Help! Need a new mask that's TMJ-friendly

[Cultural Gangster]

Hello everyone - I could use some advice with a new mask that's TMJ friendly.  Here's my situation:

I was recently diagnosed with severe apnea and have been trying to get used to CPAP for the past few weeks.  Unfortunately despite recommendation from the nurse, nasal pillows aren't really an option with snoring and mouth-breathing.  I've tried it again off and on several times, but it always ends with a frustrating end and terrible night sleep.

The Airfit F30 showed a lot of promise.  It's comfortable when sitting/awake and breathing feels pretty natural.  Unfortunately after a few hours of it it place, especially when lying down, it puts pressure on my jaw triggering an old TMJ and I wake up with unsustainable jaw pain.  To continue getting used to the CPAP, I significantly loosened to bottom straps to minimize jaw pressure but now it leaks something fierce.  In looking at pictures of just about every alternative, the lower straps all seem to run along the jaw line, which I'm afraid will cause similar pain.
I was wondering if a full-face mask might be better, since it distributes the pressure a little more broadly but of course the DME is unwilling just keep trying all possible masks.

Any help/advise would be fantastic!

[SarcasticDave94]

I'm going to play a broken record of mine. Since I was introduced to a Fisher and Paykel Vitera full face, it's been my go-to until my ASV therapy didn't want to play well together with COPD.

The Vitera is at least a possibility. It is a full face type and you need to wear the straps rather loosely intentionally due to the RollFit bellows on the cushion. You need to wear it lower on the nasal bridge than ResMed's masks to keep it from leaking there, but it's a minimal adjustment thing.

Give it a look and see what you think. I used a ResMed AirFit and AirTouch F20 mask, mostly medium-sized was best. I use the Vitera in medium also, but check for for yourself to be sure of correct fit if you get one.

[lvmickey]

Do you have a mouth guard from your dentist? I use nasal pillows unless my nose is stuffed up to reduce issues with TMJ as well. Currently I’m using the brevida and have used the nuance pro.

[Dawnstar]

About three years ago, I was having similar issues, eventually seeing an oral surgeon who injected cortisone into my right TMJ, which was quite effective. Subsequently to this my hematocrit and hemoglobin were indicative of low grade anemia, and ensuring that I get enough iron in my diet I think has kept the issue from returning. My TMJs still aren’t in great shape, but there’s no significant pain at night anymore.

[Cultural Gangster]

Thanks for the advice!  Intentionally loose sounds promising - I'll take a look.

My TMJ needed a lot of treatment about 20 years ago but since then I pretty much just live with it and avoid things that aggravate it.  It hasn't really been a big problem until CPAP therapy.

[Cpapian]

I have had TMJ dysfunction for many, many years. When I hooked up with XPAP I started pushing my front teeth out. I added another mouth guard so now one on top and one on bottom. If you haven't been wearing a night guard in recent times, I would recommend getting one from your dentist. Having stuff on your face can change the dynamics. I was wearing the Resmed n20 when this happened.

[Christina5818]

Hey how are you doing now? I'm also in Toronto and struggling to use bipap and n20 resmed nose mask. I also have terrible TMJ issues. Have you found anything that works for you? Thanks so much

[Big Guy]

I started out using an AirFit F20. That mask did fine, with the exception that it pinched my nostrils closed. 

I then tried the AirFit F30 and realized it to be a better mask for me. I'm going to try the F40 as soon as I'm due new supplies. 

My mask trials have been limited.