Full face mask vs nasal pillows - advice needed

[johns019]

I go back to the sleep study center next week for a "set up" appointment - not sure exactly what that entails, but I assume we'll be figuring out what type of machine and mask to get.
I didn't like the full face mask during my inital sleep study when it was used with CPAP.
I tried the nasal pillows during my bi - level titration study - had to wear a chin strap because I'm a mouth breather. When I woke up at 3:00 am and couldn't get back to sleep, I found that lying on my side made it easier to breathe out (I think I probably created a big leak). I'm reconsidering the full face mask now. I hadn't thought much about it before, but my nose is quite often clogged up when I wake up in the morning.
So I'm wondering if I'd be better off to start with a full face mask?
Any advice will be much appreciated!

[zonk]

I've been user for over 18 months and still wake up with clogged nose but it does clear up after a while. I would suggest to try a nasal mask before going back to full face mask such as Activa LT or SoftGel nasal masks. Mask choice is individual choice and whatever works for me might not work for you or anybody else but its the most important part of PAP therapy to work effectively and its normal to try several masks to find the right one.

[Sleepster]

The nasal pillows will help keep your free of congestion. There's only one way to find out if it helps enough, though.

The technician will pretty much make you wear the full face mask if he can't good data -- due to mouth breathing or mouth leaking -- during the sleep study.

One you get set up with your own CPAP you will be able to try a variety of masks and may even get your provider to give you both masks so you can see which one works best for you.

There is also a hybrid mask that consists of nasal pillows plus a mask that fits over your mouth.

I also highly recommend the NeilMed Sinus rinse kit. It helps a lot with nasal congestion.

[johns019]

Thank you for the advice - hoping to get off on the right foot.

[TorontoCPAPguy]

Please. Whatever you do, do NOT under any circumstances tape your mouth shut nor wear headgear that does the same. I had a friend who had his mouth taped and threw up, and needless to say was asphyxiated.

I LOVE the Quattro full face mask and I have used them all and still have nosebags and nasal pillows in sealed packages. Once I hit the Quattro that was IT. It is wonderful for those of us that like to smoosh our face into the pillow as it tends to stay put with a great forehead brace and a wide cushion that offers greater stability than anything else I have used (I have a large box full of masks that I have used once, disinfected and packed back up). If your nose plugs up during the night you can mouth breathe and continue to sleep with positive airway pressure. If you want to go to the washroom at night you need only pop off the air hose swivel from the mask and go to the washroom and reverse the process when you get back to bed.

The Quattro may not be for everyone but I highly recommend it amongst the first masks that you try. As with all masks, you must adjust it properly and size it properly in order to achieve comfort and reliability.

Good luck and do not give up.

Oh, one other thing, exhalation relief is critical. ResMed calls it EPR and I have mine set to max all the time. Makes breathing in and out quite comfy.... and you can take this from a guy that was not only intubated three years ago but also, at a less critical stage, had a BIPAP ventilator working me (I was in a coma for most of it but awoke to discover this thing on my face.... no fun indeed having the air pushed in and sucked out of your lungs without any input from you yourself.... it is pretty tough and they wound up sedating me to stop me from struggling with it).

Good luck.

[archangle]

Find out what CPAP machine you will be getting BEFORE the appointment. Tell us what it is before the appointment. This is the most important decision you will make in your CPAP career.

DMEs usually get paid the same amount for any CPAP machine, so they sell you cheap dumb machines that don't record any data. For the same money out of pocket, you can get a machine that will monitor your therapy all night long, every night. This is really important to being able to get good therapy.

Some DMEs provide good machines, many don't. The bad ones will lie, cheat and steal to trick you into the dataless machine. Many doctors are clueless.

Do NOT accept any Philips machine that has "Plus" in the name. Or any ResMed machine with "Escape" in the name. Remember plus is a minus, and run away if you hear "escape." There's also a Philips DS150 machine that I would avoid.

Philips Pro machines are good, Auto is better. Resmed S9 Elite is good, AutoSet (not escape Auto) is better.

You have the right to get the CPAP machine from any DME (CPAP seller). There will probably be several who accept your insurance. If one won't get you the right machine, call around and ask if another DME will give you the right machine to get your business. DO NOT let your doctor route your business to his buddy, unless you get the right treatment.

[johns019]

Thank you for your help - I'm really glad that I found this forum.

Oh, one other thing, exhalation relief is critical. ResMed calls it EPR and I have mine set to max all the time. Makes breathing in and out quite comfy.... ).

So it doesn't have to be a bi level machine to ease the exhale?

Find out what CPAP machine you will be getting BEFORE the appointment. Tell us what it is before the appointment. This is the most important decision you will make in your CPAP career.

DMEs usually get paid the same amount for any CPAP machine, so they sell you cheap dumb machines that don't record any data. For the same money out of pocket, you can get a machine that will monitor your therapy all night long, every night. This is really important to being able to get good therapy.

That is a great idea - never thought about it - I'll give them a call - I'm hoping to get one of the Resmed 9 machines.

[EyesWideOpen]

I thought that I was a mouth breather before I started CPAP therapy because I was always congested, and would wake up with a dry mouth, or drool all over my pillow. However, most of that was caused by congestion and snoring. When I started CPAP therapy they gave me a full face mask that leaked and was very uncomfortable. Then I tried a nasal pillow, even though I knew that I was a mouth breather. As it turns out, once I started getting enough air through my nose, and the snoring was taken care of, I stopped opening my mouth. I still get a little congestion and I use a nasal gel on the end of a cotton swab and run that around inside my nose before bed, to cut down on the dryness caused by the rushing air.

I'm not saying that you'll keep your mouth shut once you have air being delivered to you, but there is a good chance that everything will be OK with a nasal pillow. I've tried a few, and I really like the ResMed Swift FX.

Good luck with your choice. Rememeber that you can have the best machine out there, but if you can't keep the mask on, the CPAP machine is just another clock radio on your night table.

[ScottBerglin]

I think you body creates more mucous to keep your sinuses from drying out, hence greater congestion in the morning, unless you use a humidifier. In some respects this is counter-intuitive...adding moisture to reduce the moisture (mucous) in your sinuses. But bottom line for me is, if the humidifier is working, I don't get congested.

[BabyDoc]

Humidifiers don't work well for everyone. I have just about given up on using mine. The higher my humidity setting, the more congested I become. Right now mine is set at 0.5 which is about as low as it gets before turning it off. Any more than that and my nose is running. Perhaps it will be different during the winter, when the air is more dry.

As others have said, I would try the nasal pillows. If it works for you, there is no more comfortable option. Use a chin strap initially. It does two things. It reminds you to keep your mouth shut, but isn't so tight that it will not let you open your mouth. It also wraps around your face and can help to keep your nasal pillows in place. I have the Swift FX and it seems to be working OK, although without the strap in did seem to move about when I rolled to my other side and then begin to leak. If you use nasal pillows, you have to adjust them just right (that's probably true of any device). If they are either too loose or too tight, the pillows will leak.