Ultra mirage II sore nose!

[anstroth]

Hi,
Just trying out new cpap with above mask from hospital for this week but its a little sore on my nose at the bridge and at the base and leaves it a bit red and sore. Is there a best way to deal with this? I realise it can be loosened but might this upset the trial etc?
I hope to have a health supplied system once all the trials are settled and would consider something a little less "full on" for my type of sleeping which is mainly side and stomach, like the "Venise" model.
Thanks.
Stuart.

[James @ Intus]

Hi Stuart,

Loosening is a part of the equation indeed. The straps are meant to keep the mask *in position*. The cushion creates the seal, much like the skirt of a hovercraft. Some people think the straps make the seal, which often leads to overtightening. Playing with that a bit shouldn't affect the trial too much at all.

For side sleepers, a nasal pillow CPAP mask indeed is often more comfortable. In combination with special cut-out pillows, you then get very little interference with the mask indeed.

If your clinic only has ResMed masks available, you can ask for the Mirage Swift II or the Swift LT.

[anstroth]

Hi James,
Thanks for the swift reply. Just to add that I notice that I still have a quite marked red line around my nose where the cushion rests and furthermore a small red mark at the base of the nose which also had white spot appearing! This is after taking off the mask at around 7.30 this morning.
Might it be a reaction to the neoprene or whatever it is?
Perhaps a call to the hospital is in order?
Thanks.
Stuart.

[James @ Intus]

Some people have a reaction to the silicone in the masks but almost all masks are of that material. Cleaning your face helps as it avoids getting toxins and bacteria trapped between the mask and the face, causing irritation. Cleaning the mask is important too.

For the ultra mirage full face mask, there are RemZzzs mask liners to counter exactly those problems but here are none for your specific mask.

If loosening it slightly and cleaning thoroughly doesn't help, indeed a different mask may be the only option.

There are a few thread in the forums here on skin issues with various tips and tricks so you may want to browse around in the mask section a bit too.

[anstroth]

Thanks again for the quick reply.
In the meantime I did give the hospital a call and the technician suggested I treat my nose with e45 or the like tonight and not wear the mask then tomorrow to try some vaseline. Naturally I will keep things clean around face and mask. Will look around as suggested and definitely look into the alternative mask type though.
Thanks again.
Stuart.

[Simes2112]

Sore nose sympathy

I have been on CPAP for almost 2 months now - initially everything went really well. I was so overjoyed to get some proper sleep - even though it took me around 2 hours to get to sleep because of the strangeness of the mask etc.

Now though - I am at the mask fit issues stage. I am no longer exhausted, the therapy is working ... BUT I am still having mask issues.

I am using an Ultra Mirage full face mask - which is very similar to yours but I suspect it is an earlier version. I've even gone to the trouble of visiting one of the Resmed sleep centres (costs £25 for a 30 minute consultation) and they explained and demonstrated that "The straps are meant to keep the mask *in position*. The cushion creates the seal, much like the skirt of a hovercraft. Some people think the straps make the seal, which often leads to overtightening." - to quote James.

I got my Remzzzs about the same time and started using them too and I was over the moon with them - and I think that was mainly because they feel nicer on my skin than the silicon.

I've trimmed my beard off almost completely.

I don't know what to try next - because every night I get leakage issues that disturb my sleep UNLESS I sleep on my back, as soon as I roll over onto my side the mask shifts and I get air blowing into my eye and I wake. So out of sheer frustration at 1am or so, I tighten the damned mask to 'clamp' it into position. This works....

BUT ... the downside it causes problems. I have a couple of lovely open wounds just above my nose where the mask has been pressing on my face.

You can see one of these wounds on the linked image:

http://picasaweb.google.com/lh/photo...eat=directlink

In the picture you only see one of the small sores due to the bad light in here.

I am not sure where to go next with this:

1) Stop using Remzzzs and put up with the alien feeling of the silicon.
2) Believe the theory of the seal - and resist overtightening.
3) Completely shave my face - hard to do, as I have some psorasis!!
4) Find someway of padding just above my nose to stop the hard plastic of the mask breaking my skin
5) Go back to the hospital lung techs and moan about the issue (again)
6) Win the lottery and buy lots of masks until I find one that suits me.

[James @ Intus]

Hi Simon,

Thanks for the picture, good to see a face to the name!

The Ultra Mirage is a full face mask, the Ultra Mirage II a nasal mask. Very confusing indeed!

You may have to find a combination of the 6 options you list. Commenting on each:

1) Using the RemZzzs will at least give the skin some slack, healing faster.
2) Yes, believe it, but ony works if the mask is right for your shape anyway.
3) Perhaps avoidable, did you try nasal pillow masks?
4) As 3, did you try ansal pillow masks?
5) As 3, they may be able to hand you a "direct interface" aka nasal pillow mask
6) I know a place that sells good masks

Given the wounds and psoriasis, a full face mask is likely to keep bothering you until your skin has healed completely. A nasal cushion mask isn't going to change the nose bridge situation much either.

So I'd be gunning for a nasal pillow mask, possibly (but after trying the nasal pillows) an oral mask.

If you struggle with blocked nasal airways and hence reluctant to drop the full face mask, you can adopt a sinus care routine that ensure free nasal breathing. Free upper airways plus a nsal pillows mask means no more mask touching your skin, other than the very edges of your nostrils. This gives your face time to heal and perhaps later you can alternate between the masks.

So try and get one of those masks I'd say. If your hospital is in bed with ResMed, they may have a Swift LT. Otherwise, I can highly recommend the F&P Opus 360 and Air Liquide Venise.

[anstroth]

Well I've done the test week and returned the mask etc.
I was requested to comment on a form the hospital supplied so I made sure they were aware of the issue
I still have the scab on the side of my nose which is gradually getting back to normal
The slipping mask and blowing air in eyes is not a great experience and it has made me consider alternatives of course but I will wait out the results from the test first. I do feel a little sharper and less fuddled even after a week but it is nice to sleep without contraptions
once I know my future? I will think about alternating nights with and without maybe. I am apparently at the lower end of the aponea scale according to the hospital but it still merits treatment so they say.
Good luck with your efforts in getting right fit etc.
Stuart.
ps. thanks to James too

[steve44]

I have been using a mirrage quattro for abot three weeks now and my nose was really sore at the start. My solution so far has been clean the mask spotless every day, wipe my skin down before and after wearing the mask with TCP neat. This seems to remove any oils etc plus kills any bacteria that may be lurking. I also use waterproof dressing strip to cover the bridge of my nose. I cut most of the adhesive part off, leaving just 4mm either side. this saves ripping half your face off when removing yet still keeps it in place. I round off the top of this strip at the top to keep it away from my eyes and then place another strip on top.This means I have a double layer of padding with a minimum adhesive contact with my skin. The waterproof strip seems to hold to the silicon of the mask well enough an I seem to get a good seal. I do have the straps tight to get a seal to the rest of my face and have marks next day but for the sheer bliss of proper sleep I cam put up with them. It was just the sore nose I found intollerable and that is now resolved.

I have a beard that I keep short and that gets a dose of TCP as well just to keep everything sterile.