Forum · mask seal

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[-] wiredgeorge +0 points · almost 2 years ago Sleep Enthusiast

Currently use a P&K Simplus full face medium mask. No facial hair; wash face good before use and clean mask with mild hand soap to remove oils. Seal is fine 4 out of 5 nights and then bingo... leaks around bridge of nose and on cheeks. This starts about a half hour after beginning use. I breathe through my nose and don't move around. O2 pressure needed is 25/20 using a Bipap.

I went to another forum just to see what type answers I would get. Almost everyone told me to use nasal pillows and that manufacturers were just worried about litigation by not recommending them for people needing high pressures for therapy. I look at specs of a couple pillow masks recommended and none seemed to provide enough O2 at my pressures which were not listed in specs (if that makes sense). One person swore by pads to reduce leaks and another a different pillow.

I would like to get a consistent seal. Any tips or pointing me to a mask that would resolve the issues would be appreciated. I have no difficulties or problems with my current mask otherwise. I am not sensitive to masks.

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[-] DanM +1 point · almost 2 years ago Sleep Enthusiast

Hi @wiredgeorge. There are some constraints on how much air can move through a nasal pillow, as the openings are much smaller. If you only breathe through your nose and not your mouth, you might consider asking your DME if you can try a nasal only mask. There is a difference between a nasal mask and a nasal pillow. Full face masks are the most difficult when trying to obtain a good seal because there is more area to try and seal. You may also consider another manufacturer's mask to see if you get a better seal. Your DME provider should be able to assist you with trying other masks to see what works best for you. Pressure of 25/20 is a pretty good amount of air, so it is important that the DME company fit you with a mask and then pressurize it at your BiPap setting to assess for leak. Keep us posted!

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[-] wiredgeorge +0 points · almost 2 years ago Sleep Enthusiast

The Bipap machine I have has a mask seal function and the mask almost always seals fine during this test but begins to leak; especially around my cheeks at about 15-30 minutes into running. I have a 5 minute ramp set. In any case, I will definitely look into the nasal masks you suggest. The company where I received my equipment (national company) isn't big on trying on masks because they feel once you do, you have a used mask; or at least that is my impression. I did try the current mask on and since it seals fine for a few minutes, I thought I was good to go. I wasn't and the mask issue is really the only fly in the ointment at this point. Thanks Dan, you have been great!

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[-] DanM +1 point · almost 2 years ago Sleep Enthusiast

Thanks, @wiredgeorge. Glad to be able to help if I can. My guess is that your mask seal is changing as the muscles of your face and jaw begin to relax with sleep. Hopefully, your DME provider will allow you to try masks until you find the right fit and realize that you will be a long-term customer! Happy to hear the rest of your treatment experience is positive!

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[-] CalmJungleGreenSandpiper8386 +0 points · almost 2 years ago

I use nasal pillows and they work well except occasionally I wake up with a dry mouth, especially if I sleep on my back, so I know I've been exhaling thru my mouth. Chin straps don't help because I can still breathe air out of my mouth thru my with my teesh clenched. My lips just pop open and let the air out. I can sense my self doing that once in a while. Fortunately my releasing air thru my mouth doesn't happen often enough to throw my numbers off according to my doctor when he reads my card.

My girlfriend has had a machine for a few months and has gone thru 3 full face masks without much luck in preventing leaks. She's about ready to give up. She tends to exhale thru her mouth when sleeping so nasal pillows aren't an option. The medical equipment techs that come out and show her masks are just "okay" at fitting them on her. They don't seem to really be much more than delivery guys. I feel a mask fitting should be done in a sleep study environment by professional techs until a mask is found that WORKS. This wondering thru masks process with these med device companies is a MAJOR hole in the process of getting therapy that works.

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[-] DanM +1 point · almost 2 years ago Sleep Enthusiast

Proper mask fitting is a very important part of the process for any patient starting therapy. I have written in other posts about this, and I agree that mask fitting should be performed by an experienced technologist or therapist who understands the importance of good fit and the relationship to treatment success. Patients should be allowed to try masks in various sleeping positions with the machine set at a pressure at least similar to their prescribed pressure.

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[-] PatrickH +0 points · almost 2 years ago

In regards to your dry mouth issue; I have always been a mouth breather until I went on a CPAP with Nose Pillows. However there are days when I may be feeling congested at sleep time (from allergies, cold or maybe put a few too many back) where I would wake up with a dry mouth. Similar to you it doesn’t throw my numbers off. I found that using a saliva inducing mouthwash like Biotene on those nights takes care of that. In fact my Respiratory Specialist suggested this after I begin asking about acquiring a full face mask Otherwise using the pillows really force my mouth closed. Could your issues be on nights of congestions? Either way try giving Biotene (I use Kroger store brand) a shot. In regards to your lady’s issue; did she ever try the pillows? I know you say they aren’t an option. As I mentioned before I was completely a mouth breather until I started using the CPAP with the Pillows. When I had my second sleep night at the Sleep Center (where I did my study at), not only did they fit for the correct pressure they had me try all three styles of masks to see which was the most comfortable while achieving the best results, changing the equipment through the night where needed. I was expecting to have to use a full face mask but was very surprised and happy I didn’t have to. Would the option for your lady to go back for a sleep night and have them work to fit her better? Also the company I use for my equipment has an in-house Respiratory Specialist whom has been my go to. Anything like that with her equipment provider?

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[-] CalmJungleGreenSandpiper8386 +0 points · almost 2 years ago

My sister is extremely Chemically sensitive and the plastic from the hose and humidifier tank give her bad allergic reactions. When are the CPAP companies going to actually ADDRESS this issue, instead of just blowing off all the chemically sensitive population and just serve the higher percentage of patients who don't have this problem??? This problem is slowly killing her and they COULD do something about this for her and all the other patients with similiar problems but I believe they just WON'T because it's not cost effective for them. I'm sure everybody here is aware that just about anything can be accomplished in the field of medical equipment if the engineers are allowed to work on it long enough. They just need to be ALLOWED to do it. Something needs to be done to force them to care for everyone, not just the largest percentage of customers that can tolerate all this plastic in their face each night. This sucks!!!!

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[-] HappySleepingUser +0 points · almost 2 years ago

I know. My Mom had this same trouble. very very sad. In 2010 or 11, I was actually told that there had been one mask that was made that didn't ahve the one thing that they suspected was the trouble. They discontinued making them as There wsan't a large enough market... nice huh?

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[-] ResourcefulViridianPanther8723 +0 points · almost 2 years ago

There is a wonderful alternative for those who cannot tolerate CPAP. I have had Inspire Therapy since 2011. It is a solution well worth looking into it - my experience is perfect sleep. You can check it out and hear testimonials at inspiresleep.com

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[-] BrainsNeedSleep +0 points · almost 2 years ago Sleep Commentator

Very few people work voluntarily for free. But there may be people who are equally interested in this issue and one of them might be an engineer. In fact, why not get pro-active about the issue, and visit your nearest college with an engineering department (bio-eng, if possible) and put the question to them? They may make developing the solution a class project. A whole lot of improvement in patient care has come from patients helping each other - usually for free - so maybe you will find a way to do that. Good luck!

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[-] wiredgeorge +0 points · almost 2 years ago Sleep Enthusiast

Just to follow up and maybe some info that will help your girlfriend with her full face mask issue.... I didn't immediately buy nasal mask as Dan suggested. I had already purchased some mask pads as trying them seemed like a non-expensive experiment.

I bought some pads; a 30 day supply as a trial. The main issue I was having was mask seal. The mask would make disgusting noises at times and get air in my eyes; neither issue allowed me uninterrupted sleep. Anyway, the mask pads fixed the issue. I have slept over 6 hours every night without waking once which is real good for me.

The seal with the mask pads isn't perfect but they make the annoyances go away. I don't care about seal leaks if I am getting plenty of sleep and have very low AHIs... have been under 1 per hour since using the pads. Hopefully this trend will continue and I can continue to use the machine without drama.

One thing that does bother me some is dry mouth when I wake. I breathe through my nose exclusively and have the machine set on humidity at the 8 level (highest) and pre-warm the water. The water is gone after about 4-5 hours and I have learned NOT to overfill as it blows water up your nose. Perhaps turning the humidity down to a lower level will help the water supply hold out longer but it doesn't make much sense to make a machine that only has 4-5 hours of water at the highest humidity level... I guess this is a relatively minor complaint. I also have a 17 year old blind chihuahua that sleeps in the crook of my next that I can't get fixed either hehe.

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[-] DanM +1 point · almost 2 years ago Sleep Enthusiast

Hi @wiredgeorge. Glad to hear you are having success with the mask liners. I have had the experience of a water tank running dry during the night, and it can be uncomfortable. A room humidifer helped me because it helped humidify the dry air in the room and caused the water in my water tank to last a bit longer.

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[-] GeoVoice +0 points · almost 2 years ago

Hi everyone. I just joined. I was diagnosed about 30 years ago and had surgery (Uvulopalatopharyngoplasty). Ten years latter I needed to begin using a CPAP pump. The mask option were pretty limited compared to what's available today. I had the original "Ultra Mirage" with a hose connection at the top of the mask. Never had a problem. Now the "Ultra Mirage" and most other masks have a swiveling hose connection on the front of the mask. I have tried these and the position of the connection creates a greater force on the cushion that tends to produce leaks. It's basic physics. I don't understand why the manufactures won't address this problem.

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[-] DanM +1 point · almost 2 years ago Sleep Enthusiast

Hi @GeoVoice. I agree the pull on the hose causes mask leak for some. I tend to tuck my tubing under the covers with some slack in it to try and help prevent this. Some patients report that using a tube stand or holder that suspends the tubing above the head is very helpful.

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[-] BrainsNeedSleep +0 points · almost 2 years ago Sleep Commentator

I bought a bed with a headboard with a downward curve to it, hang the hose over that, and flip the pivoting mask-hose fitting upward. so far, pretty good.

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[-] wiredgeorge +0 points · almost 2 years ago Sleep Enthusiast

If I read the poster GeoVoice's post correctly, the swivel in the center of the mask PUSHS the seals out.... I am thinking that movement of the hose can also hurt seal IF a person wiggles around while sleeping. Since I had not gotten a solid night's sleep in many years, I now lay on my back with pillow propping my head/neck and DO NOT MOVE all night. The hose is actually about 4-5 feet long and I have to loop it over a bed post to keep it from flopping all over.

I would LOVE to see some company work on mask design... take all the loss of mask seal factors into account and come up with a mask for folks with seal problems. We put a man on the moon and can't get this done right? These masks would be aimed at folks using higher pressures that are unable to use a nasal pillow type affair.

The straps on a mask contribute to the seal problem. Adjusting them each night helps but it is hard to get consistent tension. My RESMED scores for mask seal have been lousy since using the mask liners but I am not aware of much leaking and last night was the first night since using those things where I actually got ONE POINT our of a possible 20 for mask seal... hehe

The material that contacts your face is likely the culprit as it doesn't conform to the contours of your face adequately after your face muscles relax. Just an opinion...

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[-] BrainsNeedSleep +0 points · almost 2 years ago Sleep Commentator

With the advent and perfecting of 3-D printing coming along, I think it only a matter of time before DMEs will have face-scanning devices and possibly the printers right there...tah dah, mask that should fit much better. But our faces sag and squish during the night depending on position, pillow, etc, so it probably will never be perfect.

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[-] DecisiveTealGerbil0072 +0 points · almost 2 years ago

Hello,

I hope you can help with a few questions. I am a new cpap user and don't feel like I'm getting the help and answers I need from my doctor.

I just completed my sleep study and the dr said I have severe sleep apnea with 02 at 81%, one event every two minutes, 11 lbs of pressure needed.... Didn't get much more info.

My mask breaks seal multiple times (10-15x) per night for no reason. It also breaks suction when I move, which is often. I wake to readjust and often can't get it fixed.

Also, the mask actually hurts because it's so tight. It digs into my face and makes my nose, teeth and jaw sore. It's a partial nasal covering mouth.

Dr doesn't seem interested in allowing me to explore diff sizes/types and sent me home for 6 weeks to give this mask a try. I'm tempted to go on Amazon and buy a few myself. I just can't afford to purchase ones just to try on. I feel I've gone too far with this dr to start over.

For the record, I did the sleep study 20 years ago and was diagnosed with apnea but gave up cpap after having these same issues. I just need this to work this time as my apnea is getting worse.

HELP! Thanks, Ruth

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[-] Sherry +0 points · almost 2 years ago

Ruth, finding the correct mask is the key to success. I would encourage you to call the Dr. or Medical Supply Company and ask for a re-fit and insist that it happen. Masks can usually be exchanged within a certain period of time. They should be able to let you try on several and find one that feels most comfortable. Once you find the right mask, there are cushions that can be used to keep it from digging into your face and make it more comfortable. I purchased mine at www.cpap.com under asscessories, cleaning and comfort and then skin irratation.

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[-] wiredgeorge +0 points · almost 2 years ago Sleep Enthusiast

I have come to the conclusion that a mask will leak a bit regardless of fit and size correctness. The uncomfortable noises and leaking air are not productive factors for a person who wears the mask. The first inclination is to ratchet up the straps so the mask is very very tight. I doubt this helps seal. One thing I have learned since using mask pads is that you place it on your mask and then bend over to fit the mask to your face. Then sit up and put o the headgear. I seldom adjust the straps anymore and fitting the mask as I described allows me to keep the straps relatively loose. Even with a full face mask and the full headgear I don't get any marks as I did when I fist started wearing a mask. The mask pads hide leaks somewhat so small ones don't blow air into your eyes or out from around your cheeks. I don't worry about minor leaks now.

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[-] DanM +1 point · almost 2 years ago Sleep Enthusiast

Hello Ruth (@DecisiveTealGerbil0072) and @wiredgeorge. I agree with Sherry's comment that good mask fit is key to success with therapy. Ruth, I also encourage you to contact either your physician or your home care company and insist on a new mask fit. The home care company should fit you in person and allow you to try masks until you find one that is comfortable. I would let them know that the mask is causing pain and skin irritation, as you want to avoid skin breakdown from the mask. Wiredgeorge also makes a good point about the straps (headgear). A mask that is too tight will often leak as much as a mask that is too loose. A mask should be snug against the skin but should not cause pain. The pads that Sherry mentions, along with mask liners, can often help with comfort and obtaining a good mask seal. Thanks for posting, and thanks to Sherry and Wiredgeorge for their input!

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[-] NeedMoreInfo +0 points · over 1 year ago

I use Swift II nasal pillows. I know it's an old design, but is comforable for me. No leaking. The best mask I found is the Dreamweaver by Respironics. It is heaven. I wish I could use it but I need a non vented mask. The slit cannot be sealed as nothing sticks to it.

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