Tried 5 masks, still cannot get good fit, am I doing anything wrong?

[brianz]

Hi

I've been trying to get into CPAP for my mild sleep apnea. I got a Philips Dreamstation APAP machine. And I'm having tremendous difficulty getting a good mask fit. I've tried the following:

Resmed Airfit P10 (mouth opens during sleep)
ResMed F20 (seal repeatedly breaks at the bottom left/right of the face in the middle of the night)
F&P Vitera (solid fit, but causes tremendous nose itching)
Philips Amara view (largely the same as the F20 above)
Philips Amara full face mask (both nose and lower face breaches even easier)

These masks fit fine during the day when I wear it lying down to try to get used to them. But all sorts of issues crop up during the night. The leaking air prevents me from falling asleep, and wakes me up in the middle of the night because of dry mouth or something.

The main issue seems to be my jaw drops in the middle of the night because I've been a mouth breather, and this breaks the seal. I have a small nose, which requires a small mask, but I probably need a medium size to prevent leakage at the bottom, but then the nose won't have a good seal.

I'm happy to keep trying, I'm wondering is this normal to have so many masks not fit me. Any suggestions on what to do? Should I try to ignore the leaks? Keep trying until something fits? Am I not wearing the masks right? Something else?

Thank you

[Pugsy]

I have always said that finding the right mask is the hardest part to this cpap therapy.

How bad are the leaks? Are they waking you up?

I don't worry about big leaks if they are random, brief and don't wake me up. My sleep quality is more important than a leak score.

Now some people do use one of those foam cervical collars to help support the jaw to help reduce the mouth/jaw from dropping open and breaking the seal with full face masks. You might look at adding one of those and see if it helps or not.

Are you using software to evaluate just how bad your leaks are or are you just using a score on the machine's LCD screen?

If you don't know about the software available
OSCAR https://www.sleepfiles.com/OSCAR/
http://www.apneaboard.com/wiki/index.ph ... stallation
http://www.apneaboard.com/wiki/index.ph ... rpretation

[chunkyfrog]

Not really.
FEW people were given the right mask first.
Dealers like to make money--some by selling masks that they "should know" will not fit.
I tried over 20 masks before finding the right one.
Hang in there.
I survived the first few months by alternating masks,
which let my skin heal between bad choices.

[brianz]

I have always said that finding the right mask is the hardest part to this cpap therapy.

How bad are the leaks? Are they waking you up?

I don't worry about big leaks if they are random, brief and don't wake me up. My sleep quality is more important than a leak score.

Now some people do use one of those foam cervical collars to help support the jaw to help reduce the mouth/jaw from dropping open and breaking the seal with full face masks. You might look at adding one of those and see if it helps or not.

Are you using software to evaluate just how bad your leaks are or are you just using a score on the machine's LCD screen?

If you don't know about the software available
OSCAR https://www.sleepfiles.com/OSCAR/
http://www.apneaboard.com/wiki/index.ph ... stallation
http://www.apneaboard.com/wiki/index.ph ... rpretation

The leaks are bad. I'm not judging by software because it keeps waking me up, and it takes forever to fall asleep (1-2 hours). The worst are the times when I wake up in the middle of the night and I still can't fall asleep after 2-3 hours. I just need it to not wake me up in the middle of the night, and allow me to fall asleep in a reasonable time, say under 1 hour.

[brianz]

Not really.
FEW people were given the right mask first.
Dealers like to make money--some by selling masks that they "should know" will not fit.
I tried over 20 masks before finding the right one.
Hang in there.
I survived the first few months by alternating masks,
which let my skin heal between bad choices.

That's a bit more reassuring to hear.

My dealer is awesome and he's letting me try different masks for free. I'm sure he wants me to find a good fit ASAP.

[Pugsy]

Since the leaks are a huge sleep quality factor....keep trying masks as much as you can.

Do consider maybe adding the cervical collar...I know it sounds like a PITA but maybe it will help. We have a lot of forum members who use them and find they are worth it.

We gotta get to sleep and stay asleep first and foremost for any of this to matter.
Full face masks present extra challenges for sure. If nothing else just the amount of real estate involved needing to keep the skin to mask contact sealed is greater.

The Amara View...not the greatest of designs IMHO.
The DreamWear full face mask...a better design but not perfect. It does take the nose fit issues out of the question though.
Maybe look at the DreamWear full face mask or even the ResMed F30 or F30i models....keep the nose fitting needs out of the equation.

[zonker]

Hi

why, hello. and welcome to the zoo!

you'll get good advice here. pay close heed to pugsy. she knows what it's about.

as frog has stated, it's unusual to have your first mask be perfect. our faces are different. the way we sleep is different. i feel very lucky in that the p10, which was my 4th mask, seems to do it for me.

i want to second the idea of wearing a cervical collar. these can be found in your local drugstore. over by the canes and bedpans and walkers and such. it really helps keep the chin up.

they can also be found on amazon, if going out in a pandemic is too much for you.

https://www.amazon.com/Coreline-Cervica ... 698&sr=8-1

that link takes you to the one i use.

good luck!!

[joeljjk11]

I would recommend the Airfit P10 with a chinstrap. I use the Halo Chinstrap which is decent.

[ChicagoGranny]

The main issue seems to be my jaw drops in the middle of the night because I've been a mouth breather, and this breaks the seal.

For many years, I've been using a foam cervical collar to prevent jaw drop. It was easy for me to become accustomed to sleeping with it.

As far as sizing and adjusting a mask, search on youtube for the mask model you would like to use. There are lots of helpful videos. Some are from manufacturers, some from DMEs and some from CPAPers.

[PatOnCPAP]

Try the P10 again but tape your mouth closed and wear a foam collar or chinstrap to keep the jaw closed. Best mask I found - zero leaks and no fiddling with it all night.

[Sleep2Die4]

Try the P10 again but tape your mouth closed and wear a foam collar or chinstrap to keep the jaw closed. Best mask I found - zero leaks and no fiddling with it all night.

It hardly seems like a "best mask" if you have to tape your mouth shut and wear a collar.

[chunkyfrog]

Many find relief from a mask liner (Pad a Cheek), which quiets/softens leakage;
as noise and sensation is often how a leak wakes us.

[jimbud]

Try the P10 again but tape your mouth closed and wear a foam collar or chinstrap to keep the jaw closed. Best mask I found - zero leaks and no fiddling with it all night.

It hardly seems like a "best mask" if you have to tape your mouth shut and wear a collar.

The "best" mask for each individual is the one that allows the wearer to sleep "best".

No matter what one has to do to make it work.

JPB

[brianz]

I will try each of these suggestions, chin strap, tape to mouth, mask liner, cervical collar, and see what happens! Thank you guys

[SyCoREAPER]

My experience is contrary to everything and everyone would recommend but in my situation is was simply not being tight enough. I had to tighten mine more than videos and what people said you should. Not tight enough to be uncomfortable but more than. You think it should be.

Not saying that's right or wrong, but my mask was leaking nonstop until I really tightened it up. Also make sure you wash your face right before bed and wash the mask daily.