Move from FFM to Nasal Mask is working for me

[MurrayNevada]

My attempt to move from my present DreamWear FFM to the DreamWear nasal cushion is working for me. I tried many times before with little success. I am NOT a mouth breather but air did rush out through my mouth. The use of a cervical collar like device has held my mouth closed and eliminated the problem. Because my mouth cannot drop open during sleep my tongue is held in the proper position eliminating air leak. Also, the pressures needed during the night are less than when using the FFM. Does anyone know why less pressure is needed with a nasal mask? Below is my latest SH chart to assist with your thoughts on this.

[cpapbro]

I'm a newbie, but in my first week I have been experimenting with a dreamwear nasal cushion and I also have a airfit f20 that i've been switching between. I have noticed the lower pressure as well with teh nasal only. My assumption is that the exhaust holes on the FFM are much more so it seems to me tha when you have it set for FFM the machine has to push harder to get the same pressure to open your airway, hense the higher pressure readings in your sleepyhead results. It stands to reason that when you change the setting of the nasal vs ffm on your machine the algorithm would know it's going to have to push harder through two holes (mouth + nose) vs just nose which would require a greater overall pressure regardless of if my assumption about more venting in a FFM being accurate or not.

I'm almost the opposite of you, I am a mouth breather, but want to train my body to breath more through my nose and was kinda hoping to use a nasal cushion wtih mouth tape/mouthpiece/cervical collar to achive the results I wanted. I'm still going to pursue this, but I've been having congestion issues while getting started on cpap and while that is going on I've had to use the full face mask to be more comfortable. both have been working out good as far as getting my AHI below 1, but I'd like to get to the point to find a proper nasal cushion (which I like the fit and above head connection of the dreamwear) but be able to figure out a combo of thigns that trains me to breath through my nose more during my sleep and I move a lot during sleep, so I've been having bumps and adjustments with the airfit f20 that I don't have with the dreamwear.

really wanting to get a small FFM cushion and the matching headgear to try to see if that's a better result for me with the sleep movement by for more comfort with mouth breathing/congestion if i'm not able to successfully train myself to use the nasal cushion only.

[ChicagoGranny]

My attempt to move from my present DreamWear FFM to the DreamWear nasal cushion is working for me. I tried many times before with little success. I am NOT a mouth breather but air did rush out through my mouth. The use of a cervical collar like device has held my mouth closed and eliminated the problem. Because my mouth cannot drop open during sleep my tongue is held in the proper position eliminating air leak. Also, the pressures needed during the night are less than when using the FFM. Does anyone know why less pressure is needed with a nasal mask? Below is my latest SH chart to assist with your thoughts on this.

Murray, You mention two variables - switching to a nasal mask and using a cervical collar. Either of these could result in lower required pressures. If you changed both variables at the same time, you can't tell what effect either is having.

[Stom]

Wasn't their a published study that found nasal masks are generally more effective than FF masks? I vaguely remember skimming a study like that when I was researching CPAP on-line.

This isn't the study I remember, but it touches on the issue:

most studies showed that oronasal masks are less effective and are more often associated with lower adherence and higher CPAP abandonment than are nasal masks. We concluded that oronasal masks can compromise CPAP OSA treatment adherence and effectiveness. Further studies are needed in order to understand the exact mechanisms involved in this effect.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4301251/

[ChicagoGranny]

Wasn't their a published study that found nasal masks are generally more effective than FF masks? I vaguely remember skimming a study like that when I was researching CPAP on-line.

The most cited study has quickly become this Meta-Analysis from 2017 - https://www.ncbi.nlm.nih.gov/pubmed/29273515

FFMs are associated with:

- on average, +1.5 cm H2O higher pressure requirement

- +2.8 events/hr higher AHI

- a poorer adherence -48 min/night

(I love my FFM -> 100% adherence, AHI < 1.0.)