Nasal mask to Facial mask increases the AHI a lot

[Pierrec83]

Hello to all

Someone in my family is using a Resmed S10 (as I do). She has a humidifer.
She was using a nasal mask, and the results were amazing (AIH always below 1). But at the same time, she had quite some leaks (around 12 l/min), and also a very dry mouth.

So she asked for a facial mask to try, and she did try for 4 days

I managed to get her Remed files remotely into my Oscar software, and this is what I saw :
With the facial mask, the AIH immediately jumped to values between 8 and 11, of which 3to 4 are unclassified apnea and 2 to 3 OA. And also the total time in apnea jumped up 15 to 30 minutes
The leak rate also jumped to 60
her mouth is even drier than before.

I noticed that the EPR is set to 1, and Ramp only

So tonight she decided to go back to the nasal mask, considering the facial mask is not for her.

Any idea of why going from nasal to facial mask could trigger such differences?
Do you think that the facial mask could be a solution to her dry mouth?

Thanks

[SarcasticDave94]

The success of either nasal, pillows, or even full face is partly dependent on leak rates. Mouth leaks may cause dryness of mouth due to airflow. I think either leak type can cause errors in accuracy of PAP therapy and reporting. And different individuals will be more or less irritated by leaks; each person reacts differently.

Depending on which leak type you're dealing with depends on what method to solve them. If it's mask leaks, then gaining better fit and proper adjustments are needed. Mouth leaks either need to master the tongue suck seal, maybe taping the mouth, a strap, or maybe going full face.

I do believe the PAP therapy is only as good as your mask fit and leak control allow it. If one has a continual leak then treatment may be hindered and it may affect accuracy in reporting and therapy.

[staceyburke]

If you have a high leak you do not register apnea events correctly. I went from a pillow masks to full face (ResMed F30) and my leaks went down to almost 0 and the apnea went down also - I’m not sure just how much because of my high leakage with the pillows.

[Benzi]

Every person is different. Some people manage with full face, some with nasal pillows. If one doesn't work, try something else. I use nasal pillows because it minimizes the contact that my face has with the mask and straps. Good luck!