British Snoring & Sleep Apnoea Association

I've had a ResMed CPAP (actually I think it's an APAP from what I've read) machine for a week and a half, and it's driving me nuts. I've tried two different masks, a normalish looking mouth & nose one and a Quattro FX contraption which covers half my face. Both masks seem to be really temperamental, the slightest movement makes them leak and wakes me up. Last night was my best night so far and I think I managed 2 hours asleep without interruption.

They seem to fit ok, and I use the Mask Fit function to check it before going to sleep, despite that I rarely manage more than 1 - 1.5 hours of sleep before I wake up with the mask leaking air somewhere.

My AHI was over 70 so I really need to get to grips with this asap. The large Quattro one seems like it should work but it goes almost to my chin, which seems a bit excessive. With both masks it feels like they are pivoting on my cheekbones like a see-saw, and if I have it tight enough to seal at the top & bottom it gets quite uncomfortable. I sleep with my mouth open and when the airflow is fully on it feels like my mouth is being inflated like a balloon!

Is this normal for people starting out? Do I have the wrong size or shape of mask? Do I just need to persevere?

Welcome to the forum, and even though you don't think you're getting anywhere fast at the moment, it takes courage to post so well done.

I think you will find it takes some time to adjust to your mask. I use a nasal mask but there seemed to be unexplained leaks at one time last year so I was asked to try the Quattro to see if that improved matters. Despite being a confirmed hosehead of longstanding, I found it hard to use and had some rotten nights because I couldn't work out if the air I was feeling was inside or outside the mask! It took about 2 weeks to adjust and I was SO glad to go back to my old nasal friend when it was proved that it wasn't the mask that was the problem ... just an old S8 that needed an overhaul!

I suspect you might not be fitting the mask correctly. OK so you're checking for leaks when you have fitted it and are lying relatively calmly so you think all is well and are getting the green light ... but what you are describing sounds like you might have the straps too tight and the adjustable dial not correctly adjusted. So let's see what we can do.

First of all, the principle of the mask is that it lies gently across your face, a bit like a hovercraft's skirt on water, so that you can move and the mask will stay put. It should not be clamped down.

So, don't turn on your machine.

Lie down on your back with your face looking at the ceiling and with your mask on LOOSELY and with the adjustment dial turned fully ON ... by that I mean that you are turning it CLOCKWISE as you are lying down until it can't turn any more.

Tighten up the top and bottom straps one at a time. Pull them gently towards your ears so that they are the same length (or feel the same) and then press the velcro so that they are held in place. They should just touch your face not press down on it. Make sure your nose and lips are well covered.

Now gently turn the dial on the top of the mask anticlockwise - gently now! - so that the top of the mask adapts to fit the bend of your forehead.

Now try turning the machine on. The mask should sit well on your face but also allow you the possibility of changing position without leakage.

(Are you sure that you are not confusing the sound of the air leaving the machine by the 'non-return valve' at the top and centre of the mask for leaks? I found it hard to accept at first. The 'non-return valve' stops you from rebreathing your exhaled air ... you need oxygen not carbon dioxide!)

Try adjusting your straps and then your dial if you don't feel the fit is good. Do try to persevere - we all have to at the beginning of our xPAP journey! - but don't hesitate to get your 'fit' checked by your sleep clinic if you're still feeling unhappy with your mask after a week.

All the very best and please stay in touch.