Ok...it's been a full 7 days and now I can write a more in depth report...
Respironics FitLife Total Face Mask
- sizing (there is no medium), adjustment time
- sealing, comfort, sleeping positions
I'm going to preface this with some info about me. I don't have very bad apnea numbers to start with (AHI=6)...I'm not a full on obstructive sleep apnea patient. However, I do have some severe sleep disruption when I am not on CPAP because of Upper Airway Resistive Syndrome (UARS). Think of UARS is mini-apneas....my body catches the apneas early enough to not have "big" events, but it still results in my being aroused / woken up from sleep to breathe just the same as regular sleep apnea...which lead to a sleep disruptive index of 49 (i.e. 49 mini-apneas an hour, which is pretty severe).
Ok...in my previous search for a ffm, I did try a few Respironics products and they simply didn't work for me...I wasn't sure what to expect here, but wanted to try this mask for a couple reasons. My line of work puts me in total face masks on occasion for some long periods of time...overall and especially for pressurized work (i.e. SCBA situations where, like CPAP, you are breathing slightly higher pressure air than what's surrounding you) I have found a total face mask to be more comfortable. I wanted to see if that held true there. I also am trying to find "the one" mask that gives me my ultimate treatment....low AHI and leak rate, minimal mask marks and feeling good in the morning.
Ok, lets start with the obvious...this is a total face mask (or what those of us who work with respirators and SCBA / SABA systems will call a "real" full face mask). It covers not only the mouth and nose, but also the eyes. The seal is on the outer edges of the face, above the eyebrows, outside the eyes and down to the "usual" spot on the chin. It has a clear faceplate and, once warmed up so it doesn't steam up, it allows you to read and watch TV just fine.
As for the usual questions: Unless there was a substantial leak somewhere, I did not find any appreciable feel of air movement across my face and no, my eyes did not dry out. Conversely, though, it does have a higher "dead air space" volume....this means I had to turn down the humidity and temperature a bit to feel comfortable (it was a bit hotter and kept the air a bit moister than most ffm's...my original settings for a "normal" ffm made it a bit of a sauna). If you are running a lower therapy pressure, I can see it having a bit more of a feeling of not getting quite enough air or feeling that it isn't "clearing" it quite quick enough.
Sealing was remarkably good. It has a wide seal all along the perimeter and it is very robust. if the mask isn't on "just right" the seal swells / puffs out a fair bit to make it work. I understand that Respironics recently "tweaked" the seal a little to address some leak concerns and it seems to have worked. I found it to be both a comfortable seal and one that was not prone to leak all that easily.
Because it is so much wider, a little push on one side tended not to get it bent out of sorts and it held its seal very well. You'd think it would "lever" the other side more, but with the headgear connections at the edges, it gives the headgear extra "oomph" to resist being dislodged. If you "overdo it" it will usually give you raspberries to let you know. Of course, with where the seal is, there was no issues with the bridge of the nose....in face, the mask has a "well" near the nose and mouth that even my large schnozz couldn't get contact with.
It is not a lightweight mask...especially by today's standards, but the sealing is worth the extra weight if this mask works for you. I tend to sleep in a variety of positions and like a "memory foam" pillow of some sort. With my conventionally shaped pillow, I was able to back and side sleep with this mask without problems and with minimal "bumps" causing leaks. I was very pleasantly surprised to find it tummy sleeps well too, depending on arm positions.
For me, I found the mask took a day or two to get used to....it is a big departure from the "conventional" masks out there and is a heck of a lot more mask to deal with than a nasal mask or pillows. Still, the the better seal and pretty comfortable overall nature of the mask actually improved my numbers for the week. Overall, compared to the "new generation" ffm I usually use, my AHI dropped by a little over 1/2 and my unintentional leak rake dropped to essentially zero. I felt even better waking up, which I didn't think was possible.
There is an on-line video review of this mask where the reviewer considers it a "mask of last resort." I would strongly disagree with that assessment of the FitLife mask.
In today's world, where lots of RT's subscribe to the "less is more" view....lowest possible pressure to get under an AHI of 5 and the smallest interface possible (probably to try to get the best compliance)...I can see why this mask wouldn't be a top choice by a DME or RT. In practicality, though, it is a comfortable mask that, although it can take a couple days to get used to, can provide some exceptional therapy for the patient who can tolerate the larger form factor. Although it is larger, I strongly suspect the FitLife will become my "go to" mask in the future.
Be open minded and you may be pleasantly surprised on this one, folks