Trying to adjust to the Liberty....

iguru42 · Post by **iguru42** » Thu Jul 10, 2008 7:04 am

I've been using CPAP for about a month now, when I originally got it no one talked to me about mouth breathing. I'm a big mouth breather and when I got my first mask I was very disappointed to be told that there was nothing that could be done about it! I had to use the nose mask and that was that.

So last week after getting fed up with the information I was getting locally I started googling and can you imagine my surprise to find that there are in fact FFMs and hybrid masks?!?

So after looking around and reading on this forum I bought a Liberty but the transition has not be as perfect as I would have liked.

With the nose mask (not sure what one it is, but it is a Resmed) I get a good nights sleep, sleeping through the whole night. My problem is (minor issue) I've never been happy with the headgear, and (bigger issue) I have to concentrate on keeping my mouth shut while trying to get to sleep, and I've always assumed that I must be leaking at night.

I've been using the Liberty for about a week and I have yet to sleep through the night. I've been waking up in the 4-5 am hour. Not sure why. I do feel as thought I'm getting restful sleep, but I am annoyed that I'm not sleeping through the night.

The place I bought the mask from will take the Liberty back within 30 days of purchase. Is the fact that I'm waking up at 4ish a large concern? Am I still adjusting? Could it be a leak issue?

I'd really like to find out what my machine has to say about my sleep, I'm going to look into that, see if I can get that data...

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CPAPopedia Keywords Contained In This Post (Click For Definition): resmed, CPAP

skjansen · Post by **skjansen** » Thu Jul 10, 2008 11:58 am

Well, I don't know what to tell you. When I first got the Liberty (about 1 month ago) I thought I had finally found my dream mask. I was waking up several times to mess with the nose part of it but would go right back to sleep. Now, I am waking up ALOT because not only am I having a hard time keeping the nose part in place, but now I am experiencing leaks around my mouth. I tried taping the nose cushions but that did not work either. I am very discouraged at this point and I am considering trying a different mask. I am however running out of options!

Good luck!

Guest · Post by **Guest** » Fri Jul 11, 2008 2:50 am

I've had some success using Macks on the mouth seal but like you I find the pillows leak through the night. I'm going to see if I can find a solution to that.

skjansen wrote:Well, I don't know what to tell you. When I first got the Liberty (about 1 month ago) I thought I had finally found my dream mask. I was waking up several times to mess with the nose part of it but would go right back to sleep. Now, I am waking up ALOT because not only am I having a hard time keeping the nose part in place, but now I am experiencing leaks around my mouth. I tried taping the nose cushions but that did not work either. I am very discouraged at this point and I am considering trying a different mask. I am however running out of options!

Good luck!

wjp · Post by **wjp** » Sat Jul 12, 2008 7:41 am

My DME let me borrow a Liberty for two weeks, and I found I also could never sleep more than 4 hours with it. I found the pressure of it pushing up into my nose to be uncomfortable. The way the mouth seal was designed also seemed to force my mouth to come open which made my mouth very dry.

I have since picked up the Hybrid and find it much more comfortable. It is a similar design, but far more adjustable. It came with three sizes of both the mouth seal and the nasal pillows.

The nasal pillows can be adjusted to two different heights so that helped me keep them from pushing against my nose too hard.

On the hybrid the mouth seal has a piece that goes down under your chin. I personally find this to make it more stable, and again keeps the mask from riding up into my nose, however I have seen posts from people that find it very uncomfortable to be going under the chin.

It took a few nights to find what combination of sizes and adjustments worked best for me, but was sleeping through the night with it after four nights.

Might be worth considering before you give up on this mask style.

chipbutty · Post by **chipbutty** » Sat Jul 12, 2008 8:40 am

Yes, the Hybrid is definitely worth a try. A much more reliable interface than the Liberty. I've never been completely happy with the Hybrid but it's about the best I've found so far.

birdshell · Post by **birdshell** » Sat Jul 12, 2008 10:32 am

I have used the Liberty mask for nearly a year. I, too, had problems with the nasal pillows shifting and leaking. That wakes me up, IMHO.

My solution:

Tie a REAL pantyhose leg (cut from the rest of the pantyhose, please!) around your head with a flat knot. The center of the leg goes UNDER the mushroom top of the nasal pillows, on what might be called the stem.

Flat knots are made by starting to tie your shoelace. I flip the end around 3 times for the pantyhose leg; it seems to need a bit more friction to stay in place. Stop before you make the loops, or bunny ears, or tree...

Click Here for Flat Knot Instructions

AFTER the above is done:

I do adjust the nasal pillows a bit to get the best airflow into my nostrils...they are sometimes giving me a feeling of not allowing enough air to flow through. There are even times that one nostril seems to be getting no air.

If I tweak the position ever so slightly, it makes a big difference. Maybe this is due to my slotted nares, but I have had leaks at the very tip of my nares with nasal pillows.

Personally, since that is the only thing I have to do to the Liberty, I am very much in favor of the headgear. Previously, my nightly routine for preparing to sleep was at least a 5-10 minute job, minimum. I need to do NOTHING to wire the nasal pillows together, tape my mouth (or don a chinstrap), adjust the tube length, adjust the angle length... Well, you get the idea.

One more thing that I do find helps a great deal: using a pillow with a cutout, so that the mask does not rest on the pillow while side-sleeping.

Yours for pantyhose legs and tweaking,

Karen
Who is sleeping more and adjusting the mask less!

oakmont · Post by **oakmont** » Sun Jul 13, 2008 12:20 pm

i love my liberty.

I found that once I switched from the small to the large mouth piece that my DME originally gave me, it was NIGHT and DAY.

You need to also play around with the correct size nasal pillows. I use the large mouth piece with medium nasal pillows.

Also, make sure the nasal pillows are clean and dry. If you have a runny nose, make sure you blow your nose as the nasal pillows dont seal well if your nostrils are moist

make sure that the pressure of the top strap and bottom are evenly distributed to avoid leaks.

I've been using this mask for over 90 days now and love it. I did have the elbow piece break on me last nite, so I'm going to use a hybrid tonite as a back up until i get a replacement elbow.

One last important piece of advice is, Attitude! If you WANT it to work for you, it will, remain positive as the end result is worth it! I actually look forward to sleep now.

chipbutty · Post by **chipbutty** » Sun Jul 13, 2008 2:38 pm

I admire your attitude and it's one I share but I've tried for two months to try and get the oral cushion to seal on the Liberty. Some masks just don't work for some facial structures and skin types.

I've had some success in covering the seal with Macks.

[quote="oakmont"]

One last important piece of advice is, Attitude! If you WANT it to work for you, it will, remain positive as the end result is worth it! I actually look forward to sleep now.

birdshell · Post by **birdshell** » Sun Jul 13, 2008 3:43 pm

oakmont wrote:i love my liberty.
<snip>

I've been using this mask for over 90 days now and love it. I did have the elbow piece break on me last nite, so I'm going to use a hybrid tonite as a back up until i get a replacement elbow.

OH, that pesky elbow! I have had 3 break. This is obviously a design flaw, and ResMed has supposedly improved the design.

I repair them "temporarily" by using fiber package sealing tape. I take a 2 or 3 strand piece from a strip long enough to go round the squeeze release. Then, I superglue the break AND the whole piece around the squeeze release, adding the tape (sticky side down) as I go.

The packing tape fibers overlap each other over the broken part. I have found that this combination does the trick in strengthening and securing the repair to the narrow piece of plastic.

Since the cyanoacrylate superglue is outside the airflow TOTALLY, this seemed to be safe enough. I have never smelled a thing after the initial curing/drying period.

This repair has lasted longer than MOST of my elbows....

WhiteBeard · Post by **WhiteBeard** » Sun Jul 13, 2008 11:10 pm

I have been using the Hybrid since last fall and I think it is a great mask, I did have to make a mod for it to keep the nasal pillows in place, and it works fine, I have been trying the Liberty the past week and found it had the same problems as the Hybrid with the nasal pillows, luckily my mod for the Hybrid works just as good for the Liberty. Anyway my mod is made with Hair Elastics and Christmas Tree/Net Light clips it is pretty easy to do and it works great.
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The pictures are pretty self explanatory but I will try to answer any questions, if I can. I hope this helps if anybody has problems with the nasal pillows leaking or keeping them in place. I do swab my nostrils with Nasal Saline Gel just before putting my mask on, as it helps the pillows to seal. And I put a gauge pad under the elastic on my forehead to keep it from leaving a mark.

birdshell · Post by **birdshell** » Mon Jul 14, 2008 6:07 am

WOW! Now, that is quite something. Are you an engineer, by any chance?

I have the same problem, from the look of what you have done to the nasal pillows' angle. I'm not sure that I could really duplicate your solution, but really should try it. I think I still have some hair bands from before I cut my hair.

I'm guessing that it works better than my simple "pantyhose strap tied around the nasal pillows and head" tweak. Hmmmmmm.....

Thanks,

Karen

WhiteBeard · Post by **WhiteBeard** » Mon Jul 14, 2008 9:33 am

Birdshell it is a pretty effective fix, I first started making it for the Hybrid mask last fall in September, and have been using it on that mask every since then. Now that I am on VPAP the Hybrid mask isn't really recommended for my machine, do I thought I would try the Liberty mask. This mod works just as well with it, Although I still think the nasal pillows are more comfortable with the Hybrid!
No I am not an engineer or anything, in fact I am retired from the Air Force, went back to school and became an RN, and I am now on disability, cause of my back, and some other medical problems. But as they say necessity is the mother of invention, it was just a matter of finding a way to apply the proper pressure and leverage to hold the pillows into the nose, it did take some trial and error to get it to work! It is really pretty simple and most people can get the hair elastics, they're cheap, the clips might be a problem at this time of year, I got them at Target at Christmas time a few years back, but they do still sell them at Christmas. Anyway it might be worth a try, Good Luck to you!

Needsdecaf · Post by **Needsdecaf** » Mon Jul 14, 2008 3:05 pm

I find that Mack's on the mouthpiece is a must.

I am still struggling a bit with the nose pieces. I have tried the large with taping, that worked, but the tape was annoying. Now I am using the medium with Macks on the nasal pillows. That WAS working but on one of my Mack's changeouts (for fresh material) I must have put them on wrong and now they're not sealing. Little buggers.

I'll get it to work yet.

iguru42 · Post by **iguru42** » Tue Jul 15, 2008 7:49 am

oakmont wrote:You need to also play around with the correct size nasal pillows. I use the large mouth piece with medium nasal pillows.

Also, make sure the nasal pillows are clean and dry. If you have a runny nose, make sure you blow your nose as the nasal pillows dont seal well if your nostrils are moist

make sure that the pressure of the top strap and bottom are evenly distributed to avoid leaks.

I've been using this mask for over 90 days now and love it. I did have the elbow piece break on me last nite, so I'm going to use a hybrid tonite as a back up until i get a replacement elbow.

One last important piece of advice is, Attitude! If you WANT it to work for you, it will, remain positive as the end result is worth it! I actually look forward to sleep now.

I really tried to get it to work. I tried all three sets of nasal pillows, and found that the small ones worked the best, but no matter what I did I always woke up in that 4 o'clock hour. I just couldn't take the crappy sleep I was getting when I knew that I could switch back to my nasal mask and feel 100% better.

So the Liberty is going back, no biggie, what I have works, I'm just fairly confident that there is a mouth mask out there that would be better than the nose mask.

I'll be looking into the Hybrid, thanks for the suggestions guys!

birdshell · Post by **birdshell** » Tue Jul 15, 2008 8:17 am

Your experience proves the point: There is no ONE best mask, and there are several that can be used for each of us.

So, the only "best mask" is the one that works best for you!

Karen

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