Thin face, high bridge, lots of leaks

[CasitaWayne]

I have tried at least 9 masks including nasal pillows. I am a mouth breather and none fit well. My face is thin and I have a high bridge on my nose. The pain on the bridge of my nose awakens me every night about 3:00 AM. I have tried Geco's, Remzzzs, Pad-A-Cheek, all with varing degrees of success but still too many air leaks to have a successful nights sleep. My AHI runs between 10.1 and 24.5. I have both OSA and CSA with more in the CSA catagory. I think the CSA will come down if I can ever get the leaks under control. I am sooo ready for a good nights sleep.

I am ready to do something drastic. As wiered as this sounds, I have considered going back to nasal pillows and taping my mouth shut. [b] I taped my mouth shut( at night only ) for 12 years before starting on the CPAP. It kept my jaw from dropping back when I was on my back. Not to worry, I always would fold a tab on the end of the tape so that I could easily remove it if need be.
BTW, I have already had operations to correct the OSA.
Does anyone have any other suggestions? [/b]

[retired_guy]

Yes... Go to the pillows mask and a good chinstrap. I prefer the Resmed P10 with a pillow size one larger than what I think I should use. So I use the large pillow size. I also put the chinstrap on first, gently applied so as to "encourage" the jaw to stay forward and the mouth to stay shut. In the end, the actual blocking of the airway occurs because I have learned to use my tongue applied to the roof of my mouth. It takes a few days to figure that out, but it's really a quite natural thing. Once mastered, you may even be able to eliminate the chinstrap. I cannot however.

Secondly, and equally important: You need to establish a range your machine is allowed to operate within other than "puny to tornadic." Download, install and begin using the Sleepyhead software (link at the top of the page) so you can see what your pressures are doing, what your ahi is doing, and how many OA's vs: CA's etc... You are probably correct that your counts are off if your leaks are out of range. But the place to start is learning where your body likes to be, then adjusting the pressures so the minimum and maximum are not light years apart. In particular you don't really want to use a max 20 with a pillow system, or pretty much any other system, if you don't have to.

[PaytonA]

Do you have a Mirage Quattro mask? If you do and you have tried it and it has bothered the bridge of your nose, there is hope. One of the fixes that has been posted on this board is to cut away a little bit of the silicone stiffener at the bridge of the nose end. Do not cut much. Only about 1/8" from the end of the stiffener at the bridge of the nose end. Be very careful not to accidentally cut the flexible silicone seal material.

If the Quattro air has similar stiffeners, the same procedure might help.

Best Regards

PaytonA

[trish6hundred]

Hi CasitaWayne,
WELCOME! to the forum! And hang in there for more responses, best of luck to you.

[Terry]

I think the CSA will come down if I can ever get the leaks under control.

Actually, it probably won't. More pressure won't fix CSAa. In fact, sometimes it causes them.

I'd suggest talking to your doc. You might need a different machine that can handle both the OSAs and CSAs.

taping my mouth shut.

I'd suggest not doing that. If you're not breathing well and your O2 is already down, you might not be able to wake up enough to figure out what's going on and fix it, before you "sleep permanently"

Terry

[JimZZZ]

Yes... Go to the pillows mask and a good chinstrap.
You need to establish a range your machine is allowed to operate within other than "puny to tornadic.

retired_guy has some good advice for you and I would add, do whatever it takes to stay off your back while you train your mouth to stay shut. Many folks report good results with a tennis ball or other torturous device placed in a pocket on the back of your night shirt. My mouth likes to hang open too but I'm fortunate that I can successfully wear a full face mask.

[Numbat]

Hi CasitaWayne,

You mentioned a problem with a high bridged nose and that you had tried Gecko and other accessories - I tried many but the best pad of all, suggested by my wife, has been Johnson's pure cotton Make Up Pads.
They are very cheap and are soft and thin and can be used with a mask liner if required.
There are 80 in each pack and they can be used a couple of times.
No more pain and no more marks from a tight mask.

I hope this helps.

[JimZZZ]

Hi CasitaWayne,

You mentioned a problem with a high bridged nose and that you had tried Gecko and other accessories - I tried many but the best pad of all, suggested by my wife, has been Johnson's pure cotton Make Up Pads.
They are very cheap and are soft and thin and can be used with a mask liner if required.
There are 80 in each pack and they can be used a couple of times.
No more pain and no more marks from a tight mask.

I hope this helps.

I would be concerned that such a pad might get loose inside the mask and block the exhaust holes. Is your make-up pad always in place on the bridge of your nose when you awaken in the morning?

[kfujioka]

Hi. I understand. I also have a high nose bridge and a thin face. I am having the same problems. I am using a nasal mask and I bought some surgical tape so I can try it. (I was advise not to tape but what else?)
Have you found a FFM ?
I am trying the Mirage Liberty. But it doesn't seem to work. Leaks around the mouth but the nasal pillows are fitting well.

I may try the Hybrid.
Have you tried the Hybrid by Innomed?

Like the Mirage Liberty, it does not sit on the nose bridge at all.

Good luck!
If you find a FFM that fits let me know. I need the same.
Kim

[Numbat]

Hi JimZZZ,

You wrote - I would be concerned that such a pad might get loose inside the mask and block the exhaust holes. Is your make-up pad always in place on the bridge of your nose when you awaken in the morning?

Yes, they have always stayed in place until I have removed the mask and I have used them at least 80 times with both the Resmed F10 and the Resmed Nano FX Nasal.
It has made a huge difference in comfort and there are no more marks.

I have taken a photo of a pad fitted into the groove at the top of a mask but do not know how to post a photo here.
I am not in Twitter or Tumblr but would be happy to send the photo to you if you Private Message me with an email address.

Cheers