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How To Properly Fit a Mask. From a Techs Point of View.

First get your bed comfortable. Gather all of your creature comforts and make your nest. this reduces unwanted trips out of bed after the you have the mask on. This is important as you could wake your self up.

TURN YOUR MACHINE ON. Your mask should be filled with air when fitting.

Next I prefer to put the mask on sitting upright. Put the mask on just so that it rest on your face. It should be leaking at this time. (if you have a Resmed adjustable mask crank it out so that the forehead is pushed out as far as possible.)

Now I lay down on my back and listen to my mask leak for a second. Doing this trains your mind to hear them. Adjust the bottom straps first. Undue them and pull them straight out from the mask(the mask will want to slide down the straps). this is to even out the straps. If they are not even stop and fix it! Now evenly tighten the mask down just enough to form seal around your mouth(FFM) or the bottom of your nose(nasal).

Next do the sam with the top straps. Remember the top strap is more of an ancher. It should rest on your forehead rather than dig into it.(At this time if you have a Resmed adjustable mask crank it down. it should hug the bridge of your nose and finsh the seal).

Stop listen. you should not be uncomfortable and you should not here any leaks. The mask should be resting on your face at this point not digging or rubbing but resting. If it hurts loosen it.

If you hear leaks you have to options. 1 pull it straigh up off of your face and set it back down. this will sometimes fix it.
2 you can run your finger in between the seal and your skin all the way around the mask to ensure that the seal is folded under to do its job.

once you have these steps down the others are easy. Turn on your right, and left sides and adjust to rid leaks as well. This is important because the seal won't be the same on your sides as it is on your back. Set your self up for success and adjust for all positions.

Remember it only has to be as tight as you can handle comfortably. If you can't form a comfortable seal then you need a different mask.

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It so helps w/that first self-fitting to have a second pair of hands and who can see that the fit is balanced equally on both sides. But we CAN do it ourselves w/a little more time and patience (and sometimes cussing) as we try to get each side equal. Practice makes perfect. And when you get it exactly where you want it, where the fit is comfortable and leak free - don't make any further adjustment, take your mask off in a manner that doesn't affect the fitting you've made.
Rock,
Great job! I always use the finger thing, but did not know it had a name.(Kudos to Judy) I would like to reproduce this on my blog with your permision. You would be a "Guest Author". I think it would really help my readers. Let me know.
Post away Jim. If it helps spread it around. I tried to visit your blog the other day and could not.

Jim Nadolny, BS, CRT said:
Rock,
Great job! I always use the finger thing, but did not know it had a name.(Kudos to Judy) I would like to reproduce this on my blog with your permision. You would be a "Guest Author". I think it would really help my readers. Let me know.
I don't get to experience this much, but when I do have a pt that is a long time PAP user they usually don't make any adjustments. they put it on like it was a sock cap move it around a little and are ready to go. Also if my pt is a veteran I won't even try to fit the mask for them. this way I can see if they are doing it right, and also it show s me if they are having problems with leaks. I do however Talk to my vets about any problems they might be having. I will let them try on any mask they want to try. I try to show them newer versions of their own as well as the ones that might be different. I will usually run a vets titration with the humidity set at one. Almost everyone wakes up surprised that they are not stuffy like I am some kind of miracle worker. You would not believe how many vets don't know they can change the humidity level.

Judy said:
It so helps w/that first self-fitting to have a second pair of hands and who can see that the fit is balanced equally on both sides. But we CAN do it ourselves w/a little more time and patience (and sometimes cussing) as we try to get each side equal. Practice makes perfect. And when you get it exactly where you want it, where the fit is comfortable and leak free - don't make any further adjustment, take your mask off in a manner that doesn't affect the fitting you've made.
Small glitch on the site Thursday, all is well now.

Rock Hinkle said:
Post away Jim. If it helps spread it around. I tried to visit your blog the other day and could not.

Jim Nadolny, BS, CRT said:
Rock,
Great job! I always use the finger thing, but did not know it had a name.(Kudos to Judy) I would like to reproduce this on my blog with your permision. You would be a "Guest Author". I think it would really help my readers. Let me know.
Rock, thanks for the good info on fitting CPAP mask (I prefer to call them C-CRAP).
My husband uses a full-face, but I can not tolerate this type, due to extreme claustaphobia..(can't spell TODAY)

I have a nasal pillow, with two straps across my head. I also cannot wear a cap, headband, or anything on my head without developing a headache. I fear the loosening I have to do on the straps may be causing leakage, but trying to go to sleep with a pounding headache will not happen.

I can not stand anything to cover my face, so I guess I am doomed.
L McClure, you would be surprised what you can adjust to when you realize your actual life is at risk if there is no other alternative. It just takes an attitude adjustment from I can't stand .... to I'll do it, by hook or by crook, I'll do it. I'm not saying it is easy or will be easy, what I am saying it CAN be done IF you make kup your mind to do it.

It may take months of a few hours today and a few more tomorrow and every day just sitting reading a book or magazine, working a crossword or jigsaw puzzle, kintting or crocheting, watching TV, whatever in the living room or family room, w/your mask on and CPAP turned on, SOMETHING to occupy your mind w/something other than "I've GOT to get to sleep!"

Or you can investigate whether you are a true candidate for surgery and what kind of surgery - or go for the ONLY CURE - a tracheotomy.
Thanks, Judy. No, no, a thousand times no, I do not want surgery and I probably made my non-compliance sound worse than it truly is. I do not want to wake up dead!!

I have many other illnesses, disorders, syndromes that contribute to my insomnia. The air from my CPAP makes my chronic dry eyes worse and also dry mouth. I have been told I do not have Sjorgens, but I sure have all the symptoms.
Also have very bad Fibromyalgia, bi-polar disorder and hypothyroidism, to name the top 3.

As a former college library research assistant, I certainly know that knowledge is power, and I research every condition and aliment I have, as well as family and friends. I am curious by nature and have to know everything about everything.

Linda
Is it a "given" that higher pressures make a mask more prone to leaks? I've not had any leak issues in the couple of months I've been using my CPAP, and know how fortunate I am for that. My CPAP is auto, and my pressure usually hovers around 6. Is that why I've been so lucky? If my pressure has to increase for some reason, will leaks be more of an issue?

I'm soon going for my next follow up with my therapist, my last appointment was 30 days ago. In my fist 30 days of treatment my leak rate was always zero. I haven't been checking my daily data, I have to start doing that, I just never think about it, but after my next check in, I don't go again for three months. It'll be time for me to start my own moitoring.... Little bird... fly on your own!!!! :-)
i think it depends on the mask. Some mask will actually develop a lower leak as you pump air into them.

Moe-jo said:
Is it a "given" that higher pressures make a mask more prone to leaks? I've not had any leak issues in the couple of months I've been using my CPAP, and know how fortunate I am for that. My CPAP is auto, and my pressure usually hovers around 6. Is that why I've been so lucky? If my pressure has to increase for some reason, will leaks be more of an issue?

I'm soon going for my next follow up with my therapist, my last appointment was 30 days ago. In my fist 30 days of treatment my leak rate was always zero. I haven't been checking my daily data, I have to start doing that, I just never think about it, but after my next check in, I don't go again for three months. It'll be time for me to start my own moitoring.... Little bird... fly on your own!!!! :-)
Ah, Linda. You do have a tough row to hoe. But, heck, if you've been able to cope w/all that .... You'll make it w/CPAP too.. Someone, I can't remember who, has mentioned that they use a black sleep mask over their eyes and under their CPAP mask which works great for them to protect their eyes and the bridge of their nose. For the dry mouth I assume you have tried Biotene or similar? And most deifinitely you should have a humidifier w/your CPAP. Adjust it as high as you need. Effective CPAP therapy should help improve the FM symptoms somewhat.Our RRTs and RPSGTs will cringe at this suggestion buy MANY CPAPpers use it quite successfully. "Tape" your mouth shut. Actually, you can use a very thin layer of PoliGrip Denture Gel on yur lips, or PoliGrip Denture Strips. It won't hurt or irritate your lips, it does a pretty good job of keeping your mouth shut, but you can easily open your mouth if you need to, and its just a mater of licking your lips to moisten them to "tape" your mouth shut again.Or you could probably acclimate yourself to a chin strap as well as the CPAP mask. You will find we have all kinds of tips to get acclimated to CPAP and mask we are more than happy to share..
Congratulations, Moe-Jo. Most of us have a devil of a time and go thru several masks before we get those leaks under control. You are right, tho, it does help to have a low pressure setting. Quite often the higher the pressure the greater the tendency to leaks. But once having mastered sleeping w/a mask and finding one with a good fit if you do have to go to a higher pressure you shouldn't have much trouble w/leaks.

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