[Equipment] Mask recommendation for a sensitive side-sleeper who might have an unusual face shape

[PersonInNY]

Interesting. The large cushion looks to be a very different shape -- much wider and shallower. I figured it wouldn't fit me, but maybe it's worth at try. I don't think my nostrils are covered at all, though. The problem is that it gets hard to breathe when there's upward pressure on the sides of my nostrils. I can replicate the effect with my fingers.

[PersonInNY]

I've been using the F40 for a few months now. It helped a lot at first, and it's undoubtedly a big step up from the F20. It doesn't leak -- unless I lie on my back -- and the straps don't need to be nearly as tight. But I've been increasingly having the same old head pains and neck pains from headgear. The last few nights, the plastic ring near the temple has been giving me a splitting headache that's been nearly 24/7. I've gotten new neck and back pains from sleeping in weird positions to relieve pressure from the headgear. For example, if I fall asleep on my side with a CPAP pillow with a cutout, I roll face-down onto my front in my sleep then wake up with back pain.

Although the F40's problems are mostly milder versions of those I had with the F20, the F40 has one unique problem: it presses on my sinuses, and I think this must be moving some congestion around, because it gets *much* harder to breathe through my nose once I put it on.

I've spent the last two months experimenting with different (head) pillows and sleeping positions and even a new mattress, and things have only gotten worse. I'm grumpy! I'm going to give the Bleep system a try. My nasal congestion has improved, and I think I've stopped mouth-breathing, so maybe nasal pillows will work better for me on the second try. A nasal/pillows mask would also give me the option of sleeping on my back when I find myself on a hard mattress while traveling.

I also wonder if a tube-at-top mask would help relieve face and neck pain, or if that will just move my headgear problems to different locations.

[ejbpesca]

I have read your quest for a well-fitting mask with interest.  I have been seeking one for 17 years.  I started Evora FF last Feb. and it has been an improvement for side sleeping, leaks, and overall therapy. I prefer it to the F10 and F20.  When my nose gets totally blocked due to allergies I have my F20 at the ready.  

I had a nostril alignment problem with the Evora FF at first.  Even though I measured as medium size I went to a large nostril opening and still did not feel like the nostril opening lined up with my nose.  By strap adjustments and wiggling the headgear around I got it lined up.  The straps were irritating at first.  Fiddling with them has improved that or maybe I got used to them.  Then there was the issue of feeling like an exhale was belabored.  The EPR setting helped relieve that.  I would like an AirCurve machine to reduce exhale pressure even more than the 3cm my AutoSense 10 has.

Another issue with the Evora was what mask type setting to use on the AirSense 10.  Full Face or Pillows?  I have chosen pillows after finding that the Evora's mask pressure specifications are much like the F40 that, as per instructions, calls for Pillows setting.  It is interesting that with Pillows setting the Evora FF will not actuate auto start, but with FF setting it will.  I wonder if the F40 is the same...no auto start.

I am hoping to have an F40 to try soon.  It may be better than the Evora FF. 

Best of luck.

[BuzzaJim]

I had a similar alignment problem with nostrils to mask openings and resolved it the same way.  My first mask was the Evora.  Not realizing my crooked nose could be the problem, I switch to an F20 and it worked fine.  Problem was the horrible bruises it left on my face and nose due to anti-coagulants.  I tried a F&P Vitera FFM and it wouldn’t seal as well so back to the F20.

When the F40 came out, I gave it a try and have never regretted it. I adjust my headgear to align with my nostrils.  That means the mask angles slightly to one side but still completely covers my mouth. Obviously, each strap on the headgear is a different length.

It doesn’t leak as much either when I grind my face into my pillow when sleeping on my side.

I’ve had the same behavior with Autostart since switching to the F40.  I think there have been other early reports of this on the F40 threads. I’ve found if I inhale and exhale really hard a couple times, it starts.

[PersonInNY]

ejbpesca: I have an Evora sitting in my closet. I wore it for about five seconds before deciding it was too wide for me.

I didn't realize that autostart was influenced by setting the machine to "pillows"! I had thought autostart wasn't working on my machine, and I've just been starting it by pressing the button.


Update: I tried the Bleep mask last night, and I'm confused about how it went. Once I got used to it, I felt more comfortable than I ever have with the CPAP and finally felt my tension headache go away, then I woke after an hour and couldn’t get back to sleep. I spent the rest of the night without the CPAP.

Question 1: Was the leak on the Oscar chart below a mask leak or a mouth leak? I've attached screenshots of the hour I was asleep only, since I was awake more than I was asleep last night.
   

Question 2: Can there be mask noises that don't register as leaks? I had a sense that I kept dropping off and then waking from a mask noise, but my perceptions may be wrong; Oscar only shows one leak. 

Question 3: After the leak resolved around 1:15, my breathing got weird. Inspiration time went way up, expiration time went down, and my breathing overall got chaotic. My breathing never looked this bad with an FFM. During this period of time, my ear was hurting from lying on it, so maybe I was just not sleeping soundly due to ear pain. Any guesses on whether this was sleep-disordered breathing vs. light sleep due to pain? I used a different pillow than usual last night, so it could be either.

   
   

I'm not sure where to go from here. Give the Bleep another shot, hoping that time and a comfier pillow will resolve the problems? Try a traditional nasal mask, hoping it will be less leaky and not cause too much headgear pain? An FFM isn't an option at this point, because the past couple days I've had such a bad headache I simply can't sleep with one.

[somniosus]

Hi—I'm sorry to bump a slightly older thread of yours, but it seemed the best place. A PM was another option, but I decided against it since the forum encourages making public posts instead of PMs. Unfortunately I don't have any recommendations for you or anything, but I wanted to ask a few questions because it seems like we're in fairly similar positions in some ways. I'm very sensitive to discomfort/pain with headgear and masks, and am also a side sleeper who rolls onto my face. "My doctor says I have a big wide tongue and low soft palate, and I have a narrow, crowded mouth"—I've been told exactly the same. And I also have EDS, in my case the hypermobile subtype, though it still affects my skin enough that it's easy for masks/straps to slip all over the place. I found your thread when I searched for 'side sleeper mask'; that's a fairly general search term, so it was funny that I happened upon a post listing a bunch of other specific problems that I also deal with!

…Anyways, obviously we're different people so what works for you won't necessarily work for me, etc. And from your recent posts I know you're still working on trying to find the right mask and mouth breathing and stuff. So I'm not expecting you to, like, provide me with all the perfect answers or anything! I just wanted to talk a bit since as I said, our situations seem to have a few similarities. I'm about to start therapy (for the second time; first try a few years ago was an utter failure) but haven't ordered my first mask yet; I'm curious which ones (if any) you feel have worked best for you so far? Mostly in terms of comfort/fit and being able to fall asleep with them on. (Leaks are a whole separate beast... I may end up having some issues there, but my priority is finding a mask that I'm able to actually wear and fall asleep in, and then from there hopefully improve on any leaks/mouth breathing issues.) I'm also curious about the Bleep; the design really appeals to me, but I'm worried about how it might fare with the whole rolling-onto-the-face thing. Have you had any issues with it so far when you've used it? And do you use any sort of hose holder/management (like the hose buddy or similar), or have some other method to position the hose in a certain way, or not? What sort of pillow are you using?

Sorry to sort of hijack your thread with the questions; it's totally fine if you don't feel comfortable answering for whatever reason!

[ejbpesca]

I have been using the relatively new F40 mask for a month.  It is the smallest, most flexible, full face mask made to date.  I can move to a near face down position without it losing its seal or irritating my face.  I get the least leakage from the F40 than any of my previous 5 masks.  I Evora full face and found it an improvement over F20.  The F40 is like an improved Evora FF.  Just last night though the F40 began making a strange popping sound upon exhale.  It is time to change out the cushion though so that may be the issue.

Now, if I can find a way to keep my mouth shut I may get some decent therapy.  (tape, chin strap, and collar failed)

[PersonInNY]

Hi somniosus, happy to meet another hEDS person. I'm not surprised we have so much in common, since a high arched palate is one of the diagnostic criteria for hEDS, and 1 in 3 people with EDS have sleep apnea, even among pre-menopausal, non-overweight women. (I'm annoyed that no EDS site or doctor or ever told me the latter fact, and instead they kept running blood tests when I complained about feeling bad!) I'm curious, has your hEDS impacted your sleep apnea treatment in other ways? An ENT said that he'd be reluctant to operate on me for fear of causing damage even if I had an an anatomical abnormality that was amenable to surgery, and that he wouldn't advise an oral appliance because my teeth move very easily and my jaw could get upset. Some people on the UARS subreddit get MARPE to expand their palates. I had a palate expander as a kid.

I never really got the F40 to work. At one point, I changed my pillow and got a headache severe enough to interfere with work for nine days. It took me that long to figure out that the cause of the headache was a hard plastic piece of the mask pushing into my temple. I've tried pillows with bigger cutouts and even constructed a few of my own, but they either put a painful amount of pressure on a small portion of my head or made me roll face-down into the hole. I eventually resorted to wearing a beanie at night along with a DIY version of Padacheeks (I cut holes in cheap socks and put them around the headgear).

I have been slowly reducing mouth leaks, and now that I'm mostly through that, I'm really happy with the Bleep Dreamports! (I figured out that "chipmunk cheeks" were why my breathing appeared chaotic on OSCAR -- the machine doesn't understand what's happening when air gets diverted into the mouth then gets re-inhaled and exhaled later.) I'm currently using a rectangular pillow by Lofe that's made of several 1" slabs, and I've put in a little mask cutout in the top layer. That allows me to sleep in the slightly-face-down position I like without the pillow touching the Dreamports and to adjust the pillow height for different mattresses. I have a hose holder at home, but I've used the Dreamports in a hotel with no hose management system at all. My main complaints about the Dreamports are that I can't blow my nose with them on and that the system is a hassle to attach, but I'm getting faster at it. To be fair, some people do hate the feeling of the hose pulling down on your nose.

The Bleep Eclipse is even smaller, and you can easily take the tube part on and off, but I felt like it pushed my nostrils into an uncomfortable position, and at some point I took it off in the middle of the night, put it back on, and then felt like inhaling was very strange and difficult. It's a clear #2 for me so far.

[Deborah K.]

You could also use one spray of AstePro antihistamine spray in each nostril before bed.  I used to use Flonase then read it could cause glaucoma, so I recently switched.  One thing I like a lot is that it can make you sleepy, and since I use it right before going to bed I do notice I'm sleeping longer.  Yay!

[ejbpesca]

You could also use one spray of AstePro antihistamine spray in each nostril before bed.  I used to use Flonase then read it could cause glaucoma, so I recently switched.  One thing I like a lot is that it can make you sleepy, and since I use it right before going to bed I do notice I'm sleeping longer.  Yay!

I have been using both Flonase and Azelastine sprays twice a day for over 30 years.  No glaucoma yet.  Using them before sleep keeps my nasal passages clear for the night and I think breathing through a CPAP filter helps too.  These medications have been very important to me due to being allergic to just about everything in the air in my area which to me is the allergen capital of the universe.  Without them, I would probably have continued to get sinus infections twice a year as I did for decades.

When my nose completely seals up I use a tissue-shrinking nasal spray which luckily is not often.  I tried flushing out nasal passages with salt water using various pumps but that is painful and clears my nose for only an hour or so.