small leaks tend to wake me. Up until the Simplus, my go to mask was the Mirage Quattro. Now, my preferred mask is the Simplus. The Simplus will leak, but generally not as much as the Quattro and it is not as noisy. Sometimes, I will be aware of the Simplus leaking around my cheeks, but it's not squealing and it rarely leaks into my eyes. Additionally, to me, the Simplus just feels more comfortable than the Mirage Quattro. I do find the Simplus headgear seems warm and I've been using the Quattro Air headgear in its stead (I could not tame the leaks of the Quattro Air).
The Simplus is relatively inexpensive and a lot of folks like it, but of course, that doesn't mean it will work for you. My pressure is a lot lower than yours as well. So, who knows? But, I think the Simplus is worthy of your consideration.

Just trying to understand something:

You say:

KenTheriot wrote:I was using S9 APAP with pressures of 7.5 to 12 and a nasal mask before. When I could breathe freely (less than half the time) all night through my nose, that worked really well - AHI of like .8 on average. (emphasis added)

and

I've moved to the ASV with FF mask after a titration in January, and the pressures are much higher - can max out at 25. At those higher pressures, none of the FF masks I have tried (Quattro, Amara, Fisher-Paykel FlexiFit) can withstand the higher pressures without leaking like crazy. Though SleepyHead reports pretty decent AHIs around 5.0, I wake up 15 or 20 times during the night due to the "face-farts" and thin streams of air blowing into my eyes, etc. (emphasis added)

Why were you moved from the S9 APAP to an ASV machine????

Was any attempt made at trying to address the nasal breathing problem by using a FFM with the S9 APAP at the original lower pressures???? If so, what were the results? If not, why not??

Ken:

First of all, best of fortunes. I have a Quattro FX - the best of many I tried in the initial stages of using CPAP - and have learned how to succeed and thrive with it after an awful first few weeks in early 2013.

I was a lousy sleeper my entire adult life and began CPAP. Right off the bat, I had many problems and frustrated as hell but have found nocturnal bliss as I adapted to the gear and the way it works.I've got a simple program that did wonders for my adaptation to assisted sleep. Here it is:

This is the four-step program I devised. I had a tremendous sleep study at the local hospital but ran into a granite roadblock as I attempted to get accustomed to masks on my own. You might want to give this a try:

My main advice is to back away from immediately trying to do all-nighters with your full-face equipment. Use my four-step weekly plan which has worked wonderfully for me:

1) During the first week sit, watch TV, or read with your equipment whirring away next to you. Get accustomed to the sounds, feelings of the moving air, and all the external trappings of the great chance at quality sleep you are nearing. Do NOT go to bed with the equipment.

2) Take the phone off the hook, draw the shades, evict everyone from the house, don't think about any nearby clock, and loosen your clothing as you lie on your bed in mid-afternoon. Turn on the CPAP gizmo, put the mask on your face, and close your eyes. Think peaceful thoughts, whatever they are to you. At some point in the week you WILL fall asleep. After you have this nap, you'll be amazed at what a refreshing experience it was.

3) During the third week have all your CPAP gear ready for action as you go to bed for the night. As you've done so many times throughout the years, you'll awaken far before morning. When you do, slap the mask on your face and turn on the CPAP gear before your groggy brain has any idea what's going on.

4) After successfully completing the first three steps at your pace, decide on a night (mine was March 3rd, 2013) when you have full confidence and will retire for the night WITH your mask on. You'll succeed!

My biggest mistake was expecting everything to go perfectly from the first night. It rarely occurs because the brain must be retrained after all those years of awakening in the middle of the night. One must be patient and keep anxiety as far away as possible. On March 3rd, I had a goofy sort of celebration to mark one year of refreshing sleep I never had - over four decades - before last year.

By the way, I went to bed at 11:00 a few weeks ago and awakened non-stop at - ready for this? - 7:00 the next morning. For DECADES a sleep of that sort was only a dream; now it's a reality.

Be patient, best of luck and God bless

I wish I was in a position to give you "the answer" to your question. I run bi-level 19/21 the two biggest challenges BY FAR have been mask leaks and a sore nose bridge. I have a drawer with 8 assorted full face masks, an Amara with a gel cushion that is working well enough for now, and a SimPlus mask and a Pad-a-Cheek liner on the way for my next things to try.

I will follow this thread with interest though to see if I can pick up any new tricks.

My hubby uses a FFM & has had various leak issues. He just started using the Fit Life mask https://www.cpap.com/productpage/respir ... dgear.html
and he is having nights of NO LEAKS.

I didn't think this was possible but he is on night 7 tonite & so far he only had one small issue with leaks. He started with the Large & had a few leaks into his eye area, so small they weren't reporting. He switched to the medium cushion & has no eye leaks & is reporting no leaks. He is a stomach sleeper, so I am delighted he found something that seals so well. This is not a popular mask, but he saw it and wanted to try it.

He started with the Amara, went to the Quattro Air & this is his 3rd try. Looks like 3rd times the charm for him!

Jen

Denial Dave wrote:I got higher pressures than most here and the Quattro FFM with pad a cheek liners work awesome for me...

Have you read the "taming the Mirage Quattro" blog yet?

http://maskarrayed.wordpress.com/taming ... e-quattro/

it has numerous tips for solving leaks that work with all FFM's

Dave

Yes I have, Dave. I went through all his steps carefully to no avail.

I do have the Pad-a-cheeks liner. It helps some, but does not solve it by any means.

Ken

Hi Ken. I have my settings at 16/22. Much higher settings than most. I have been on bi pap for 3 months and have tried many full face masks. I just got the mirage liberty, and my leaks are way down.
This is a hybrid mask. I was told that I was a mouth breather and I needed a full face mask. I would also recommend the airfit p10. It is a nasal pillow mask, and it worked pretty well also, even at these
high pressures. Hang in there. There are a lot of good people on this forum that can help you.

Thanks Benny.

Ken

Did you ever consider that it might be your bed pillow and not your mask?


Den

.

If you want to try the Fit Life mask I have one. Send it to you if you cover shipping cost. Let me know.

Ken,
I had a huge leak problem when I started cpap in early February, and I tried several mask liners, some I didn't like. The RemZzzzs worked great for me, the noisy 'face farts' from the Quattro Air stopped, and I rarely wake up from leaks, which do exist according to sleepyhead; lately no higher than 45L. I'm sometimes aware of them, but only as silent blips. I didn't want to spend $30/month on them, so I made some out of an old t-shirt. I recently learned that someone in my town uses them, and she discovered that with hand-washing, and then ironing the RemZzzzs so they hold their shape, she can use them over and again. I started doing that; flattened them out on a towel to dry before ironing. It works, and so do the liners that I cut from the t-shirt.

kona0197 wrote:If you want to try the Fit Life mask I have one. Send it to you if you cover shipping cost. Let me know.

Kona. I'm not familiar with that mask. But I'm getting to the point that I'll try anything. I'll PM you. Thanks!