F30 Full Face Mask - total failure??

[BobH56]

[attachment=43205]I am brand new to CPAP, just a few weeks use now I was so I'm still very much learning.
I was diagnosed with Obstructive Sleep Apnea 52 AHI.  My sleep study showed no Central Apneas.
With an N30 Nasal Cushion mask, AHI has been 5-6 most nights so reasonably controlled.   I figured my leaks were my mouth opening so I ordered an F30 full face mask which I thought would solve the problem.

I've worn it once and it was an absolutely HORRIBLE experience.
It started off feeling just like the N30 but after an hour or so I was struggling to breathe.  I could not exhale  through my nose  at times and had to gasp and exhale through my mouth, a disturbing feeling. My breathing was all over the place, the AHI on the machine
showed 40+!  My cheeks kept ballooning out under pressure as well as air forced from my lips?
I would release all the pressure (machine showed it was at 15.8 most of the time) and I'd try again, but quickly it reached a point I couldn't nasally [attachment=43206]exhale and all of the above repeated.  

I took the F30 off about 3:20am in the morning after no sleep and went back to the N30. I woke up to an AHI of 16 for that night, the worst night ever with CPAP.
This is reflected in the Oscar chart attached as the AHI came back to 16 as a result of the switch from the F30 to the N30.

Is there something about a full face mask I should have been aware of?
It was not prescribed, I just thought it would resolve mask leaks which it did,
the leak rate for the time I had the F30 on was 7L/min.

Any insights or advice as to why such a horrible experience with a full face mask?  Is there something I can do to improve my results using the
N30 Nasal Cushion mask??

Any advice is very much appreciated.

Bob H.

[mchris]

Hi Bob,

I'm also a newby with CPAP, so you might get some better advice from more experienced users. I've used the F30 shortly, I couldn't get it to properly seal all night. Are you putting it very tight, if so it could be that you are pulling your chin backwards which can result in more apneus. (Figured that out with another mask)

Good luck,
mchris

[BobH56]

Thanks for the reply.. I don't think I had it (F30) too tight but something was obviously triggering apneas and strangely my inability to exhale through my nose.  I might risk trying it again at some point and will make sure its not overly tight if I do, thanks.

Not sure why my cheeks were being inflated with the F30 either.  I'd naively thought it would function just like my N30, only without mouth leaks since my mouth was covered.
Well it did solve mouth leaks but the results were all but worse than not using a CPAP machine at all which I find baffling. 

I have no idea what to make of it.  With the N30 I'm kinda in the 5-6 AHI range. I have tried a chin strap but it triggered
OSAs which were less than 1.0 otherwise without the strap.   

I turned off EPR other than a brief ramp time and that seemed to improve the Central events.  I just tried mouth taping the other night
but not much improvement as yet. 

I am open to any suggestions with  either the the N30 or if I dare try it again, the F30.

Thanks

[unidee]

I got yesterday AirFit F30. And large leaks are now 0,03 %. With P30i they were 40 - 60 % !!

[BobH56]

I had been getting an AHI of 5 or 6 with an N30 nasal cushion mask but felt mouth leaks were a problem.
I have tried a chin strap which seemingly triggered Obstructive Apneas, then bought a F30 full face mask. 

I tried the F30 again last night and the results were all but horrific.  Obstructive apneas with the N30 were < 1.0 and now are 20 with the F30??
The only thing I can guess is that if I have any tension on my jaw or chin, obstructive apneas are triggered in a big way.   Is that a reasonable assumption or is there something else with full face masks I need to know.  I did have EPR 3 set full time.   With the N30 I have EPR as ramp only.

Below are charts using the N30, and also the F30 last night.  I just can't believe the F30 works so poorly.  It did solve my leaks
and dry mouth but the AHI is horrible! 

Any advice or suggestions for either mask would be much appreciated.  I'm going back to the N30 for now and maybe
will try the F30 once more in a few days with the lower straps as loose as possible before I give up.

Thanks

Bob H.

[Millstone50]

The machine is bouncing off the limit of 16cm due to the OA. Not sure if it's mask related; could be positional apnea. Did you change the mask type in the menu when you changed types?

[BobH56]

Thanks for the reply.  Yes I did set the mask type on the Airsense 11 to full face for the F30.  I just changed it back to Pillow for the N30
as I don't want to try the F30 again for awhile.   I just have no idea why such a dramatic change in results.

[Millstone50]

I want to like the F30/F30i but just can't because of the constant leak issues. But someone else may be able to comment more on why it gives you a ton of OA.

[DaveCar]

Many variables;
Everyone's face/head is different.
Overall tightness of mask.
Relative tightness of mask straps to each other.

I love my F30. It would be great if there were better instructions (with all masks) to "Begin by adjusting straps A for.." and "Then adjust straps B for.." etc.
We're more or less left to fiddle until it works or doesnt.

For me, I adjust and readjust until I get the F30 pulling slightly up on my nose (helps keep my nasal route open) and at the same time somewhat tight on my chin to help keep my mouth closed. Where the top overhead strap sits for me seems to be quite a bit more forward than recommended. The middle straps pass very close to my eyes (instead of closer to ears).
I started this journey with very high AHI, but now regularly hit 0.x numbers.

[BobH56]

I too want to like the F30 as I don't get that dried out mouth result as I do when I use a nasal mask.

Using a nasal mask I mostly have CA type events as obstructive events are less than 1.0 and my total AHI averages 5.5 or so thus far.

I thought with the F30 I'd have even better results but it seems to somehow induce a massive increase in both Obstructive and CA apneas??!

I tried a chin strap & also had the same increase albeit far less severe.  I am guessing (I am new to all of this, 3 weeks now) that my chin/mouth
position is extremely sensitive to any external pressure.  If any tension or pressure, the OAs seem to explode.

Maybe I'll learn to keep my mouth closed and the CAs will lessen with time.  With the  N30 its  been 3.5-4 CAs, and .05-1.0 OAs.  I did have one
night of 3.5 AHI so the mask can work fairly well, but I do have to drink water to hydrate my mouth at least twice per night.
With the F30 apneas jumped to 20+OAs & 10+ CAs which baffles me and frankly scares me off from any full face mask usage at the moment.
I hope someone can give me so ideas as to what might be the issue with my using a full face mask.

I appreciate all of the comments thus far.