View source for Hybrid Mask Modifications

[[Image:Ladiestightsexamples.jpg|right|thumb|300px|Use a bit of ingenuity to improve your treatment<br><br><br>]]

by Rooster 

Hybrid Mask Adjustments: Just One Man’s Opinion at One Point in Time 

(updated 12/28/2006)

If you are a mouth-breather or mouth-leaker and don’t like mouth taping or chin straps or traditional full face masks, then the Hybrid mask may be the solution for you.

Three critical things to do: watch the manufacturer’s video, watch the manufacturer’s video and watch the manufacturer’s video.

I am 95% convinced that the Hybrid will fit most people and provide appropriate therapy if you can get the right combination of:

• Chin flap or no chin flap. I cut the chin flap off. The rest of the discussion assumes the chin flap has been removed.

• Mask size. In my case the large appeared to be the correct size. After some trial and error, I finally got the medium to work. It is barely wide enough to cover the corners of my mouth but it works and is not uncomfortable.

• Pillow size. The medium pillows “appear” to be the correct size and some trial and error confirmed that they are.

• Pillow height. Pillow height depends on the mask size and the distance between the top of the mask when it is in place and the nose openings. Select a pillow height that will provide a snug fit to the outside of the nostrils. When in place between the outside of the nostrils and the top of the mask, the pillows should be compressed about 50% of their normal height.

• Top strap of headgear. This strap should be adjusted fairly loose. It is to provide some upward stability to the headgear.

• Top side straps. These straps provide stability of the mask on the upper lip and pull the pillows against the nostrils. They should be adjusted evenly on each side to assure the mask is centered on the face. The top side straps are critical to preventing leaks between the pillows and the nostrils. They should be adjusted snugly.

• Bottom side straps. These should be adjusted snugly to provide stability of the mask on the chin. They should be adjusted evenly on each side to assure the mask is centered on the face.

Adjust the headgear in this order:

• Place your xpap on a counter with a mirror.

• Place the pillows in the mask and twist them into the openings so that they align well with your nostrils.

• Place the mask (with pillows already attached) into the hard shell. Make sure the rim of the mask is inserted completely into the groove all the way around the shell.

• Attach the top side straps to the shell.

• Slide the headgear onto your head and place the mask on your face in a position that appears to be leak-free and comfortable.

• Attach the bottom side straps to the shell.

• Make sure the mask is centered on your face. As noted above each set of side straps should be adjusted evenly on each side of your face.

• Check that the pillows create a seal with the nostrils that appears secure. Use thumb and forefinger to adjust each pillow into the opening of the nostril.

• When everything looks and feel “right”, turn on the xpap machine to the maximum pressure you will be using. Check for leaks. You can place your two index fingers over the exhaust ports and listen for leaks elsewhere in the mask. Don’t do this too long because you aren’t breathing fresh air when the exhaust ports are blocked.

• The pillows should not be separated (cut apart) unless you have two very different sizes of nostrils. I know many patients cut the connector between the nasal pillows. Personally I think this is a mistake. I find the connector adds considerable stability to the pillows, particularly preventing them from flaring out to the sides of the face. The pillow openings are not round; they are oblong so you may need some adjustment (reorientation) to align the axes of the oblong openings with the axes of the nose openings. Place the pillows in the mask and twist them into the openings so that they align well with your nostrils. In my case the pillows both need to be twisted slightly inward so that when adjusted the connector is no longer straight but forms a slight arch out toward the mask shell.

• If you get the adjustments right, there should be no need for dental floss or rubber bands to hold the pillows.

• When you arise in the morning only unclip the bottom side straps. Leave the rest of the headgear as is.

• I remove the mask from the shell one morning per week and wash it briefly in warm soapy water. Rinse well and leave it in a safe place to air dry during the day.

It took me about five nights to get an adjustment that works very well. I find that the headgear needs readjusting every few weeks. I am not sure if this is because the headgear is stretching or the velco slips slightly.

I have used the Hybrid Mask 3 months and 16 days. It is trouble free most of the time. For the litmus test, I am beginning to feel better and have had some wonderful dreams most nights for about two months. It has been ten or more years since I had dreams like this.

Don’t forget three more things: watch the manufacturer’s video, watch the manufacturer’s video and watch the manufacturer’s video. Call their customer service number if things don’t work well for you immediately.

Good luck.

Update 1/17/2008: I have been using the Hybrid about 18 months now. Occasionally I would get a leak from a nasal pillow getting pushed out of my nostril when I rolled around in bed. About a month ago, I took a leg out of a lady's pair of tights and tied it in a circle. 

I place the tights leg on my head after the mask goes on, positioning it under my ears. I pull the tights over the nasal pillows. This works great and the nasal pillows never pop out. I also don't even notice the tights on my face.


Did I mention that a pair of Pad A Cheeks helps with comfort? I wouldn't be without them.

[viewtopic.php?f=1&t=36928&p=322402#p322402 Link showing ladies tights fix]