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Are nasal masks as good as ffm at reporting apneas
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I_will_never_sleep_again Offline

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Machine: Resmed airsense 10 elite
Mask Type: Nasal mask
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Location: indiana USA

Post: #1
Are nasal masks as good as ffm at reporting apneas
For the last 4 nights I have been using nasal masks (dreamwear 2 nights and wisp the other 2) my AHI has been 00 .10 00 .09. Before I was using a FFM and AHIs were good but not this good. I have turned down pressure to 11, my RX is for 16. (I think eliminating alcohol has allowed for the reduction).
With the nasal masks I have found the only way to keep my mouth shut is with a 4" piece of sports tape across my mouth, the chin straps don't work 100% of the time and it's uncomfortable. The tape works for me.
I am wondering if breathing through my mouth with FFM causes throat to close and results in a higher AHI or are the nasal masks not as good at reporting AhIs. The tape forces me to nose breathe only.
I am going to lower pressure again to 10 and keep going until I get bad results.
This makes me wonder if I could force myself to nose breathe, would I be able to get rid of the mask, or would it be dangerous to sleep with tape over the mouth and no mask.
How low should I go on the pressure before trying no mask assuming my AHIs stay close to zero?
(This post was last modified: 04-09-2016 09:47 AM by I_will_never_sleep_again.)
04-09-2016 09:46 AM
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surferdude2 Offline

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Machine: ResMed S9 AutoSet
Mask Type: Full face mask
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CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
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Post: #2
RE: Are nasal masks as good as ffm at reporting apneas
I suggest you use a chin strap if you want to test without the CPAP mask and flow generator. I also suggest that you get and wear a recording oximeter to make sure your O2 level is staying within reasonable bounds.

There is no reason to tape your mouth in absence of flow generator pressure, so a chin strap will be fine.

It is generally accepted that a nasal mask will allow reducing the therapy pressure as much as 3 cm H2O.

Furthermore, some folks can escape using CPAP by taking care to not sleep in the supine position and at the same time encouraging nasal breathing as much as possible, even using internal nasal devices or adhesive strips.

All such tests should be judged by how well you feel and how well your O2 levels are maintained. You can have disruptive apnea events without O2 deprivation so it alone isn't completely accurate in indicating how well you are resting but it can still be helpful as an indicator of how well your particular testing is working withing safe bounds.

Dude
(This post was last modified: 04-09-2016 11:08 AM by surferdude2.)
04-09-2016 10:58 AM
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vsheline Offline

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Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
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Post: #3
RE: Are nasal masks as good as ffm at reporting apneas
I think any mask which pulls our lower jaw back toward our throat (like Full Face, hybrid and Total Face masks do) will tend to pull our tongue back toward the throat, which may increase our pressure needs to some degree, as well as could gradually cause jaw problems.

The dental appliances for treating very mild OSA work partly on the principle of holding the jaw in a forward position, which tends to help the tongue stay away from the throat.

I use a FFM because my pressure needs are very high, I'm a mouth breather, and I have narrow nasal passages which are a little hard to breathe through.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 04-09-2016 06:15 PM by vsheline.)
04-09-2016 05:59 PM
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palerider Offline

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Posts: 440
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Machine: s9 vpap auto
Mask Type: Nasal pillows
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Location: Dallas(ish)

Post: #4
RE: Are nasal masks as good as ffm at reporting apneas
I've heard a number of comments from people that had lower pressure needs with a nasal or pillow mask presumably because the jaw's pushed back with a ffm, as vsheline alludes.

since switching to a pillow mask, I sometimes wake up and find my lower teeth forward of my uppers, kind of giving me an underbite, but that would tend to open up the throat more, and could lower pressure needs.
04-09-2016 06:18 PM
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PaulaO2 Offline
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Post: #5
RE: Are nasal masks as good as ffm at reporting apneas
I have about the same AHI with my Simplus as with my Nuance pillows.

I am not a believer that an FFM will push the jaw back far enough (or at all) to make a difference in the AHI. The masks do not sit on just the jaw. When sitting correctly, pressure is the same across the entire seal. If a FFM is so tight across the chin that the jaw is pushed back so far it is contributing to the OI, then it is too tight.

When I wore a chin strap, it did feel as if my jaw was being forced back. However, my AHI was low because of the lower leaks from lip leaking.

With nasal pillows and without a chin strap, my jaw tends to fall too far forward, pushing my lower teeth against my upper teeth. It is very uncomfortable and has made my lower teeth loose.

PaulaO2
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
04-10-2016 11:50 AM
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palerider Offline

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Mask Type: Nasal pillows
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Location: Dallas(ish)

Post: #6
RE: Are nasal masks as good as ffm at reporting apneas
(04-10-2016 11:50 AM)PaulaO2 Wrote:  I have about the same AHI with my Simplus as with my Nuance pillows.

I am not a believer that an FFM will push the jaw back far enough (or at all) to make a difference in the AHI. The masks do not sit on just the jaw. When sitting correctly, pressure is the same across the entire seal. If a FFM is so tight across the chin that the jaw is pushed back so far it is contributing to the OI, then it is too tight.

I respectfully disagree, based on many comments I've read, and personal experience.
04-10-2016 02:46 PM
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PaytonA Offline
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Post: #7
RE: Are nasal masks as good as ffm at reporting apneas
I think there is some oversimplification in both schools of thought. Two things come to mind immediately.The first is that the lower seal is not completely on just the chin, and the other parts of the face that it rests on depend on whether the user sleeps with their mouth open a little or completely closed. Secondly the portion of the inflatable seal that goes across the chin has no stiffener like other parts of the seal, which makes it softer and more compliant putting less force on the jaw.

I went from a nasal mask (not nasal pillows) to a FFM and reduced my AHI and the nasal mask can not put any pressure on my lower jaw because it was worn properly.

There have also been a fair number of people who have gone from a nasal mask to nasal pillows and reported a reduction in AHI!! I think there is something to the nasal pillows but I do not think that it is solely pressure on the lower jaw.

Best Regards,

PaytonA
04-10-2016 03:21 PM
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I_will_never_sleep_again Offline

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Posts: 96
Joined: Nov 2015

Machine: Resmed airsense 10 elite
Mask Type: Nasal mask
Mask Make & Model: Dreamwear
Humidifier: unsure
CPAP Pressure: 16rx now using 13
CPAP Software: SleepyHead

Other Comments: Was diagnosed after multi A-fib events at night

Sex: Male
Location: indiana USA

Post: #8
RE: Are nasal masks as good as ffm at reporting apneas
(04-09-2016 10:58 AM)surferdude2 Wrote:  It is generally accepted that a nasal mask will allow reducing the therapy pressure as much as 3 cm H2O.

Dude

I only got down to pressure 10 from 13 and Ahi started to go up, 1.7 last night
!3 was my best pressure with FFM, and 11 is my best pressure with pillows, so I believe your statement is right about reducing pressure with nasal masks.
I also think that anyway a person can keep from mouth breathing will help AHIs.
04-11-2016 09:56 AM
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PaulaO2 Offline
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CPAP Software: SleepyHead

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Sex: Undisclosed
Location: western NC, USA

Post: #9
RE: Are nasal masks as good as ffm at reporting apneas
When wearing a FFM, the mouth breathing does not matter. It is why you are wearing it. You are still maintaining the Constant Positive Airway Pressure (CPAP).

Also, do not form a conclusion on a single night's worth of data or experience. You need to gather one or both for at least a week or more.

I look forward to reading how it goes for you!

PaulaO2
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
04-11-2016 01:32 PM
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PaytonA Offline
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Post: #10
RE: Are nasal masks as good as ffm at reporting apneas
FYI, regarding FFMs and lower jaw pressure.

I tried a quick test with my Mirage Quattro. I put the mask on my face and pushed it very hard into my face- pushing at both lower corners of the mask. The mask did not push my jaw back at all and I only felt a little added pressure against my jaw and this was without tensing my jaw at all.

Of course, this may not hold true for all FFMs.

Best Regards,

PaytonA
04-11-2016 06:03 PM
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