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need help with full face hybrid masks
#1
need help with full face hybrid masks
Hi all, 
I am posting here for the first time looking for advice. So far I have only used nose masks and nasal pillows. My pressures are getting high and I have needed to tape my mouth as it opens a lot while sleeping because of the rising pressures. My Doctor suggested I use one of the newer masks for the nose and mouth. Any advice on mask type with pros and cons would be greatly appreciated. My current mask has given me no leaks at all. I also like it to be quiet and hopefully no marks on face. Thanks for your help.
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#2
RE: need help with full face hybrid masks
Do you know why your pressure is increasing? What has changed? Is it something that you can address outside of PAP therapy, such as losing weight or reducing alcohol consumption?
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#3
RE: need help with full face hybrid masks
Hi, I was diagnosed with severe sleep apnea. I dont drink or smoke. I am a vegetarian. I am overweight because of my Chronic fatigue syndrome which makes exercising very hard to accomplish. I had lost a bit of weight 2 years ago but it did not make any difference. every couple of years my pressures  have needed to go up. My AHI is still not below 5 so I was asked to look into hybrid full face masks. Huh
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#4
RE: need help with full face hybrid masks
Im gonna bump this topic since I am also thinking about purchasing a hybrid full face mask. The one I am looking at is ResMed AirFit F30i.

So far I have been using the Dreamware nasal cradle and the Airfit n30i. The n30i is the only mask I can actually sleep with. But I also need to use a chin strap because I open my mouth from time to time.

I also have a Dreamware Full face mask which is a hybrid but I was not successful with it because of the following reasons :

1. I had a lot of leaks going in my eyes, same issue with the nasal cradle from them.
2. It in general leaks a lot more than the nasal masks, which is normal
3. I was super hot when I exhaled
4. Whenever I smiled a bit, I would push the sides of the masks and create leaks.


Now I am considering a F30i because it has the same nasal shape as their nasal cradle ones, which fits me perfectly. But I am also afraid of investing 170 euros into something that I might not be able to use.
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#5
RE: need help with full face hybrid masks
Welcome to Apnea Board.

There's several good choices on full face masks, some classic full face and the newer hybrids. Some examples of the classic full face would be ResMed's F20 in AirFit silicone and AirTouch in memory foam. The newer F30 and F30i represent a hybrid. The F30i has a top of the head vent with side air tubes, similar to the N30i and P30i. Note that ResMed clues you in on mask type by the letter in the model. F for full face, N for nasal, and P for pillows. Philips Respironics has a hybrid called Air View. Fisher & Paykel is another popular brand to consider. There's more out there, this is just a sample.

Also, consider getting the free report tool OSCAR to enable adding a chart. It would help us help you in determining why the pressures are jumping. It may clue us in and then be able to assist in better therapy. Another thing to consider on the masks of any type is to adjust to prevent leaks in proper fashion. If it's tight enough to hurt some aspect is wrong, either the mask cushion or headgear size with cushion size being off more typically.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
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RE: need help with full face hybrid masks
Thanks for your reply. I am going to look at those masks definitely.
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#7
RE: need help with full face hybrid masks
I tried a mask like yours, it's PR dreamwear. The bottom of the mask puts pressure under the bottom lip to keep jaw shut. Never been woken up from pressure leak out of my mouth.

I have a leak test option on my machine... test at average ramp pressure, not start pressure for 45 seconds.. and then adjust tension on harness, remember to set back to start pressure. That should do the trick.

Also go with the OSCAR software a definite plus as Dave said. Dreamapper shows how many events you had for the night and by the hour, however, you need to know other pertinent information to be able to get better therapy by adjusting your machine periodically.
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#8
RE: need help with full face hybrid masks
I started with the F30. It can work very well, but it takes some patience to get the straps adjusted right. At first I was breathing through both my mouth and nose, but the F30 helped me transition to breathing only through my nose.

I can’t use a true full face mask such as the F20 or Vitera. My nose closes within a few minutes, forcing me to breathe through my mouth only. I can’t sleep that way.

Pillow masks like the P10 and P30i, and nasal cradle masks such as the N30, N30i, and original Dreamwear help keep the nose open (though they can’t clear blockage). With therapy pressure inside the nose and atmospheric pressure outside, the pressure difference helps hold the nostrils open like breathe-rite strips.

Hybrid masks like the F30, F30i, and Dreamwear preserve that benefit, but also cover the mouth. You can breathe through your mouth if you need to, but ideally they just balance the pressure inside and outside your mouth so you don’t need to tape.

However, the Dreamwear FF leaked very badly for me. The F30 was a lot better, but still finicky.

By practicing tongue exercises, I was able to switch from the F30 to the P30i without mouth leaks, and had my AHI well under control.

Then I started losing weight, initially with WW, then switched to intermittent fasting and a greater focus on managing insulin per The Obesity Code by Dr Jason Fung.

The good news is that I’ve lost about 75 pounds so far. The bad news is that the changing shape of my face and airways ... changed everything.

I get better results now with the N30i instead of the P30i. That is largely because of my very Roman/British nose though. I suspect most people would still prefer the P30i. My wife does.

However, with weight loss, I can no longer keep my mouth shut. Lowering the pressure a bit (consistent with weight loss) helped, but not enough. I’ve had some success using Somnifix mouth strips that have a small vent. I won’t say I love them, but they do work. Many find relief using a soft cervical collar, and they can also lower your AHI if you tend to tuck your chin, but they didn’t help the mouth leaks for me.

I’m now experimenting with an F30i. It’s still a bit finicky to get adjusted right, but I think it is more comfortable than the F30 and seals better. With the hose over your head, it’s easier to move without leaks.
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#9
RE: need help with full face hybrid masks
Btw, although I can’t use a full face mask, the large size fits best. I use the medium F30/F30i/N30i (largest available size), and a large P30i (I wish there was an XL).

Even with weight loss, I’m still a big guy with a big face (nose bridge to mid-chin).

Nevertheless, I use the small size frame for the P30i/N30i and F30i. My hair is thin, so ymmv. I can also use the standard size, but small fits better.

The point is, don’t assume your mask size and headgear/frame size will be the same.
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#10
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RE: need help with full face hybrid masks
Thanks so much for sharing. I use my mask with a strip of micropore tape with a small slit in the middle. There are no leaks but ahi is between 6 and 12. I don’t know how to use the Oscar software and read it yet but I am working on it. Thanks for your help so far.
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