FullFace versus Pillows

[marybarnes]

Hi Everybody..This is my first post .I have only had been using CPAP for 41/2 months and I really love it .The first 2 nights I had Nuance Pillows and chin strap ( I slept 9 hours!) but I developed a sore inside my nose and sinus infection so my doctor ordered an FF mask (so the therapy guy took the pillows away and gave me an Amara ,FF Silicone cushion mask, small size ) which I have been using but my leaks are over 65% and I sound like Darth Vader at night..I have deep lines on my face at each side of my mouth-no cosmetic fillers will erase nature .LOL MY insurance will pay for a new mask next month so I am hoping for advice on what to do now. Full Face versus nasal pillows..I am an active( I have RLS and not in the good way!) side sleeper and mouth breather. My mouth is so dry every morning even with the humidifier.My pressure is max 10..I do find my Amara silicone a bit warm and occasionally claustrophobic. Thanks so much for all the advice already received. Its been a life saver

[crnolen]

I started with a Fullface and had major leakage issues like you're experiencing. The best FF that I tried was the Airfit F10 but still had leaks. You're not really receiving any treatment if you're having leaks at that rate.

I'd suggest trying the Airfit P10 mask with a chinstrap.I've had pretty good success with that combo. The P10 has three different pillow sizes and hopefully one will work well for you.

[marybarnes]

Thank you.I will try that combo

[princessbelle]

I have the Air Fit full face mask and had leak issues until I received my pad a cheek liner from Karen. The liner works great for the leaks, but the mouth open dries my mouth into a desert even with the humidifier maxed out and on auto. I tried Biotene as suggested on this forum and it only works about half the night for me. It is worth a shot some use it with great results. I highly recommend the pad a cheek liners.

[robysue]

Hi Everybody..This is my first post .I have only had been using CPAP for 41/2 months and I really love it .The first 2 nights I had Nuance Pillows and chin strap ( I slept 9 hours!) but I developed a sore inside my nose and sinus infection so my doctor ordered an FF mask (so the therapy guy took the pillows away and gave me an Amara ,FF Silicone cushion mask, small size ) which I have been using but my leaks are over 65% and I sound like Darth Vader at night..

Is that "leaks are over 65%" coming from the machine's LCD? And are you using a Resprionics (PR) System One?

If so, then that indicates that you are in official Large Leak territory for 65% (or more) of the night. And that's way, way, way too much leaking: Long, large leaks can adverserly affect the efficacy of your therapy as well as distrub your sleep. So you have to get the leaks under control.

And have the leaks been this high the whole time you've been using the Amara? Or did they only recently get this high? If the leaks only recently started, the mask cushion may simply be worn out, and replacing the cushion might fix the problem.

Given that you also say:

I have deep lines on my face at each side of my mouth-no cosmetic fillers will erase nature .LOL MY insurance will pay for a new mask next month so I am hoping for advice on what to do now. Full Face versus nasal pillows..I am an active( I have RLS and not in the good way!) side sleeper and mouth breather. My mouth is so dry every morning even with the humidifier.My pressure is max 10..I do find my Amara silicone a bit warm and occasionally claustrophobic. Thanks so much for all the advice already received. Its been a life saver

I would suggest that you talk to the DME before you order your next mask. Tell them that you want to try on some other masks before you place the order for the replacement mask and tell them why the Amara is not working for you.

Almost any mask can be made to work for active sleepers. I use nasal pillows and I do move around a fair amount, but I don't have RLS. I don't have any serious problems with movement triggering leaks. But I'm also NOT a mouth breather. Sure, I open my mouth occasionally (mainly in allergy season) and breathe through it for maybe 10-15 minutes at a time a couple of times a week. And even then, I don't tend to get leaks that are high enough to be flagged as official Large Leaks.

It may be worth trying another nasal pillows mask for your replacement mask. It may also be worth trying a nasal mask instead of a FFM. But check with the DME about the return policy for the mask that you intend to purchase when your insurance will pay for it---some DMEs are more friendly about exchanging nonworking masks during the first 30 days of the mask's life even if the person is not a brand new PAPer any more.

Finally, the dry mouth problem while using a FFM and doing mouth breathing is unfortunately not uncommon. The heated humidifiers are designed to humidify the air needed to keep the upper airway happy, but once air gets into the mouth (due to mouth breathing), there's a lot more air being pumped into the "semi-closed" system comprising the machine, hose, mask, your nose, mouth, and upper airway.

[marybarnes]

I have been using Biotene mouth wash for a few years to help the dry mouth caused by the RLS meds and it really helps for about 4-5 hours .
My Machine is PR System one and is showing leaks over 65%.I have changed the mask cushion every 30 days as recommended and still have the leakage so am definitely keen to try something new. I was given no choice day one in what I use and I have asked Rotech again about changing with negative results. I will not take No for an answer. I did read all your comments again and watched some videos . One basic thing that I had not been doing was inflating the mask before clipping it in position. I slept 8.3 hours with leakage of 63%-I feel fantastic this am. The previous night was awful with 5 hours therapy and Mask Leakage 28%.I was exhausted. Obviously the leakage rate is better but imagine what I would feel like if I could limit it to 80% or better..Is that possible?

[Julie]

Mary - Do yourself a favour and try on (while lying down) various full face masks - there seems to be a loud crowd here who consistently push the 'no FFM' agenda, but there are also many of us who've worn them for years, have no dry mouth, routinely very low AHI's and are quite happy to wear them... feel naked without! They were designed for a reason and do their jobs well if you find the right style, size and are fitted properly for them. At least give them a fair try because you could well be cheating yourself by not doing so, as well as undergoing all kinds of trouble. Nothing to lose!

[hyperlexis]

I have been using Biotene mouth wash for a few years to help the dry mouth caused by the RLS meds and it really helps for about 4-5 hours .
My Machine is PR System one and is showing leaks over 65%.I have changed the mask cushion every 30 days as recommended and still have the leakage so am definitely keen to try something new. I was given no choice day one in what I use and I have asked Rotech again about changing with negative results. I will not take No for an answer. I did read all your comments again and watched some videos . One basic thing that I had not been doing was inflating the mask before clipping it in position. I slept 8.3 hours with leakage of 63%-I feel fantastic this am. The previous night was awful with 5 hours therapy and Mask Leakage 28%.I was exhausted. Obviously the leakage rate is better but imagine what I would feel like if I could limit it to 80% or better..Is that possible?

There is no reason you should be getting leaks that large with any properly sized and fitted mask. Something is likely wrong with the sizing, or the way you have it fitted and adjusted. As you said, the straps are very tight and that alone could be causing leaks. Overtightening causes leaks. Plus you said the pillows mask was also giving you ulcers -- again, you may just be tightening these things too much.

It really is not a question of mask type, but a question of use and fitting. Have you watched the lankylefty27 videos on youtube or the manufacturers' fitting videos online? You really should.

If you want a good training wheels mask, one of the best, most comfortable and easy to fit masks is the old Resmed Quattro FFM. I would return the Amara and get a refund (you have 30 days with most places, if a mask wont work) and try the Quattro, if readjusting and refitting the Amara does not help. (Or, ask to try the Amara Gel cushion which is blue and simply snaps into the Amara frame in place of the existing clear silicone cushion - It is 'squishier' and may work better for you). Alternatively there is the newer, more compact version of the Resmed Quattro, the Quattro Air, or now the F10 (which is even more compact and has no forehead bar).

Good luck!

[49er]

Julie,

With all due respect, the issue isn't about anyone having an anti FFM mask agenda. It is about what will work best for Mary. And using a FFM does not protect against a dry mouth.

Mary, are you now allowed to wear nasal pillow masks again since you mentioned you might try the P-10s. Do I assume correctly that since you slept 9 hours with the pillows that they seemed to be working well although obviously 2 nights doesn't prove anything?

What is your gut feeling about what you think might work the best for you? I know you asked for opinions but many times, when people do that, they have some sense of what might work and just want confirmation.

49er

Mary - Do yourself a favour and try on (while lying down) various full face masks - there seems to be a loud crowd here who consistently push the 'no FFM' agenda, but there are also many of us who've worn them for years, have no dry mouth, routinely very low AHI's and are quite happy to wear them... feel naked without! They were designed for a reason and do their jobs well if you find the right style, size and are fitted properly for them. At least give them a fair try because you could well be cheating yourself by not doing so, as well as undergoing all kinds of trouble. Nothing to lose!

[Pugsy]

Where is this % of mask leakage being reported coming from?
Is it from the machine's LCD screen? If so that is % of time in large leak and even 28% is too much.
Or is someone seeing 68 L/min and mistaking it for % and that's a totally different ball game.
Or is it from SleepMapper reporting? And if so I think that higher is better.

So it's real important to know where the leak number is coming from.....

[OkyDoky]

For the Dry Mouth try the OraGel for Dry Mouth. It seems to last all night for me. I put some on the tip of my tongue and then rub it between my gums and cheek. Also if you decided to try pillows again try Lansolin to help protect the nostril until it gets use to the silicone.

[chunkyfrog]

Since my jaw drops when I fall asleep, and my nose is tiny, I could only find ONE full face mask
that gave me consistent fit; without destroying my lovely face:

https://www.cpap.com/productpage/pr-com ... -mask.html

It is a heavy beast, but it was the only full face mask I could stand.

[Janknitz]

I'm not going to suggest any particular mask to you. I just want to point out that your Amara does not appear to be properly fit. It may be the way you have adjusted it or it may be the wrong size, or it may be the wrong mask for your face. In any case those leaks are way too high for much benefit. FF masks are almost never leak free, but that's not doing you much good at all.

Take a look at "Taming the Mirage Quattro" in my signature below. Even though it's a different mask, the same principles apply for fitting. If those suggestions don't help you might try going to the manufacturer's website for Amara and look for sizing information. Check to see if the DME gave you the proper size (often dme's don't knowwhat they are doing).

If the size and fitting are not tge issue, you need to try other masks. Take your pillow and machine (without hunidifier) and even if you have to lie on the floor, test samples in a lying down position. Trying a mask sitting up will be a waste of time because your face contours are very different in a horizontal position.

[hyperlexis]

If the size and fitting are not tge issue, you need to try other masks. Take your pillow and machine (without hunidifier) and even if you have to lie on the floor, test samples in a lying down position. Trying a mask sitting up will be a waste of time because your face contours are very different in a horizontal position.

--Even more, you have to lie down and force yourself to try and relax your facial muscles while fitting it. Almost to where you open your mouth -- because that's what happens while sleeping. With practice and time, eventually this all becomes familiar and solvable. Just takes practice.

[marybarnes]

I have used Sleepmapper since Day 1 and my last 30 day average mask fit is 61%with my best at 83% and worst at 28%.I downloaded Sleepyhead two days ago and it says under heading " 90% leak rate" is 38%. Definitely something wrong with my mask. Ive checked the size and that's correct size so will follow all the suggestions and I think I'll order a Halo Chin strap from cpap.com and try that with a Pilairo Q nasal mask the sleep center gave me and see what happens