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[Equipment] Common to switch between nasal and full-face mask as needed?
#1
Common to switch between nasal and full-face mask as needed?
New to the world of sleep apnea, first-time post. Thanks to everyone who participates in this board—the information has been most useful so far.

63-year-old male diagnosed with mixed apnea (AHI 13.8 on an overnight home sensor test, though actual AHI was probably higher as I was awake for about an hour during the test) and have been prescribed what I gather is a pretty standard first option, ResMed AirSense autosense with pressure between 4–20 cm; mostly it has stayed below 8 for me. I have started off with a nasal mask, despite some misgivings, as over the past couple of years I've often had sinus congestion that prevented me from breathing through my nose fully on some nights. It doesn't appear to be purely allergy-related but instead connected with getting older & having mucosal engorgement independent of external factors, plus a slightly deviated septum. 12-hour OTC nasal decongestant spray works wonders for it but that's a last resort for me as it does lead to rebound effect with repeated use.

I was surprised to find that most nights I'm breathing OK with the nasal mask. But not every night. Some nights I'm clearly laboring to breathe through my nose & have waked to find myself exhaling through my mouth; no doubt I'm doing some mouth-breathing while asleep.

So I'm planning to try a full-face mask (one of the new Respironics Dreamwears), but am thinking that if that works out I might want to purchase one of their nasal masks to use when I'm breathing freely at bedtime & feel that congestion won't be a problem. How many folks out there follow a switching strategy like this, and does it seem to work well, in terms of adapting to both masks and keeping AHIs low and constant?

(I'm not seeing stellar results after two weeks on the machine, OAs reduced to near zero but lots of central events, AHI averaging around 7–8, so also wondering if a full-face mask might do anything to improve that.)
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#2
RE: Common to switch between nasal and full-face mask as needed?
I regularly switch between Swift, Airfit and Dreamwear. A nightmare for the DME due to the paperwork, but sticking to one resulted in sores. I have diabetes so maybe that contributed to it. So, I use one mask for 4-5 nights, and then switch to another one. I buy the Swift FX mask and parts on my own dime and alternate supplies between Airfit P10 and Dreamwear. One of these days, I will try an Airfit N20 just to see if maybe I would have better luck with that.
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#3
RE: Common to switch between nasal and full-face mask as needed?
I gave up on nasal type as I am plugged often, wasn't worth the switching so I just went to ffm all the time. I just got the dreamwear ffm and it is excellent so far, but also really li ke the f20 airtouch as well. I will probably switch back and forth if one starts causing sores or just for a change, it doesn't take long to switch the hose over.
Resmed autoset 10-Care thru VA 
F20 Airtouch-F30 my favorite  My Air and Oscar
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#4
RE: Common to switch between nasal and full-face mask as needed?
I use the same N20 mask.   I am roughly in the same range of pressure as you with straight CPAP. As a person whose jaw sags and lips open when I sleep, I have to tape my lips closed using a water-resistant surgical type tape.  In nearly five months of therapy, I have only had to rip off the tape once, and that was just minutes prior to my normal waking time.  My nostrils had swelled shut seconds ago, and I awoke with a start and ripped off the tape.  This hasn't happened since.

I feel for people who must constantly fiddle, or make choices between various methods or forms of equipment, in order to maintain a reasonable quality to their therapy.  My own AHI's are very low, and the mask doesn't seem to bother me much at all.
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#5
RE: Common to switch between nasal and full-face mask as needed?
Creosote, you say sometimes you labor to breathe and also that your settings are 4-20. I'm no expert by any stretch of the imagination but I've frequently read on this forum that most of us are starved for air at the low end of pressure. Hoping the experts weigh in... they might suggest you increase your min pressure.
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#6
RE: Common to switch between nasal and full-face mask as needed?
creosote
I recommend changing your min pressure to 6. That should help you breathe. 4 causes many people to feel like they are not getting enough air. Make that change a try it few days. If you are still have issues raise it by 1 and try a few more days. You can also tun off ramp.

Please let us know your progress
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#7
RE: Common to switch between nasal and full-face mask as needed?
Thanks, I have ramping turned off on the machine already. A general question about changing minimum pressure and other prescription settings, though. Thanks to this board I quickly learned how to use data on an SD card and how to get into the clinical settings on my ResMed machine. I did try modifying my EPR setting for a couple of nights but noticed that when I fired up Sleepyhead there was a display line showing something like "changes from prescription" with a datestamp noting the change I had made. I assume that this information will be available to my prescribing doctor & whoever monitors for compliance for insurance purposes. Could changing prescription parameters without consulting one's doctor cause problems with insurance? I.e. could it be considered to violate compliance rules?
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#8
RE: Common to switch between nasal and full-face mask as needed?
The Resmed and most other machines transmit the settings and results, but not that date-stamped change list. Compliance is defined as use of the equipment (4-hours or more at least 70% of days in a 30 day period, within the first 90 days). Settings are not part of compliance. Most of us optimize our machines and if anyone is concerned about it, the results count...just talk to your doctor's office and explain why you made the change. They can easily amend the pressure prescription.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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#9
RE: Common to switch between nasal and full-face mask as needed?
I switch between a Swift FX II, a Wisp and an Easy Life mask at semi regular intervals.
I bought extra heated tubing so the mask is all complete just unplug one mask and plug in another to my CPAP and away I go .
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#10
RE: Common to switch between nasal and full-face mask as needed?
If I get irritation around my nostrils, I'll switch to a Dreamwear or a Whisp.
I do have an Airtouch F20 that I rarely use... reserved for when I am so congested that there is no way I'm going to be able to use a nasal mask.
-- Rich
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INFORMATION ON FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

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