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Best method to wear chinstrap with nasal cushion mask?
#1
Best method to wear chinstrap with nasal cushion mask?
I have a lot of leaks with my ResMed N30i nasal cushion mask, but I want to continue using it because it's less cumbersome and intrusive than other mask types.  I tried the similar ResMed nasal pillows mask and it irritates my nostrils.  I have been using a Vyaire chinstrap as well, which I've always put on first so it's positioned under the CPAP mask.  I've been using it for about six months, and CPAP for eight months.  The few things I've found online suggest that the chinstrap should go underneath, but a couple of the posts or websites mention wearing it either under or over.  One in particular suggests that wearing it over the mask can help keep the mask in place.  My belief is that my problems arise from the mask shifting when I'm asleep and move around.  In particular, as a side sleeper I suspect that the bed pillow may push against the mask and cause it to go out of position, though it apparently goes back in place since the high leak periods are for a finite period, from minutes to a couple of hours.  Then they end, assumedly when I move so that the mask is back in position.  If I tighten the mask it can be uncomfortable, and it seems impossible to find a sweet spot where it's not too tight but also doesn't leak.  I also sometimes awaken with what feels like obstructed airflow, which is remediated when I simply pull the mask's nasal insert down a fraction of an inch.

What's the experience of others to help curtail leaks by wearing a chinstrap on top of the nasal cushion mask, rather than underneath?  Or, are there other suggestions aside from switching to a mask with more facial coverage?
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#2
RE: Best method to wear chinstrap with nasal cushion mask?
I find that positioning the top of the mask so it sits on the strap on the top of my head helps keep the mask in place.  A contoured pillow is also key for me, though.  Keeping the sides of the mask from pressing into the pillow makes it much easier for me to keep the nasal cushion from getting pulled to one side or the other.
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#3
RE: Best method to wear chinstrap with nasal cushion mask?
From my experiences chinstraps are difficult for most, impossible for many. They tend to require being very tight, which may pull the jaw back causing other issues. It may work a while for some but over time loses their effectiveness.

A better option may be using a soft cervical collar and/or CPAP pillow. You could even try a full-face mask that would remove the need for using a chinstrap or SCC.
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