Need help with Dreamware Nasal fitting

[Sheepish]

As others here note, adjusting the straps may take several days of fine tuning, but then you'll find the Goldilocks zone.

As for the cushion, definitely try one size up from what the template told you, and you may find yourself more comfortable (i.e., less starved for air both in and out) with a large, as long as it doesn't leak. tl;dr Go big!

[cisbrane]

Thanks everyone for the feedback! Oops, DreamWear duh, I guess working in software got me used to using "ware" lol.
So I had my machine set to Nasal, but I can try Pillows. I wasn't sure what to set it to for this mask as the documentation assumes you have a Phillips machine.
Next, my doctor is lazy and wrote it for 4-20 pressure since it's an APAP. Also, my insurance refuses to do a titration study. However, after looking at my results in sleepy heady, it looks like I average around 5 - 6 pressure setting.

The fit of my large frame seems fine when I put it on my head at first. Doesn't slide forward, or back, at a nice spot on top of my head, and not too tight. However, when I lay down, the sizing changes. The compression of the headgear loosens up the frame. the Frame ever so slightly moves backwards, but does not go past my ears like in the photos. I really like the position of it across my face and does not interfere with the corner of my eyes.

The straps, however, have a tightness issue. The headgear slides up my head while I sleep, which causes the mask to move. I am waking up pressing the straps back down to get my fit back.

I did order my mask from a supplier with return insurance. It really sounds like I should try the Large cushion. I can return my setup to get the medium frame fit pack with all the cushions, I just need to make my choice soon. Otherwise, I can return to get a large frame and large cushion.

I have gotten the perfect zone a couple of times, but once I move my head on the pillow it goes away.

[cisbrane]

So I got my Medium frame fit pack. I tried this out last night, and wow this is so much smaller than the large. It sat really far forward on my head with the sides close to my eyes. I gave it go last night, and had no luck... I first tried the Large cushion, and it was ok ish on my back. I noticed an immediate increase to the air flow which was appreciated. However, once I rolled onto my side, the mask lost seal and kept leaking and woke me up. I tried the medium nasal cushion, next thinking the large was too big. I noticed the trouble with the air flow again, but now, once on my side again, the mask lost seal. Lastly, I still had my large frame, so I tried the large cushion. Back sleeping was great, but once I turned to my side I lost the seal again.

I have found Large frame, medium cushion is overall the best, if i could my head gear to stay in place. I have a lot of hair, and it just slides around while I sleep. I had the same behaviors in the medium frame as well. I'm going to try and put a cap on my head to see if that can create enough friction for the mask to stay in place.

[Fats Drywaller]

Are you sure the frames you were given are sizes M and L?  On mine, there's a "MED" or "LG" label in black at the top, under the hose elbow, and the silicone has "MED" or "LG" molded into it (you can see that if  you look into the top, through the hose connection, and hold it up to the light).

About the cushion leakage when side-sleeping, I'm afeared that it has happened to a lot of folks, including me (it has been mentioned in other reviews & discussions here). Apparently the only fix is to switch to the nasal-pillows nosepiece, using the same frame & headgear.  I think the official name for it is "gel cushion" and it may or may not be called "pillows", so be aware of that if you shop online. Or if you can get it from your DME, no problem.  Here's a photo of size M gel cushion.  Because you said that the difference in air flow was noticeable between cushion sizes, I think I would start by trying size L, if I were getting only one.

   

I haven't used my Dreamwear lately (because of the noise), so having said all that, I'll defer to anyone else with better ideas. I liked the non-gel cushion type and I'd rather use that than the pillows, but I don't know how to get it to stop leaking.

[cisbrane]

Yes, it says MED and LG, the frames are correctly sized.

So I used my large frame, medium cushion and put a bandanna over my hair. The head gear strap moved significantly less last night. Overall, was able to sleep on my sides and back without too much issue. I did have to make adjustment as i moved to my side but it did at least stay in place. With the things properly set, my cushion was in the right place and breathing was good. Going to give it another night to see if this helps long term. Unfortunately, my head was too large for pre-made, one size fits all, caps made to sleep in.