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About Mask Tightness

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Hannah14 +0 points · 5 months ago Original Poster

I can't thank you all enough (Sierra especially), I am experiencing terrific sleep! My roommates are on vacation and I no longer have any events in the last 2 hours of sleep. I was having 11-18 awakenings and events every morning. It is such an unusual experience to wake up before the alarm and feel cozy and peaceful. I have no desire to nap and no tired feelings in the day.

I've had my mask since Oct 8th 2018. I could feel it started leaking about a month ago, I put the bottom clip on, as my leak rate has increased I added the top one. Here is the questions:

  1. the clips fall off, how to keep them on?
  2. at first my mask was crazy tight, should I try to return to that level of tightness?

I sleep on both sides and my back and roll over numerous times. I also have untreated but not noticeable symptoms of restless leg syndrome. My trigger is heat so not an issue now.

Thank you!

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bonjour +0 points · 5 months ago Sleep Commentator

The most common problem with masks is that users wear them too tight. I like to hand fit my masks Under pressure. I get in sleeping position because gravity, and relaxation are as important as facial shape to fit. Then under pressure and without straps I hold the Mask to my face moving it about, in and out until I be At a good leak free fit. If I can't it is not the Mask for me. Next I attach the straps and adjust them to match the feel of my hand holding the mask in place.

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Sierra +0 points · 5 months ago Sleep Innovater

What type of mask are you using? I'm guessing it may be a ResMed AirFit P10 nasal pillow based on your reference to clips? If so I have used that mask for some time and I gave up on the clips, and finally cut the two straps, overlapped them about 1", and sewed them up again. It helped a lot.

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bonjour +0 points · 5 months ago Sleep Commentator

I like that

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Hannah14 +0 points · 5 months ago Original Poster

AHI 0.16 1.00 2.15 2.27 Obstructive Index 0.00 0.15 0.15 0.27 Hypopnea Index 0.16 0.60 1.73 1.75 Clear Airway Index 0.00 0.25 0.27 0.25 Flow Limitation Index 1.09 0.90 1.38 1.52 RERA Index 0.16 0.52 0.78 0.58 Leak Statistics Average Leak Rate 5.97 3.82 1.95 1.33 90% Leak Rate 14.00 10.00 0.00 0.00 % of time above Leak Rate threshold 1.30% 3.90% 2.50% 2.13%

This is my data for last night and then Jan, Dec, Nov.

Yes, I have p10 for her. I'm scared to death to cut my mask, I only have one. I will try getting a fit down first. That's a good idea to have the pressure on when I do it.

Just curious, SH gives the message that I had significant leaks last night. Is that a meaningful statement?

I haven't worked with a DME as my AHI was 6 before I got fat and out of shape. Does this mean I will get a new mask at the 6th month?

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Sierra +0 points · 5 months ago Sleep Innovater

Since you are using SleepyHead, I find the leak graph to be the best indicator of leaks. See example below for a good and bad night for leaks. I recall both were with the P10 mask.

Bad Night:

Good Night:

If you are looking for one number I find the % of time above the Leak Redline to be the best single indicator. I like to see it under 1% and ideally zero.

Some of the SH messages which show up on the Welcome screen can be a little harsh. I go more by the time over the leak redline and the leak rate graph. If you are using a DreamStation it is the bottom graph that is the important one. It is the unintentional leaks.

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Ruby +0 points · 5 months ago Sleep Commentator

I wear a full mask and wear it a lot tighter than was recommended when I was fitted. I also use cheek pads so the headgear straps don't leave as many marks and feel more comfortable. I know this isn't scientific like the above posts but might help a little. I does amaze me that most people are fitted with a mask (especially for full masks) while sitting up. It simply doesn't fit the same as when you are lying down.

PS--I have RLS also.

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bonjour +0 points · 5 months ago Sleep Commentator

Ruby, while you may be getting good therapy I assure you that you are wearing the wrong mask for you. Awesome that you recognize the need to try masks lying down in sleeping position and under pressure (which you didn't mention)

Read the Mask Primer and keep looking for opportunities to try new masks.

[http://www.apneaboard.com/wiki/index.php?title=Mask_Primer]

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sleeptech +0 points · 4 months ago Sleep Enthusiast

I'm afraid that P10 of your is just going to get looser and leak more unless you do something. You say that you're scared to cut up the straps, but they will become completely useless if you don't. You could buy a new strap every 3 - 6 months, and ResMed would love you for it, but it will cost you a lot of money.

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Sierra +0 points · 4 months ago Sleep Innovater

Hannah, I think I have made a breakthrough with my P10 mask. I fitted it to the Swift FX headgear which you can buy for $31. It is only $6 more than the replacement flimsy headgear intended for the P10, and even comes in a smaller pink For Her version. It does require you to cut the gray plastic legs on the P10, but it is no big deal. Here is my post on how to do it.

P10 Headgear Upgrade

It may be partly good luck, but I got another really good (for me) leak rate chart with the hybrid setup last night.

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jeffez +0 points · 4 months ago

Thanks for this discussion. Anybody tried the new Resmed N30i? Had my Aircurve 10 S for 4 days and don't like F20 full face. Also want the Auto version of 10 S instead since it's same price with added capabilities. We'll see how well my Cigna handles that swap. Told I have 30 day window get best solution.

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Sierra +0 points · 4 months ago Sleep Innovater

It would be best to start a new thread with your questions so they get the most visibility. Bonjour has experience with BiLevel machines as I recall and perhaps can help you there. Make sure you include what your maximum pressures are.

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bonjour +0 points · 4 months ago Sleep Commentator

Yes, start your own thread. Why do you have a BiLevel machine? I do suggest the ResMed Aircurve 10 VAuto. It has "S", "VAuto", and "CPAP" modes.

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jeffez +0 points · 4 months ago

Thanks, bonjour. Dr. prescribed BiLEVEL. I guess to enhance my exhale function after 2 sleep studies, 1]one no mask, and 2] with F20 mask and BiPAP. Before starting use, discussion with Dr. gave me impression that he didn't favor AUTO model (maybe too many variables?) but that he could reset AUTO and take those features out of play. Does this make sense? Now had only 5 sessions.

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bonjour +0 points · 4 months ago Sleep Commentator

Total sense. Doctors want control, and manual "S" mode gives them the most control. My Doctor gave me an Rx of 21/25 in "S" mode. I now use VAuto mode Min EPAP: 11, Max IPAP: 25 but rarely go over 15.5, My AHI is consistently under .5. I am essentially in "S" mode but with the capability on surging higher (20 every week or so) to work on apneas that manual mode would not catch. I have coached individuals into using "S" mode because Auto Mode would just run the pressure up with no effective change in AHI (therapy). Dr. said she wasn't pleased I had changed the settings but couldn't argue with the results and promptly changed her Rx for me in the records.

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Hannah14 +0 points · 4 months ago Original Poster

I have royally messed up my screen so ignore it, but the flow graph is still good, or should I say it is bad? I made the mask really, really tight SH keeps riding me that I need to do something. What do you think? Interesting idea Sierra, I happen to own a swift mask. The pillows never fit on it.

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Sierra +0 points · 4 months ago Sleep Innovater

Wow! I've never seen the happy face before. You must have done something to really impress SleepyHead...

Your leaks are not super bad. Ignore the top green line as it includes intentional venting from the mask. However if you had to tighten the mask super tight it must not be very comfortable. I agree that the Swift pillows are somehow slightly different. I much prefer the P10 pillows. If you have the headgear from the Swift you may want to try my conversion trick. I'm three nights on it now and liking it a lot. I tried the Mefix tape last night that was suggested by Vulegnarts in the thread on mouth taping. I did not use the chin strap and got acceptable leaks. See this Leak Rate chart.

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bonjour +0 points · 4 months ago Sleep Commentator

Hannah, I'm not going to argue with your results, but that mask is not the right mask for you.
Read the Mask Primer I threw together. The last article talks about mask tightness. http://www.apneaboard.com/wiki/index.php?title=Mask_Primer#How_to_achieve_the_perfect_mask_fit_-_GUARANTEED.21_by_Jeffy1958

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Sierra +0 points · 4 months ago Sleep Innovater

To fix up your SH chart make sure the Event flags are turned on. See the highlighted area at the bottom left of the graph. You can click on each flag type to turn it on (green) or off (red). I would turn them all on except perhaps for VS2 which tends to clutter up the screen. Check the area in the bottom right. They should all be on (green) too.

I normally leave the Events bar pinned to the top of the screen. First click on it and drag it to the top. Then double click on the title to make it pinned.

You could probably improve the usefulness of the Leak Rate chart too by changing the scale. If you right click on the scale it should let you manually set minimum and max. I would set it for 0 minimum and 50 max. That will get rid of most of the top green trace which is not useful, and let you see the bottom trace in more detail, which is important. It is your unintentional leak rate.

Hope that fixes it up...

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