Area and pressure: finding the right mask

[sleepyblade]

I think I've reported on both the Resmed Mirage Liberty and the Innomed Hybrid on here before. Or maybe it was over on CpapTalk.
I lose track!

I got the Hybrid first and liked the general design but could never prevent leaking. So I though I'd try out Resmed's oral/nasal interface and that was no better

I found the Hybrid is the more versatile of the two. Some folk cut off the chin flap and find that it gives a better fit. The chin flap does keep things very stable though. I found the nasal pillows much better on the Hybrid. They're more stable than the floppy ones on the Liberty. Again, many people like the Liberty nasal pillows.

I'm still looking for reliable mask that is both comfortable and doesn't wake me up with leaks. Been through around 8 different ones now

If you go down the nasal pillow route be prepared for some initial irritation of the nostrils. Lanolin or Ayr gel is very good for keeping them moist.

Hope it works for you. I find that I have to give a mask at least a month before I know if it's going to work or not.

You've been holding out on us, sleepyblade!! You've had a Mirage Liberty for eight months???

I'm just back from Abingdon and a pleasant experience with very helpful people. The £25 was worth it not so much for the fitting session, but what I found out from people in the know.

Mirage Ultra Full Face Mask - there is a second type of cushion that gives more "padding" on the chin. At first trial, flat on my back in the fitting room, this cushion seems to solve my "why has it suddenly started to hurt?" problem. They gave me such a cushion for free.

Mirage Liberty - and probably any other hybrid mask - possibly the answer to a lot of our complaints (it leaks, it's noisy, it's uncomfortable, et al). Sits over your mouth and two pillows rest against and seal against your nostrils. Feels very strange at first but hopefully the ramp will take care of most of that. Comes with one size fits all (but not sleepyblade, unfortunately) mask over the mouth and small, medium and large nasal pillows.

A 360 swivel elbow attaches to the mask but the hose swivel is incorporated in an extra 8" hose that fits to the elbow. It is unheated and un-sheathed and just before the mask, so we may get rain-out tendancies. The swivel is at the end away from the mask (hard and soft fittings make it so) but a carefully made sheath should be possible. Lorr!!

While at Abingdon, my right nostril was partially blocked and the seal on the nasal pillow had a hard time coping with that. Amrutanjan (from India) cleared the blockage soon as I got home and the pillows worked just fine then. It seems, then, that the mask may be susceptible to blockage and blow-back.

I'll give it a go tonight and find out.

Tigers Fan

[leswaller]

Tigers Fan
I solved the unheated hose extension problem by not using it ! the mirage mask seems to work happily without it

[Tigers Fan]

One night stand

Hi Les - am I missing a post from you? You seem to have been using a Mirage Liberty and that might explain your "What about me?" of a few days ago.

I understand you to have taken the extra hose and the swivel out of service with your Liberty and not suffered any consequences. Is this so?

I had a good night with mine - except it was a bit fiddly getting it to seal again after a trip to the loo. I slept for longer periods than my norm. I was disappointed about dry mouth with it - until I discovered I'd neglected to fill the humidifier!!

This morning, I find that I repeatedly want to pinch my nostrils together - to overcome the fixation that the nasal pillows have flared them out!

The headgear is designed around an "average" head, I guess. The top straps are solid and at a fixed angle (to give 'lift' against the nostrils) and then give way to soft straps that are supposed to fit around the crown of one's head. Clearly, my head is not 'average'! But no news there!

I have high hopes for this mask - but I reckon sleepyblade is right about giving it time.

Thanks for your post, sleepyblade. I remember reading about cutting off flaps in this forum - but not about what they were attached to in the first place!

I did the last hour with the 'narrow' cushion for my Ultra Mirage and found it very comfortable.

Tigers Fan

[leswaller]

Hi Carl
Yes I tried the mirage liberty for a while but couldnt get on with the nasal prongs so reverted back to a full face mask. However I can confirm that removing the extension tube didnt affect the fit at all as far as I was concerned

[sleepyblade]

Thanks James. I've sent you an email.

No definite as we have a lot going on right now but if you know about the mask already and just want one, we can get them in before they go on. My best guess would be that the new catalogue will be available Jan 1st.

[dkyb2008]

Do sleep clinics do made to measure masks?

If one required an item from an orthotist, legs, arms etc would be measured to ensure a proper comfortable fitting ensuing the treatment would work better too..
Does anyone think like me and think perhaps our cpap masks could be made to measure too?
does this already happen? where? is there a charge?

[James @ Intus]

A dentist (of all people) used to offer custom-made CPAP masks. It was a service provided jointly by Weinmann if I remember correctly. In the dentist's chair the patient would be measured and plastered up to make a model of his/her face. Weinmann would then mold a mask according to the unique impression. It was cumbersome, expensive and not as good as you may think so if my memeroy serves, for those reasons it didn't really fly.

[Tigers Fan]

Cue: James' Hannibal Full Lower Face Mask

What a wonderful idea, dykb2008!!

If you were to take James' Hannibal Full Lower Face Mask, put inside a thick layer of that revolting gloop dentists use to take an impression of your teeth, push a tube through between the bars of the mouth piece, then clamp the whole thing over the OSA Patient's face, wait while the patient freaks out and the gloop sets, prise off face (best be clean shaven guys!) and presto! we can mould a cushion to suit your unique facial contours.

Might be a problem making millions of unique moulds; our changing faces with weight loss/gain; leaving us little to talk about when the first mask suits everyone perfectly. Details! details!!

Where is the Patents Office? what's their number?

Tigers Fan

[dkyb2008]

well they make mould of faces when doing wax works and life like models & television work etc.so surely it could be done, id be willing to pay.

[James @ Intus]

Problem is, your face changes when you sleep. Not just gravitationally (is that a word?) but muscles relax and your face is different when on your back, left and right.

So making the mould would have to be done whilst asleep (no chance) or under aneastethic. And then you have to sleep in the position the impression was taken in.

These things probably added to the downfall of the idea.

The best-fit idea I've ever thought of is pretty much a bag around the head with draw-strings/elasticated band around the neck. The neck is about the only predictable shape there is above someone's shoulders so it offers the best chance of a good seal.

Two examples to illustrate this type of design:

[leswaller]

I have wondered whether or not the full face masks used by scuba divers so they can talk for things like TV programs could be converted. As a diver myself I think it would solve all the problems of facial movement as the seals are round the side of the head and under the chin

[James @ Intus]

That sounds like the Respironics Total Face Mask:

http://totalfacemask.respironics.com/

[leswaller]

Is it any good, have you any feedbaack on it?

[James @ Intus]

We don't sell it but cpap.com's reviews are always a decent indicator. It's like any other mask and a bit like marmite. For those who get a good seal, it's great. For those who can't get a good seal, you know the deal!

I'm not sure it's even available in the UK yet.

[leswaller]

its a pity you dont sell it as I would have given it a go as I am fedup of having red marks on my nose and forhead