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+--- Thread: [Equipment] Mask recommendation for a sensitive side-sleeper who might have an unusual face shape (/Thread-Equipment-Mask-recommendation-for-a-sensitive-side-sleeper-who-might-have-an-unusual-face-shape)
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Mask recommendation for a sensitive side-sleeper who might have an unusual face shape - PersonInNY - 04-23-2024
Hi, I’d love some advice on buying the right mask. I’ve been using a CPAP for two months, and on most nights I feel a lot better than I used to, and OSCAR indicates I am breathing fairly well. But I find the mask very uncomfortable and spend a lot more time awake in the night than when I don’t use the CPAP. Some nights are awful, and on those I don’t get much deep sleep or REM. I’ve had a few nights of magical, uninterrupted sleep, but there’s no much rhyme or reason to how that happened. I replace parts at least as often as recommended.
Fitting a full-face mask is hard because I have a bumpy nose and a narrow lower face (even for a woman). I’m between the small and medium sizes with an AirFit/AirTouch F20. My skin is stretchy and moves easily due to Ehlers Danlos. I sleep on my side and tend to roll onto the front of my face, pushing the mask sideways, even with a CPAP pillow with a cutout. To make matters worse, I’m very sensitive to the pain caused by tight headgear, and if I leave it looser I get leaks — it seems like I’m either waking from pain or from leaks, and lately it’s both. Mask liners and a gel nose pad only made matters worse.
I think I usually breathe through my nose but sometimes through my mouth, possibly due to mild nasal congestion. I’ve been taping my mouth half-shut, and that seems to work well, letting me breathe through my mouth as needed while preventing excessive jaw movement. I'm not sure I can completely avoid mouth-breathing. I tried taping my mouth all the way shut and using nasal pillows, but my sleep quality was abysmal, OSCAR showed a lot of leaks, and I woke up a couple times having forced my mouth open.
I think chin movement contributes to the fit issues, but I'm not sure I want to keep my teeth closed, because I tried a chin strap and that made it it feel harder to breathe by forcing my tongue backwards. My doctor says I have a big wide tongue and low soft palate, and I have a narrow, crowded mouth, so I think there’s not enough room in my mouth with my teeth closed.
I tried a Fisher & Paykel Evora under-the-nose FFM, hoping that would alleviate fit issues at the bridge of my nose, but the holes didn’t line up right with my nostrils with any of the sizes, and the mask seemed too wide for comfortable side/front-sleeping anyway. I thought the nostril hole issue would get even worse if I rolled onto my front in the night and pushed the mask sideways. I didn’t actually sleep with it on.
I’d love some suggestions on what to try next. A different under-the-nose FFM might work, especially with one big nostril hole instead of two little ones. Has anyone used the (discontinued) Resmed Mirage Liberty? I’m wondering if the nasal prongs would help. Or perhaps a very different over-the-nose FFM, like the Philips Amara, which has a forehead attachment, would stay in place better? Or maybe any other over-the-nose FFM would work just as long as I'm not in between sizes. I would especially like to avoid headgear that is tight at the back of my neck or base of my skull.
RE: Mask recommendation for a sensitive side-sleeper who might have an unusual face shape - cps22 - 04-23-2024
I've been using the new ResMed F40 hybrid FFM the last few nights, and it's been very leak-free for me, even when sleeping on my side or stomach. I am also kind of between small/medium on the F20, and I find that the F40 medium works well. There is also a large and small/wide, which are both better suited for people with wide noses. You can find the fit template on the ResMed website in the support documents.
I also have a problem with my jaw moving, and using a soft cervical collar really helps me with that. It doesn't force my teeth to close all the way, but it does keep my jaw from dropping down/back. I use the Caldera Releaf neck rest instead of a medical cervical collar and it's pretty comfortable.
The biggest issue I'm having with the F40 is that on some nights it has caused me to have a sore septum in the morning. But that hasn't been every night, so I suspect (hope) it's just a matter of getting the right fit with the straps. I have the top straps pretty loose. I've seen a few other people who have had that complaint as well, though.
RE: Mask recommendation for a sensitive side-sleeper who might have an unusual face shape - PersonInNY - 04-23-2024
Thank you! Both the F40 and the cervical collar sound worth a try. Especially helpful to hear from someone else between small and medium on the F20.
RE: Mask recommendation for a sensitive side-sleeper who might have an unusual face shape - BuzzaJim - 04-23-2024
Ditto on the F40!
I had exactly the same problem you experienced with the Evora when first starting therapy. I had to go to the F20 AirTouch and have hated it for the last year. Very uncomfortable, easy to knock loose when side-sleeping and, worst of all, it was starting to leave ugly bruises on my cheeks. Since I take anti-coagulants I bruise easily.
The F40 was just released a few weeks ago and has gotten many favorable reviews on this forum. Because of my previous problems with the Evora, I was skeptical because of the hybrid design of the F40 but decided to give to give it a shot. I disliked the F20 that much.
The end of my nose is visibly asymmetric which caused fit problems with the Evora. The F40 design is much softer and apparently able to seal to my nose. I am exclusively a side-sleeper and this mask stays in place, even when I grind my face into my pillow.
There are two active threads about the F40 and the comments from other users were very helpful in getting the headgear adjustment figured out. It’s worth consideration.
It’s possible you might come across an early post where I was critical after the first two nights. That was before I figured out how to adjust the cushion fit. I need to post an update.
Good luck,
Buzz
RE: Mask recommendation for a sensitive side-sleeper who might have an unusual face shape - Deborah K. - 04-23-2024
If you would like to try a 'maskless mask' that uses no straps or headgear at all, and that cannot be moved around by sleeping on your side or stomach, you might want to look at the Bleep Sleep System. Lots of us use and love this system. It is fiddly to use at first, but so worth it. You can see it at bleepsleep.com. If you use this you will need to use mouth tape. I use 2-inch wide tape cut to 5-1/2 inches. This works very well for me. Good luck with finding something that works wonderfully for you!
RE: Mask recommendation for a sensitive side-sleeper who might have an unusual face shape - BuzzaJim - 04-23-2024
I appreciate the suggestion. I actually had pretty good success with the P10 and mouth taping last year. I’m sure the Bleeps would be successful but during prep for a cardioversion in August I mentioned the mouth taping. I explained that I kept a corner of the tape turned over in case I needed to remove the tape quickly. The cardiologist said it wasn’t blowing chunks out my nose I should be concerned about but aspirating them.
Since my father died from aspirating food, I decided to eliminate mouth tape from the toolbox. I’m normally a risk taker but that was one I understood all too well. I do think folks that mouth tape be aware of the possible dangers.
Thanks again for your sincere suggestion.
RE: Mask recommendation for a sensitive side-sleeper who might have an unusual face shape - PersonInNY - 04-24-2024
BuzzaJim, thanks for the suggestion! I ordered an F40, and I'll take a look at those headgear adjustment threads.
Deborah, thanks for the suggestion and encouragement! I expect the Bleep would have the same problem I had with the P10 -- I'm not sure what the problem was, but I slept really terribly with it even though the headgear didn't bother me. My guess is that my body really insists on doing on at least a little mouth-breathing.
Last night I took off the allergy cover I'd had on my CPAP pillow, switched back to an older mask cushion, and actually slept really well, with no pain and only three minutes awake in the night. I think that the allergy cover was pushing on the mask, because it makes the hole in the CPAP pillow less deep. Of course, removing the cover brought my dust mite allergy symptoms back. I'm hoping that either a different mask or an oversized allergy cover will make it possible to use both the CPAP and an allergy cover.
RE: Mask recommendation for a sensitive side-sleeper who might have an unusual face shape - ButtonNoseBarbie - 04-28-2024
Check out AI took to get a list of masks tailored for your face - basically computer generated picture of your face move to see best fit mask for you. I tried it and it works. It narrows down your CPAP masks to top 10 options.
This is a video on YouTube of what it looks like in 1 min clip
https://youtube.com/shorts/6SuvZufgo-I?feature=shared
This is full video 12 minutes on YouTube
https://www.youtube.com/live/yyJ9pWGy4tM?feature=shared
RE: Mask recommendation for a sensitive side-sleeper who might have an unusual face shape - PersonInNY - 05-14-2024
Update: After three weeks, the F40 has been working great for me! Although I've actually had more leaks with it than with either F20, I've slept soundly through them since the mask doesn't leak air into my eyes or loudly "fart." My leaks have never been very high with either mask, but they were more disruptive with the F20.
My one complaint about the F40 is that it doesn't seem to interact well with nasal congestion. I have a bad dust mite allergy and a mild allergy to my pet, and the mask smushes my nose a little and makes it harder to breathe when I'm congested. It helps to keep the mask loose. I'm now working on reducing the nasal congestion. In addition to all the usual things to do for allergies, I've placed an air purifier right under the CPAP, which seems to help , and I'm getting hypoallergenic CPAP filters.
RE: Mask recommendation for a sensitive side-sleeper who might have an unusual face shape - BuzzaJim - 05-14-2024
I had/have the exact same experience with the mask sometimes interfering with airflow into my nostrils. I jumped up to a large cushion, even though the fitting gauges in the kit said medium. Huge improvement. The openings for the nostrils are a lot larger. Leakage is just as good.
If it feels like the mask is restricting flow to one nostril, I briefly flick the nubs on top the cushion on either side of the nose, just enough so a brief puff of air escapes. I might do that a couple times a night. It’s way more comfortable than the F20 and the leakage is almost as good.