New Mask/Machine Help

[newguy99]

Hi,

I had previously attempted APAP Therapy about 5 years ago after a sleep study but failed due to not getting a mask that would properly seal. Short notice but tonight I’m scheduled to get a new machine and pick a mask. With COVID I WON’T Be able to try on masks

Looking for advice on machine and mask. I have read about the machines here and as much as I can on masks. I am scheduled to get a NEW not used, Airsense 10 APAP. 

My sleep study is over 5 years old, insurance refused a new one. My ahi was 63 per hour and I believe titrated pressure was 13. I have gained weight since then, my sleep doc figured this model should work even though my weight was up about 35 lbs., if not he thinks insurance would require a new titration to get approved for a BIPAP.

The Airsense 10 had worked back 5+ years ago when I could get a seal. Is it ok to start with the Airsense 10 APAP or should I press for a different Air 10 model????

Second, I need to pick a mask and as we know I get 1 and possibly a second backup as a second try thru insurance. I’m looking for educated guesses from folks.

FYI, I’m a mouth breather so need a full face type mask, my previous mask was I believe a Resmed F10 that sealed decently except around the bridge of the nose. Even one of those “gel” nose pads didn’t quite fix it. During my sleep study I had a Fischer FFM that wasn’t great.

Also, I’m a stomach and side sleeper and tend to flip side to side a lot during the night. I was thinking of the Airfit F30i since the connection on top in theory avoids dragging the tube across your body every time I’d go side to side?

Also thinking if I’m correct my nostrils can be used along with my mouth but may have less leak problems since it doesn’t going up on the nose bridge?

I read it’s harder to size because 2 pieces need to be sized (cushion and another piece) versus some need one size measurement?

So bottom line any thoughts whether the F30i is good/downsides or other FFM that would be good in my situation????

Thanks,

Bob

[staceyburke]

I think you are on the right path with a ResMed F30 or F30i. The F30 does not have the hose coming out the top but is easier to fit the difference is the headgear on the F30 has adjustment on the top of the headgear to tighten the nose piece.

[newguy99]

I found the original sleep study report that recommended an auto CPAP 10-15cm water, pre-treatment apnea/hypoapnea 73, RDI included RERAs 73. “Respiratory events virtually eliminated at 12 cm of water with an AHI of 2” Lowest oxygen saturation pretreatment was 76%, post treatment low 89% briefly.

[michael9346]

Hey newguy99 Welcome. Please be aware that both F30 and F30i only come in small and medium cushions. I presently use the F30 as testing the newer F30i was not successful as I toss and turn and the F30i has the air tubes along the side and my head would slow down the air flow and put more to the other side which increased the noise. You said you had a weight gain and a medium mask cushion could be a problem if you lose weight.  Wish I knew why ResMed only makes a small & medium as it really is a good mask.

[newguy99]

[font=.SF UI Text][font=.SFUIText]Thanks Stacey and Michael,[/font][/font]

[font=.SF UI Text][font=.SFUIText]I went yesterday and was thinking the F30 or F30i would be my choice. The “Respiratory Therapist” was not helpful saying the AirTouch Foam F20 is the best mask there is. He said the nose membrane on the F30’s would leak with my high pressures like 9 to 18cm, (though from sleep study it may be lower showed 12, doc put 18 I think because study was 5 years and weight was 237, now 270 lbs).[/font][/font]

[font=.SF UI Text][font=.SFUIText]Also they had a Dream Station not a Resmed Air Sense APAP for me, called today and it was a screw up on DMEs part so fixed. Really want to get started. So no mask/machine yet until I decide and am REALLY confused as to which mask to choose initially, my sleep docs clinician was no help, any thoughts or guidance on masks??[/font][/font]

[SarcasticDave94]

The very good news as it is would be that they weren't able to issue a Respironics. ResMed is that much better for most.

Do you mouth breathe when you sleep? That is the key to deciding on a full face mask. The RT that told you certain masks can't handle high pressure probably haven't used a mask. Bogus info IMO. This is assuming you do enough work to choose a right for you mask type, correct cushion size, and research proper strap adjusting. If you do it right, almost any mask can work for the highest pressures. I had the ResMed F20 mask and it didn't seal that very good for me so I switched to a Fisher and Paykel Vitera. That handled my ASV pressure up to 25.

Best plan of attack, if you don't think you mouth breathe, pillows then nasal then full face or hybrid. This order is least to most mask/facial area to seal and most likely to leak.

Just keep in mind, you get to choose. The RT can advise but that's it. They're not going to wear it. Check out our mask wiki.

[newguy99]

Thanks SarasticDave,

I DEFINITELY mouth breath, year round nasal allergies. 5 years ago I struggled thru for a bit using an F10 and the gel gecko nose pad but never really sealed around sides of nose well no matter what, kept waking me with leaks.

So I’m thinking F20 might also have sealing issues around nose. FYI, in my sleep study used I think a Simplus but not sure, wasn’t great either. I flip from side to side throughout the night and am 55 years old.

[michael9346]

The F20 Airtouch is a good mask but the instructions say you can't wash the foam. I used to wash mine about once a week and wipe daily with a baby wipe containing no chemicals, scents or alcohol. I could get over a month out of it, but that was an expensive cushion so I stuck with silicon. Remember many mouth breathers can also be mouth droolers and foam can get nasty. Your DME should allow you a fitting of masks to see what may work for you. For them to tell you a F20 or F30 is the best, is a decision only you can make. Whoever can invent the "one size fits all" will become a wealthy person. I also would not worry about your pressure as adjusting your EPR will lesson the pressure and make it more comfortable.

[SarcasticDave94]

My Simplus and similar but newer model is Vitera. Both allow me to back and side sleep with transitions without breaking seal. Pressures with the ASV may be up to 25.

There's an art in adjusting it. If you still have your Simplus, let me know. We can adjust it to work very well. Or get the Vitera, it's not much different than Simplus but I like Vitera best. The RollFit makes a big difference IMO.

[newguy99]

Thanks, yeah I understand air restriction on one side on the F30i could cause noise. About 9 months a year I sleep with a thru the wall air conditioner, place is just too hot otherwise so that might be as loud as air noise from mask?

Continuing to look for opinions, and I guess it's an educated "crap shoot" on mask pick initially. I think I'm going to just pick one and have them send it and machine. I'm initially down to F30, F30i and I guess F20 either airtouch/foam or airfit/silicone. When I saw the masks in person it seems Resmed changed the Silicone to be Cheaper/thinner? My old F10 Silicone pad seemed much thicker/sturdy?

I tried to track my sleep position, as a side sleeper, you can go thru stomach or thru back position going side to side. Without CPAP, 90% of time I seem to go side, to my stomach down, to the other side, NOT the other way. To be more natural, if it doesn't leak does that indicate an F30i would be more natural positionally with Tube at top?

With the F20's or F30, the tube would drag under my body probably end up being forced to turn the other way, would that be less restful/more arousing?

Has anyone else used the F30i and either works fine or found it got knocked and caused leaks?

Thanks.