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Full face and pillow masks -> different pressure and AHI count...

I have recently been diagnosed with apnea (AHI ~60) and started to use a ResMed AirSense A10 Autoset (range set to 5-20). I have the Resmed Airfit F10 full face and P10 pillow masks as well as the Respironics Wisp nasal mask.

I found the Wisp less useful - it comes with the disadvantages of both the full face mask (covers my nose) and the pillows (leaking if I open my mouth).

Both the P10 and the F10 work fine. I found the F10 has a slight edge as I can open my mouth, even talk with this mask on, and it does not irritate my nose like the P10. I found it easier to breath with it, too. (in the other hand at higher pressures - ref. below - it does leak if I don't tighten it really hard)

However, checking the data on ResScan, the machine registers much more AHI event with the F10 mask (AHI ~5) than with the P10 mask (AHI between 1-2). The pressure is also significantly higher with the F10, it goes up to 13 at times, while with the P10 it never goes above 6-7 tops...

(ref. attached the ResScan graph for the P10 and the F10 one day apart, otherwise under the same conditions - sorry, I'm not allowed insert images to the post yet)

So I wonder whether the machine fails to record a bunch of events with the pillow mask, or is the P10 pillows really that much better in maintaining much less AHI event with significantly lower pressure.

What do you think about it?

Thanks and BR,


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Set up SleepyHead so you can compare mask leak rates.
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ReScan shows leak rates!

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Good to know.... let me change that to, "Use ResScan to compare leak rates." Big Grin
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Flow rate seems to be ok for both masks, the F10 leaks at higher pressures (~13) if I don't tighten it down strongly. However the leak is way below tolerances, so it should not cause the higher AHI count...

In the end I'm fine with both ones, but if the P10 can provide so much better result (i.e. much less AHI event at a significantly lower pressure) then the choice is obvious.... I just wonder if this is really the case or it is just the machine records data differently with the two masks. I mean the P10 comes with so much better result which makes me suspicious...
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Are you picking up more clear airway events (aka centrals) as a result of the higher FFM pressures?

(I know it's on the graph, but I'm having trouble reading it)
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Hi CoyoteV8,
WELCOME! to the forum.!
Hang in there for more responses to your post and much success to you with your CPAP therapy.
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A lot of people report having lower pressure on a nasal pillow mask (P10) than a full face mask (F10). This has been my experience as well.

One potential explanation for this is that nasal pillows reduce the nasal valve collapse and nasal resistance, more effectively than an FFM.
PRS1 Auto & Dreamstation Auto w/ P10 and straight pressure of 7cm. 
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I used to switch between a nasal pillow (Nuance) and a full face mask (Simplus) and the FFM always had higher AHI. The leak rate differences were comparable because I kept lip leaking with the Nuance (even with the chin strap). So I stopped using the Nuance and now use the Simplus full time. After I started using the mask liners (and using the correct size), my AHI slowly settled and now it is always less than 2. It has even started being less than 1!

If the machine needs to be told what mask type you are using, make sure you are making that change each time you switch.

If you are opening your mouth at night with the pillows, then you need a chin strap. Or you need to just use the FFM.

Decide which one you want to use then try using it consistently for several months. You should see the AHI settle into a pattern. With the FFM, it may take longer (or may not). If the leaks continue with the FFM, consider either using liners or trying a different mask. There's a lot of different ones out there and the F10 may not be right for you.

As for why the AHI is higher with the FFM than the pillows, I have some theories. Mine was quite different. Sometimes I think maybe it is just the way the air is delivered. Our throats and nasal passages get used to being pushed out of the way and now it comes at it from different angles. The pressure from the pillows comes at it right there. No buffer, no nothing. FFMs however, the pressure is the same but it is more... Pillows are like having the corner of a heavy book balanced on the back of your hand. Same weight, but it is right on that corner, so you are going to feel it. FFMs are more like the book on its edge. Same book, same weight, but it is spread out a little more. So I think the throat muscles and tissues are being pushed kinda differently. Over time, everything settles into it and reacts as it should. I know, I know, same pressure and all that! But it is my theory! LOL
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(07-30-2015, 11:34 AM)iSnore Wrote: Are you picking up more clear airway events (aka centrals) as a result of the higher FFM pressures?

(I know it's on the graph, but I'm having trouble reading it)

Yes, although I'm not sure if the pressure is up because the machine records more events or vice versa...
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