[Equipment] Had it with lip leaks - going FFM

[PaulaO2]

Okay, I've had enough. I've done everything but taping and denture cream (don't even suggest it, I'm not doing it).

I started out using nasal masks but none worked due to leaks into my eyes. I have an odd, tiny nose and none would form a seal at the top. It is why I have used nasal pillows and have enjoyed them ever since.

Years ago, during a bad bout of allergies, I tried a hybrid mask, the Liberty I think. It was like being in a wind tunnel. My lips cracked, my skin was chapped, I couldn't keep my mouth closed because it was constantly being blown open. It was awful. But that was a hybrid. and all the "open" air was blown into one location.

And then a while back, for some reason, I started leaking air through my lips. My mouth does not open. I either fill my mouth with air and then puff it out, close, fill, puff, close, repeat. Or the air comes out through my lips constantly. I've tried chin straps (fake Ruby Red, PAP Cap, and home made) and nothing stops it.

With the PAP Cap, the leaks are not so bad most nights that it interferes with treatment. Especially since my mouth doesn't open. And the constant leaking only happens for a few minutes at a time before it wakes me up.

And I've had enough. My mouth is so nasty dry in the morning. How can I be leaking air when my tongue is stuck to the roof of my mouth? I wake up so many times a night from the sound. My AHI is high, up above 5 now, nearly every night. Combine that and the waking up so much, I'm exhausted.

So I'm looking at full face masks, not hybrids. But I have some questions.

1 - was my experience with the Liberty just because it was a hybrid? As in the wind tunnel thing? Seriously, you should have seen my lips and face. It was like I had just come down from climbing Mt. Everest or something.

2 - which one would work best with my wimpy nose? I know I will have to make a padding, probably out of the Mack ear plugs. Or will I just be trading one irritating leak for another?

3 - should I seek the advice of my DME or just pay out of pocket from online suppliers? My state did not accept ACA so I lost Medicaid due to my SSDI is too much income under the state's new rules. Medicare is covering most of the cost of my supplies but I'm not sure how friendly the DME will be with me needing to try so many masks. My bet is they will not be.

[Sleepster]

I also have significant bouts of mouth-leaking and may have to go to a FFM.

I started out using nasal masks but none worked due to leaks into my eyes.

I don't see how a FFM will be any different unless you go with a hybrid.

I don't believe there'll be any more air coming into your mouth with a hybrid than with a regular FFM. Plus, I recall Arch saying something about the S9 inflating a FFM in a way that's more comfortable than some other brand of machine.

You may need to get your doctor to write a prescription for a FFM so that your DME will be forced to fund it.

[PaytonA]

Back when I went to a better DME for a while, the RT, after listening to my experiences with an FFM and a nasal mask and my high pressure, recommended the Mirage Quattro which has served me well. It has the adjustable distance from the forehead piece to the seal at the bridge of the nose. That might help with your low altitude nose bridge....maybe.

If your pressures go up to 20 very often you may find that you need to cinch it down pretty tight in order to maintain the seal.

One other note: I have found that there seems to be a difference between using the mask fit feature and using the CPAP mode to do mask fitting. With CPAP mode, I seem to get higher pressure at 20 cm then when using the mask fitting feature in S mode. Could just be harsher changes in the system because the CPAP mode without EPR does not attempt to ease the pressure change when you first breathe out.

We have also heard some good things about the Simplus and the roll seal may work for your nose. The other possible recommendation might be the Fitlife mask, since it does not attempt to form a seal across the nose.

That is about all I can think of with my limited experience with different masks. Hope you can find a mask that allows you to get some decent sleep. We do not need any sleep deprived madwomen running around the forum with a hammer.

Best Regards,

PaytonA

[surferdude2]

Second the Mirage Quattro recommendation. It seems to fit a wider range of people since it has an adjustment feature. Other makers should take heed. No mask is pleasant to me but the MQ is least unpleasant. They all cost much more than they should and it's high time for some opportunistic manufacturer to come out with something fairly priced and blow the market open.

Ps. I would love to have been able to use the Simplus but I tried, and tried, and tried some more but couldn't get the leaks to stop. I also couldn't tolerate the P10 nasal pillows since they insisted on blowing air out my mouth and, even worse, through my Eustachian tubes. Nothing's more uncomfortable than having wind blowing through your inner ear! Perhaps I don't have enough gray matter up there to serve as a wind break.

[woozie38]

Okay, I've had enough. I've done everything but taping and denture cream (don't even suggest it, I'm not doing it).

Hi Paula.
I have two ideas that may help, but first read the last para of this post #1.

The problem of therapy air escaping orally when using nasal masks is beginning to be understood. Since nasal & oral breathing paths link together in one airway, it's understandable that air at pressure administered via the nose will exhaust via the mouth. That is unless there is something there to stop it, & there really isn't.
here are my two ideas you may like to try...

1. Use of mandibular advancement device as in this post. However instead of advancing your lower jaw, just close it normally. The device with the help of your chin strap will now stay in place and stop the PAP air from escaping, which is the cause of your dry mouth.

2. Use a F&P Simplus FFM in conjunction with a "Woozle" [url=http://www.apneaboard.com/forums/Thread-The-Woozle-Alternative-to-Chinstrap-for-FFM]as in this post (again)[url]

[Peter_C]

For basically the same reasons as Paula I went from nasal masks to FFMs starting around DEC or so. The mirage Quattro is my old faithful, and I have tried all the newer Quattros with limited success. The newer ones are nicer, smaller, lighter etc - but you will lose the adjustment at your nose.

Check Supplier #1 as most of their Resmed masks come with free return insurance. So that may help you a bit.

[PaulaO2]

Woozie, prior to just a few months ago, I was so good at blocking air coming from my mouth, that I could talk just fine while wearing the nasal pillows. I had to think real hard to do whatever with my throat in order to get air to come out my mouth. Then, for some reason, it just won't stop. I'd tried all sorts of stuff. Tongue placement, jaw placement, chin straps. I have jaw issues but my jaw doesn't fall back, it falls forward. So much so that I've ruined my front teeth and will be having false teeth soon. I have some muscle issues on my jaw and temple but that's been ongoing. So nothing new that we can point to and say "AHA!".

[woozie38]

Woozie, prior to just a few months ago, I was so good at blocking air coming from my mouth, that I could talk just fine while wearing the nasal pillows. I had to think real hard to do whatever with my throat in order to get air to come out my mouth. Then, for some reason, it just won't stop. I'd tried all sorts of stuff. Tongue placement, jaw placement, chin straps. I have jaw issues but my jaw doesn't fall back, it falls forward. So much so that I've ruined my front teeth and will be having false teeth soon. I have some muscle issues on my jaw and temple but that's been ongoing. So nothing new that we can point to and say "AHA!".

Paula, I was the same too. I used the F&P Opus 360 NP for <> 6 yrs. if fact used up 2 of them. A good mask but once the air begins to exit orally, one has to abandon its use. My suggestion of the "SnoreBlock" device was not to advance your jaw, but to prevent the PAP air from escaping via mouth. It works, I tried it, but in view of the possibility of storms & power outages, I declined to use it.
During a power outage one would have to breathe through the machine & that would have a similar effect to hypopnoea.

Dry mouth will accelerate tooth decay, since there is no saliva present to break down digestive acid.

[Eurika]

Paula

I found this device on a UK site that seems to stop mouth breathing, I haven't tried it yet, but plan to as I really like my nasal pillows but I sometimes mouth breathe.
It might be a help for you.
Good luck

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[PaulaO2]

I have some massive tooth issues going on. Nothing new, part of my syndrome. I'm sure the CPAP isn't helping any. But as much as we complain about the CPAP industry, it's nothing compared to dentistry! OMG, the cost!