AHI down after quitting a FFM

[hillbilly1979]

Well, I had often wondered what might happen if I tried a nasal mask of some sort. Of all CPAP masks, the nasal pillow variety seemed most interesting to me and I perceived them to be the most comfortable aspect of therapy if I could ever manage them. After years of fighting with FFM and TFM, I decided to try it. Knowing I was a mouth breather, I decided to purchase a chinstrap and the Swift FX nasal pillow mask. The Swift FX is literally the most comfortable piece of CPAP equipment I have tried to date. It is lightweight and the pillow that came preinstalled is perfect. Since I began using this mask, my leaks have dropped from 50 l/m or more (not vent, just leak) to 0-6 l/m depending on the night. I wake up with the mask on in the morning around 95% of the time, whereas I usually removed the FFM after a few hours each night due to excessive leaks. I wish someone had told me to try this earlier. My AHI has been averaging 3-4, which is unbelievable considering where I was prior. My doc originally put me in a FFM because I was a mouth breather without considering a chinstrap. If I had been aware how easy it was to get around that issue, I could have saved myself many sleepless nights and a lot of strain on my heart. I just want people to be informed because there might be someone like me out there that needs to know this.

[Pugsy]

When you have time you might want to change the mask in your equipment profile to reflect your new found friend.

I am so glad that you were able to make the nasal pillow mask work for you. I know people seem to always say "you are a mouth breather so you just have to use a full face mask" but it doesn't always have to work out that way.
There are ways to reduce or limit the mouth breathing should a person want to try a nasal mask.
I always tell people if you want to try a nasal mask..then try it and see if you need to do anything special about the mouth breathing and deal with it if needed. Hey, it might not even be needed. For some people the mouth breathing reduces because the cpap pressure and the humidity can improve any nasal congestion that might have been causing the mouth breathing in the first place.
Also seems like some people have a deviated septum and they think they can't use a nasal mask but sometimes they can. You never know until you try and if a person is wondering or wanting to not use a full face mask...hey..at least try something else. It might just work out even better.

Oh....in terms of AHI reducing when using the same pressure settings. That's not uncommon at all. For some people nasal pillows do a "better" job at the same pressure in terms of holding the airway open so the AHI drops.
Not sure why because in theory X amount of pressure should equal the same results no matter which way that pressure is delivered but it might have something to do with the way full face masks seem to sort of pull back the jaw a bit with that lower strap needed to hold the mask in place. Pulling the jaw back a little might close of the airway a little bit.

[linuxman]

This intrigues me. I don't mind my FFM..it''s pretty comfortable but I am envious of those that can do the nasal thing. I'm cautious about trying nasal only because when I just consciously breath though my nose only I don't feel like I can get enough air. With CPAP (especially at 16.5cm), maybe that wouldn't be the case. There's no way I could train myself to keep my mouth closed - it just opens automatically..but maybe a chinstrap could work. I'll have to give this a shot sometime. If anything, something that would have a lower propensity to leak for a heavy mover would be a good thing.

[magentapolkadots]

I also experienced an improvement in my therapy after switching from a FFM to nasal pillows with a chin strap. I had always been FFM due to mouth breathing and had invested considerable time, effort and money into things to help me get a good enough seal, avoid pressure sores, and prevent irritation to my overly sensitive skin. I never would have tried nasal pillows except that the RT at my sleep doc suggested I should. I just assumed they wouldn't work for me.

The pillows are SO much more comfortable even with the addition of the chin strap. The pillows last longer for me too. Something in the chemistry between my skin and the FFM cushion always caused the cushion to soften too much too fast. I'd have to buy extra cushions out of pocket because mine got leaky in about 2-3 weeks while the insurance only provided one per month. My AHI improved as did my overall sleep quality because I'm not fighting with a pillow pushing against my FFM any more.

So yes, I would recommend to anyone that they at least give nasal pillows a try. Good topic, good post hillbilly1979.

[Pugsy]

This intrigues me. I don't mind my FFM..it''s pretty comfortable but I am envious of those that can do the nasal thing. I'm cautious about trying nasal only because when I just consciously breath though my nose only I don't feel like I can get enough air. With CPAP (especially at 16.5cm), maybe that wouldn't be the case. There's no way I could train myself to keep my mouth closed - it just opens automatically..but maybe a chinstrap could work. I'll have to give this a shot sometime. If anything, something that would have a lower propensity to leak for a heavy mover would be a good thing.

If it interests you...something worth trying down the road if you want to scratch that curiosity itch.
Watch the forum...sometimes unwanted masks get given away or sell really cheap so it wouldn't cost you all that much to scratch that itch.
I think everyone should try to scratch that itch if they are wondering and wanting to.
The only way to learn is to try and it might work out.

We have a forum member (not around so much anymore) who thought he just HAD to use a full face mask because of his deviated septum causing breathing problems and making him mouth breathe out of necessity.
His pressure needs with a full face mask was around the 16 cm range. That pressure makes any mask a challenge to control the leaks. I nagged him something awful to at least try a nasal mask and he finally agreed to (probably to shut me up) and I think it was the Swift FX he tried. Lo and behold he was able to breathe just fine with it and the mouth breathing really didn't happen all that often and he learned he could get by with 12 or 13 cm pressure. He was a happy camper for sure.

Can't guarantee it would work as well for you but it wouldn't be totally impossible and if you are wondering...worth at least trying.
Now for people who aren't wondering and trying something different doesn't interest them then of course stick with what you are happy with but if a person has that curiosity itch...by all means get it scratched if possible.

I have tried a large number of nasal pillow masks (probably almost all of the ones available and some that have been discontinued). Not all were successes but I learned something with every experiment...now sometimes all I learned was how much I hated so and so mask..but I learned and got that itch scratched.
Right now trying the brand new Brevida nasal pillow mask...still not even available in the US. It looked interesting and I got that old curiosity itch again. Only one night with it so far and what I have learned at this point is that I like it well enough to use it more nights to see how it does for me.

So at some time in the future if you still have the nasal interface mask itch...try it. You will learn something one way or the other.

[linuxman]

Thanks Pugsy..indeed I will do that. No reason not to, really. Even if I bought new, I could likely offload it pretty easily.

[OkyDoky]

Hillbilly, I remember seeing that very leaky screen shot. And I said getting leaks under control is going to be the first step you need to take. Sounds like you have found your solution.

[hillbilly1979]

Hillbilly, I remember seeing that very leaky screen shot. And I said getting leaks under control is going to be the first step you need to take. Sounds like you have found your solution.

You have no idea. I need to go back and post an update. It is crazy. I was worried that my leak info might not be correct. I verified that my mask was set correctly in Sleepyhead. It is crazy to see little to no leak after my experiences with different FFM. Thanks for remembering.


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[MrsAgathon]

Hey Hillbilly1979 - What kind of chinstrap do you use, and do you ever feel like you can't get enough air through your nose only when falling asleep/sleeping?