Can somebody talk me into a nasal mask?

[cathyf]

Ever since my epiphany about the cervical collar (thanks to my friends here!) I've been trying to figure out if I have to use an FFM. (I was always a mouth breather while asleep.)

I've tried the dreamwear nasal bar, the P30i -- both small and medium cushions, and the N30i. Some parts of some nights are great, but most of most nights I'm just a leak train wreck.

Here's a week to illustrate...

Day 1 -- FFM: https://www.dropbox.com/s/jz6ultm4njsfhi...M.png?dl=0
Day 2 -- P30i: https://www.dropbox.com/s/vki99ljo6itc72...M.png?dl=0
Day 3 -- P30i: https://www.dropbox.com/s/isjlx35ov777x5...M.png?dl=0
Day 4 -- P30i: https://www.dropbox.com/s/yx5uen1pgeioe9...M.png?dl=0
Day 5 -- P30i: https://www.dropbox.com/s/w2c5chqhapvgc2...M.png?dl=0
Day 6 -- P30i: https://www.dropbox.com/s/rp39m0z3dztbj6...M.png?dl=0
Day 7 -- P30i: https://www.dropbox.com/s/mt24wzc6f49ulz...M.png?dl=0
Day 8 -- FFM: https://www.dropbox.com/s/jf1wvrd1b96and...M.png?dl=0


I can get virtually leak-free with the FFM, but not even close with any of the nasal masks. Should I just give up and stick with the FFM?

[clownbell]

Would you consider pillows? I have had extremely low leaks with the Brevida which feels like it's not there. Leaks over redline of 0% to 5% of the night, which is pretty small.

Also somewhat-higher-but-still-small leaks with the N30. 

YMMV of course.

[GuyScharf]

I can get virtually leak-free with the FFM, but not even close with any of the nasal masks. Should I just give up and stick with the FFM?

If a FFM is working for you, why do you want to switch to a nasal or pillows mask? Are there comfort issues, therapy efficacy, or what?

I use an AirFit F30. I've tried various other masks over the last few years but keep coming back to the F30. I recently tried a F&P Evora for several days. Sure, it's lighter and has fewer straps. But I had to make more adjustments during the night and the machine was reporting a nearly constant but very small leak (about 7 lpm). While a small leak like that has no effect on therapy, I did find the leaking air to be slightly disturbing.

Which FFM are you using?

[Sleeprider]

Nasal pillows have the smallest surface area that need to create a seal. All you have to do is avoid pressurized air form blowing out of your mouth. Nasal pillows are a far less invasive interface than a nasal mask, and don't need to seal around your nose, just under it. The biggest advantage is you no longer have any pressure on your sinuses along the very areas the FFM and NM need to establish a seal. Try this...breathe in and out through your nose, then apply pressure on both sides beside your nose where the FFM and nasal masks rest near the side of bridge of the nose. I rest my case.

[CorruptAlligator]

I think what works depends on the individual. I have tried many types of masks, and nasal masks works the best for me. The problem is, it's not as comfortable as nasal pillows. But, it's not as invasive as FFM, and I consistently have the best FL and AHI response, and I cannot figure out why.

I understand nasal pillows are popular, but doesn't work well for me. I get frequent arrousals, and recently started getting greater FL. My firsf couple of nights with pillows, it would wake me up frequently, and much more so than any other masks.

When I look at my flow rate, I can see instances of lower flow with pillows, and I had couple nights of low flow rate period that caused me to wake up trying to breath. So, I think I don't breath as well though pillows as well as masks (FFM, Nasal).

For some reason, I do not suffer from positional apnea (or is it something else?) with nasal masks as I do like a FFM and cannot figure out why. I assume it's the bottom straps pulling my jaw back with FFM.

I have issues with Airfit N20 in terms of leak when side-sleeping, and then tried Resperonics Wisp, and I get no leaks if tighten it just enough.

Wisp is great for no leak, but comfort is and issue when I side sleep. I'm trying to find a nasal mask that's more comfortable
(please let me know anybody has suggestions).

Next for me is N30i cradles. I'll see how well that works for me because I don't like the side brackets on nasal masks when sidesleeping.

[cathyf]

For some reason, I do not suffer from positional apnea (or is it something else?) with nasal masks as I do like a FFM and cannot figure out why.  I assume it's the bottom straps pulling my jaw back with FFM.

I've been using the F30, and one thing that I think happens is that if I keep the straps loose enough, then if I tuck my chin down -- causing positional apnea -- I get a leak out the bottom of my mask which wakes me up enough to fix the chin tucking and stop the apneas.

With my attempts at the nasal pillows, I go to sleep and it's fine, and then I wake up with it leaking like crazy, probably with my mouth open, and I can't fix it without getting fully awake and a whole lot of messing around. Then later I look at OSCAR and I spent a whole lot of time with massive leaks sleeping right through it, too.

Nasal masks seem to be the gold standard for therapy, and I can't get over the hump in figuring out how to make them work!

[Gideon]

The best mask for you is the one that works for you.

The suggestion I have on mask types is to start small and work up.

So

1. Pillow mask
2. Nasal mask
3. Full Face masks
4. Specialty masks

[nightgagger]

It is a dilemma for a mouth breather, chin tucker.
The masks I've tried and used:F20, N20, P30i, N30i, F30i, F&P Brevida, Simplus.

Out of all these, the most consistent and best that's worked, after much trial and error, and help on this board is

N20.

Along with BSN Cover Roll tape that I pull my mouth and chin into a single piece of human tissue and with the help of CPAP pillow, side sleeping has really helped in the leak, AHI and FL numbers.

Do I wake raering to go...well, yes and no, but I've noticed now after about 8 weeks of good numbers that I'm not needing a afternoon nap, or coffee...that's got to be a good thing.

Anyway, runners up, the Brevida is a great mask...but it does something weird with my face...high respiration rate..not sure why. In fact, I used it last night just to see, but I woke a few times through the night concerned with it...it's frustrating.

P30i great mask as well as the N30i...but with the caveat that side sleeping with movement will pull the seal.

Again, all of these masks work for me when I use the BSN Cover Roll tape...no other.

The FFMs didn't work for me as my mouth/jaw/chin just relaxes too much when I'm in deep sleep and the masks just leak (tried different cushions for the Simplus as well).

Nevertheless, I think you just have to find the mask that fits your face, as Gideon notes.

Tape may be the answer for your situation, and how comfortable you feel doing that is up to you.

[Deborah K.]

I think the most comfortable mask of all is the Bleep system.  There are NO straps of any kind.  The mouth-breathing folks try a couple of different things.  For some, a soft cervical collar helps keep the mouth closed and also prevents chin tucking.  Others use special tape to keep their mouths closed.  Good luck in finding a solution that works for you!

[CorruptAlligator]

@cathyf, how's nasal mask the 'gold standard?' What makes you say that?

Based on what you say about mouth breathing, unless you can put up with stuff that helps you keep your mouth closed, non-mouth breather masks may not be for you. If you suffer from nasal congestion and sometimes cannot breath well through the nose, you may naturally breath through your mouth. If you commonly get congestion, you are likely better off with mouth breathing mask.

Last night I was testing N30i, and I noticed that I cannot breath easily with it, and decided not to try it. Stuff like this is anxiety provoking because prior episodes of waking up gasping for air from bad mask situations. N30i setting for CPAP is pillows, and it seems pillows do not push as much air as my nasal mask. For pillows it seems to makes sense for less air flow, but for some reason, cradles seems even harder to breath with pillows setting.

Anyway, I get best flow of air through masks, and cradles and pillows feels like not enough air flowing.

I have TMJ and I cannot stand straps around my jaw. I wish I can find some that work well for this. I like nasal cushions, but I don't like the straps on N20 and Wisp. And the straps are required to be tight enough to keep the cushion stable for side-sleeping. I like the straps on P10, but the air flow doesn't work well for me. So, I'm still looking for better.