[Equipment] Mask type and fit

[Nick1]

I'm in the UK being treated for sleep apnea through the NHS.

I have suspected for some time that I might have sleep apnea but eventually got round to being tested a couple of months ago - results were an average of 33 events per hour OSA. I received a Resmed Airsense 10 Autoset at the beginning of the month with an Airfit F20 mask size medium. Generally, I am okay wearing a mask in that it doesn't bother me having a mask on, but I cannot seem to get a good fit - I'm not expecting miracles, it's only been two weeks - but I'm wondering how much experimentation to do compared with spending more time using what I have.

With the medium I steadily increased use over the first week, but whilst the fit on the nose was pretty good, the sides of my mouth could on the seal whenever I moved, and the bottom of the mask rode up into my bottom lip. This resulted in leaks at the bottom of the mask and cold air blowing on my chin. I talked to the clinic and they sent out a size large to see if it helped. Whilst the fit of the large is slightly wider and is much better at not catching my mouth at all, it feels too long and I seem to be regularly getting blasts of air in my eyes. It's tempting to think I should try the f30, but perhaps I should just persevere with the medium for a few weeks and see how it improves. 

The good news is that wearing either mask has a very positive effect, down to 5-7 events per hour, the problem is, I only tend to be able to keep the mask on for 4hr 30min per night. I have watched a lot of videos on getting the fit right, but I'm not able to find the happy medium between leaks and clamping the mask on too tight.

I do have oscar, though I've not really been reviewing the results, thinking it's best to get to a consistent 6 hours with the mask on each night before setting out to tweak the settings. The settings are actually set by the clinic and they have remote access to get the ResMed reports.

Interested in peoples thoughts on persisting with the mask or trying a few early on. Of course any other thoughts greatfully received.

[Nick1]

I did not have a great night last night, though I did keep the mask on for 6 hrs. From Oscar it looks as though the whole night was pretty much a large leak. Has anybody any thoughts based on the chart below?

   

[DaveCar]

I'm pretty sure it was an F20 (or quite similar) that they set me up with originally. I couldnt get to a happy place, it was either pushing my nose down too much and blocking nasal air or it was too floppy and spraying my eyes.
Traded it for an F30 and have been happy for 2 years.
I keep the bottom fairly tight, I think it helps keep my mouth closed. The overhead strap, I tighten just enough to lift my nose a little. The overear straps I adjust for overall face-seal.
It works great for me, but everyone's face is different (identical faces doesnt happen until 2170).
Keep at it though, great to hear of good numbers. 
Once you get the kit set up , it's just routine and you will love the better living.

ps- Hello to the UK, my wife is from Southport.

[Nick1]

Thanks for the encouragement Dave,

I was thinking about the F30 as an option. I think I’ll give it a go.

I’m in Manchester, and know Southport quite well.

[Sleepster]

IGenerally, I am okay wearing a mask in that it doesn't bother me having a mask on, but I cannot seem to get a good fit - I'm not expecting miracles, it's only been two weeks - but I'm wondering how much experimentation to do compared with spending more time using what I have.

My recommendation is that you set your current mask aside, perhaps to be tried again at some future time. You want to experiment with a variety of masks and sizes, and your health care providers are expecting this. It is quite common to have to try several masks before finding a good fit.

(I look forward to the day when we can all have custom made masks that fit perfectly!)

When I was trying to find a good mask I would often rotate masks, trying again a mask that I hadn't tried in a few days or even weeks.

[staceyburke]

Of course the high leak rate is the problem!  But what is causing the leak?  Of course it can be an ill fitting mask, no doubt but let me ask a question.

Could the reason for the large leaks be positional apnea? That could cause the pressures to increase to high to keep a seal.

Positional apnea is when your chin drops down to your Sternum cutting off your own airway. It can be caused sleeping on your back or even to high of a pillow. If simple changes don’t work look into a collar. PLEASE look in my signature for a link on collars.

This may NOT help but collars are less than 20$ at Walgreens. You need to get the right height. Take a measurement betweeen tryout chin to sternum.

[SarcasticDave94]

I'll offer a consideration, look up the Fisher & Paykel Vitera full face. I tried for over a year with the ResMed F20, in small, medium, large, and in AirFit silicone and AirTouch memory foam.

I was issued a F&P Simplus during a sleep study and afterwards the Vitera at another study later. Either the Simplus or Vitera will be many times better than any F20.

[Nick1]

Thanks for all the posts, a lot to consider. I am getting the F30, it should arrive in a few days. But will also look at collars and the F&P masks mentioned. The graph I posted was a particularly bad night, but some nights I can't get a decent seal at all and give up after an hour, other nights I get to sleep but keep getting woken up with air blasting in my eye, or a freezing cold chin. I think there is something in @stacyburke's thoughts because I do sometimes wake up with the mask riding up enough that the bottom of it is in my mouth. I do turn quite a bit in my sleep, hunting for a cooler spot on the pillow.

I had a good practice with the F20 today and tested the large and the medium sizes. I'm going with the large tonight and will spend more time looking at some of the info in Oscar to understand what is going on.

Thanks again, I appreciate everyone's thoughts.

[Big Guy]

I went from an AirFit F20 to an AirFit F30. It was a good move. I do sue the F20 once in a while, just for a change of pace. But.....the F30 is my primary mask.  

[Nick1]

I have added an o2 Ring to my arsenal of data. I used the F20 with a large fitting last night. Still plenty of leaks, but not quite as many. I did 4 hrs with the mask on, then slept a couple of hours without it. I noticed in the graphs that the leaks seem to start at a pressure of 7.5, which is low, but even at that low pressure the events appear to also be low and my spo2 is reasonably consistent. Without the mask, my sp02 is more erratic.

Whilst I wait for the F30, is there any benefit in setting the max pressure to 8 to see if I can avoid leaks?