6 masks down, still haven't found anything that works.

Without going into extraneous detail here (it's been covered in previous posts), I have to use a FFM. I've tried both hybrids (for a few weeks each), and those are no-gos.

The FFMs that I've used thus far (other than the hybrids) are the Quattro Air and the F&P Simplus. In fact, I got the Simplus today.

I'll start with the Quattro Air. I've been using this mask for about 5 weeks. Other than the nasal mask I was issued when I was put on CPAP, I try to give each one a fighting chance. I'm now sleeping about 12 hours per night (basically, no different than pre-CPAP). My AHI has more than doubled. Granted, we're only talking from ~0.5 (pre-Air) to ~6, but that's still a significant difference. I also have what seems to be a semi-permanent red ring of irritation that runs from the edge of one side of my lips, up and across the bridge of my nose, and down to the edge of the other side of my lips. I've gone the last 3 nights without this mask (I used my Swift FX, and gotten horrible sleep because of it), and the irritation still has not improved. As far as fit is concerned, I'm pretty sure that the medium that I was given is just too small. My sleep tech used Resmed's Quattro Air fitting guide in his office 6 weeks ago. He said that I was right between the medium and large, so he went with medium. I have had some issues with my mouth coming ever so slightly open, which, because of the fact that it's such a close fit, would invariably cause my lower lip to fall just below the bottom edge of the mask. I'd wake up, close my mouth, reposition the mask, and go back to sleep. As far as I remember, this happens at least twice a night. It could be more, but how would I know? Looking at my data, I do see very large leaks that I can only assume are from this happening. Sometimes they're very brief, other times I'm in the 100L/min range for well over an hour. I'm sure this has led to me sleeping for 12 hours per night. Normally, I'd be willing to try the next size up, but the skin irritation is not something I'm willing to put up with. Call me vain if you will, but I'm 35 and going to college with people half my age. The last thing I need is a ring around my face to further set me apart from everyone else. As far as fitment is concerned, I've followed Resmed's fitting instructions to a T. I have all the straps set at the loosest possible configuration that still prevents leaks. If the irritation is caused by over-tightening, it's only because it would leak otherwise.

I tried the Simplus on (with the machine running) while at my computer about an hour ago (for about 15 minutes). While watching the fitting videos on YouTube. I was given a large. Apparently, I need a medium. But, this mask is not going to work either way. I have never felt claustrophobic or had a difficult time breathing while wearing a mask. This mask makes me feel like I'm slowly suffocating (I was going to say "suffocating to death," but that's kind of redundant, no?). To say that it's very difficult to breathe with this thing is an understatement. I checked everything on it. All vent holes are clear, and the auto-asphyxiation flap (I think that's what it's called) is working properly. I even switched out to the Quattro Air to see if I had a hose or machine problem that just happened to pop up at the same time I tried this mask. I could breathe just fine. I did make sure that the "Mask Type" settings in the machine were set to FFM before proceeding. This was a brand-new mask. At this point, I don't feel comfortable wearing this in bed. If anyone has any ideas to fix the difficult breathing problem, I'll give any idea a shot.

*EDIT (before I even post this damn thing) - this took me a while to write. Lack of sleep tends to do that. For the last 20 minutes or so, I've been wearing the Simplus again. The suffocation feeling has dissipated to at least a semi-tolerable level, but is still more difficult to breathe than it should be. I also adjusted the top straps of the head gear so that the entire mask sits lower on my face. The bridge portion of the cushion now sits more closely to where it's supposed to (it wasn't far off to begin with). This has eliminated most of the leaks at the bridge, but I can still feel the occasional one hit one or the other of my eyes. Of course, this has caused the bottom part of the mask cushion to sit far below where it otherwise should. Namely, almost to the bottom of my chin. This might actually help with my mouth coming open though, as it will allow my entire mouth to actually remain within the confines of the cushion. But, I also have to over-tighten the bottom straps to prevent leaks. I can't see this helping my skin irritation. Bottom line is this: I'll wear the mask tonight. Hopefully it will work. I'm not gonna hold my breath though. This mask will do it for me.

I had a CT scan appointment today at the Amarillo VA, and dropped by my sleep tech's office to see if he had a few minutes. He actually spent about 15 minutes with me. Great guy. He's the only one there and has over 2,500 active patients. Some people at the VA actually do care. Anyway....I wanted him to see the irritation in person, as it looks much worse than I can describe. Bright red. Flaking skin. Even after 3 days of not wearing the damn mask. He doesn't normally have masks on hand, but he did happen to have the Simplus. He didn't even bother using the sizing guide. He just opened up the new package and had me try on the mask. It seemed fine in the office, but with actual air pressure, it just doesn't work. I can get everything to seal properly, except the area around the bridge of my nose. There are two possibilities. One, I just need a smaller mask. Two, the actual construction of the bridge piece just doesn't work with my nose (it's kind of hinged; hard to explain; I can post pics or a video if anyone needs the visual). The problem with the hinge-like bridge construction is that it doesn't move any closer to your face no matter how much you tighten any of the straps. It's kind of independent of any tightening. I assume that this is by design, in order to alleviate pressure on the bridge. All it does for me, though, is cause air to blow into my eyes. I can physically (with my fingers) press it closer to the bridge of my nose and the leaks into my eyes stop. Maybe the smaller size will fix this, maybe it won't. I'm not familiar enough with this mask to make a guess one way or the other.

My sleep tech did ask if I'd ever considered a cloth mask. I told him that I'd seen and heard of them, but never really looked into them, so I told him I would. I'll start that tomorrow.

Does anyone know of any good FFMs that have a chin-support piece like the Hans Rudolph 7600 (or any opinions on this one in particular)? I hate chin straps. Well, I hate the one chin strap I was given. My noggin is a bit large, and the damn thing is really tight with minimal overlap of the velcro (meaning maximum allowable head size has been reached). Besides, it's just too much extra crap to deal with. At this point, I don't care what kind of oversized monstrosity I have to stick on my face (Alien anyone?), so long as I can get a mask that is comfortable and doesn't leak like the Titanic.

If anyone has any suggestions about possible solutions to the problems with the Air or the Simplus, please help. If you have suggestions for other FFMs based on similar experiences with the above masks, please share. If you have other suggestions, such as that I should go to hell for making you read my shitty prose, believe me, I already know I'm going to hell. But tell me anyway. It always livens up a place.

Do you need a FFM because of mouth breathing? Do you also have nasal congestion, especially at night?
Both of those together suggest that an oral mask may help.
Mouth breathing without nasal congestion might mean a cervical collar will help with the leaks.

Read my post (link at the bottom of this post) to see what the issues are for the Oracle 2 oral mask to see if it could help.
Especially pay attention to the comments on fitting the mask and on the use of a cervical collar to help keep your mouth closed at night.

The Oracle is very different and some folks can't tolerate it at all.

digitalepiphany wrote: Two, the actual construction of the bridge piece just doesn't work with my nose (it's kind of hinged; hard to explain; I can post pics or a video if anyone needs the visual). The problem with the hinge-like bridge construction is that it doesn't move any closer to your face no matter how much you tighten any of the straps. It's kind of independent of any tightening. I assume that this is by design, in order to alleviate pressure on the bridge. All it does for me, though, is cause air to blow into my eyes. I can physically (with my fingers) press it closer to the bridge of my nose and the leaks into my eyes stop.

Maybe you would do better with a FFM with a more traditional forehead support---one where the forehead support actually is adjustable. Or maybe the key is to try a FFM that doesn't have a forehead support at all.

I'm sorry, I just couldn't quite make it through your entire post but I did read the part about the Quattro Air. If you'll accept a hint from a fellow Air user, what they don't tell you is that the Air runs about one full size smaller than most, if not all other FFMs. If you normally wear a medium, get a large. And if you're in between as you say you are, you've likely gone the wrong way-get a large! I myself have had the EXACT same problem as you with the bottom of the Air winding up in my mouth. I think the real problem is that I need an extra large, which of course isn't made. In the meantime, I solved the problem by following a diligent protocol of face washing right before bed and a hot water/baby shampoo washing of the seal every morning without fail. These two things evidently help the seal to get traction on my face and prevent the slippage you are experiencing. One night last week I forgot to wash my seal until almost bedtime and there wasn't time for the seal to dry, so I cleaned it thoroughly with a couple of mask wipes. It was a no-go; I "ate the mask" that night for the first time in months since I started the routine.

You might give these things a try.

Good luck!

Masks are really tough because every one is different. I went through 6 different masks also. Mainly, I use the Zzz-Mask Full Face CPAP Mask with Headgear by Probasics.
I like that it does NOT have the forehead support. The other thing I like about it is the price, it is about $100.00 cheaper than the name brand masks.
It seems I always try to make cheaper work. Leaks are minimal with the mask for me so I don't have to constantly adjust it.

Good Luck in your search..

Maybe try the ResMed Ultra Mirage Full Face mask.

Also, you may want to look into a different bed pillow.

And, if you're using a higher humidity setting, you might want to try lower of "Off" (passover). Too much heated humidity could exacerbate the suffocation/claustrophobic feelings.


Den

.

My hubby just began using the Full Life by Philips Respironics. He usually wears a large mask, but the medium fits in this one best. He has used the Amara (first mask), then the Quattro Air, briefly tried the SleepWeaver Anew and all leaked to various degrees. He's been using this just over a week & NO LEAKS! Now before you get excited remember everyone is different, but you might want to give it a try. He had some rubbing at his nose bridge, but I had some Gecko pads & that stopped the rubbing without affecting the seal. Its a funny looking mask but it sure works for him.

JDS74 wrote:Do you need a FFM because of mouth breathing? Do you also have nasal congestion, especially at night?
Both of those together suggest that an oral mask may help.
Mouth breathing without nasal congestion might mean a cervical collar will help with the leaks.

Read my post (link at the bottom of this post) to see what the issues are for the Oracle 2 oral mask to see if it could help.
Especially pay attention to the comments on fitting the mask and on the use of a cervical collar to help keep your mouth closed at night.

The Oracle is very different and some folks can't tolerate it at all.

I mouth-leak. I breathe primarily through my nose, but my mouth tends to come open at times, which causes the mouth leaking. This is why I can't use pillows, unfortunately. The Swift FX has been my favorite mask. Almost completely silent, and very comfortable. And, no marks on my face.

FFM is my only option at this point.

robysue wrote:

digitalepiphany wrote: Two, the actual construction of the bridge piece just doesn't work with my nose (it's kind of hinged; hard to explain; I can post pics or a video if anyone needs the visual). The problem with the hinge-like bridge construction is that it doesn't move any closer to your face no matter how much you tighten any of the straps. It's kind of independent of any tightening. I assume that this is by design, in order to alleviate pressure on the bridge. All it does for me, though, is cause air to blow into my eyes. I can physically (with my fingers) press it closer to the bridge of my nose and the leaks into my eyes stop.

Maybe you would do better with a FFM with a more traditional forehead support---one where the forehead support actually is adjustable. Or maybe the key is to try a FFM that doesn't have a forehead support at all.

The Quattro Air does have an adjustable forehead support. It's not exactly the same as the Quattro Mirage, but it is adjustable.

old dude wrote:I'm sorry, I just couldn't quite make it through your entire post but I did read the part about the Quattro Air. If you'll accept a hint from a fellow Air user, what they don't tell you is that the Air runs about one full size smaller than most, if not all other FFMs. If you normally wear a medium, get a large. And if you're in between as you say you are, you've likely gone the wrong way-get a large! I myself have had the EXACT same problem as you with the bottom of the Air winding up in my mouth. I think the real problem is that I need an extra large, which of course isn't made. In the meantime, I solved the problem by following a diligent protocol of face washing right before bed and a hot water/baby shampoo washing of the seal every morning without fail. These two things evidently help the seal to get traction on my face and prevent the slippage you are experiencing. One night last week I forgot to wash my seal until almost bedtime and there wasn't time for the seal to dry, so I cleaned it thoroughly with a couple of mask wipes. It was a no-go; I "ate the mask" that night for the first time in months since I started the routine.

You might give these things a try.

Good luck!

The general rule of thumb when between sizes is to go with the smaller one, which is why he gave me the medium. The mask isn't slipping upward on my face. In fact, it stays pretty well in place. Instead, my lower lip is dropping below the mask when my mouth comes open. That's how close the fit is. Because of the skin irritation I've experienced with this mask, he decided to try a different one instead of just giving my a large Air.

As far as washing my face and the mask on a daily basis...Not gonna happen. It's not that I wouldn't be willing to, I just know that I wouldn't be able to keep up with it. I'm almost to the point where I can function on a daily basis, much less clean shit on a daily basis. I need something low-maintenance.

Wulfman... wrote:Maybe try the ResMed Ultra Mirage Full Face mask.

Also, you may want to look into a different bed pillow.

And, if you're using a higher humidity setting, you might want to try lower of "Off" (passover). Too much heated humidity could exacerbate the suffocation/claustrophobic feelings.


Den

.

I've tried 3 different pillows, so I don't believe that really has anything to do with it. Granted, that's a small sample size, but I can't exactly try out every pillow known to man.

I have the humidity set at the highest setting, "6." I've tried it at lower settings, and that's a no-go. It's really dry out here in West Texas, so that doesn't really help matters any.

jencat824 wrote:My hubby just began using the Full Life by Philips Respironics. He usually wears a large mask, but the medium fits in this one best. He has used the Amara (first mask), then the Quattro Air, briefly tried the SleepWeaver Anew and all leaked to various degrees. He's been using this just over a week & NO LEAKS! Now before you get excited remember everyone is different, but you might want to give it a try. He had some rubbing at his nose bridge, but I had some Gecko pads & that stopped the rubbing without affecting the seal. Its a funny looking mask but it sure works for him.

I've considered that mask, but I tend to sleep on the side of my face a lot. Even when I go to sleep on my back. I figured that if I was having problems keeping a good seal on these smaller masks, that I'd have a really tough time keeping that one sealed. May I'm wrong though. But, that one is still on my list, even if it is near the bottom.

So, I tried the Simplus last night. After wearing it while typing my original post. It actually worked out quite well. Once in bed, it got easier and easier to breathe with it. It's also very quite. In fact, it's the quietest mask I've used, other than the Swift FX.

My AHI was 1.24, and my leaks maxed out around 13 (for a very short period of time). It's difficult to see what the max leaks were accurately (so, 13 is my best guess), because there's a huge spike (~130) at the beginning where I was trying to fit it properly while lying in bed. I really wish SleepyHead would let us delete certain time periods from out data, even if only temporarily, so that we could more accurately view it.

I still slept for an inordinately long period of time, 16 hours and 26 minutes to be exact. I'm sure there's something else going on here, but I have no idea what. Looking back through my data, before the Air and Simplus (when I was using the hybrids), I was sleeping for about 7.5 hours per night. I had lots of leaks with those masks, and they've improved with the Air. So, I'm not sure if the leaks were just so bad that I couldn't comfortably stay asleep, or if something else entirely is going on.

The Simplus is too big. I'm sure I need the medium. But, I also didn't wake up with the bottom part of the cushion in my mouth (which is why he went with the larger size to begin with). I'm sure my mouth opened at some point in the night, but the fact that the mask is large enough, and sat low enough on my chin, my opening mouth never completely broke the seal. So, it's either go with the smaller one (I might run into the opening mouth issue again), or stay with the larger one and deal with having to over-tighten it.

This is the main reason I was looking at masks with chin support. Does anyone know of any good FFMs with chin support? Other than the Hans Rudolph I mentioned in my first post? Or, if anyone has any opinions or experiences with the Hans Rudolph mask, it'd be good to hear about those as well. I can't really find anything in searches.

Also, price isn't an issue here (with masks, that is). My sleep tech at the VA can get me any mask I need. Now, that doesn't mean I'm going to intentionally waste their money, but that does mean that I can try a mask that may be considered too expensive by most (they're all expensive to me). On the other hand, I don't have the money to buy mask liners and such. The VA won't pay for anything other than machines, masks, and supplies specifically for those. Liners, pillows, hose-management systems, etc. are not covered, and I cannot afford any of that on my own.

digitalepiphany wrote:The Simplus is too big. I'm sure I need the medium. But, I also didn't wake up with the bottom part of the cushion in my mouth (which is why he went with the larger size to begin with). I'm sure my mouth opened at some point in the night, but the fact that the mask is large enough, and sat low enough on my chin, my opening mouth never completely broke the seal. So, it's either go with the smaller one (I might run into the opening mouth issue again), or stay with the larger one and deal with having to over-tighten it.

One nice feature of the Simplus is all the cushions fit the frame. If you want to try the medium you only need to get a medium cushion which runs $40 on cpap.com and swap it.

digitalepiphany wrote:Does anyone know of any good FFMs with chin support? Other than the Hans Rudolph I mentioned in my first post?

Good? I'm not going to endorse either of these, but the F&P Forma has a small chin cup built into the cushion and the FullLife has a chin strap as part of the headgear.

Wulfman... wrote:Maybe try the ResMed Ultra Mirage Full Face mask..

This is what I use and I like the adjustable support on the forehead. It can be adjusted to not be used at all.

I have a beard and it seals very well. I measured my own face and ordered the large mask about four years ago.

I sleep with my mouth open and I really like this mask.