All For One and One For All

I have three chinstraps. Each a staunch friend and ally in my various battles.

Initially I was content to face my many adventures without allies but over time I found that I would come limping back to reality with a parched mouth and a serious hangover so I went in search of friends.

The first one was a single strap version and would disengage and leave the battle with the least provocation.

The second one was a bit more determined with two straps and the kind of tenacity I needed in an ally but it did nothing to enable my mask to stay in place during the long hours of darkness.

The third one was like a knight in full armour. Double reinforced tough and almost undefeatable in battle.

There was an added bonus too. It made me feel like royalty! After all didn't the man in the iron mask have royal blood?

Of course the downside of all that surplus armour is the endless itching and discomfort but that's part of the adventure right?

Unfortunately I have a skin condition which periodically feels like I have spilled acid on my face and chin. A serious distraction from the purpose of all that gear.

Last night I had another exciting dream. All fangs and claws. So I dragged myself out of bed and waited for the monster to fade off into the distance.

In the meantime I mowed off my hair and plastered cortizone all over my face, then found that my best friend, Courage, had packed his bags and gone on holiday. Seems like he wanted to find his own dragons and monsters to slay.

I can tell you I was rather put out with him deserting me in the early hours of the morning like that but I rallied my allies and decided that I would dig my old chinstrap out of it's crypt and equip it for battle once more.

Well the plan, born of desperation and lack of sleep, seemed like a good idea at the time but I had forgotten about the endless leaks and so I endured many hours of oxygen deprivation and the resulting consequences, feeling like I had spent the night on the rack.

Eventually dawn arrived and my oldest ally, Courage, returned so I was able to equip the iron mask and venture back into battle.

Who knew that a simple chin strap could be so much fun!

It is a tough battle. The most effective chin strap I found was the BreatheWear Halo. It always kind of bugged me because it seems it was made for someone with lower ears than mine, It seemed to rub on the top of my ear and irritate me. And, I also found it was not good enough to keep my mouth closed, so I had to assist it with tape on the mouth. Finally I found the chinstrap so annoying that I gave up on it, and just went to wider tape on my mouth. That has worked well for a long time. Then a few days ago I pulled the tape off too quickly, and too part of my upper lip skin off at the same time. Ouch!. Now I am also using copious amounts of hydrocortisone cream, and it is recovering slowly. Will not do the rip it off like a band-aid trick again! It does work though. Most nights I get no more than a couple of percent leak rate above the redline score.

I am a dentist working in dental sleep medicine. It is so frustrating to hear these endless stories about mask leakage and chin straps when the answer to the problem is sitting right in my office. I have a leak-free nasal pillow mask with an attached soft intraoral mouth shield that seals off the mouth from the inside. It is comfortable and it works. O.K., you say, if it is so good why can't I buy it right now at CPAP.com. Well it is due to a combination of politics and regulatory red tape. Even though every part of my device is made up of F.D.A. approved parts, they are configured in a novel way and the F.D.A. would consider that to be a new usage, thus subject to further review. You CAN get the device directly from me and it is production ready for volume production under an investigational device protocol, but few patients know to do that. So people will continue to suffer unnecessarily as I slog along trying to figure out how to get the necessary approvals. VERY FRUSTRATING. Dr. Luisi