Mask suggestions for a friend

[Lifeisabeach]

Howdy all. I have a friend who is having trouble acclimating to her CPAP machine and am looking for thoughts on masks she should be looking at. She currently uses a Respironics DreamWear. Her problem indicated to me is that she wakes up every hour when using the CPAP. Says her mouth fills up with air and "mouth glued shut with dryness". Machine is an AirSense 10; pressure set to 9; and she says the problems persist with or without humidity. Any thoughts on what she should be using? A full face mask seems obvious, but she's open to suggestions.

[loggerhead12]

Really dry mouth can be an indication that the air is leaking out her mouth. It still happens to me. Do some searches and read up on mouth taping and chinstraps to keep your mouth closed. I had good luck with a chinstrap for a couple of years. Then one night I forgot to put it on and figured out that I didn't need it any more. I guess my mouth learned to stay closed.

Posting Oscar charts would go a long way to confirming the mouth leaks.

[CaptainRaven40]

That is tough. Masks are very personal and work for everyone differently. Like me I used to use a P10 with a chinstrap with great luck. As I have gotten a little older the chinstrap stopped working for me due to asthma issues so I had to move over to a full face mask. I now use the F30i and love it. However, there are people that don't love the F30i. The mask is just something you have to try and try until you find what works. Sorry I couldn't be of much help. I am sure others will be along that know way more than me that can be of more help. Good luck to your friend!

[Lifeisabeach]

Thanks. Yeah, a chinstrap was a thought, though I doubt she'd use it since she hadn't taken to even using the machine until encouraged by my experiences. I've been fortunate to never need to use a chinstrap myself. I do know of some neck braces someone posted about some months ago here, that may be a good option.

Cap, she has severe asthma also, so if that plays a factor in chinstrap effectiveness, then it sounds like a full face mask is the way to go.

I don't think she's able to do OSCAR charts herself. I'll start with trying to help her pick a mask, but it may be some time before I'll be able to get her SD card to post charts for her. Thanx for the insights.

EDIT: quick update. She sent me her MyAir data for last night, which is something. AHI 1.7 and a high mask leak rate of 31 L/min. Based on that, would that indicate just a seal issue with the mask, or possibly her mouth opening up also?

[CaptainRaven40]

Thanks. Yeah, a chinstrap was a thought, though I doubt she'd use it since she hadn't taken to even using the machine until encouraged by my experiences. I've been fortunate to never need to use a chinstrap myself. I do know of some neck braces someone posted about some months ago here, that may be a good option.

Cap, she has severe asthma also, so if that plays a factor in chinstrap effectiveness, then it sounds like a full face mask is the way to go.

I don't think she's able to do OSCAR charts herself. I'll start with trying to help her pick a mask, but it may be some time before I'll be able to get her SD card to post charts for her. Thanx for the insights.

EDIT: quick update. She sent me her MyAir data for last night, which is something. AHI 1.7 and a high mask leak rate of 31 L/min. Based on that, would that indicate just a seal issue with the mask, or possibly her mouth opening up also?

It is hard to say for sure. I know last night my leak rate was higher at around 35. It was from leaks for me though. Something I am battling right now with a full beard. It could be an issue with both. It is hard to tell just off of the number. Someone would be able to tell you a lot more if we had some Oscar data to look at. However, I am sure someone with more knowledge than myself will be along and be able to help you a little more.

[Pugsy]

MyAir data for last night, which is something. AHI 1.7 and a high mask leak rate of 31 L/min. Based on that, would that indicate just a seal issue with the mask, or possibly her mouth opening up also?

First you have to understand what the 31 L/min leak number represents. The machine and MyAir reports what is called a 95% number and all that mean is the person was at OR BELOW that number for 95% of the night. It is NOT an overall average number. It can seem high based on relatively short period of time at the higher leak numbers.
The leak can be either mouth opening/breathing leak and it can also be simply mask movement leak.
31 L/min 95% number is still within the machine's ability to compensate fairly decently any leak over the line in the sand of 24 L/min that ResMed gives us. There's no way to know for sure if the leak is mouth breathing or mask movement without for sure limiting the chance of mouth opening (taping the lips shut and have the tape not come loose) and then evaluating the leak graph/numbers.
With the history of extreme dry mouth it is entirely possible there is significant mouth breathing going on but it doesn't always take massive mouth breathing for prolonged periods of time to dry the mouth out to points of it being so annoying. I can get really bad dry mouth from as little as 10 or 15 minutes of very minor mouth breathing.

Here's an experience of mine some time ago where I had a 95% number of 48 L/min. Sounds horrible doesn't it but you have to look at the actual leak graph to see that while I had some significant leaks happen....they really weren't present for the bulk of the night.
viewtopic.php?f=1&t=108724&p=1036669&hi ... t#p1036669

It's critical that people look at the actual leak graphs when they evaluate 95% leak numbers that might be iffy.
A bad one hour leak that is really large....yeah, it's bad but there is often other parts of the night where the leak isn't so bad. So overall the therapy isn't in the toilet as much as we might think.

[peke]

Has she tried Res-Med's P10 pillows FOR HER or P10 full face mask FOR HER? They are smaller in mask size and in headgear size. I think they have a new N10 For Her. The FOR HER versions made a huge difference to me. The headgear stretch out quickly so keep the 2 plastic clips they provide. Easy to lose them.

A pony tail helps keep the masks on. Or putting the lower headgear band below your hair helps a little. Most of the masks slip and slide on long hair which causes leaks. Chin straps help, but I didnt need to wear mine for long because I got used to keeping my mouth shut. Every once in a while, my mouth fills with air, but not often.

Use nasal gel to moisten nares if using pillows. I also use a very firm sculpted pillow which is for people who need better neck support. It will not squash flat. If I dont have my pillow at a hotel, I get air leaks.

[cyberdreamer]

I've been trying the Resmed F30 for the past four days and it apparently has eliminated my dry mouth! Need more time to tell but I feel it's easier to keep my mouth shut with it than previous nasal mask (swift fx nano) where I had horrendous mouth leaks.

[nicholasjh1]

I had similar issues and a chin strap never worked for me. 2 things worked, 1. taping, 2. some kind of full face mask. Right now I'm using the one that sits under your nose and just covers your mouth with 2 holes on the top for the nose (considered hybrid). Working pretty well, but I have to strap it pretty tight to get the edges of the mouth part not to leak due to my face architecture (long mouth compared to the slope of my mouth). I still breathe through my nose, but the pressure outside my mouth takes care of pressure differential, so air no longer tries to escape out of my mouth.

There are other solutions, that's just my experience. I did nasal for the longest time, just switched to full face because of some pressure sores from the nasal mask, and now back to hybrid. I think I sleep better with the mouth pressure even with tape in consideration, because even with the tape I think it still disturbed my sleep some just not as much.

[bwexler]

I have been trying different masks for 10 years.
I have used at least 15 or 20 different masks.
I have a few favorites.

Having now become now expert in masks, I am sure there is no such thing as a perfect mask.