Startling difference w/full face vs nasal mask - OSCAR

[DurtGurl]

I have been on a CPAP journey since receiving my ResMed Airsense 10 Autoset and Resmed AirFit N30i in October 2020. Right away, I found I was a mouth breather. Ended up using tape on my mouth then opted for full face masks. I tried both the F30 and F30i and then those would blow out around the cheeks at night. I am battling the slowness the facility who my doc sent me to for the equipment. The cheek blow-outs tell me that the pressure is likely too high but they are still working things out with the doc's new orders. Thanks to this forum I found the ResMed Airsense detailed menu and reset the high pressure from 20 to 15. I then upped it to 16 and have been there a few days. Much better! But, the fit is still super fussy and all the straps hurt my head enough to make me wake up so I last night in the middle of the night I went from the F30i to the N30i with mouth tape. Also thanks to this forum, I got OSCAR this week. While I only have detailed info for this week I do have the summary page for all days I have used the system. It is very interesting to note that last night and also in October when using the nasal mask and mount tape, I get zero or very few OAs. When using the full face masks (this week and early last night), I have tons of all the events (OA, H, CA). Why the huge difference? Could it be that open mouth breathing, which is allowed with the full face masks, is causing or related to the events?

[DurtGurl]

Here are the graphs

[Deborah K.]

Lots of folks find that they get less leaking with a nasal mask. For some a full face mask is all they can use, but others will go to great lengths; mouth taping, etc., to be able to use a nasal mask. So, if it works for you, stick with it!

[chunkyfrog]

Since you are getting pain from the straps, I suspect you are wearing the mask too tight.
I suggest you watch fitting videos by thelankylefty on youtube.

[DurtGurl]

I have been on a CPAP journey since receiving my ResMed Airsense 10 Autoset and Resmed AirFit N30i in October 2020. Right away, I found I was a mouth breather. Ended up using tape on my mouth then opted for full face masks. I tried both the F30 and F30i and then those would blow out around the cheeks at night. I am battling the slowness the facility who my doc sent me to for the equipment. The cheek blow-outs tell me that the pressure is likely too high but they are still working things out with the doc's new orders. Thanks to this forum I found the ResMed Airsense detailed menu and reset the high pressure from 20 to 15. I then upped it to 16 and have been there a few days. Much better! But, the fit is still super fussy and all the straps hurt my head enough to make me wake up so I last night in the middle of the night I went from the F30i to the N30i with mouth tape. Also thanks to this forum, I got OSCAR this week. While I only have detailed info for this week I do have the summary page for all days I have used the system. It is very interesting to note that last night and also in October when using the nasal mask and mount tape, I get zero or very few OAs. When using the full face masks (this week and early last night), I have tons of all the events (OA, H, CA). Why the huge difference? Could it be that open mouth breathing, which is allowed with the full face masks, is causing or related to the events?

I'm thinking I didn't pose this question too well... Note that I used a full face mask for the first part of the night and nasal mask with taped mouth second part of the night. I found quite the difference in my OSCAR results using different masks and wonder if mouth breathing within the full-face mask is causing the OA, H, and CA events? This has been repeated with two nights of ZERO events while wearing the nasal mask and taping my mouth. Perhaps I don't need CPAP at all and just need to close my mouth? Any thoughts???

[Pugsy]

Most likely you just need a little more pressure with the full face mask than you need with the nasal mask.
This seems to happen quite often with people. I think it has to do with what the lower straps do to the position of the airway by tugging the chin back a little and maybe making the airway slightly smaller or harder to keep open.

I know lots of people who need 2 to 3 cm difference in minimum/baseline pressures between a full face and nasal interface mask.

[ChicagoGranny]

This has been repeated with two nights of ZERO events while wearing the nasal mask and taping my mouth

When the mouth opens, the tongue drops down to allow airflow over the tongue. The lower position of the tongue forces the jaw back slightly. This results in a narrower airway. It's unlikely that mask straps are strong enough to push the jaw back.

BTW, nasal breathing is much healthier than mouth breathing for a number of reasons.

Perhaps I don't need CPAP at all and just need to close my mouth? Any thoughts???

Why did you seek a sleep study? What was your untreated AHI? How old are you?

[Pugsy]

two nights of ZERO events while wearing the nasal mask and taping my mouth. Perhaps I don't need CPAP at all and just need to close my mouth? Any thoughts???

The machine only reports the apnea events that slipped past the defenses. The fact you had 0 events just means the machine was doing a good job. It in no way means that you don't have sleep apnea and don't need cpap. All it means is when you used the machine with that mask on that night that the airway didn't collapse. We have zero way to know how many apnea events it prevented from happening.

[zonker]

We have zero way to know how many apnea events it prevented from happening.

and not just re-inforcing this for this particular conversation. i want newbies far and wide to read this. it was one of the hardest lessons for me to get through my thick head when i first started.

and it's just so true.

[DurtGurl]

Thanks all! I learned important nuggets tonight... that the flagged events are events missed by CPAP and that an unknown number of events were prevented from happening when the CPAP therapy is working properly. Good to know!

To answer Granny's questions - I am 58 and have been feeling like crapola for 5+ years. I was diagnosed with moderate sleep apnea with AHI ranging between 25 and 37 over three partial nights with a home sleep study kit. I was always super athletic (avid mountain biker) but now can barely bike or hike without needing a few days of recovery. My primary care physician ordered the sleep study as nothing else seems to be helping me improve. In addition, I have a 20-yr history of osteoarthritis (2 replacement hips) but my rheumatoid arthritis has recently been rediagnosed as fibromyalgia. I've long been blaming all these issues of pain and exhaustion with just getting older, but wouldn't it be something if I just need a good night's sleep?

p.s. I'm also a failure analysis engineer in the medical microelectronics industry. I LOVE data and figuring out problems, so all this CPAP stuff is right up my alley

[Pugsy]

I've long been blaming all these issues of pain and exhaustion with just getting older, but wouldn't it be something if I just need a good night's sleep?

Well....I was let's see...11 years ago so 57 when I was diagnosed but I had a hubby telling me that for probably 2 years I was snoring enough to break windows and I was stopping breathing to the point he was scared I was dying.
All this started about the time menopause started...did you know it is common for women of menopause age to have OSA crop up as well?
I also have some bad arthritic issues and even a metal plate in my neck because the arthritis ate so much bone away...and I know I have similar issues in the lower spine and pelvis now.

So you might be like me....you might have more than one thing going on and while I know first hand that we would really like to blame sleep apnea for all the crappy feeling we have and all our crappy sleep...the cold hard fact of life is that often we have more than one thing going on and no matter how much we might want to blame it all on apnea and have cpap fix it we just have to realize that cpap can't do much about anything other than airway issues.

Now it doesn't mean we don't try to optimize our cpap therapy or our sleep but it does mean that sometimes we have to be more realistic with our expectations. I know I still don't sleep so great but it is from pain. CPAP hasn't helped my arthritis one bit.
When I don't sleep so great then I don't feel so great but that would happen even if I didn't have OSA and use CPAP.
So I tell people that while I don't wake up just rearing to go run a marathon that I at least don't wake up feeling like I just ran that marathon and got run over by a bus at the end of it.

While I hope that cpap helps you sleep better and feel better....you also have to realize that you do have other potential issues that might be a factor also that the machine really can't do much about no matter how much we might want it to.
I think this is one of the main reasons a lot of people give up on cpap saying they didn't feel any better using it despite maybe things looking good on paper but they had some unrealistic expectations that cpap will fix all our problems and there are simply some problems it can't fix.

When we get older we just will often have more than one physical problem contributing to not feeling so great

[ChicagoGranny]

Perhaps I don't need CPAP at all and just need to close my mouth? Any thoughts???

Here is the answer to your question ---->

have been feeling like crapola for 5+ years. I was diagnosed with moderate sleep apnea with AHI ranging between 25 and 37

You need CPAP. Welcome to the sisterhood.

[DurtGurl]

I dearly want CPAP to solve all my issues, but the hard reality is that like Pugsy I have many issues. So for now, I will concentrate on getting CPAP to do its thing and hopefully solve one issue. Last night I tried Somnifix strips instead of the medical tape I had laying around and it was a disaster! You can breathe through that fancy Somnifix so my leak rate with the nasal mask was thru the roof last night! The experiments continue...

[ChicagoGranny]

You can breathe through that fancy Somnifix

Did you follow the instructions precisely? They can be a little tricky to apply.

The opening in Somnifix is tiny. Usually, my lips are held in such a way that no air is vented through that little opening. Even if you breathe through that opening, the additional leak rate is minimal.

If you are unhappy with using tape, I encourage you to give Somnifix another try.

[DurtGurl]

You can breathe through that fancy Somnifix

Did you follow the instructions precisely? They can be a little tricky to apply.

Oh Granny, I did not even read the instructions. I did however clean my mouth and nose with soap prior to putting on the Sominex tape and nasal mask and was careful that the Sominex completely covered my mouth and the little hole was right in the middle. Last night was just horrible and I'm a wreck today. I even put some non-porous tape over the Sominex tape in the middle of the night but then it was like some nights when I tape my mouth (with medical tape) and my mouth will fill with air bubbling into my cheeks. Eventually I'm a drooling mess and the tape will slide off due to moisture and I'm mouth breathing again.

So, I'm a mouth breather, but when I try to correct mouth breathing I end up being a mouth bubbler/drooler. Perhaps I need to give the full face masks another chance due to this air bubbling into my closed mouth and lower the pressure again so I don't repeat the side blow-outs. I hate changing more than one thing at once but I'm desperate!