Any tips on Back-Sleeping with the Amara View?

[Gideon]

How about starting with the basics.

First realize that the Amara View mask is designed to seal ONLY when air pressure is applied.  The straps are to hold the mask in the correct position.  Because it is a "light fit mask" the weight of the hose can pull it out of position, so some hose management system to prevent that (I use a velcro around the hose that I attach to either my pillow or my PJ top.

That said

1. Lie down in Bed on your back in "sleeping position.
   
2. WITHOUT STRAPS place the mask in position lightly on your face 
   
3. While under normal CPAP Pressure move the mask around until it seems to stop leaks
   
4. Attach straps to your head and adjust to the same mask feel you determined above.
   
5. Tweak as necessary.
   
6. Remember that the AMARA view needs a light touch (Watch the vendors video on how 
   

[AlwaysTired2018]

I like the Amara view better than the rounded triangle shaped ones, which don't maintain a seal at all for me, even when made extremely painfully tight. However, I did run into leak problems sometimes with the Amara View. I can no longer sleep completely flat, so I have used a recliner for many years now. When I started using the Amara View I had to keep it on too tight to prevent leaks from occurring part way thru the night. After a while I did some research on fitting the mask, to make sure I was wearing it correctly, and found I had been positioning the back of the harness too high, so I took to making sure it was set lower. This helped some and let me loosen the mask up some, but still didn't fix the problem all the way. Then I observed that the hose tended to tug a little as I would move a bit in the recliner while sleeping, causing it to sometimes break the seal, so I created a hose hanger for the recliner by putting a couple of large bungees around the back of the chair, and then tying the hose loosely to the back side bungee with a short ball bungee. This allows me to adjust the hose and mask position up/down and left/right a little, without letting it move too much while sleeping, and helped some more with the leakage problem. I eventually noticed that some of my leakage problem was caused by my head falling forward and to the left too much, sometimes causing the mask to shift, breaking the seal. Even when the seal isn't broken, if my head falls too far forward while sleeping, I've found that it cuts off my wind pipe. Not good. I decided to use a backward facing neck pillow, but the commercial ones are too thick, so I made my own out of old socks stuffed into an old long winter sock. I put a bunch of my old shorter socks onto my hand until I had an extremely thick amount of fabric there, then put the long winter sock over them. Once I had them worked down to the toe end of the winter sock I put an additional bunch of old short socks onto my hand, but not quite as thickly, then added that to the inside upper part of the long winter sock. The thick lower part goes under my neck to keep my wind pipe open. The slightly less thick upper part of the homemade neck pillow goes on the left side of my neck and then tucks in behind my head to keep my head from falling toward the left, which would give me a terrible crick in my neck. I already have neck arthritis on that side, so I really need to prevent my head from falling too far to the left. For some reason it really has a tendency to do that.

Even with the leakage problems I've had with the Amara View, I like it better than the triangle style masks, so I didn't want to go hunting for a new mask. Fortunately, between the homemade neck pillow, the homemade hose hanger, and learing how to properly adjust the mask harness, I've managed to mostly eliminate the leaks. Bear in mind, even with everything set up correctly, when we shift around while sleeping we will sometimes cause the mask to shift enough to break the seal, so it's impossible to completely eliminate this problem. However, if everything is set up correctly, we can at least greatly reduce the problem.

I hope my info of my leakage problems, and how I dealt with them helps others here.

[ragtopcircus]

Would a cervical collar help to keep your neck extended

Oh boy.  It probably would. But I'm unwilling (at least until I exhaust other alternatives). LOL

Ha! I am (for a few days) indulging the RT’s instructions to NOT use the collar. After just one night, I know I’ll revolt soon and start using it again. It helps!

The RT held the Amara View up to my face for just a few seconds and saw it clearly wouldn’t seal well on me. We settled on the F30 instead (which I was already using anyway). It is similar to the AV but fits a little different. I can’t say one is better than the other, it just depends on your face shape. They are different enough that it might be worth a try.

I noticed a big difference when switching from a 12mm hose to 15mm. The bigger hose affects the mask fit a lot more, and that’s with the ResMed swivel elbow. I may be switching back.

[AlwaysTired2018]

Hi!

Thanks for your reply to my post. I've been spending the time since I made the post a little while ago, looking into more CPAP stuff, including the AirFit F30. I noticed right away when I was at that site that this model strongly resembles the Amara View. I also noticed that the nose part of the cushion on the AirFit F30 seems to come up a little more, and thus may provide a better fit against leaks. Unfortunately, my insurance probably won't cover it, as it costs more than the Amara View mask, by quite a bit. Perhaps I can treat myself to one over the holidays, and then I can compare them.

Your comments about the width of the air hose made a lot of sense. I don't know the width of mine, but my Amara View mask only takes one size of hose end, and from what I've seen, each width of hose has a different width of hose end for connecting to masks. I may be wrong about this, as I am definitely no expert on all things CPAP. That's one of the great things about forums. They give us a chance to exchange info, and learn more about all kinds of stuff.

Again, thanks for your reply.--  

[ragtopcircus]

I think most or all masks take standard 22mm couplings. 15mm, 19mm, and 22mm hoses all come standard with 22mm couplings at both ends.

The Dreamstation Go comes with a 12mm hose with a standard 22mm coupling at one end and a proprietary coupling at the machine end (even though the machine will also accept standard 22mm couplings).

I’m still trying to find a 12mm hose with standard couplings at both ends.

[AlwaysTired2018]

Hi again!

Thanks for the update. It does make sense to have the hose ends of different size hoses all be the same size. Think of the trouble it can cause having to have different machine models based on all different sizes of hose ends. Life is already complicated enough without stuff like that to deal with.

[ragtopcircus]

Btw, there is some noticeable restriction with a 12mm hose if I exhale forcefully, but that’s not really representative of sleeping.

Anyway, the point was that even small changes in the hose weight/stiffness/position/length can affect the seal. Others have mentioned a hose buddy, (I just have mine looped over the headboard post), but maybe there’s a lighter version of whatever hose size you already use.

[AlwaysTired2018]

Hi again!

Regarding the restrictive breathing when exhaling hard, another poster mentioned setting the exit exhale force lower, which helped him.

Regarding hose buddies, I was having a problem with the hose and thus the mask moving too much while sleeping. Because I sleep in a recliner I can't use the hose buddies sold in stores, as they are designed for use with a bed, so I made like MacGyver, and made my own. I connected two large bungee cords around the back of the recliner. The one in front was a flat one, so I wouldn't feel a bump behind me. Then I took a small ball bungee and knotted it around the hose and the bungee on the back side of the recliner. The knot is loose enough so I can adjust the hose left/right, and forward/back, as needed, but it's no longer free to move all over, and no longer falls off the back of the recliner. This was a big help.

[jaswilliams]

Would a cervical collar help to keep your neck extended

Oh boy.  It probably would. But I'm unwilling (at least until I exhaust other alternatives). LOL

Ha! I am (for a few days) indulging the RT’s instructions to NOT use the collar. After just one night, I know I’ll revolt soon and start using it again. It helps!

The RT held the Amara View up to my face for just a few seconds and saw it clearly wouldn’t seal well on me. We settled on the F30 instead (which I was already using anyway). It is similar to the AV but fits a little different. I can’t say one is better than the other, it just depends on your face shape. They are different enough that it might be worth a try.

I noticed a big difference when switching from a 12mm hose to 15mm. The bigger hose affects the mask fit a lot more, and that’s with the ResMed swivel elbow. I may be switching back.

When you changed the hose did you go into the machine and change the hose type from slimline to standard ?

[ragtopcircus]

Yes, I did change the setting.

The 12mm hose is nice because it is so light and flexible. Even just breathing through the hose directly though (no mask or machine), there is a noticeable difference in restriction. I think 12 is going to be the lower limit.

According to the Dreamstation Go specs, the pressure accuracy is +-0.5 with 15mm and +-1.0 with 12. For now, I think I’ll stick with 12 for travel and 15 for home use.