Full Face Mask worst option according to professionals?

[Mask2sleep]

I guess the topic title says it all. I am wondering why professionals, or at least self-labeled professionals, consistently claim that the FFM is the worst type of mask for xPAP therapy?

I do not see this opinion hardly at all on this forum. However, I have read through posts at Binary Sleep and the folks over there, a majority of whom claims to be respiratory therapists and sleep techs, would have one believe that using a FFM is barely better than not using anything at all. They are quite pointed on the subject and go so far as to verbally degrade and question the education of anyone, fellow professional or not, who dare suggest that a FFM is a valid mask choice in all but last ditch cases.

I personally think the argument is a bunch of hooey, but I am trying to understand how they think it is valid? The two recurring themes I read is that a FFM puts pressure on the lower jaw, thereby pushing it backwards and worsening OSA events, and that patient adherence of a FFM over a nasal mask is much less. Mind you I have never seen them document this with any source material; it is just what they repeat over and over. I even question the claim on the FFM putting pressure on the lower jaw to the degree to cause increased events. If one is wearing the FFM right, especially in the case of a Quattro and it is “floating”, I would think pressure on the lower jaw would be fairly minimal. Same goes for FFM like the Forma or 431 that goes under the chin rather than resting against it. This is just my uneducated opinion of course, but I’ve tried virtually all the FFM out there, and haven’t noticed this increased pressure to be much of a problem. They also make light of air escaping from the mouth and say that mild to moderate air leakage from the mouth while using a nasal mask is preferable in most cases to a FFM, which I just don’t get. How does no leakage with a FFM equate to being worse than some leakage with a nasal mask? I don’t get it.

Mask choice is of course a very personal thing, and comfort wise I do prefer just a nasal mask, be it something like a Swift FX or a Comfort Gel. I’ve got a Comfort Gel from cpap.com and when I put it on I barely realize I have it on compared to most of the FFM, but without exception I wake up during the night with air escaping from my mouth, even using a papcap, and always a dry mouth in the morning. So it’s always back to a FFM for me, because I know it works and the proof is in the pudding because air doesn’t escape and don’t wake up with the Sahara in my mouth. What’s more, my DME and doctor didn’t give me one bit of grief over the choice to use a FFM. There’s even a thread over there where they are arguing that the Resmed ASV machine shouldn’t use a FFM, even though Resmed suggests it. Maybe is a marketing thing by Resmed, who knows, but I would assume they know what works best with their machines.

As an off-topic aside, thanks to suggestions from this board, I called my doctor a couple weeks ago with a constructive argument about where my therapy is currently at (AHI 15ish) and my concern of his wait and see plan with no changes to therapy, and he agreed to get me an auto machine. So tomorrow I’m changing from a PR System One BiPAP Pro to the PR System One BiPAP AUTO. I am looking forward to this change and am also slightly nervous as I’ve never been on an auto machine before, but I am hoping it will be of benefit.

[Portageegal]

I breath though my mouth, so a FFM is the ONLY option I have. What do "professionals" know, anyway ?

[Eureka]

I asked my DME about the number of his patients who use FFM -- he said about half. And that's what HE uses. Me, too.

[Madalot]

I've read over at binarysleep as well and have seen the same thing. I am no expert and can only go on personal experience.

From what I've read over there, they say that breathing through the nose is normal and even mouth breathers can be trained to breathe through their nose if they try hard enough.

In my case, I simply could NOT tolerate a nasal mask PERIOD and found a full face mask that works for me. If it's a matter of using a full face mask or nothing at all, obviously giving me a full face mask is a better choice. I think others are in a similar situation.

[B_4]

The two recurring themes I read is that a FFM puts pressure on the lower jaw, thereby pushing it backwards and worsening OSA events

My chin strap puts pressure on my lower jaw and pulls it backwards......

[LSAT]

The two recurring themes I read is that a FFM puts pressure on the lower jaw, thereby pushing it backwards and worsening OSA events

My chin strap puts pressure on my lower jaw and pulls it backwards......

If I tighten my Quattro too tight, I get the feeling that it is pushing my lower jaw backwards. The key is to NOT tighten it to that extent. As far as FFM worsening OSA events....if this was true there would not be as many people reporting very low AHI numbers with the FF Masks.

[So Well]

Full Face Mask worst option according to professionals?

That is why I have a great appreciation for the forum binarysleep.com.

It gives the sleep professionals a place to muddle around and STAY THE HELL out of here!

[Big S]

I like a FFM because I can breathe in and out any of the holes that can serve that purpose. I tried a nose mask two different times and after a couple of hours, I felt like I was hanging from a couple of meat hooks at my nose, not a good feeling. The only reason I gave it a second chance was that I thought I could've been wrong since I am a newbie. After 4 months on a FFM, I'm happy to report that I barely know it's there.

[Madalot]

I like a FFM because I can breathe in and out any of the holes that can serve that purpose. I tried a nose mask two different times and after a couple of hours, I felt like I was hanging from a couple of meat hooks at my nose, not a good feeling. The only reason I gave it a second chance was that I thought I could've been wrong since I am a newbie. After 4 months on a FFM, I'm happy to report that I barely know it's there.

Sometimes I wake up early in the morning and feel to make sure it's on -- I don't notice it much after I go to sleep. It's a part of me now. I never could get a nasal mask to work well enough for me to be like that.

[Mask2sleep]

Thanks for the replies, I'm glad its not just me who thinks the idea is cooky.

[xenablue]

I just went to my dentist the other day for my regular 4-monthly cleaning and check-up. As this was the first visit since OSA Dx, I asked him a bunch of questions, including about the impact of the mouth part of my Mirage Liberty on my lower teeth, as occasionally I wake up with my lower teeth - not exactly in pain, but discomfort for a short time.
My dentist said he has never seen any issues with teeth/jaws for CPAP users. He said if I was concerned, he'd make a note on my file to look carefully for any changes on my next x-rays. I've been going to this guy for 12-years and he's one of the most dedicated dentists you could meet.
He said I need to be more concerned about mouth breathing and waking up with 'desert mouth' causing problems like gum disease.

Cheers,
Xena

[DocWeezy]

I never cease to be amazed at the arrogance and ignorance of people who assume that they know what is best for me, and the statement that everyone can be trained to breathe through their nose just cements my opinion of people like that. Sheesh!

What is more important--breathing "properly" according to some "professionals" or receiving good therapy with a FFM????? if I had been forced to use a nasal mask, I would NEVER have been able to adjust to a cpap because I can't get enough air through my nose and have claustrophobia issues besides and go into a panic if I can't use my mouth to supplement my nose when breathing.

I continue to be grateful for finding a great sleep doc, whose motto is: "I never met a mask I didn't like--as long as my patient likes it and is happy" I even switched to a mask that he didn't think would work well for me, and once I told him I liked it and was using it, he was thrilled I'd found something and said he was changing his opinion of the mask (particularly when he saw the low leak rates).

I wonder how many people who need xpap therapy end up not complying because they are being forced to learn how to breathe "properly" and use a nasal mask?

Weezy

[Madalot]

What is more important--breathing "properly" according to some "professionals" or receiving good therapy with a FFM????? if I had been forced to use a nasal mask, I would NEVER have been able to adjust to a cpap because I can't get enough air through my nose and have claustrophobia issues besides and go into a panic if I can't use my mouth to supplement my nose when breathing.

This is EXACTLY the problem I have. If my nose becomes blocked or for any reason I feel a need to breathe through my mouth, I will panic if I cannot do it. So somebody FORCING me into a nasal mask is a disaster looking for a place to happen.

[john_dozer]

I believe nasal masks are far easier to control leaks from the mask itself and have fewer complications like dry mouth and possibly even lung infections. While getting a good FFM for yourself can be a bit of journey. I suspect to a small degree they want nasal masks to be superior for CPAP because it simplifies their dealings with patient's secondary issues.

As for myself, I'm on the verge of feeling claustrophobic (is that the correct term for fear of asphyxiation?) as it is. Taping or chin straps are out of the question.

[carbonman]

They will have to pry my FFM from my cold, dead hand.

OT

Nice looking hourglass dulcimer you have there.

A few life times ago, I built dulcimers.
Beautiful instruments.