Dreamwear full face mask setting for Airsense 10

[MikeE3]

I've been using a Dreamwear Pillow mask for the last 3  1/2 years.  Since the start OSCAR's Leak chart has consistently shown a lot of leaks with 'flat tops'. I've learned from this board, that usually indicates mouth breathing. And my wife recently confirmed it. When she wakes in the morning sometimes I'm breathing lightly through my mouth. 

I tried a chin strap but that wasn't working for me. So bought a Dreamwear Full Face mask. The one that sits under your nose but covers your mouth with the tube attaching at the top of my head. My thinking was this would help with my mouth breathing. 

After reading the wiki on mask fit, reading the instructions that came with it, and watching a few YouTube's for fitting it I tried it last night. I got it where the Airsense 10 Mask Fit was giving me a Smiley Face with the medium cushion. 

Disaster Struck: My AHI averages under 1. Last night with the new mask it was 8.7 (even higher than my AHI when I had my sleep test done w/o a CPAP machine). The Airsense 10 reported a Smiley face for mask fit but Oscar showed a lot of leaks. 

So it's back to trying to refit it and perhaps change size to small from medium. Using the nose template I fall right on the border of medium / small. I did run the Mask Fit and got a smiley face for the medium mask.

Enough of the back story. My question is with this Dreamwear FFM do I set my Airsense 10 for Full Face mask. I'd like to get confirmation on that before proceeding to try to get this new mask working for me. 

I think it's too early to be sharing OSCAR charts until I can get my AHI down. And then if needed I'll find my therapy post/thread and continue asking therapy questions there. 

Thanks.

[DaveL]

Hoping to help sharing my own experience.

I use a nasal mask and a chinstrap. Wearing all this gear sucks on bad days. I figured I would try full face masks again. Conclusion--didn't work for me.

I have the same machine as you. I tried the ResMed F30 and found it leaked, terribly. Tried several versions. I didn't last the night in about a week's testing. I tried other masks... End result was I went back to my nasal mask ResMed N20. And I use a cushion I made myself or a chinstrap. Knightsbridge Dual Strap.

The other day I decided to try the new OSCAR here. Found I hadn't used OSCAR in 67 days. Found I had regular sleep interruptions. And I was mouth breathing.

Don't know about the Respironics masks. ResMed masks tell you what setting to use. On the box if I remember right.

Funny...I used my Breeze nasal pillows mask for the first 5 years of treatment. Back then there was no OSCAR or sleepyhead. My cpap was a respironics that just gave hours of use. That was so the quack of a sleep doc could see I was compliant.

Hope someone can pick this up and give you the advice you need.

Darn OSA. If I have to wear all this gear it better work.

[clownbell]

This is more complicated that might first appear.

When you buy a ResMed mask, it comes with an instruction pamphlet -- which I imagine many users do not read. Hidden in there is a fine print item telling you which mask setting to use. Any assumptions can be wrong. One might assume that when using the N20 nasal mask, the correct machine mask setting would be "nasal" which sounds logical. BUT the booklet says to set the machine mask setting to "pillows." Seems illogical, and I dunno why, but that's what's in the pamphlet.

It's been a long time since I bought a DreamWear mask, and so my memory may be wrong, but I believe it also will have some documentation which should be read.

Wit all due respect, do the homework.

[MikeE3]

Wit all due respect, do the homework.

Likewise, with all due respect I did some research / google-fu / apnea board searching as well as reading the owners books and info on the packaging of my Dreamwear masks before asking the question. I don't have any Resmed masks. 

The Dreamwear FFM Mask instructions / package show a setting of "X1". (which BTW is the same value Phillips says to use for the Dreamwear (Pillows) Under the Nose Nasal Mask).  That's not a setting used by the Airsense 10 unit. 

Resmed's owner's book says to set their similar mask, the Airfit F30I, to Full Face and for their N30I Nasal mask use the pillows setting. 

So to me their's kind of a discrepancy between the two manufacturers which confuses me when using the Dreamwear FFM on the Resmed Airsense 10.

Phillips set's their FFM to the same value as their under the nose pillow mask but Resmed set's their version of the mask to Full Face. 

So that's why I asked the question because I'm mix / matching manufacturers mask and CPAP unit. If both my mask and unit were from the same manufacturer I have the info on what to set mask type.

[Phil7]

I tried a Dreamwear Full face mask for 1 night (only).   It had the smallest footprint of any full face mask that I had tried.   At some point in the night, my mouth opened and fully came out of the mask when my lower lip fully exited the mask.   This caused a violent wake up event.   That was the first time something like that had ever happened to me in a full face mask.   The full mask and it's headgear found it's way to the trash right after that.

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[hegel]

Mike, I usually use the Airfit P30i, but get mouth leaks, especially if I don't wear a collar. So I recently went back to an F30. This mask solved the mouth leaks...but my ahi soared. Exactly as you report. I set my machine to FF at the start, and then raised the minimum pressure to over 8 from my normal 7.2. Still too high an Ahi.

With the P30 my ahi hovers around 1, even with mouth leaks (last night without the collar I was over red line for 4 plus minutes, with lots of time around 15. this is the longest I've ever been over the red line.) So like you, I'd like to know if re jiggering pressure on the F30 might bring down my AHI while solving the mouth leak issue. Maybe I was too timid with my minimum pressure?

I started a thread called Learning to Live With Leaks, where I discussed this. If I feel rested and recall lots of dreams, even with higher mouth leaks than I like, and have a good AHI...then why not accept the P30i as the best compromise? Mouth leaks it is. I'd still rather have it all! better leak rate, good ahi.

I can tape with no issues, but oddly, it doesn't seem to help---I still get leaks. I use great tape too.

[SarcasticDave94]

First off, set the ResMed PAP to full face as that's probably most appropriate here.

Next, let's look at a standard view OSCAR screenshot of Daily Details via the F12 key. Although we're going to focus on the leaks chart, let's see all of this standard shot. This will include the left panel data too, also this will be important.

Now here's the theory before the proof, keying in on your description AHI increases when leaks decrease type of thing. Note to salvage you sanity, I'll suggest you focus on OSCAR data for leaks, and that which you manually detect, only. Forget the PAP mask fit grinning ghouls silliness. They're only bubble headed cheerleaders and not helpful to therapy or leak control. Trust me skipping this helps tremendously to your sanity.

Here's what's happening when a PAP user has a lot of leaks, the accuracy of event control goes down proportional to increasingly higher leaks. And accuracy in reporting therapy diminished too. This is very important. Now, reverse this scenario, lower the leaks with your full face mask and accuracy of therapy and reporting has improved. Hence new high reported events. Yet this is the more realistic, accurate number reported.

The image to illustrate this: you're attempting to blow up a balloon, blowing hard lots of air going in, BUT there's a big hole in the balloon on the back side. Your balloon maybe will be inflated at 1 PSI but you blew that and then some, almost all of it leaked out.

Once you get the OSCAR shot, we'll likely see that you also need to pay attention to pressure settings to reduce events. AHI 8.7 isn't treated, so obviously things need a refresh.

[MikeE3]

@hegel - yep, I was taken aback too. The transition from pillows (I've used since 2017) to FFM is certainly not seamless. The 1st night I used the medium sized cushion mask and had an AHI of 8.67 and maxed out my pressure at 16. Typically my pressure runs between 10-11 and I've never maxed it to 16 before. The 2nd night I switched to the small cushion mask. My AHI dropped to 2.16 but I still maxed my pressure to 16.

I started with the medium because it felt more comfortable and per the sizing chart the end of my nose was right on the dividing line between medium and small. But a.) since I've been using the small size pillows and b.) the instruction book said try to use the smallest size cushion that works I went down to the small.

What @SarcasticDave64 makes sense. A bit hard to comprehend that I've always though my AHI was averaging under 1 since I started therapy in 2017 and that perhaps last night AHI=2.16 is more accurate.

I'm totally discounting the 1st night's attempt with the medium mask that gave me AHI=8.67

My next few posts will be to @SarcasticDave64 who kindly asked for my OSCAR data.

I didn't mean to turn this into a therapy thread when I asked my initial question, but perhaps it will help others changing from pillows to FFM mask style.

[MikeE3]

@SarcasticDave64 ... thanks for the explanation and taking interest in trying to help by reviewing my OSCAR charts. I've been doing therapy since 2017. So this first post is just from the summary page to give you an idea what my 'numbers' look like over the last year. I was using a Dreamstation 1 until the recall came along. I bought out-of-pocket an Airsense 10 and started using it July 7th.

As you'll see my AHI was around 1 or less using the Dreamware Pillow mask with both machines. And my pressure stats were all much lower than when I switched to the Dreamware FFM.

   

   

Next post coming typical OSCAR data with the pillow mask.

[MikeE3]

@SarcasticDave64 ... this is a typical OSCAR set of data prior to using the FFM. Maybe my leaks with this mask aren't 'bad enough' that I shouldn't have tried to fix them. But from my reading here at the forum 'flat tops' on the Leak graph is an indication of mouth breathing if I understand correctly. So that's why I tried the FFM.

The 1st two screen shots are in this post. Next post will have remaining 2 screen shots.