Mask Trouble

[jillybean]

I have been having trouble with my mask, Mirage Quattro full hovercraft type.
I rang the clinic and was told to try for longer and have now got appt in a couple of weeks. I have tried all ways to adjust it and it leaks at the bottom really badly if I move at night. If I get the bottom of it right the top leaks into my eyes, its driving me mad, I have had it since beginning of Dec how long would you say is a fair trial
To say it should sit lightly on you face is a joke to make mine not leak its strapped down like a car on a ferry in a force 9!!
Thanks for any useful suggestions

[leswaller]

Hi JillyBean
I use a quattro as my regular mask and I admit it did take a bit of adjusting to get it right, but now it is really comfortable and doesn't leak. I have discovered that having the straps too tight makes it leak more as it squashes and distorts the seal. Just have them tight enough so that it holds to the face reasonably firmly without making a dent in your cheeks. Before you put the mask on make sure that both top straps are fitted and also one of the bottom clip straps, then wind the headpiece adjuster right out, and place the mask on your face putting the top of the mask on first whilst ensuring the top seal isn't distorted or kinked. Do not move it about once you have the mask in place. Then tilt the mask downwards until it makes contact with your chin. Making sure you dont move the mask hold it with one hand whilst you pull the straps over your head and engage the bottom clip. You can then adjust the position of the straps if they are not comfortable but do not move the mask about.
With the head piece adjuster screwed right out the mask is tilted to apply more pressure to the mouth and chin seal, screwing the adjuster in changes the tilt and applies less pressure to the chin and more to the nose. So if your nose seal is leaking turn the adjuster inwards but DO NOT move it more than half a turn at a time before giving the seal chance to readjust to the new position. I have found that I only need about one complete turn on the screw to get the perfect peosition, but it may be different for you. I have also found the ResMed, the quattro distrubuters, help line very good for advice their number is 01235 862997

[Tigers Fan]

To both your posts today

Hey jillybean

My guess is that your problem with the mask is due to the wide pressure variation of your APAP.

I have mine set at maximum pressure 4 cm H2O above my normal-breathing-without-apnoeas pressure. Yours is giving a 7.5-odd difference. At 19.4 I reckon you'd need the steel bars used in container ships, not car straps.

Tell your clinic to stop messing you about with trials and to adjust your max pressure downward.

Tigers Fan

[James @ Intus]

As per the other thread, one of the screens will give you a 95 or 90 percentile which means "your pressure is 95 (or 90) percent of the time at or below this number". That particular number, when taken from the 30 day average, is a good starting point to base the variabel pressure on. As TF says, put the minimum pressure a couple of points below and the maximum a couple of points above this optimum and you get the benefits of a tight range (avoiding excessive fluctuation and mask issues) yet retain the benefits of an APAP.

FYI: The SandMan machines allow patients to adjust the pressure themselves by a little bit of margin. It also features a "fast pressure reduction". Where SleepCubes and S Series machines can stay 20 minutes at a high pressure to only then lower this by a decimal point per minute, the Sandmans can be set to lower this faster, reducing unnecessary long high pressure situations. Clever stuff!

[leswaller]

Tigers Fan,
I am curious, how did you establish your normal respiration pressure

[Tigers Fan]

Same as you

Hey Les!

Long time.

I started at the NHS guesstimated 10 cm H2O, which gave a high AHI, and kept increasing every two nights by 0.5 cm till my AHI dropped to 5. I then went on a bit further but started to run into mask lift-off problems like jillybean and then came back down again by 0.5 cm every other night till I reached an acceptable compromise between the mask staying on my face and a low enough AHI; the compromise is to have both parameters at an acceptable level on most nights.

Occasionally I tweaked up or down 0.5 just to see if I could get an improvement but I've been at 14.5 cm for ages now.

jillybean - I risk the wrath of Nurse Ali by adjusting my APAP myself and you shouldn't try to do it till you are confident that you know what you are doing. It's very easy once you discover how to access the Clinicians' Menu for your machine - then you don't get told to try it a bit longer!

Tigers Fan

[leswaller]

Hey Carl
Was away over christmas in warmer climes, hence my absence. You did pretty much what I have done, I just thought you may have done a scientific calculation. I ought to have known better you worked by the 1st rule of engineering "suck it and see"

[jillybean]

Thanks Boys will try readjusting tonight and see how I go let you know tomorrow! Good nightx

[Tigers Fan]

British, don't y'know

That Les, is the first rule of British engineering.

Hard to believe, I know, but I have it on good authority that Ginger Beers from elsewhere so lack self-confidence that they actually read the instruction book before starting a job. Which is probably why they don't have a Brunel or a Stephenson in their efficiently kept records.

Tigers Fan

[jillybean]

Well did adjustments as advised and was a bit better but still not great. Roll on clinic appt where I am going to charm Him into giving me nasal pillows to try




Founder member of the I Hate My Mask Club

[leswaller]

Jillybean
Keep trying with the adjustmenst, you will eventually get the optimum setting. I hated nasal pillows, they made my nose sore, bunged me up and made me breath through my mouth which totally defeated the objective of having positive air presssure..... but they might work for you. You could also try a different mask, your clinic should offer you different ones to try, I went through three or four before deciding on the quattro and one called the zzz mask. I now alterante between the two depending on how I feel. The zzz mask is great as it is really soft, but it only has a single sealing element so may not work well at very high pressures.
Dont give up, the extra effort now in experimenting is well worth the end resuly

[jillybean]

You are probably right but its really not easy is it?
I have only been at this for about 7 weeks and the only thing that keeps me at it is that I do feel better.
I did not realise how tired and sh**ty I actually felt until I did not feel like it.
A bad night with the apap is better than a good night without.

[James @ Intus]

Which is a typical experience, jillybean. Most people slowly drop into this state of being a sleep apneic, it worsening over many years. Feeling crap becomes the norm and people think it's quite normal. Only when you get a glimpse of what it can be like to feel re-energized and more healthy is when it hits home. That's the magic of CPAP and definitely worth the bit of hassle that inevitably goes hand in hand with it.

[leswaller]

No its not easy, but any small improvement you can get is better than feeling like you did before you were diagnosed. It will slowly get better and better but you do need to keep experimenting with different things and keep looking for that next improvement increment.
Women are supposed to be the superior sex...You can do it !!!

[Tigers Fan]

Keep on tweaking

Having said that I've been at 14.5 for ages, I thought to try increasing the pressure 0.5 cm now I'm using a chin strap to beat dry-mouth. I also noticed my AHI for the last week was 6.something. Guess what? Down to 3 instantly - well, over-night. I'd also had a tweaking my mask straps session last night.

Point being, jillybean, you have to keep on tweaking even after you have it right because other factors change and cause your mask to change.

A major factor is learning to love your mask. Why would you want to sleep with the enemy?

For come-uppance, I washed the exhaust port silicon gizmo down the plug-hole during mask cleaning this morning. I suppose I should be pleased it hasn't happened before, but .......

Tigers Fan