Best method to wear chinstrap with nasal cushion mask?

[hypopneac]

Deborah K.,

Thanks, but I believe that the leaks are from positional changes of the nasal cushion mask while moving around when asleep.  Also, when I awaken in the night I like to grab a little water from a bedside bottle.  Although I'll concede that the dry mouth which leads me to want a drink could be a result of mouth breathing despite the chin strap, I'm not fond of the idea of taping my mouth shut.  My objective is to have minimally invasive CPAP, which is why I use a top of head attachment mask and prefer the nasal cushion to the full mask.  If necessary, since the leaks are typically at worst from 5% to 8% (but have been less than 2% yet a few times close to 30%, which of course is unacceptable), I'll probably just live with it.  My hope in opening this thread was that others might have favorable experience in putting the chin strap OVER the mask, but then I tried it myself and saw that it compressed the air tubes which run along the side of one's face from the top of head connection to the actual nasal cushion.  So that isn't going to be a remedy.  Maybe I'll get a different kind of contoured pillow; I have one now which is higher/lower on the two long sides, but is quite firm so might not give way and instead may push the mask depending on my position.

[SarcasticDave94]

My opinion, but you're maybe overlooking the fact this mask isn't working well for you. You mention that you've tried making it tight, even if only for a short amount of time. This alone says the mask is not fitted right.

There's 3 things I can think of in mask sizing, cushion, frame, and overall shape. Any one of these will make it hard to fit consistently with minimal leaks.

Back in 2017, I was on an ASV for Central Apnea treatment. I felt stuck with the mask, a ResMed F20. I stuck it out for 9 months to a year. Every time I put it on, adjust the straps. Then I hit a frustration level, and made an effort to replace the torture device.

Just a suggestion. Maybe you need to simplify your issue. Shop for another mask model.

[hypopneac]

Dave,

I have an F&P Evora full mask and cushion mask, my first masks from last April, both for front "elephant hose" attachment.  Stopped using those in August after about 3-4 months on CPAP due to annoyance with that attachment method.  I also have a ResMed AirFit N30i cushion mask which is a model with top attachment and is what I've been using ever since; switched to the wide cushion for what I thought was a better fit.  I have other sizes of cushions and the P30i pillows cushion as well.  I'll probably start rotating back through various of these to see if one of them is better.  Thanks for the suggestion.

[SarcasticDave94]

Welcome. I've only had 8 mask models.

Philips Respironics Amara View

ResMed F20, N30i/P30i (with cushion swap)
Fisher and Paykel Simplus, Vitera, Evora Full

Myself Fisher and Paykel masks were great. Once I start therapy again, I'll use the newest, Evora Full hybrid.

[hypopneac]

Wow, that's a lot.

If you don't mind me asking, why would you have stopped therapy but with a stated expectation of resuming it at some point?  Not being nosy, just curious about all the situations which one might expect to encounter or experience while going down this proverbial road.  If you're inclined to answer but without having a big audience, perhaps a PM would be more suitable.

[SarcasticDave94]

Because everything in Dave's world is super complex. I have complex Apnea, both Central and Obstructive. Also have lung disease COPD. Heart timing issue called PVCs. Very bad back with spinal cord stimulant implant like a built-in TENS treatment, because a medication caused osteoporosis, and I broke 7+ vertebra over 9 months in 2018.

I need to go above ASV Central Apnea treatment to accommodate COPD breathing, which needs manual timing controls.

I had a video doctor consult with my sleep neurology doc at Johns Hopkins. She's working on plan to get me onto ResMed AirCurve 10 ST-A, a tweener machine. It looks like other ResMed CPAP, but it's a baby ventilator.

Like I said, just a bit complex. Yours is likely a bit easier.

[hypopneac]

I'm sure mine is a lot easier than that!  Sorry for your multiple issues, and much praise for providing information and advice to those here who request it, despite your own challenges.  Does misery love company?  If so, know that I've just had a repeat MRI and EMG to help figure out what's up, after they were first done while in the throes of excruciating pain which continued over two months this summer for an L2-L3 disc extrusion, a level on which I had neurosurgery ten years ago.  Now I'm thankfully pain free but at a stasis plateau after 20 PT sessions.  Absent pain, I still have upper thigh numbness and leg atrophy due to the femoral nerve compression which started with my onset of the back pain in late May which continued to early August months ago.  It was precipitated by a lengthy walk from a parking garage and then descent of a great many steps down to the front row of an arena, then back up.  I think I'll live with the numbness and keep at the PT on my own rather than submit to a possible three level spinal fusion open surgery, mentioned by my new orthopedist's NP since the two next levels below also have various protrusion/extrusion issues still seen on MRI, though currently asymptomatic.  Seeing her boss, the doc, for an opinion per those new studies in a week.  Meanwhile, hope you do well with remediating your several problems in the coming year.

[hypopneac]

Thanks for the suggestion; I'll have it here for reference but mouth taping is not too appealing.

[SarcasticDave94]

Thanks for your thoughts. Best wishes you get your needs addressed.

[artsyuno]

FYI, the pillow I use is the Contour CPAP Max.  I like it but haven't tried others so I can't compare.  It's pretty firm but has padding in one side of the cover (I use that side up) so I find it to be surprisingly comfortable, although I've seen a few comments from others who think it's too firm.  It's height adjustable - 3 pieces of foam that you can use in any combo - the height is best for me with the middle piece removed.  It's a fairly small pillow, but side sleeping at one end allows the masked part of your face to basically hang off the end of the pillow with the jaw, forehead and side of the head behind the mask frame supported so it doesn't feel like you're dangling or tipping off.  The area where the mask frame would otherwise be on the side of the head is tapered so that it's lower than the rest of the pillow leaving room for the mask so that it's not pressed into the pillow.