Resmed AirFit F30 FFM

[Big Guy]

When I use my F20, it puts enough pressure on the sides of my nose to partially close my nostrils. I'm not a nose breather, but when I try, I like to be able to take in enough air. 

The F30 doesn't impeded my nostrils in any way. I think it actually helps to keep them more open.

[cathyf]

Dealing with my own F30 leak troubles...

I shifted from a dreamwear to F30 last fall, as I realized that I just get fewer leaks with it. I've always thought that getting a new mask cushion every month was pretty ridiculous, so didn't think much about it using the same cushion up through the summer. After my life-changing education about positional apnea and starting with the cervical collar, I decided that I wanted to try nasal pillows since I can (for the first time in my life!) sleep with my mouth closed. First I got a free sample dreamwear nasal (the bar mask). Not bad, but I always had a few good nights but mostly leak-train-wreck nights. Next I moved to a P30i, which I really tried, but again the leaks were train wreck level. With the added complication that I woke up with the size small pillows having pushed up my nose and that pinched them totally shut, so I switched to the size mediums. Geez, the edges of the pillows feel smooth and soft and great when I rub my finger over them, but feel like razor blades on the base of my nares! So then I moved to the N30i cushion (which I could get as my next month's cushion as frame & headgear are identical.) Those both leak like a sieve, too... I keep trying these for a couple of days at a time but then always go back to the F30 because I can be virtually leak free!

I'm at my out-of-pocket maximum for the year, so I'm trying to milk the insurance for all I can get LOL, so I got a new cushion for the F30 last month.

I'm now wondering if ResMed changed something in the materials between my original F30 cushion that I got back in 2019 and the one I just got last August. First of all, it had a somewhat unpleasant "new car smell" for the first couple of days that I used it -- never had that with any other cpap mask in 7 years of this game. And then, like 3-1/2 weeks in, it has been leaking all night every night. I'm used to being able to go zero leaks all night with this mask, and now I can't get the leaks under control at all!

I dunno... Maybe I moved the headgear position? Or the headgear is stretching out? Because the stupid "size small" headgear/frame is too freaking humongous I've got it cinched up really really tight on the top strap -- that's the only way to get it up off my ears. So then the bottom straps and middle straps (that go into the back of the headgear) can just meet in the middle at the back of my head without having to overlap. But that puts the straps at a really weird angle, and I'm wondering if it's rocking vertically on my face and leaking out the top and bottom.

... ok, so this is a lot of useless frustrated rambling here, and all I can really offer is the thought: the struggle is real...

[cathyf]

Ok, figured something out last night: my latest leak problems started after I washed my cushion. The first morning I took the mask off, the cushion dropped out, as it wasn't snapped into the frame. Took me some serious messing around to finaaly get it to actually snap into place. Yesterday morning I washed it again, and last night was having -- again -- lots of problems getting it to snap in. At one point I was looking down at it from the front, it snapped in, and I realized that it was slightly -- but noticeably -- rotated. I pulled it out and lined it up so that it was square in the frame. Last night I was back to zero leaks all night.

The ring on the frame that snaps into the ring on the cushion is perfectly round, so you have to really pay attention or it ends up c**k-eyed. If you are having problems you should examine that fit really closely.

[GuyScharf]

I also often find it difficult to get the cushion snapped into the F30 frame properly. Sometimes it just doesn't want to snap and I have to mess with it more than I would like.

[Big Guy]

I went and double-checked my F30 to insure that the cushion was properly snapped into place. It was.

[NelsonM]

I switched from an F20 to an F30i and it took awhile but I think I've got it dialed in now. The F30i is different from the F30 (top hose vs front hose) but has a similar cushion design.

OSCAR tells me I have a lot more leaking with the F30i. Including some large leaks (something I never saw in the F20). OTOH it doesn't seem to affect my actual CPAP therapy; AHI and details of apnea events look about the same between the two masks. The main way I know I have a leak is it will blow air up the side of my nose into my eye and wake me up. Maybe once every other night.

It took awhile getting the F30i to fit right. The key insight was the nose leaking problem. I finally realized I needed to wear the cushion higher on my face, so my nose is actually quite a bit inside the cushion. The bottom of the cushion just barely sits under my lower lip, nestled in the labiomental groove (ie: the indentation between lip and chin).

The biggest problem I have is if I lie on my side and push the mask to the side, it creates a gap around the nose. Part of the fix for that is not rolling over that far; I've managed to train myself to keep the cushion off the pillow. You can also get special "CPAP pillows" that have the corners scooped away to make room for a mask.

I still think of the F20 as being a more reliable mask and I keep one around. But the F30i is more comfortable and I think I'm making it work OK.

[Big Guy]

I just might try an F30i the next time I'm due new supplies. Not having the hose right at your mouth could be a good thing, in regards to hose management. 

I'm a side sleeper and have issues with my pillow putting pressure on the hose swivel.

[DaveL]

cathyf good suggestion.

Is there any possibility that mask parts are forgeries? It's amazing what people can do these days.

[DaveCar]

Re: F30 headgear
I prefer to set mine so that the top and rear straps are sorta pulled towards the rear of my head and down.
Doing that of course puts slack in the bottom of the mask (since the whole thing is rotated), but then I tighten that down to make it leak-free and as a side effect, it seems to press enough below my lower lip to help me keep my mouth closed. It works for me.
Do any mask makers provide some kind of flowchart-guide for set up ? If I recall, the F30 docs were basically a "adjust for comfort and leak-free". Im sure they could do better.

[mjphyi]

I'm not familiar with other FFM's. I'm a die-hard mouth breather, and a side sleeper. That's what I liked about the F30, it did the job until it no longer did. 

And in my opinion, this is the problem. I used to be you; one or both nostrils would always be clogged when I lay down to sleep, and pre cpap, I had to sleep on my side to breathe at all.. So when a CPAP came along, I said that only a full face mask would work on me. Went through the big masks that left lines on my face, went from a Resmed S9 to a 10 Autoset, tried a multitude of collars to no discernible effect, and then tried a F30 mask.

That was the start of good things, because before that, my AHI started off at about 57, and with this mask, it averaged about 25. Then one morning, lying awake, but unwilling to get up yet, I noticed that I was breathing perfectly well through my nose, which was a great surprise to me; I hadn't thought that was possible. Fortunately I was awake enough to realize that I needed to know what the mask pressure was right then, so I first held my breath for over 10 seconds to make the CPAP reggister an apnea, and then I turned it off. Oscar said pressure was 12. From previous very uncomfortable experiences with a FFM, I had learned that at pressures above 17, I get aerophagia (for 4 hours or so)

A friend on CPAP told me that he had learned to nose breathe with a nasal mask, but was unable to tell me how he did it.

So I got an N30i and its mate, the P30i, and tried them with pressures allowed to range between 12 and 17. I also  practiced pushing my tongue forward against my upper teeth and nose breathing while awake.

So I would very strongly urge you to try this. You can experiment while awake to find the minimum pressure you need to keep your nasal Airway passages open reliably. The CPAP WILL open them with the right pressure, and I believe we humans are designed to be able to breathe through our noses.

The pressures you list in your profile beside the post would not be enough to keep my nasal airways open.
I did learn to breathe through my nose at pressures over 12, although the first 10 seconds are a bit forced until the machine adjusts and the passages inflate. For a nasal mask, you would need one which fits under your nose like the F30 or N30i or P30i do. One that covers both the bottom and sides of your nose will have the same pressure inside and outside your nasal airway, and they will not be under Positive Pressure, and will not inflate and open.

I'd suggest that while you might think you could test this with your F30, but I suggest you don't, as the increased pressures will act to reduce the firmness of the fit of the mask on your face, and that, combined with all those face muscles we have twitching, will probably lead to leaks.

With a nasal mask and increased pressures of 12-17, my AHI came down to consistently around 10. The N30i has a rear strap, and that allows the mask to rotate around my head sometimes, so for a year, I learned to sleep on my back, anovelty after 55 years. Now I'm learning how to sometimes sleep on my side.

And then there's the next issue. It's my belief that the 10 Autoset is not very capable of providing good therapy in the presence of leaks. I did find language in one of the Resmed guides for an Aircurve variant that suggested just that. In particular, it seems that the sudden ending of a leak and resultant mask pressure rise will be taken for an apnea, and the pressure will be raised, probably leading to more leaks. I even tried a plain old CPAP (not APAP) pressure of 15, and it worked just about the same as APAP 12-17.

On the advice of someone here, it was suggested that I might do well with a VAuto. It came via Craigslist after the nasal mask improvements, and my average AHI came down from around 10 to around 3.

And then about a year after that, I ran across another Craigslist ad that was local and easy to visit. The seller wanted about $215 for it, and when I noticed it was an ASV, I bought it.

And my experience is that it is much better than the lesser machines. I don't believe it's the hardware, it's the algorithms in the software. It really is the top of the line machine. On it with the N30i mask, my AHI is consistently below 1.0, and is sometimes 0.0 Oscar sometimes shows leaks but the ASV doesn't give a ****.

So my sleep apnea is of course not cured, but my need to mouth breathe might well be cured. You can get an N30i on sale for less that $70, making it well worth trying. IMO.