Help with mask selection (see picture)

I’m new to cpap and struggling to find a proper fitting mask

So I’m looking for some help selecting a full face mask for my rather unique profile. Picture an older, uglier, and male version of this lady and that’s what I’m up against. (hopefully her picture appears below)

Basically it’s a big nose/small face problem. Here’s what I’ve tried. A Fisher Vitera with a small cushion will seal but only with the cushion completely compressed against the bridge of my nose. The cushion is compressed to the point of causing pain within the first hour of use. The same Vitera with a medium cushion won’t seal effectively on my cheeks.

An Amara View with a small cushion pulls down on the tip of my nose to the point of discomfort. A medium cushion won’t seal.

Hoping someone here can direct me to a model that’s a better fit for my facial features.

Maybe a "hybrid" full face mask, like the ResMed AirFit F30 or F30i, or Philips Respironics Dreamwear Full Face mask that all fit under the nose?

AG56 wrote: ↑

Mon Aug 09, 2021 12:56 pm

Here’s what I’ve tried.

Have you studied three or four fitting and adjusting videos of each of those masks? They are on youtube.

Also, you can go to the forum sponsor's website, https://www.cpap.com/plp/full-face-cpap-mask/ZT0yNjU , to view most of the available FFMs and see ratings and reviews.

Hi AG56,

I too have a big nose (think Mikhail Baryshnikov). I found that my hunt for a mask with enough room was to always pick the Large size, and not go by the standard fit diagram.

And with this selection criterion in mind, I bought and tried: (1) the Mirage Quattro; (2) the Amara View; (3) the very elegant (meaning fewest parts) Quattro Air; and (4) the Air Fit f20.

In my experience:

The cushion on the Amara View is too floppy for me – lots of leaks.

The cushion on the Quattro Air (large) is too rigid for me – not enough molding to the face. Leaks.

The Air Fit f20 ((large) has the merit of having the same number of bits as the Quattro Air, but a slightly softer and more 'giving' cushion. I like it, and I alternate it with ...

.. the Mirage Quattro (large) which (a) is a classic, and (b) has enough space in the frame to clear my nose, and (c) has a double cushion for a good fit, and (d) is by far the roomiest of the four all round – but which (e) is more than 10 years old in design, and is made up of 10 separate bits. Takes longer to wash.

I hope this is of some help.

Thanks for the quick replies.

Rick, you mentioned choosing the Large size aside from what the size diagram might suggest. For the Mirage Quattro I’m right in the center of the Medium marker on the template and a little concerned that going to the Large would make the cushion too long and therefore low on my chin and/or high on my nose bridge.

Thoughts?

It's a trade-off. If we call the extent to which a frame sticks out from the face its depth, then to get the depth needed, you have to accept that the cushion of a Large-size Mirage Quattro will be a little higher on the bridge of the nose, and a little lower on the chin. It's not ideal – but it works.

Another thing you might try, although I don't know how easy it might be for you to do. Because of my location (I'm in the UK), I can buy spare mask parts direct from ResMed UK. So I can, for example, buy just the frame of a Mirage Quattro, in addition to the complete Medium-size mask that I've already got. And I can buy, separately from buying the complete Air Fit f20, the memory foam that turns the f20 into the Air Touch.

And I have experimented with shoe-horning a Medium-size Mirage Quattro cushion into a Large-size Mirage Quattro frame – and packing the 'rim gulley' where needed with silicon pieces taken from previous cushions.

Again, it's not ideal, but it works.

Thanks Rick. You've given me a starting point, I'll post back my results.

One of the beauties of the Mirage Quattro is that dial at the nose. It lets you have a lot of adjustment around a point that can be problematic. I tend to dial the nose piece way out and really tighten the chin. This lets that cushion around the nose inflate and really hug the nose without a lot of painful pressure at the bridge of the nose.

Update: I purchased a Mirage Quattro and an Airtouch F20. I got the Quattro in a medium because I was squarely in the middle of the medium on the sizing guide. I had high hopes for the Quattro as I thought the adjustable forehead gizmo would help me tweak for nose clearance and seal. But I think the bridge of my nose is just too narrow for the Quattro, it leaked on each side of my nose at the bridge and no amount of adjustment helped.

I got the Airtouch in a large as the sizing guide put me between a medium and a large. I like it and it seals good enough but will leak when I lay on my side. The memory foam is nice but probably not a long term solution as I can see where it would definitely need to be replaced often since cleaning isn’t an option. Replacements are relatively expensive at $59 each

I’ve ordered an Airfit F20 but haven’t received it yet. Assuming the Airfit seals as well as the Airtouch it would likely become my primary mask since it can be cleaned daily and replacements are cheaper.

Have you considered the Bleep? As it adheres to the outside of the nares, it has a leak-free seal. Unless, like me your mouth occasionally drops open. Fortunately that does not happen often/long enough to impact my therapy, only enough to dry out my mouth <sigh>. But it solved my other leak issues and saved my eyes! And I love the no-headgear.

Did you try the Airfit P10?

Like you I have a big honkin’ nose. I currently use a Resmed P10 and P30i with the pillows which work fine. It took me a while to adjust to them, but once I did there are now no issues. Find videos to help with the fitting and adjustments as it makes a big difference in comfort and effectiveness.

So far I've only been trying full face masks because I was pointed in that direction when I mentioned occasional allergy related congestion to the clinician. Since I haven't needed to breath thru my mouth thus far maybe I could consider a nasal pillow down the road.

The Airfit arrived over the weekend but it doesn't seal nearly as well as the Airtouch so it's Airtouch for now. I'd just really like to find an alternative to memory foam so I can clean it daily in the normal manner.

Hi AG56,

Some people find a mask liner helps with the seal of a full-face mask. Ready-made liners are available from padacheek.com – and they are cheaper than a fresh AirTouch cushion every four to six weeks.

Even cheaper is if you make up some washable and re-useable mask liners from an old tee-shirt.

I use the Airfit 420 and only wash once a week. Daily I wipe down with non-alcohol wipes(cut in 8's)
I also found using a different pillow helped with the side leaks.
My preferred pillow at the moment is the one from the Purple Mattress company.
Firm but gives with the mask rather than shifting the mask.