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Mask Suggestions? - Dopey696 - 08-22-2018
Hello everyone. I was diagnosed with Central Sleep Apnea, my overall treatment has been amazing. I went from an AHI of 72 to typically under 1 with my Aircurve ASV. The biggest problem I have is that my machine pumps up to just under 20 and I'm having trouble getting a good seal around my nose. I have a very skinny yet very tall bridge on my nose and I can't find a mask that won't spray air into my eyes. I currently use the Airfit F10 full face mask, and have tried the F20 (it keeps tearing across the bridge of my nose when the pressure ramps up to it's highest), as well as the Amara view a respironics hybrid and another hybrid one (the name fails me) with nose pillows and a mouth piece. My pulmonologist will only give me the F10 and refuses to talk to me about other masks, I hate kaiser and will never have this insurance again, but for now I'm stuck. The F10 is the best so far but it leaves red marks all over my face from being strapped down so hard. All other masks I have I bought on my own and it's getting quite expensive that way. I have been looking at the Sleepweaver Anew but when I asked my doctor she just said, "I hate that company, great people but stupid products, no I won't give you a prescription for that." Personal opinion shouldn't get in the way of my health and so I'm posting this to get suggestions and possible advice for which masks people are using and suggestions that might work for me.
This ended up much longer than I meant it to be, thank you for reaching the end. I hope I provided enough info about my issue and hopes. I love my machine. I went from sleeping 12 hours and still being so tired I would fall asleep if I sat still for to long, to sleeping 6-8 hours a day. I hope yours is going well too.
RE: Mask Suggestions? - DeepBreathing - 08-22-2018
G'day Dopey696. Welcome to Apnea Board.
Sounds like your doc is a bit of a fool. As you've found out it can be very difficult to get a mask that suits and you should have access to the widest range possible.
Have you tried a nasal mask or pillows? Given the shape of your nose, a pillows type mask might work better for you - they basically inject air directly into your nostrils. The Resmed P10 is very popular here, though personally I don't like it.
Another alternative is to stay with the full-face mask, but pad the bridge of your nose (which is what I do). Take a piece of soft fabric (eg flannelette) about 100mm x 75mm. Fold it in thirds lengthwise so that you're left with 100 x 25mm x 3 layers thick. Drape this over your nose with the end hanging down to your cheeks, then position the mask so that the cloth sits between the silicone and your skin. Its easier to do than describe. You might need a bigger or smaller length of fabric and more or fewer layers. Give it a try - costs nothing and might be the solution.
RE: Mask Suggestions? - jaswilliams - 08-22-2018
I use the resmed P10 Pillows with my ASV I did successfully also use the Resmed F10 but I also experienced dry eyes due to small leaks/venting getting in my eyes.
I do sometimes leak air out of my mouth with the highest pressures but only for a very small percentage of the night 2-3% which equals about 12 minutes so I don't worry about it so I don't use a chinstrap collar or anything else
RE: Mask Suggestions? - SarcasticDave94 - 08-22-2018
I have the ResMed AirCurve 10 ASV paired with the F20 AirFit (silicone) in Medium. It took me some trial and error to get the fit right and to get leaks down. It probably was several weeks worth of adjustments until I got consistency. I also have one Small F20 AirTouch cushion, that's the memory foam version. I have as well an AirFit cushion in Small. And I have an Amara View from when I was on a BPAP.
Unfortunate for us hose heads, mask fit and leak control can consume lots of time in the trial and error mode. Worse yet when you have an obstinate Duck (doctor) that refuses to listen to the patient, like you have come across. Maybe shop for a better doc?
Note my combo of the ASV and F20 AirFit took pressure ranging up to 21 last night. Leaks were well within acceptable range. The air leaks up the bridge of my nose if I don't position it just right, but it does work. Mine has not torn period, and the current Medium silicone cushion is about 9 months old and still in use. Actually, the only problem my F20 has is that the cushion falls off the frame very easily if I'm NOT wearing it. BTW I have my old F20 frame paired with the QuietAir elbow too.
RE: Mask Suggestions? - Gideon - 08-22-2018
The Mask Primer (see my signature) will give many hints on fit, never a bad read when dealing with mask issues.
You are leaking from the bridge of the nose into the eye. To trial I like to gently hold a mask, while under pressure, to my face with my hand, then move it around and see if issues arise. If not I adjust the straps so the mask feels the same on my face as it did with my hands. Usually works.
Many tighten their masks FAR far too much, modern masks seal to the face utilizing the pressure generated by the CPAP.
In general try masks from the smallest to the largest / least intrusive to the most intrusive,
Try masks without anything on the bridge of the nose (one or more masks with bridge pieces will likely work)
Nasal Pillows (ResMED P10, Dream Weaver)
Amara View (FFM that comes up to the bottom of the nose.)
A Full Face Mask that covers the eyes, nose and mouth.
Mirage Activa by ResMed -- A nasal mask with a conventional modern seal (good) that is held in place by a flexible silicone bellows which in turn is mounted on a conventional hard plastic mount. This allows a very light amount of pressure because of the bellows. A lot of flexibility for movement with this mask and it does have a bridge piece.
RE: Mask Suggestions? - sheepless - 08-22-2018
I agree that your docs are way out of line. if you explain your problems with the masks they tell you to wear, tell them exactly what you want and why, and they still won't acquiesce, fire them (or at least work around them).
you can buy the airfit p10 online for about $100 usd. get a copy of your Rx from your doctor if you haven't already. you should have that under any circumstances but alternatively, you should be able to buy the headgear separately from the mask assembly w no Rx. I use the p10 nasal pillows with aircurve 10 asv with pressure support frequently pushing ipap to the max possible of 25cm. I'm not aware that the mask ever leaks but I do get chipmunk cheeks and lip flutter leaks at anything over about 13cm. I avoid all but an occasional mouth leak by wearing a soft cervical collar. p10 works well with facial hair if that's a factor.
RE: Mask Suggestions? - Stom - 08-22-2018
I've got Kaiser in California and I never saw a doctor at all. The script was written by the RT on a pre-signed form. She selected "patient choice of mask". Not sure if you have that option orr not. For me they don't care because I don't have DME coverage and I have to pay for my own masks.
Even if you can't get them to give you a script for your mask choice, you can buy new masks from many on-line vendors without a script. (Some sell you the mask in pieces to avoid the RX requirement, some don't bother. )
The "get in shape" store on the ecrater sales platform sells the P10 fit pack for $80.
RE: Mask Suggestions? - Dopey696 - 08-23-2018
Thanks for all the responses. I was originally told that with my high pressure I couldn't use nasal pillows, and I'm primarily a mouth breather so I didn't even question it. Do any of you primarily breathe through you're mouth? If so how do you not open your mouth while sleeping and defeat the machine, I've heard strapping it shut is dangerous? I tried using the bridge pads and just couldn't get used to it, to many moving parts I decided...lol. Silicone irritates my skin so I do use the remzzz's though, maybe I could fold something like that up and combine it to give extra padding there. When I started kaiser my doctor did a mask fitting for the F10 and didn't say I have it to tight. I do have it pretty tight though, it's the only way I've had success with diminishing the leak around my nose. It currently doesn't leak but it's strapped down hard. Chipmunk cheeks, lol, that's how I know it's workin. My machine thinks I don't breathe enough even when I'm awake and have it on so it's easy for me to test different masks. I have a cheyne stokes style of breathing but no symptoms of heart failure. I will look into the P10 pillows, they look nice at first glance. And Dave, your success with the F20 has bolstered my confidence to try them some more, I have one thats still in the package, and another I modified with silicone ribs to make the nose area more sturdy, maybe I gave up on it to soon.
I'm also in california, my insurance covers all my supplies so I shouldn't have to pay for anything but with my doctor being so stubborn (and other issues I have with kaiser) I'd rather just go out of pocket for now and get a new doctor through different insurance. I'm actually in a quite funny situation where my previous Obamacare style insurance offered by my city actually sent me, when I was diagnosed, so much I have a stockpile of masks and filters, nearly two years worth, but all the masks are the F10, I wish I could give them away. On the other hand I have to fight kaiser to switch masks and they still send one a month of a mask I told them I don't want and don't need. Fortunately I am switching jobs and am overjoyed to be losing my kaiser insurance, after that I'm hoping I'll have better luck with a new doctor.
I'm still absorbing all the info on here and I feel more questions forming but I'm sure you're all getting tired of reading my longwinded post already so I hope you all are having a great night's sleep.
I love my machine and not waking up feeling suffocated, it's amazing!
RE: Mask Suggestions? - SarcasticDave94 - 08-23-2018
As if you don't already know, IMO the mask selection, fitting, and adjustments are the hardest thing in the therapy to get right. No, not as hard as dealing with Wrongling Brothers circus of Duck doc, DME, and insurance, but it's up there on potential high frustration causing.
Follow bonjour's suggestions on the Mask Primer. It really works for nailing the fit and adjustment stuff down. I was a former as tight as you can get it will stop the leaks...found out it will be quite the opposite, looser is far better...
RE: Mask Suggestions? - PaulaO2 - 08-23-2018
You shouldn't need a prescription for a different mask. They are all the same as far as the insurance coding is concerned. Ask the supplier when you are due for a new one and when it is time, ask for the one you want. Or ask if they have a mask trial program. Many do.
I use the Nuance nasal pillows for pressures up to 20. It does rather well. For your mouth opening, you can try a chin strap. The latest thing is to use a foam cervical collar (like for whiplash). The idea is it keeps the chin in place and your mouth doesn't open.
Everyone's face is different and what works for me might not work for you. This is why a mask trial option is fantastic. Many of the online retailers now do it, too. Some charge a fee, some do not. I use Supplier #26 and they don't charge a fee for most masks (some they do).