Area and pressure: finding the right mask

[Tigers Fan]

I'm using an automatic APAP and have two masks. The Mirage Quattro is a little larger than the Mirage Ultra. I find the Quattro more comfortable to wear as the profile better matches my facial contours.

At least, I find it more comfortable when the APAP is delivering lower air pressures. If I am awoken to find air leaking everywhere (higher air pressures) and tighten the straps just to the point of preventing leakage, it becomes uncomfortable.

The Ultra is smaller - has a smaller surface area and thus less "lift" at any given pressure compared to the Quattro - so the straps don't need to be as tight. It is therefore more comfortable at higher pressures.

Apart from (expensive) trial and error, is there a way of finding the "right mask for you". People in the forum talk of being on their fourth, fifth, sixth mask. Is there a place - medical centre, shop, clinic - that helps you find the right mask across all the (at least several) manufacturers?

Currently, I have my eye on a Respironics ComfortFull II but I'm put off by the cushion being an integral part of the mask. Has anyone any experience of these masks at higher pressures? (By higher pressures I mean above 10
cmH2O - my first titration, but I'm getting an AHI of 10 so anticipate an increase in pressure - obviously don't know to what - at my second appointment on Thursday.)

Tigers Fan

[leswaller]

Hi Tigers Fan

I have used the Mirage Quattro and I also use a ZZZ-mask which is almost totally flexible and confirms very easily to your face at all pressures. The only down side is that because the whole thing is silicone there is no seperate seal and if/when the seal goes you have to buy a new mask. However this is only half the price of the quattro

[Tigers Fan]

Finding the right mask

Thanks for that, Les. I've added a ZZZMask to my list of masks to check out. Reviews of the ZZZ seem to read like a Marmite Review, with most of the negative coming from small size users and most of the positive being absolute raves.

The more I read the more I understand it's a personal issue - but still want somewhere to go and check lots of manufacturers and their products. It's called a shop for any other commodity I can think of and they are in the US. Why is it so difficult to find here in the UK??? Is OSA an "embarrassing condition" here?

Tigers Fan

[leswaller]

I think the main difference is that the majority of people in the USA have private health care and so have to buy their CPAP equipment, whereas in the UK most people are treated on the NHS which is a closed market and there is no need to compare, you just use what you are given as it is free and there are few options, especially as the NHS seems to have a monopoly contract with ResMed. However some of us have decided that in the interests of comfort we are prepared to buy an alternative out of our own pockets. I totally agree with you that a shop where you could actually look and feel rather than having to buy from a picture would be a real advantage.
Sleep Well

[Tigers Fan]

Sometimes, I find it hard to think like an Englishman

Thank you for this explanation, Les. I feel relaxed and comfortable because you have laid bare what was a mystery to me. Sometimes I find it hard to think like an Englishman (maybe in Scotland and Wales you have CPAP shops) and find myself trying to pull water up a hill with a hook. I guess passivity was missing from my mother's milk.

Anyway. I'm off to see Nurse Ali tomorrow (my current favourite person because she gave me a CPAP to try) and I'll see if I can't persuade her to open up the Consultant's Goodie Locker. Your comment about an NHS monopoly and Google lead me to discovering she is listed as the local contact for Respironics and ResMed. Surely she carries stock - but how extensive is it and is it get-at-able??

So we have to start a campaign. The NHS might be a good place to start if we all go there for CPAP in England. Now might be a good time, what with all Gordon's talk of Patient Satisfaction. A conversation with the Consultant seems to be in order and my MP after her.

Tigers Fan

[Tigers Fan]

Update on the Goodie Locker

We had a long conversation about leakage and the problem under the NHS and England being without CPAP shops, of finding a right fitting mask. Then we spoke of the Goodie Locker - Yes, they have a cupboard - "but it isn't well stocked". It did contain a large Comfort Full 2, however, and Darling Ali opened the wrapper to let me try it on for fit and comfort. At 15 cm H2O I liked it.

Then came the surprise! The original mask they had given me so I could try out a CPAP was mine! They don't take them back as they can't be sterilised. What about the Comfort Full I'd just briefly tried? Mine for free as well as I had self-financed my APAP!

Seems churlish to start a campaign when I'd just been given two masks from the Goodie Locker. Given- as in, for free.

Could I buy items from the Locker? "No - it doesn't work like that."

They don't stock ZZZ Masks, Les - so let's look for a good price now. A buddy is flying in from the States in a couple of weeks.

Amazed

Tigers Fan

[leswaller]

Hi Tigers Fan
Yes, I had the same experience when I was first kitted out, I tried several masks in the hospital all of which they gave me because they can't reuse them. What a waste! why cant they have a selection of dummy masks that they use for trying for size etc which then go through a liquid sterilising solution. OK, so it discolours the silicone, but if they are not being used for real then does it matter? No wonder the NHS is strapped for cash.

[michelle]

Hi to everyone, I am still struggling with my therapy and have even forgotten how long I have been on it. I am back on therapy after a weekend break due to filing up with air,( and it doesn't go anywhere!). My smartcard was sent off and I have got alot of leakage. I did start with a nose mask, but because I am a mouth breather, I have been given a full face mask. I am trialling a new RESPIRONICS Gel mask and I thought it fit ok, but obviously not. Now I have altered the straps, stability selector and mask in fact everything I can think of, and still get leakage, more now than before. I just can't find a comfortable fit. I must have tried to alter the mask in my sleep as I knocked the tube off the mask through the night. I really feel like I am not getting anywhere, must be 4 weeks now if not more? Any solutions?

[James @ Intus]

Getting the right mask and then getting the right mask to fit comfortably and effectively is unfortuantely hit and miss, trial and error. Some people get lucky and the first mask does the job but most people chew through two, three or four masks before finding one that fits their particular facial shape. Keep trying is the best answer. If you've given a particular mask say 4 nights, adjusted every possible strap, pad and seal then you can safely assume the next mask is better for you than this one.

[puffin]

In the first few months I went through 6 masks before I found one that worked for me. Unfortunatly as I've lost weight I'm having to readjust almost weekly.

[michelle]

hello again, still having problems with masks that leak. Now have a small Respironics Comfort Gel full and find this is too small and the medium too big. Blessed thing leaks everytime I turn over and I seem to be up more times than I care to remember! I also feel like I am eating the silicone membrane and if I put it higher up the bridge of my nose I get Leakage in my eyes. Does anyone do half sizes!!!!!

[Tigers Fan]

No, but .....

Hi Michelle

I have a Mirage Quattro large, which I find a little large and leaky at higher pressures. I also have a Mirage Ultra large, which is just that bit smaller and doesn't leak. Both full face, by the by.

Don't know, but maybe a Mirage Ultra small and medium are just that little bit smaller, too.

Tigers Fan

[Tigers Fan]

Help, please, James

Hi James

Can you help me ID a mask I saw the other day and now cannot find. I expect I saw it on the Respironics web site whilst looking for address and phone numbers - but it could have been anywhere.

The mask fitted over the client's mouth and had two (apparently flexible, presumably sprung) prongs to deliver air to the nostrils. I dismissed it at the time but now I think just maybe it might work for me.

Other web sites have photos that are unclear to me so I can't even find a generic name for the mask type, let alone the specific mask.

Can you help me on this, please?

Tigers Fan

[Sleep2Snore]

It may have been Optilife

[James @ Intus]

Sounds like Sleep2Snore is right. The only one I know which is a nasal piilow type direct interface with a strap around them outh, to help kepe it closed, is the Respironics OptiLife.