trying nasal/pillows masks

I've been currently using F10 with great success (usually). It's taken awhile to get past only 4-5 hrs of sleep per night. I've been sleeping 5 1/2 to 6 hrs for several weeks now. I'm so encouraged by my recent success that I'm ready to try the new challenge of changing from a FFM to a Nasal or Pillow type mask. I'm definitely a mouth breather and have used the Mirage Liberty and the Hybrid so I know that I'm able to tolerate nasal pillows. I do recall when using the Liberty and/or Hybrid that I felt like the air was shooting up into my brain (no other way to describe the sensation). My high pressure is 13.6 and I'm getting the aerophagia(?) with that pressure occasionally. I'm eligible for a complete new mask coming up in a month or so. One last thing, as I age, the mask marks are taking longer to go away each day so eliminating that would be a bonus.

Several questions I have:
Is the use of a 'chin strap' mandatory for a person like me?
How long (approx.) does it take to learn to breathe with mouth closed?
What are good examples of nasal/pillows masks that others have tried?

Why are you a mouth breather? Is it out of necessity due to nasal congestion issue that simply can't be cleared up or just out of habit?

If out of habit then the answer to your first 2 questions is....we don't know because we don't know how long it will take to break the habit. Chin straps are meant to be more of reminder to keep the chin from dropping down and allowing mouth to open and they aren't meant to be vise grips to lock the jaw down.
The lips can still be parted to mouth breathe even if the jaws are tightly locked together.

My mouth breathing when I first started cpap therapy was out of habit. Probably from gasping for air due to the apnea events because normally I don't mouth breathe during the day. Don't have a need to as I rarely have any nasal congestion issues. It took me about 2 months of mouth taping and I pretty much broke the mouth breathing habit. I sort of tried the chin straps but I found they moved around and were more annoying than they helped but I admit I didn't try very hard simply because what I did try was so annoying to me.
For some people the chin straps are enough of a reminder to the body to keep the mouth closed but for others they aren't enough.

Which nasal pillow mask to try? That's a crap shoot as they all have pros and cons to them. I tend to prefer as little on my face as possible so I lean towards the ones with less headgear. I give up a little stability when I do that though. For me it's a worthwhile trade off though.
The ResMed AirFit P10 is pretty much invisible on my head in terms of "stuff on my face and head" but it sometimes wants to let that back strap ride up. Not horribly annoying as it doesn't happen often but the Swift FX nasal pillow back strap did the same thing on occasion but it is overall probably a little more stable than the P10 is.
The Tap Pap nasal pillow with the mouth guard also is one that I really liked because it has no headgear at all...the mouth guard is the stabilizer. I don't know how that would work with someone who has a bad mouth breathing habit that needs to be broken. In terms of stability though...those nasal pillows never moved.

The Respironics Nuance gel filled nasal pillows are also real nice and very stable and quite comfortable.

I think for someone wanting to try nasal pillows for the first time..
ResMed AirFit P10
ResMed Swift FX
Respironics Nuance
and the Aloha..forget who makes it
all would be good choices to consider.

Very much appreciate your input. I have started using the ResMed P10(?). Size Small. Straps/pillows fit very well. No issues with fit at all. I was baffled by the chinstrap (not a brand I've ever heard of) but figured it out after much gnashing of teeth!

My readings are definitely worse than using the FFM:
11/15 Lg Leaks - 15.37% AHI 1.93
11/14 " " 5.97 " 1.99
11/13 " " 4.06 " 4.06
11/12 " " 3.74 " 2.0

Prior to the pillows - lg leaks are mostly 0.0% - AHI is usually below 1.00.

Last two nights (this may really be important as far as my treatment goes) - awakened by a horrible, acrid taste in my mouth. I think I've learned to keep the mouth closed but my nose entirely stopped up and I was dealing with Carbon Dioxide(?). Perhaps my using the FFM offers a safety net when the nose is entirely stopped up.

Pugsy nailed the best pillows (of course). I would rank Nuance Pro (fabric not had plastic headgear) above FX though.

I was a committed mouth breather forced to find an alternative by major league claustrophobia from FFMs - even the F10.

I took no time at all to lock my mouth closed but I spent a lot of energy "power" breathing through my nose (and rinsing it out - a lot!) to the point that now I can sail through the night even when quite heavily congested.

If you don't need lots of humidity and have a reasonable starting pressure (mine is 10 going up to 13 or 14) you can use dry or passover humid air to kind of blast open your nose in about 10-12 deep breaths. Just lie down and practice nose breathing for a few minutes as you go to bed. It's worth saying the P10 pillows are better designed for blasting than the Nuance once.

I am experimenting with humidity as the weather gets colder here in TX and the heater kicks in at night but I'm finding I won't need much (1-1.5 out of 6 in ResMed speak)

You are probably still doing some mouth breathing even with the chin strap. Chin straps aren't vices and can't be that tight. Heck, I can clench my teeth and still breathe through my mouth right now if I really wanted to. The chin strap's main job is to be a reminder to not open the mouth or have the lower jaw sag and drop open.
If your nose got stopped up ....I bet the mouth breathing happened and likely that is what you are seeing during the times of large leak.

I personally don't pay much attention to the % of time in large leak as long as it is in single digits and I slept through the leaks. Any leak that wakes me up though...I want to fix it if I can but because it is disturbing my sleep more than because it is negatively impacting my therapy.

The 15% of time in large leak I would sit up and take notice of though and keep an eye on it. That's getting into the area that I wouldn't want to see it happen often. If it ends up being a random fluke thing then I wouldn't worry about it.

Do you normally have issues with nasal congestion that occurs randomly during the day or night?
Congestion to the point that you would physically need to mouth breathe?
Is this why you have been using a full face mask all this time?
Or is maybe the mouth breathing just mostly out of habit?
The idea to lower humidity and let the pressure "blast" open the congestion might work if the congestion is caused by too much humidity but would be a disaster if the nasal mucosa was congested (swollen) due to their being a bit dried out. Humidity needs vary hugely among cpap users. Your nose might need more or less humidity..and is simply something you have to sort out yourself. If you sometimes have daytime congestion too....well then it may not be a humidity issue.

I doubt you were having any rebreathing CO2O issues though.

What was behind the desire to try nasal pillows? I forget. Just the desire to experiment? That's a good enough reason in my book.
Have you yet tried the nasal pillows without the chin strap just to see how bad the mouth breathing might be?
You know it took me a couple of months of trying chin straps and taping for me to sort of relearn to keep my mouth shut most of the time...but then I don't/didn't have nasal congestion issues normally that would make it a physical necessity to mouth breathe. My mouth breathing is mainly habit or gravity (my mouth likes to drop open if I am on my back).

Hi. I was diagnosed with sleep apnea in May and my setting is 7.5. I started with the nasal mask and then tried the res med pillow one. I liked it but it was irritating my nostrils just at the entrance. Is this normal? Do people lubricate their nostrils first?
Also my machine doesn't give me a reading of leaks or events, I have the Philips Respironics machine. I wasn't given the chance to try different machine. Perhaps when I go for my one year visit the respiratory tech can change the setting so I can monitor my progress.
All in all I have had no difficulty getting used to the apparatus except I hate having to dismantle it and pack it up every time we go to our cottage.

One thought - have you tried the larger size pillows - I was surprised by how the bigger ones fit better, leaked less and give better airflow?

I happen to need drier air but humidity is very personal - but can be adjusted either way, of course.

yarknit wrote:Hi. I was diagnosed with sleep apnea in May and my setting is 7.5. I started with the nasal mask and then tried the res med pillow one. I liked it but it was irritating my nostrils just at the entrance. Is this normal? Do people lubricate their nostrils first?
Also my machine doesn't give me a reading of leaks or events, I have the Philips Respironics machine. I wasn't given the chance to try different machine. Perhaps when I go for my one year visit the respiratory tech can change the setting so I can monitor my progress.

We often recommend Lansinoh lanolin ointment/cream to help with nasal irritation. Found in the baby aisle of most stores. Won't hurt you or the mask.

Which model machine do you have? The model number is on the bottom of the blower unit. A 3 digit number which may have DS, REF or P in front or behind it. If it is model 450 or higher we can tell you how to see the data it collects but if it is less than 450 there is no useful data collected and nothing for the respiratory tech to turn on to let you see except hours of use.
Before you turn over the machine to look at the model number be sure to remove the water chamber if it has any water in it.

My machine is REF 461 CA. I think I will buy a new machine in a year or so because I would like to know how I am doing. I am lucky because I no longer have the morning headaches.

What machines are similar to the Respironics in view of humidity control and noise level but allow you to view your readings?

yarknit wrote:My machine is REF 461 CA.

You don't have to wait a year....the model 461 is already a full data machine. Software will work with it (see the links in my signature for SleepyHead software information) and is free and easy to use.

There is data available on the LCD screen too. It's limited data but available....AHI and % of time in large leak.
There is a setting that needs to be turned on in the clinical setup menu for the patient to be able to view it though.
The settings is "Show AHI" and when turned on you can access the info data on the LCD screen.
You can turn it on...no need to have someone else do it...or you can use the software...or you can do both.

Go here...down near the bottom of the page are the instructions for requesting manuals.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual
and request this clinical manual..... Respironics PR System One 60 Series REMstar Pro with C-flex+
as it explains how to get to the setup menu where you can make the change to see the data on the machine

Here is the short version of how to get to the setup menu..and there's a little video at the bottom
http://www.apneaboard.com/pr-system-one ... structions
Do get the manual though because it has some useful explanations as to what your machine does and what data it gathers and what that data means.

Thanks so much, Pugsy.

Thanks everyone for your thoughtful advice. I developed a head cold so had to go back to the FFM. When I'm feeling better, will again try the P10.