I had been using a nasal pillow successfully for many years with an AirSense 10 APAP. But a few years ago, I tried full face masks after a tech woke me from a sleep study and exclaimed that I was a mouth breather. I thought that a full face mask might reduce my dry mouth, which was really the only complaint I had with using a CPAP.
I tried a ResMed Quattro FX, and F10 and an Amara. But I found that each one seemed to leak too much, primarily around the bridge of my nose. Seems they are designed more for a Roman nose and since I have a flat bridge, I’d get air leaking up into my eyes no matter how I adjusted them.
So, I had returned to using a nasal pillow until recently when I decided to retry using a full face mask. I thought perhaps some newer models might provide a better fit.
I have tried the ResMed F20 (S, M, L), F30 and the DreamWear (M, MW).
Despite trying all these, I have still had difficulty finding one that will work. They seemed to initially work with my ramp set on auto. But after falling asleep I would wake about every 1.5-2 hours feeling the pressure was too high and the air was leaking out the sides of the cushion. In the case of the DreamWear and the F30 it also seems that the higher pressure dislodges the nasal orifice so it’s not aligned with my nares and I can no longer breath freely through my nose. Each time I wake I have to reach over and turn off the machine, readjust the mask and let it recycle again. The result is that I don’t feel very rested because of the recurrent disruptions. I spoke to my sleep tech about this and he didn't know what was happening but said maybe I’d just have to resort to restarting it as I had been doing. But this is clearly not a very good way to promote sleep efficiency.
In the meantime, I got a repeat cycle timer off of Ebay to automate the process and avoid being woken up. This allows you to precisely program ON and OFF intervals in HH/MM/SS and it repeats the cycle in an endless loop.
I have attached some examples of OSCAR graphs. The first shows results using a full face mask and having to recurrently recycle the APAP manually when I am awakened (indicated by the discontinuities in the mask pressure graph).
The second shows the results when the APAP is automatically recycled by the timer. I set it to briefly interrupt the AC to the APAP for 1 second every 90 minutes throughout the night. After the first night of implementing this, I woke much more rested and slept through the entire 8 hour period without a known arousal.
I do wonder if restarting the APAP with the ramp on might run the risk of partially defeating the autoset feature? Clearly, using the timer produces a more even mask pressure graph. The average pressures are significantly lower doing this though I still do get AHIs that are generally at 1 or less. Why is there a cyclic, extended interval of low, nearly flat pressure for 30-40 minutes after each interupt? Could this be an artifact produced when the CPAP AC is fully powered on and off instead of only turned off using the start button?
Anyway, I'm hoping the many sharper minds on the forum can clarify and interpret what is happening. I haven’t taken the time to really learn how to interpret the various graphs in detail.
Any thoughts or advice would be appreciated.
Doug