[Equipment] Mask Leaks and Liners

[Let Me Sleep]

Hello,
I've been on a CPAP for about a month {yup, a newbie} and the whole time I have had full face mask leaks. I use a Resmed Airsense 10 5- 14 for pressure {down from 5-16 due to air in the stomach}. I have tried several types and sizes of masks including the Mirage Quatro. The best fit so far is the large Quatro air. Most are okay for 3-4 days and then they start leaking and I can not control it with straps.
I use the commercial CPAP mask wipes and wash my face before bed with ivory soap. I did some research on this board and see that some folks with leaks use liners. I bought the Pad A Cheek liner for my mask {I can review after a few more nights}. While I was waiting for it to arrive, I made a liner out of an old T-shirt. Both liners stop the feel of the leak and the noise, but looking at both the Res Scan and the Sleepy software, the show a sizable leak. Consistently in the 26 - 32 l/min range. My AHI is in the 1.7 - 5.4 range.
My question for you guru's: Does the leak rate really matter if the leak noise is gone as is the feeling of the leak so that I sleep? My AHI looks to be in the "safe" range. I'd appreciate your thoughts and wisdom !!

Thanks

[PaulaO2]

26-32 isn't *too* bad a leak. 24 is considered the proverbial line for Resmed machines although there is some wiggle room depending on mask and recent alien influences.

Where is the mask leaking? The Gecko and the Pad-a-cheek are both for leaking up at the eye/top of nose areas. If the mask is leaking lower, like around the mouth, it's not going to help that.

Prior to the tshirt thing, were you waking up with hearing the leaks? Or you just knew you had leaks because you had them while trying to settle the mask when first putting it on?

You say "consistently" leaking. As in all night or just most of the night or part of it? The problem with long term leaking, even that small an amount, is the AHI is not going to be accurate. So you don't know for sure if you really are getting it right. That's the big thing with leaks. Any event reported during a leak is suspect. And you never know if an event happened during a leak and wasn't reported.

Invest in a pack of Remzzz liners. Contact the company and see if you can score a coupon or something. Sometimes they do that. Or make some more out of tshirts. Put on the liner and the mask. Put the machine on straight CPAP mode on your highest setting. (which would be 14). Lay down in bed and see what happens. Toss. Turn. Get into sleep positions. Relax your face. Open your mouth (because if you are wearing a FFM, you must be doing so in your sleep, right?) Where are the leaks happening? What can you do to fix them? Cranking down the straps is not the answer. That causes more leaks and a tender face.

[Let Me Sleep]

26-32 isn't *too* bad a leak. 24 is considered the proverbial line for Resmed machines although there is some wiggle room depending on mask and recent alien influences.

Where is the mask leaking? The Gecko and the Pad-a-cheek are both for leaking up at the eye/top of nose areas. If the mask is leaking lower, like around the mouth, it's not going to help that.

Prior to the tshirt thing, were you waking up with hearing the leaks? Or you just knew you had leaks because you had them while trying to settle the mask when first putting it on?

You say "consistently" leaking. As in all night or just most of the night or part of it? The problem with long term leaking, even that small an amount, is the AHI is not going to be accurate. So you don't know for sure if you really are getting it right. That's the big thing with leaks. Any event reported during a leak is suspect. And you never know if an event happened during a leak and wasn't reported.

Invest in a pack of Remzzz liners. Contact the company and see if you can score a coupon or something. Sometimes they do that. Or make some more out of tshirts. Put on the liner and the mask. Put the machine on straight CPAP mode on your highest setting. (which would be 14). Lay down in bed and see what happens. Toss. Turn. Get into sleep positions. Relax your face. Open your mouth (because if you are wearing a FFM, you must be doing so in your sleep, right?) Where are the leaks happening? What can you do to fix them? Cranking down the straps is not the answer. That causes more leaks and a tender face.

Thanks Paula. I was waking up with a little leak around the cheeks, but mostly it was blasting into my eyes. According to the software {Res Scan and Sleepy} my leak rates are highest during and after I have events that trigger the CPAP to push to the higher limits. I start the night by putting everything on and hitting the mask fit test for a while to ensure I get the little smiley face !

[trish6hundred]

Hi Let Me Sleep,
WELCOME! to the forum.!
Hang in there for more answers to your question and much success to you with your CPAP therapy and your mask situation.

[surferdude2]

I made a liner for my Mirage Quattro mask that only covers the upper part of the gasket, the area at the upper cheek & nose. It works well for stopping the bothersome effect of air blasting into my eyes. It doesn't stop leaks, as you know, but makes them less bothersome. By their very nature, liners usually cause more leakage than the gasket ordinarily would have. By limiting the area they cover, you can reduce their leak introduction factor and still get the relief you need in a specific area. Get creative with that tee-shirt cutting and you should be able to get something similar that will work for you.

Also be sure you are tightening the straps uniformly and no tighter than necessary. I advise measuring the straps from end to end to determine the true center point between them. Mark that spot and after adjusting the straps as best you can, check to see that each strap measures the same to the center mark (correct as necessary to balance the lengths). I'm sure you get the idea. I record those measurements if/when making any changes to be able to know something about the change I'm making and to keep it uniform on each side.



You can't easily tell from the pic, but I cut a hole in the liner and installed it on the adjustment post of the mask. That works well to keep it in the same spot each time I put the mask on.

[PaulaO2]

Also check out YouTube and watch videos on how to fit the mask. It is amazing what I learn each time I do that. It's like "OH! that's what that is for!" or "Duh, I forgot that part!"

[surferdude2]

Another little tip that helped me is to use Pampers wipes rather than the professional mask wipes. I tried the pro's first, Pampers work better. YMMV. Also I found that washing the mask daily was making it leak worse than merely wiping it after use with the Pampers. I now just wipe it daily with the Pampers and wash it weekly in soap and water. When it dries completely, I wipe it with the Pampers to impart a coating on it. The juice in the Pampers leaves a film on the gasket that makes it less slick and more stable from slipping during the night. It seals much better for me using the above procedure. The daily cleaning was counterproductive, at least in my case.

Dude

ps. Pampers are alcohol free and unscented. They contain water and a small amount of aloe. They do not damage the mask cushion since I'm into the 6th month with my same cushion. The aloe coating might even be helpful to those who are allergic to the silicone cushion.

[PaytonA]

Another little tip that helped me is to use Pampers wipes rather than the professional mask wipes. I tried the pro's first, Pampers work better. YMMV. Also I found that washing the mask daily was making it leak worse than merely wiping it after use with the Pampers. I now just wipe it daily with the Pampers and wash it weekly in soap and water. When it dries completely, I wipe it with the Pampers to impart a coating on it. The juice in the Pampers leaves a film on the gasket that makes it less slick and more stable from slipping during the night. It seals much better for me using the above procedure. The daily cleaning was counterproductive, at least in my case.

Dude

ps. Pampers are alcohol free and unscented. They contain water and a small amount of aloe. They do not damage the mask cushion since I'm into the 6th month with my same cushion. The aloe coating might even be helpful to those who are allergic to the silicone cushion.

+ a bunch. I use the Pampers wipes and like them a lot. Thanks again Dude for the recommendation.

Best regards,

PaytonA

[PaytonA]

I agree with most of the previous commentary with the exception that sometimes it is necessary to tighten the mask down fairly tight. One should not go right to real tight straps to fix problems but try other fixes first.

Generally what causes flexible silicone masks to leak when tight is insufficient care in donning the mask causing a fold in the flexible silicone seal to occur. Another possible problem with tight masks and leaks is failure of the silicone seal to inflate properly so there is insufficient pressure behind the seal to hold it against your face as tight as it should. The solution to this is to don the mask and turn on the machine. Then gently pull the whole mask slightly away from your face and let some air blow out. Then gently re-seat the mask on your face. Voila' fully inflated seals.

I also feel that the Mirage Quattro is one of the masks that seals difficult faces the best due to the adjustability of the stabilizer and bridge of the nose seal. Generally people either love the Mirage Quattro or they hate it. There is a good description of fitting the MQ online. Google - Taming The Mirage Quattro.

Best of Luck,

PaytonA

[sjssf]

I have a nasal mask and it has been fine. I tried the nasal pillow but I prefer the mask.
Last night i started hearing this awful wheezing sound. It seems to be coming from the curved part that connects the mask to the hose. It has a small filter and this happened once before. I cute up a a filter and replaced it but this time within a few minutes it started wheezing again.
It wasn't a fun night!
Any suggestions?