[Equipment] Alternative to Chin Strap

[HL649]

I am looking for an alternative to a chin strap.  I presently use a chin strap with a ResMed P10.  It works quite well but I still do mouth breathe a bit.  

I was looking at hybrid masks and they look like they might work for my purpose.  Specifically I was looking at the ResMed Mirage Liberty.  Can anyone give me any insight whether this mask is any good?  Pros and Cons?

I don't have medicare so every purchase comes out of my pocket so I don't want to get a mask that won't work.

Thanks for any help you can give me.

[Gideon]

Masks must be tried on. There is no other way.

Correction. 1 other way. See a plastic surgeon to make your face match in all ways the model the mask manufacture uses.

Seriously your face is unique. There is no other way to know.

Fred

[HL649]

That is definitely my problem. I have tried on a few full face masks and they simply don't fit. I thought the Amara View would be the answer sand it was probably the worst fit of any mask I have tried.

[Marillion]

I use a medical grade paper tape for sensitive skin on my lips to prevent mouth breathing. I also do use a chin strap. Since I have been using those two I have had 0 mouth leaks.

[2SleepBetta]

Bonjour is correct.

I just got the Mirage Liberty after my DME contact (he once had a sleep lab) warned me that I would not like it and that it was an "oldie". So far, I have to say he was right, but I haven't given up. Leaks and a too-small headgear are problems to solve, if upping moisture level relieves dry mouth. Overall, my ML is a hybrid experiment that continues with me changing masks back to the P10 after about one to two hours.  Note: I don't like the heavy, stiff hose that joins the mask and comes with it. Further, the clips for the upper straps do look fragile; some say the elbow with the vent is fragile, too.

I wanted the similar Innomed Hybrid but my prominent nationwide supplier could-not/would-not supply it and it has the exclusive market under the Medicare competitive bidding area scheme (as I understood it). I wanted nasal pillows, as the P10 has, but wanted a way to simplify dealing with my mouth breathing--a problem well under control, but requiring two sealing devices, three with the cervical collar, for this side-sleeper. (Not to mention using an improvised anti-asphyxiation valve and Lansinoh, fourth and fifth elements.)

I tried FFM's, being a mouth breather who failed the tongue-seal approach: tried a ResMed F10 first for several months,  then a Simplus (model?) briefly, and, last, an Amara View. The F10 was best performer re leaks and AHI, but I hated all the FFM's. I had hope but only occasional sealing success with the (most appealing but leaky) AV. And, yes, I repeatedly read and applied excellent mask-adjustment helps on the Board with some success on the various masks.

As others have pointed out, sealing the nare-pillow-contact contour/perimeter for pillows is much easier than sealing the more variable and  much more lengthy sealing perimeter of any FFM. That made sense to me and challenged me to come up with a non-tape way to seal my mouth. I had tried three of Board-member recommended tapes.


I've been most pleased with the P10 (about one year with many nights of double naughts--no reported events and zero leaks ); this after improvising a mouth sealing method and taking Board advice to use a soft cervical collar rather than my three extended trials using purchased and improvised chin straps.

My guess is that I will resign myself to continued great success with the P10 and the complications of the Silipos sealing element, the elastic retainer that presses that sealing element to my face, the cervical collar, and the improvised anti-asphyxiation valve I use. Complicated, but not uncomfortable, and very effective. Somewhere on the Board I posted pictures that show the two pieces of the mouth sealer, the Silipos seal and its retainer. If you look, ignore the chin strap and FFM, both have been cast aside. I did steal the anti-asphyxiation valve elbow from the F10 to protect myself and, further, I now make a small slit in the Silipos seal where my upper and lower lip meet, again for safety. The seal and retainer keep my lips from flapping and leaking. The long-reuseable seal element has no adhesive, just a clinging, non-slip gel against the face.

Sorry about the long post, but for you, like so many struggling with leaks, chin straps and taping I wanted to share about my long journey from a high RDI, low-oxygen saturation state to a "double naught" state. Though weary of the complexity, I get great sleep and much better oxygen saturation. I should add that many find simple ways that are effective and simple to deal with such struggles as I have had. My way works for me (though I continue looking for a better way) and their way works for them--there are too many individual variables as bounjour pointed out.

2SB

[MikeBear]

My final solution after trying everything else, including multiple chin straps, is Nexcare sensitive skin tape to tape my mouth shut, and a soft collar around my neck to keep my chin from dropping so my Airfit P10 mask will work without losing pressure. I also had to keep doing the "tongue-trick" for almost a month before it now wants to stay in the proper place by itself, without dropping back to close off my throat.

It took a while to get used to this, BUT, my leaks now stay handled, and things are slowly coming together for me.

p.s. I have COPD (chronic bronchitis which makes me cough, sometimes productively), so taping my mouth shut was a big mental-fight with my brain and body. My coughing at night has even calmed down a bit with this modality, BUT, if I do have to cough, I've learned it can be done even with your mouth taped shut!

[mesenteria]

I also have gravitated to 3M's NexCare water resistant tape over my mouth.  I don't want to use chin straps as I am otherwise comfortable now...at last...and can sleep.  It's just that my mouth loses all tone and I can't seem to keep my tongue up against my palate as I lose consciousness. I have to tape...period.

Another tip that may or may not assist in the overall reliability of the taped mouth method, should you choose to attempt it, and that is I found I leaked less around the tape if I applied it with my lips pursed a bit and my cheeks puffed out fully.  For whatever reason, if I don't do that I get more leaks past the tape...or used to.  I reason that the tape adheres better if it is applied with my skin already stretched out the way it will stretch unbeknownst to me while I sleep.  You will get used to occasionally letting your cheeks bulge as you fall into sleep. It's weird at first...and I have sometimes just let my tongue fall and let my cheeks bulge first so that I don't awaken when the event happens just as I am falling asleep.

The things we do for REM.....

[babag1]

I use a medical grade paper tape for sensitive skin on my lips to prevent mouth breathing.  I also do use a chin strap.  Since I have been using those two I have had 0 mouth leaks.

I used paper tape first but fell in love with 3M 1538-2 Durapore Tape sold on Amazon.
Commercial Link Removed

Fold each side under for quick removal and it doesn't hurt my sensitive skin. 

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[snorybob]

mesnteria:

Thanks for the tip on taping (puffed cheeks). Always had a problem with little air leaks in the middle of the night. It's irritating to have to retape at 2 am.

Tried your method & it works great for me. Appreciate it! 

      Bob

[snorybob]

mesnteria:

Thanks for the tip on taping (puffed cheeks). Always had a problem with little air leaks in the middle of the night. It's irritating to have to retape at 2 am.

Tried your method & it works great for me. Appreciate it! 

      Bob