[Health] I have to tighten my mask so badly that my face gets puffy...

[CantSleepWell]

Hi! I'm using a DreamStation Auto CPAP (500X150) , and a resmed (official) airfit f20 with the cushion.
The machine has the humidiifier module AND the heated tube AND i put a cover on it. I spent a fortune on this stuff , as you know.

The problem is this: every morning:
- i wake up exhausted, as if i didn't use the machine
- my mouth is dry
- now my  face is puffy every morning

My 'doctor' is a london sleep clinic i won't name who gave me a machine for 1000 pounds 5 years ago, told me there was a 'sim' inside and they would monitor me remotely. They did no such thing. 

That said, the machine is not a bad one - it's just probably not configured for me at all as you all know the dreamstration has no sim. I feel angry and now i can't afford to go spend another 1000 for another doctor, so I'm hoping the community can help.

After 2 month of normal use, no wash and good care, the mask is so loose i have to tighten it so badly my face gets puffy (or else I get leaks).

I use OSCAR but in all honestly I have no clue what any of this means. I want to learn so i can get better.

I tried to attach my OSCAR data but this site blocks csv. SO i attached a screenshot. Maybe there's some 'low hanging fruit' in terms of configuration?

Thank you.

[Sunday3]

When I used to have to tighten my mask so hard I got welts, it was due to a poor overall fit. I ended up having to get a Medium Dreamwear frame and a Small cushion.

[SarcasticDave94]

Welcome to Apnea Board,

With a DreamStation, you need to set pressures close to what you need. Even though pressures can Auto adjust themselves, Philips Respironics machines need some help by physically setting the pressures closer to actual need than for example a ResMed. ResMed adjusts faster and proactively while Philips Respironics are reactive, meaning they act during or after an event. This can lead PR to miss treating that event.

Try this, edit your min pressure to 7 or 8 as your median is 7.8.

As for masks, I've tried the F20 as well, and it doesn't cut it for me. Too many leaks with too much fussing over the strap adjusting. You may need to get something else. If you don't mouth breathe you should consider nasal pillows masks, they're minimal interference and minimal seal requirements. Nasal masks are slightly bigger but still require less seal than full face.

The things that affect masks are size, fit, strap adjusting technique, brand, and style. That's a lot of variables to get right to find the right mask. And that is why mask choice is the hardest to get right.

Note this, that in every mask situation possible, if it's tight enough to hurt, it's not right.

Check the wiki on mask primer.

[CantSleepWell]

That's crazy i had this machine for ages and i had NO IDEA how it worked. No one explained a thing to me, they just said 'put it on your head and off you go'.
I guess i have a lot learning to do. I'll read the link you sent. I hope i fix it because i'm worried about health, i'm 46 and a bit fat...

[Sleeprider]

CantSleepWell, your settings are minimum 5.0, maximum 20 with some kind of Flex in place. Your median pressure is 9.5, so you are well out of range for minimum pressure. I recommend increasing minimum pressure to 9.5. On your Oscar leak rate chart, there are two lines. The bottom one represents excess leaks, and the top one is total leaks. When the excess leaks exceed the red dotted line, that is a large leak, and you don't have any. You're doing a great job on leaks, but you should be able to loosen up the mask.

The event chart shows a regular periodic flow limitation at roughly 10-minute intervals. That is kind of a curious pattern and may represent some kind of periodic movement. It would take a closer zoomed look at the flow rate (3-4 minute in the zoom window) to figure it out. We can hold off on that for now and just try the hiigher minimum pressure. This shows how to access the clinical menu to change minimum pressure https://www.apneaboard.com/dreamstation-...structions

[ejbpesca]

After a year with the F20 Resmed mask, I gave up on it two days ago.   F20 mask for me was trouble from the beginning.  It gave the impression of being a more comfortable well sealing mask but the opposite turned out to be the case.  I have moved to a hybrid nasal/full face with much improvement in comfort and leakage.

F20s lose their elasticity within two weeks of use requiring tighter and tighter straps causing pain and sores to my face.  The first time I used F20 it caused a rash and a puffy face so I returned to F10.  I gave F20 another try and all seemed well but then came the large leaks.  Since I had a supply of the F20s I kept using them thinking I may find a way to adjust them well.  Has not happened.

Using FP Evora Full for a couple of nights, I am realizing the silly cone of the F20 does not seal well to my face.  With Evora I am now able to loosen straps more than any previous mask out of six.  Evora will pass an 18cm mask fit test.  I never could pass a mask fit test with F20.

The silicone of the Evora has more tack or friction upon the skin and repels skin oil better.  Removing it after sleep has a bit of a sticky feel since the mask adheres to the skin.  That is a bit strange but fine with me to get leaks down and comfort up.

It has been only two nights with the Evora, but I have high hopes for it and I now want to investigate other hybrid full face masks.  I did not know they existed till two weeks ago.  I saw them listed here as CPAP gear for members.

[PaulaO2]

I went through a lot of different FFMs but none seemed to work for me. Each face is different and what works for me may not work for you. But if you are having to tighten it down that tight, it isn't the right mask for you.

Go to the reviews forum and check out the mask section. Don't ask questions there but come back here to this thread.

I eventually gave up and returned to a nasal pillow until recently. Someone recommended the Evora so that's what I tried. I didn't expect it to work. But it is wonderful. I only use it when congested or when I have to sleep on my back. But I may change that as it is fairly comfortable.

[ejbpesca]

Here I go again struggling with large leaks.  My new Evora has been doing well so I loosened it to the comfort level as prescribed by so many "how to" fit a CPAP mask resources.  Those instructions are not for me.  I must tighten the Evora back enough to get the leaks back under control. 

[SarcasticDave94]

As I've found on the F&P Vitera, looser is correct, if you adjust the straps correctly. It could be there's a certain order for this, or a certain method. I don't use any mask right now, unfortunately, so I can't tell you what the proper adjustment method entails.

OK, I grabbed this from Mr. Google to try to help. Review the screenshot attached to see if this method helps.

   

[PaulaO2]

I watched several YouTube videos on how to fit it correctly.

Most FFMs are designed to float on your face. The air pressure presses down on the flaps of the mask and forms a seal. If you over tighten, then those flaps can't seal.

Also try the different sizes of cushions. For me, the small fit better but was uncomfortable. The large was just too large and leaked like mad. I use the medium. I wake up at least once a night with the mask farting when I exhale but a quick pull away and resettle fixes it.