[Equipment] Masks all either cause pressure sores or blow off my face

[middleofnowhere]

Hi. So I've been cycling between different masks, mainly a full face ResMed F10 For Her and a nasal mask AirFit N20. Both of them are causing pressure sores on my nose. If I loosen them, air blasts out the sides into my eyes (and by my mouth also for the full face mask) and my machine says large leak. If I tighten them then my nose gets red marks that turn into bruises. I've tried wearing cloth mask covers and even putting bandaids on my nose. I measured my face carefully before getting the masks and I even tried one of those face scanning apps on the cell phone that's supposed to find you the perfect mask. Nothing is working and I'm sick of hurting and looking like I've been in a fight. I can't afford to keep buying more masks. The other one I tried was the F&P Evora full face mask that doesn't touch the bridge of the nose, but it never fits the bottom of my face right and it leaks and farts all night no matter how I try to adjust it. I even got the fitpack and tried all the sizes! Before that I tried the F&P Evora nasal mask, and I absolutely cannot get enough air through it and then I have lots of apnea events. I have fewer events with the full face masks.

I suspect the aquiline nose shape I inherited from my dad isn't helping, but there's not a thing I can do about that. There has to be some solution.

There isn't anywhere local to go to deal with this because I used a telemedicine CPAP service to get my sleep test with the WatchPat One device and then get the CPAP prescription. I can't afford polysomnography because my insurance is trash and I'm pretty broke. 

What do I do to prevent these pressure sores without the mask blowing off my face? It's on autoset and the highest pressure it shows in the night is only 10CM, nothing crazy.

[HalfAsleep]

I would be alternately suffocating on your settings or having my mask blow off if I rolled over. Follow exact directions for Oscar and post screen shots of a couple of nights. That’s the only way to investigate what’s going on.

Yes, you can get help for mask issues, but IMO the source problem is the pressure settings.

[middleofnowhere]

How do I attach the whole OSCAR file? I can't find instructions. If I take screen shots to get the whole thing it will use up past my attachment limit.

[Crimson Nape]

The default Daily screen layout in OSCAR has the parameters listed in order of importance.  While in the full screen mode, use the F12 key, or Fn+F12 for a Mac, to take the screenshot.  The first 5 graphs should be enough for now.  Please see the links in my signature for more instructions.
- Red

[middleofnowhere]

I hope this works. I tried to read the charts, but all I can understand thus far is when events are occurring, when the mask leaks, and when the pressure goes up and down. These pictures are from last night. Night before last was super bad with massive leaks even though the mask was tight. Thanks for helping.

[DaveL]

Thanks for your post.

I bought an F&P Evora Full after reading enthusiastic comments here. It's wonderfully well made. It's been the Best of Times! It's been the Worst of Times.

Some days using it is absolutely a miracle. Some days my AHI escalates beyond belief.

I react poorly with it. I want to tighten and tighten straps. The mask hates me when I do that. I need to loosen straps! Not tighten them.

My goals are wellness, comfortable sleep and convenience using my mask. Particularly when I wake up in the middle of the night to take a break.

My alternate arrangement is a ResMed N20i mask. Set on nasal pillows. And, either: lip taping, or a pad under my jaw or one of my Knightsbridge Dual Band caps.

Hope this helps.

[Deborah K.]

I'm sorry you are having mask problems. They can be a bear. Lots of people make the mistake of overtightening their masks. The mask should sit lightly on your skin. When the air enters it fills the mask and presses just enough against the skin to make a good seal. I don't know if that's your problem, but it could be. If you are getting bruising your mask is way too tight.

Another thing to consider is that full-face masks tend to leak the most, nasal masks leak less, and nasal cushion masks leak the least. Another advantage of a nasal cushion mask is that it makes the least contact with your face, leading to less soreness.

I see that your machine is set to start at the lowest possible pressure. Low pressures like this are mostly meant for children, and most adults feel air-starved with settings so low. I suggest that you raise your starting pressure to 7 and turn EPR on full-time, set at 3. I think you may be using ramp. Please turn it off. You get virtually no therapy during ramp. Making those changes should provide better therapy and comfort right away.

[middleofnowhere]

Thanks. I'll change those settings. I tried loosening the mask, but then it just blew air into my eyes and farted all night.   The more minimal the mask, the less I'm able to breathe properly through it. If I tape my mouth and wear a chin strap it seems to increase my AHI a lot, and I even wake up choking sometimes if I do it. The full mask hasn't caused that problem yet. This is all so complicated and frustrating.

[Deborah K.]

If you tape your mouth you don't need a chin strap.  Chin straps are supposed to help keep the mouth closed, but for most people, they don't work very well.  Just tape if you decide on a nasal or nasal pillows mask.  

Also, a good number of people like a new ResMed full-face mask called the F-40.  There's a thread on this main forum discussing it, if you are interested.  Apparently, it's different from all the rest.

In any case, good luck at finding something that works well and is very comfortable.

[Rickyricardo]

I tried full face well over a decade ago when the S9 was new, and I could not use it properly at all. It did not fit such that leaks were absent and it was far too cumbersome. And heavy.

So I switched to using just the ol' snout, and while the one over the nose was nice (N30) and soft there was not a great seal. I still have it around somewhere. Then the Swift FX which I still think is the best for durability and now the P10 which has good fit but the crappiest flimsiest short-lasting elastic headband. Buy the non OEM from Amazon. They don't last any longer but are 1/3 the price.

I worried about open mouth issues and they didn't happen. The horse whinny sound and the sudden lack of air if I opened my mouth kept the trap shut.

It looks like the Swift FX is not sold any more, no doubt due to lasting so long such that ResMed can't make bank selling head straps. The pillows by and large are almost identical between the Swift FX and P10 (not that they are interchangeable, they fit very much the same), so as long as you are not cheesed off by the short lasting straps, maybe try the P10 nasal pillow mask.

You can use a little KY jelly around the nostrils (or vaseline which is much harder to clean). But as to irritation there is so little facial contact it might be an option.

I'd like to find a stockpile of unsold Swift FX headsets and pillows and I'd buy 20 years worth.