Why no love for FFM?

[honeybadger79]

I tried a nasal pillow for the last few nights for the first time (Brevia I think).  The first night was ok. The second night caused dry-throat like you wouldn’t believe and woke me and my wife up several times.  

I usually use a FFM and I think I’m just gonna stick with that.  Why don’t people like FFMs?  Where’s the downside? I know that it’s not much to look at, but.....

[DeepBreathing]

G'day honeybadger79. Welcome to Apnea Board.

There is no downside to full face masks. I use them exclusively. I have tried nasal masks and pillows and they don't work for me, but FFM just seems natural and works well.

Some people feel claustrophobic in a full face mask and others have been indoctrinated into the cult of the P10. But as far as I am concerned, you need to try a few different types and see which one works best for you. There is no right answer in this - it's personal.

[JesseLee]

G'day honeybadger79. Welcome to Apnea Board.

There is no downside to full face masks. I use them exclusively. I have tried nasal masks and pillows and they don't work for me, but FFM just seems natural and works well.

Some people feel claustrophobic in a full face mask and others have been indoctrinated into the cult of the P10. But as far as I am concerned, you need to try a few different types and see which one works best for you. There is no right answer in this - it's personal.

Ditto. This description is my experience as well.
Everytime I've gotten to try out a different mask, I inevitably come back to the Simplus FFM. It works very well for me. I am certainly not against trying different masks a will continue to do so. Who knows, maybe I will find one that I do like better. Don't know if you don't try!

[Fats Drywaller]

When I started reading about all this stuff N months ago, I was put off of full-face masks permanently by a mention of Smashed Face Syndrome, which seems not to be common but is scary.  According to the popular summaries that I've read, it was first publicized in a 2010 paper in the medical journal Chest titled "Craniofacial Changes After 2 Years of Nasal Continuous Positive Airway Pressure Use in Patients With Obstructive Sleep Apnea": https://journal.chestnet.org/article/S00...X/fulltext

(The full text on that site seems to be behind a paywall now, which wasn't the case a few months ago, but a PDF of the entire paper can be found elsewhere with a web search.)

There are a few old posts here on AB (from 2012 & 2013) that mention it.

I'm guessing that the most modern FFMs have been designed to have less of an impact on the face & jaw, unlike the clumsy gas-mask types that were common years ago.  However, 2010 isn't all that long ago, so I continue to be wary and I intend to stick with the nasal and nasal-pillows types instead.

That's just MHO, and anyone is welcome to call me paranoid or hypercritical or whatever.  It doesn't matter; to me the precautionary principle is important and these days, in my old age, I find myself applying it a lot.

[Fats Drywaller]

I tried a nasal pillow for the last few nights for the first time (Brevia I think).  The first night was ok. The second night caused dry-throat like you wouldn’t believe and woke me and my wife up several times.  

The dry-mouth thing bugs some people (many) but not others (also many). The determinant seems to be whether someone is able to tell self "Self, keep mouth closed while wearing mask" and have it stick, so to speak. (Without tape!) I'm one of the lucky ones (he said smugly) who can do that, and I love the Brevida and don't get dry mouth with it. There are many threads here about dry mouth and whether it's possible to train oneself to keep mouth closed while sleeping. Some say yes, others say no; some are lucky, others use tape or a chin strap.

(Edited to add: Also, use the machine's humidifier and try turning the heater up.)

The bottom line with all masks is that it's not possible to prescribe or predict. Each patient has to try various things and use whatever works best within that limited sample of the products available. Recommendations are often not all that useful, except that mask reviews that mention serious flaws (what I call "Run away screaming") can be very useful in figuring out what to avoid. Just one random example: The Philips Dreamwear is noisy, so anyone who is bothered by that should take it into account before buying. Other than that, it's a great mask in a lot of ways. And so on with other makes & models; each one has its quirks.

[JesseLee]

When I started reading about all this stuff N months ago, I was put off of full-face masks permanently by a mention of Smashed Face Syndrome, which seems not to be common but is scary.  According to the popular summaries that I've read, it was first publicized in a 2010 paper in the medical journal Chest titled "Craniofacial Changes After 2 Years of Nasal Continuous Positive Airway Pressure Use in Patients With Obstructive Sleep Apnea": https://journal.chestnet.org/article/S00...X/fulltext

(The full text on that site seems to be behind a paywall now, which wasn't the case a few months ago, but a PDF of the entire paper can be found elsewhere with a web search.)

There are a few old posts here on AB (from 2012 & 2013) that mention it.

I'm guessing that the most modern FFMs have been designed to have less of an impact on the face & jaw, unlike the clumsy gas-mask types that were common years ago.  However, 2010 isn't all that long ago, so I continue to be wary and I intend to stick with the nasal and nasal-pillows types instead.

That's just MHO, and anyone is welcome to call me paranoid or hypercritical or whatever.  It doesn't matter; to me the precautionary principle is important and these days, in my old age, I find myself applying it a lot.

Interesting. The paywall has greatly limited the accessibility of the document and cut a lot out (obviously). Do you know if this was a study on developmental (neonatal/very young children) patients? Leaves a lot to wonder.

[Fats Drywaller]

Interesting. The paywall has greatly limited the accessibility of the document and cut a lot out (obviously). Do you know if this was a study on developmental (neonatal/very young children) patients? Leaves a lot to wonder.

I don't want to link to the PDF because it might be on a commercial site, so try this search in Google and use the first hit, "Original Research - SleepClinic":

filetype:pdf "although the mask does not touch the mandible" site:.be

[JesseLee]

Interesting. The paywall has greatly limited the accessibility of the document and cut a lot out (obviously). Do you know if this was a study on developmental (neonatal/very young children) patients? Leaves a lot to wonder.

I don't want to link to the PDF because it might be on a commercial site, so try this search in Google and use the first hit, "Original Research - SleepClinic":

filetype:pdf "although the mask does not touch the mandible" site:.be

Thanks much sir! Interesting read and worthwhile. I believe I will take the risk of altering my grill versus the nontreatment misery. 

I've given nasal pillows a very good try. I have a couple of Swift FX setups and I've not been successful. I haven't found commitment to change things up to give it an die hard effort. I think in order for me to go the pillows route I would have to give total abandon to FFM and I just ain't gonna do it yet :-)

I would like to add that anyone who fought the nasal pillows, which I've read lots of struggles, and won that battle, you have my respect.

[DeepBreathing]

Fats, thanks for posting that link. I've only had time to skim the paper but it seems they were studying the effects of nasal masks. FFM and pillows were specifically excluded from the study. I'll read the whole thing in more detail but at first glance it appears nasal masks are the culprit.

[honeybadger79]

Thank you all for the great feedback. I have a few pillow types to try, but I sense that I cant keep my mouth closed. I have nasal passage opening issues to start with, so that doesnt help