New mask, need advice please

[Hockenberry]

This is my first time, asking help on the Board, all suggestions greatly appreciated! 
I started using a F&P Simplus FFM, Friday night. The first night was a disaster, with an AH/I of 6.26, with no pressure increase from 12.5. (I stayed mostly between 1 and 2, with the Nuance, until the mouth leaks became uncontrollable). Very high leak rates, too. I got better, night #2, with an AH/I of 2.82, after raising pressure to 13.5, and turning off C flex. I kept the same pressure last night, and the leaks are getting better too. I messed up, and got a medium cushion, but I've ordered a large, and a comfort pad for the bridge of my nose. Every thing improved last night, except for the snore (VS2) rate. And, I have a low grade head ache, and not much energy.............

[Sleeprider]

Just to fill in the blanks, why did you change to this from nasal pillows? What kind of results did you get with the previous mask? When comparing results with the nasal pillows, did you have shorter exhale time than inhale time with those too?

On the charts, I'm partial to turning off VS2. It looks bad and means nothing.

[Hockenberry]

Just to fill in the blanks, why did you change to this from nasal pillows?  What kind of results did you get with the previous mask?  When comparing results with the nasal pillows, did you have shorter exhale time than inhale time with those too?

On the charts, I'm partial to turning off VS2.  It looks bad and means nothing.

I used nasal pillows from the beginning, of my therapy, because I couldn't tolerate the nasal mask, and my sleep tech, suggested that I try the pillows, this was circa 1996. I used the pillows and had stellar results, until recently, when my mouth leaks became intolerable, and I've had no luck controlling them.  Here is the best night I've had since I started using Sleepyhead, Jan 9, after switching to a Dreamstation Auto, from my old REMstar M Series Auto.......



Things went downhill from here, due to the mouth leaks. I'm not sure about the inhale/exhale times. but it is nice to wake up without the dry mouth. I looked back through all my data, and the insp. is always longer than exp. time, though in some cases, not much.

[chill]

It sounds to me like you have it on too tight!  I've used a few FFMs now and the Simplus is the only one that I never have pressure sores from.  Most of the tightness should be in the lower straps.  The upper ones should be looser and you should be able to stick a finger between the plastic frame and your forehead.  Also make sure that you wash your face with soap just before bed wash the silicone seal with soap daily.

A soft cervical collar fixed my mouth leaking problem.  You may want to try one.

[Hockenberry]

It sounds to me like you have it on too tight!  I've used a few FFMs now and the Simplus is the only one that I never have pressure sores from.  Most of the tightness should be in the lower straps.  The upper ones should be looser and you should be able to stick a finger between the plastic frame and your forehead.  Also make sure that you wash your face with soap just before bed wash the silicone seal with soap daily.

A soft cervical collar fixed my mouth leaking problem.  You may want to try one.

Thank you Chill, I tried the cervical collar, on your recommendation earlier, it didn't help me much. My lips open, and flap in the breeze, I think. I've been practicing the tongue suck technique, and as soon as I fall asleep, I lose it. Plus, I've been spiting blood, in the morning, but not the last two. I'LL try to loosen things up, and see if that helps the leaks, with the Simplus. The worst leak is between my eyes, I always had a hard time getting a good fit, with half face respirators, when I was still working.

[chill]

Small adjustments, while laying down with the machine on at the top pressure is the winning strategy.  The straps need to be loose enough for the mask to inflate and tight enough that the pressure does not blow the sides out.  It is a delicate balance to get to.  And yes, the bridge of your nose is the  most tricky place with the Simplus.  Sometimes, I can run my finger along/under the edge and get it to slip back into place and seal.

Spitting blood does not sound good.  Where is the blood from?

[Gideon]

You might want to try the Amara View.  It is a FFM that seals to the bottom of the nose, nothing near the bridge of the nose or the eyes.  

Fred

[Hockenberry]

It's from my sinuses drying out, and fairly resent, I thought the heated humidifier on my new Dreamstation, would stop it, but it only helped some. The FFM has shown a big difference. If it proves not to be the answer, I will see and ENT.

[Russatrice]

I had major leak issues during my first few nights with the Simplus but now I figured it out and I'm sure you will too. Had to learn not to try and fix leaks one every side but to lift the whole mask off and set it back in place with a very slight downward pull. When air leaks into my eyes I either press down the silicone seal right there for a couple seconds or sometimes it helps to just move my head, not sure why. I often wear the mask lower than what it was designed for, up to a finger width below the bridge of my nose with the bottom of the mask sitting low on my chin. It still seals and doesn't leak into my eyes, but this all depends on the anatomy of your face. Don't give up. I still use the nasal pillow in between for a night or two when I get tired of the full face mask.

Edited to add: RE: the dry sinuses, are you using a nasal rinse? I find these helpful

[Ghost1958]

One a ffm will almost always require 2 to 3 cmh20 to get the same ahi as nasal mask or pillows .

Two. Chilli is right most of the strap tension is on the lower straps. The top support should not be touching your forehead. It has a roll fit built into the top of the cushion that can't flex and keep seal if the top straps are to tight.

And the Simplus rides lower on the nose than other face masks.
Going to a large cushion will probably make the air into eyes worse not better.

You might try loosening the strap that goes over the top of your head a bit.