Best method to wear chinstrap with nasal cushion mask?

[hypopneac]

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?

[artsyuno]

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.

[PeaceLoveAndPizza]

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.

[LaurenceShaw]

Traditional neoprene chin straps wrap around the tip of the chin and the top back of the head.  That is problematic and indeed traditional neoprene chin straps generally have to be adjusted to be very tight!  The reason is that the line between the tip of the chin and the top back of head passes almost directly through the jaw joint.  This means that the force applied by a traditional chin strap is almost directly into the jaw joint, which is the least effective and most uncomfortable direction possible, and long-term use can cause damage to the jaw joint. The Knightsbridge Dual Band has a completely different type of design where the straps pass beneath the jaw and are oriented vertically so the force produced by the straps works with the natural rotation of the jaw.  And it has two bands, one elastic and one non-elastic, to allow the force to be minimized yet still effective.  It's not for everybody because the design does require a full cap, but if you're interested in more info, such as pictures and graphs, we are Supplier 37.  (Please be sure to use that link since if you use a keyword search you may end up with a counterfeit.)

[hypopneac]

LaurenceShaw:  Thanks for the promo of your product, but my Vyaire chin strap works just fine.  Chin strap was not involved in causing the moving mask issue presented in my original post.

[hypopneac]

PeaceLoveAndPizza:  As I first wrote, the problem isn't the chin strap.  It's the mask leaks apparently caused by it slipping out of position.  My wife uses a cervical collar as you are suggesting, but I have no problem with the strap.  I also wrote that I wish to avoid a full face mask, but thanks for your suggestions.

Artsyuno:  I tried your suggestion about putting the mask center piece of the headgear right on the chin strap part that sits atop my head, but it doesn't stay there.  I also tried putting the chin strap over the mask instead of under, which was what I first asked about doing, but it distorts the cushion mask's side tubes so restricts airflow.  Maybe time to try a contoured pillow.  Thanks for your suggestions.

[PeaceLoveAndPizza]

What you want vs what you need are not aligned. You have tried the various conbinations of mask/chinstrap with no success. Continuing down the same path will likely yield the same result over the long-term.

[LaurenceShaw]

LaurenceShaw:  Thanks for the promo of your product, but my Vyaire chin strap works just fine.  Chin strap was not involved in causing the moving mask issue presented in my original post.

I'm glad the Vyaire is working for you.  Yeah, I see that you were asking mainly about under versus over.  It sounds like a contoured pillow would be a good idea since you don't want to go to a full face mask.  (From the geometry of the N30i, it seems like it would benefit from an additional force near the nose either pressing inwards, or secured there and pulling down and backwards.)

[hypopneac]

Not necessarily.  I'm not inclined to try a cervical collar instead of the chin strap, because the chinstrap is not a problem nor do I believe it causes movement of the mask which is over it.  Artsyuno suggested a contoured pillow, which assumedly is the same as the CPAP pillow you mentioned, so I may try that.  Meanwhile, my original query about wearing the chinstrap over instead of under the mask is ruled out since I tried that now, and it partly compresses the air tubes which run down along the side of one's face.

[Deborah K.]

If the strap is not stopping your leaks you may want to try mouth tape.  Many of us use it every night with no problems.  Cover Roll Stretch tape and Hypafix are both good tapes.  I like kinesiology tape better as it conforms to facial contours better.  You can find all of these tapes on Amazon.

People are different, but I must use 2-inch wide tape cut to 5-1/2 inches long or I still leak.