Full face vs Nasal mask

I am a long time (25+ years) BiPap user - and been through numerous improvements and equipment (I once used an iron lung as I had polio - a very old style vent)

Unlike other respiratory issues like OSA my issue is lack of breathing muscle when asleep and restricted chest due to spinal fusion and steel rod 12” for scoliosis secondary to polio.

That aside …. My issue is that I am have equally decent o2 traces on both resmed F20 foam the nasal N20.

However I keep having poor sleep with the full face as I get central sleep apnoea events briefly without and SpO2 dip I can see. But it messes with my sleep. The N20 does have the same issue.

My problem is 1) I am spitting a lot and breathing out my mouth - even with a chin strap so am I actually getting optimal breathing? 2. My wife is sprayed and disturbed by my noise. 3) the medic still want me to use my full face as much as possible as my stats (CO2 o2 and ph) are good but my bicarbonate (HCO3) is 28-30.

The problem I’m on IPAP 26 and EPAP 6 BUR 14 and Ti 1.4 ( respiratory insufficiency with severe scoliosis is the reason for the high pressures which is challenging for most masks)

I use a NIPPY 4+ with humidifier external and heated tubing. Any views or similar people - I know I’m an outlier here as not simple CPAP patient. I slightly question how much I really need the EPAP at 6 as this raises the general pressure at peak IPAP - sadly I can’t read out leaks except ok screen and that not really accurate and medics won’t let me reset each night to see what’s happening

Apologies for long probably niche issue !

Do you know why the F20 is waking you?

It sounds like you're mouth leaking, i.e. pressurize air is coming out of you mouth, at least when you're exhaling. The only non-FFM I know of is mouth taping, and in your case I definitely would not consider it.

I do think that your best bet is trying other full face masks.

Just for example ResMed has a new FFM called F40, you can see its technical specifications here, it can handle a pressure of up to 30:
https://www.manualslib.com/manual/34030 ... =10#manual



Wishing you best of luck!

I started using ResMed F40 three nights ago. It is the smallest most comfortable, lightest, easiest to put on full face mask I've used out of 5 over 17 years. I had been using the Evora full face for six months. Both are hybrid masks that seal much better than my F10/F20. Unlike other full face masks, they do not cover the entire nose. They are like having a nasal mask that also covers the mouth. For me, the F40 is like a much improved Evora full face. For the first time, I am using a size medium mask instead of my usual large. Even though I measure for medium I have used large for F10 and F20 to ensure mouth coverage. I don't know how but the F40, a very small full face mask, covers well. My pressure rose to 20 cm last night and the F40 did not leak. The F10 and F20 straps had to be so tight to prevent leaks they hurt.