Can somebody talk me into a nasal mask?

[Ratchick]

I have seen some research that suggests that people tend to get the most effective therapy by using pillows, followed by nasal masks, and then followed by FFMs. But if you can't get good sleep because of discomfort, leaks, or whatever, then it really doesn't matter.

I mouth breathe and my jaw drops every time. What I REALLY wanted to try was the ResMed mask that had a mouth seal and pillows because I don't get on with the F30 at all.

I CAN do pillows - but I have to either wear a chinstrap or a soft collar and tape my mouth. That said, I can get my leaks down to pretty much zero that way. It just depends. Because it's such a palaver, I generally use an FFM (F20 with memory foam, love it) as I don't have a large face or throat and suffer allergies and congestion fairly often. But that said, after a couple of months, the bridge of my nose ends up getting a pressure sure - sometimes it's just reddened but most often it'll just be because the mask shifted a little one night and by the time I wake up, the skin has broken. Then I need to give it a week to 10 days to heal up, and during that time, I use pillows. Once I got used to that, I can sleep just as well with the pillows. It's just more of a process.

[DaveL]

I made my own under-jaw cushion. I found a face pad at Mountain Equipment Co-op. Bought it on a wim. It's used on a baby carrier, so I knew it's soft.

Then I found a strap. Tighten the strap around my neck wit the pad under my jaw and against my throat.

[cathyf]

DaveL -- that sounds like more-or-less what I ended up with when I removed 5 inches of foam from the length of my cervical collar.

[biorn]

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.

Exactly my issue with a FFM and my right nostril. My septum is curved and I can't breath without a pillow mask or a F30.

[FLcracker]

Mizz C tried several full face masks when she was first starting CPAP about 4 years ago. When she tried the pillows, she never looked back. Using a F&P head gear, which brings the hose up over her head, instead of hanging down the front. I set up a hose guide on the upper headboard of her side of the bed....hose goes from the machine, up, then the down to her head gear. She can sleep comfortably on either side or on on her back with no problem.

Some times she will have a 'mouth leak', which is the only time I ever hear her unit running...she'll make a noise like air being let out of a tire...which eventually wakes, her, and it gets all quiet again.... Do I complain?..Hell no! At least I know she's breathing, and that is much better then the old days, when I'd often have to nudge her so she would start breathing again...

FLc

[annoyed]

full face mask all the way....

[StevesSp]

I think the key question is: can you breathe through your nose sufficiently well, and every night, to permit the use of nasal masks or cushions?

If the answer is yes, it's probably worth persevering, but if not, why bother?

I myself cannot reliably breathe through my nose because of chronic sinus problems. Even when I CAN breathe through my nose, the airflow is usually so restricted that the respiratory effort means that I start to feel dizzy pretty quickly. I therefore have no choice but to use a FF mask. I frequently suffer dry mouth as a result, but it's the lesser of a few evils.

[2SleepBetta]

'Hope you find a method that works for you, Cathy. That took me a while and some change, more than one kind of the latter.

The P-10 pillows mask, Silipos Gel-E-Roll and cervical collar brought this slack jawed mouth breather peaceful sleep (3?+) years ago. My methods depicted at the link are not for everyone. I can use the Brevida with my sealing method, but don't. I find that the P-10 is better in clearing nasal passages when rarely needed, never have had to go back to FFM.

SR's point about the minimal skin contact of the P-10 was part of what appealed to me, as well as the corresponding fact the conforming pillow has less contour variation to bridge and seal. 

First it was the AirFit F10 FFM, then it was hellish nights with many other FFMs--leaks whether loose to float, goldilocks or tight, dry lizard in the mouth, noise, no sleep, and my dear wife taken flight to another bedroom. 

My DME told me I'd not like--I think it was--the Mirage Liberty hybrid with pillows of a kind and FFM. He was right. Still "knew" then I could never use a straight pillows mask. Wrong!

Updates of this earlier post's image: attachment.php (889×577) (apneaboard.com) :

That Deluxe chin strap was the best of my several strap attempts, but I never liked them pulling my jaw back, likely contributing to FL and OA. No more chin straps for me. I tried taping and experimented with Saran Wrap, pieces of nitrile gloves and more.

Slow to adopt the cervical collar, I eventually got a 3.5 inch one. But with it I still had some positional OA in supine sleep, which my accelerometer showed me. Eventually, other methods ineffective, I found the pictured (surveyor?) vest in a hospice thrift store after nothing else would keep me off my back. (I went to the store to find one of those denim Levi cowboy jackets I was going to have a knapsack sewed onto--figured boxes as seen would, at last, keep me sufficiently lateral.) 

I wore that vest filled with the boxes for a long time, even after getting a 4 inch collar. But not long ago decided I'd try sleeping without the vest. That made scarcely any difference and now I freely switch sides, not having to almost sit up, and now sleep supine and lateral with no trouble. That 4 in. collar makes all the difference.

Few will try the sealing method I use, but it rarely slips down to let lips leak. I got a sewing shop to copy the design of my first (last?) botched sewing experiment.

More good news, I eventually learned that "elsbow", as in the graphic, should have been spelled "elbow". 

[CorruptAlligator]

After finding out how much improvements my nasal mask help, I highly recommend nasal masks.

I looked at my FL with FFM and it was ugly.

With nasal mask, I don't even wear a collar and I get no clustering OAs. My AHI in general is much lower and even CA.

I think FFM is doing something to cause clustering OAs and I can't pinpoint exactly what it is unless I experiement with a camera. It has to do with lower portion of the mask with the straps. I wonder if most people with custering OA issues are using FFM?

Repironics DreamWisp is the best mask I've ever used. I feel rested with this mask. Masks are very important. I'm pretty sure airflow varies among masks at the same pressure that is set.

I use nasal mask with tape.

[cathyf]

I think FFM is doing something to cause clustering OAs and I can't pinpoint exactly what it is unless I experiement with a camera.  It has to do with lower portion of the mask with the straps.  I wonder if most people with custering OA issues are using FFM?

I'm pretty sure that when I used an amara view -- which doesn't fit right because it only comes in an "average" width -- I would spend the night chasing the mask around my face and tucking my chin to do it. But most nights with the nasal masks I end up with mouth wide open...