How do you know if you need a fullface mask?

InSearchofSlumber · Post by **InSearchofSlumber** » Thu May 24, 2007 8:50 am

Just curious. I'm using a nasal mask and CPAP for about a week now and am sleeping worse than I was before. I think I'm really just unused to having something on my face, and that's causing the issue. I find myself fiddling with the straps alot at night.

I sleep better when I take Lunesta, but I don't want to have to take that forever. Without the mask, I only very rarely needed the Lunesta. I also seem to have weird dreams about suffocating (go figure).

I have noticed that even with the chinstrap and humidifier, my mouth tastes a little dry/funny in the morning. Made me think possibly I'm managing to open my lips a little bit during the night. Of course, the Lunesta makes my mouth tate funny, too, so that could be part of it.

My only thought - other than just sucking it up and waiting to get used to the mask - is that maybe I'm a mouth breather. Any thoughts/suggestions?

- M Series Auto A-Flex CPAP, Heated Humidifier
- Mirage Activa Nasal Mask with Headgear
- Respironics Premium Chinstrap
- Mostly a side sleeper. Some back. Never on stomach.

skjansen · Post by **skjansen** » Thu May 24, 2007 8:55 am

If you are a mouth breather you should probably use a full mask. When I initially started on CPAP I was using a nasal mask and no one could figure out why I was still having apneas. Duh....I was breathing through my mouth. No one told me to watch out for this. My medical care has been less than stellar as you would think this is the first thing a RT would consider.

Nonetheless, if you have a sleep partner ask them to watch you while you sleep to see if you are breathing through your mouth. SOme people on the forum tape their mouths...okay this just freaks me out, but if that works for you you might want to try it.

Good luck!!!

Babette · Post by **Babette** » Thu May 24, 2007 9:16 am

FYI - You sound like me - it took me 3 weeks to get any kind of decent sleep. I had to beg for drugs to keep me functional in the AM. Doc gave me "Provigil". I only take 1/2 a pill and not every day. I decide each morning what I think I might need.

I had to take nights off to get "caught up" here and there. And I had to come home sometimes and go straight to bed after work.

It's going to take some time to get used to sleeping with junk on your face. And every night will not be great. It's a long slow learning curve.

I'm only in week 5. I'm not THERE yet. I'm still struggling. I hear it sometimes takes months.

Good luck, and keep posting!
Barbara

Goofproof · Post by **Goofproof** » Thu May 24, 2007 9:18 am

You need to use a FF Mask, if you don't take precautions against mouthbreathing, or know for sure if you do. It's nice to have, if you have congestion problems, as it can get you through the bad nights.

If you can only get one mask to work, a FF Mask is best, because it covers all the bases, if leaks are under control, treatment will work.

A nasal mask has lots of advantages, but unless you address mouthbreathing, you are only fooling yourself, and possibly not getting the treatment you need. Jim

Guest · Post by **Guest** » Thu May 24, 2007 9:41 am

Want to pressurize a system with three holes? Simply get an interface that covers all three holes, not one that covers just two holes plus improvisations to try to keep the third shut.

FF masks are great. All you have to worry about is a single seal. If that's adjusted properly, you're golden. No extra holes to worry about air escaping through. No problems with nasal congestion (just take nice, huge, deep breaths through that giant hole at the bottom!). No need to have weird paraphernalia like big whole-head rubber bands and mouth duct tape and stuff. =)

The only potential issue with FF masks is "claustrophobia", but very often this is just an accomodation-over-time issue. I HATED my FF the first night. Within a week I no longer even NOTICED that I was WEARING it. Persistance pays. Quitting on the first night does not.

Anyway, in closing, yes try an FF mask, but stick with it. In short order you may have to do what I do... reach up and touch it to make sure you're even still wearing it! And you'll get all the great FF benefits, including the simplicity of all-hole coverage and perfect handling of even the worst nasal congestion days you'll ever have.

You probably only need a nasal mask if you fail with the FF... meaning if you absolutely positively cannot stand the FF even after trying several nights in a row.

Good luck!

InSearchofSlumber · Post by **InSearchofSlumber** » Thu May 24, 2007 10:22 am

Hey guys, thanks for the info. Still torn on what to do. I definitely see the benefit of the full face mask, and I do get congested sometimes, but I hate to pour more money into this adventure at this point.

My wife says she doesn't notice me opening my mouth, but with the strap on, it would only be a slight break in my lips anyway. I guess I could tape my mouth shut, but that kind of freaks me out.

I am supposed to be studying for a licensing exam right now, so I'm torn whether to go back to normal sleeping, continue on with the nasal mask and hope it gets better, try a mouth mask, keep up with the Lunesta. Ahhh...too many variables...

roster · Post by **roster** » Thu May 24, 2007 11:55 am

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S-Dubya · Post by **S-Dubya** » Thu May 24, 2007 2:39 pm

I tried the chin strap route and found that while it kept my chin up (no pun intended) my lips would still open just enough to lose pressure. It also made noises that drove my wife nuts!

I tried taping for a couple weeks, but I could not handle the feeling of not being able to open my mouth at all.

FFMs are the way to go if you breathe out of your mouth AT ALL. The only trick, IMHO, to FFMs is getting the right one for you. We all have our favs and the toughest part is to find one that fits your face and is comfortable for you. Once you have that, FFMs are wonderful and IMHO, much less hassle than chin straps, taping or any of that.

Guest · Post by **Guest** » Thu May 24, 2007 4:29 pm

S-Dubya wrote:FFMs are the way to go if you breathe out of your mouth AT ALL. The only trick, IMHO, to FFMs is getting the right one for you. We all have our favs and the toughest part is to find one that fits your face and is comfortable for you. Once you have that, FFMs are wonderful and IMHO, much less hassle than chin straps, taping or any of that.

Well-said, and I agree. Try the Fischer and Paykel HC431 or HC432, excellent masks... the only ones that fit under the chin for extra seal quality and stability (other masks seal underneath your lower lip, which seems very odd and inferior to me).

FF masks really ought to be the standard, with nasal interfaces used only for people who can't handle the FF due to claustrophobia issues, even after a multi-day trial (that is, they can't get used to it). But then, having one's mouth taped or forcibly held shut should cause a lot more claustrophobia than a FF mask anyway, but go figure.... everyone's different I guess.

I love being able to take deep breaths through my mouth and never having to worry about a big uncovered hole leaking while I'm asleep. Gotta love the FF masks.

cpapnewby · Post by **cpapnewby** » Thu May 24, 2007 8:55 pm

The Hybrid also seals under the chin and does not give nose bridge sores like the other FFMs.

Jim

InSearchofSlumber · Post by **InSearchofSlumber** » Fri May 25, 2007 7:30 am

You know, I think I realized what my biggest problem is with the CPAP therapy. It's the breathing of mixed air. It makes me feel like I'm suffocating. My doctor recommended I use the machine while watching TV in order to speed the acclimation process. I was sitting there, feeling out of breath, and realized I really just wanted the thing off so I could breathe atmospheric air. I imagine part of the magic of CPAP is that you are breathing a higher % of CO2, which forces you to breathe more often (keeping your airway more patent).

Anyway, not sure there's anything to do but keep using it and see if I can get used to it. Last night was a pretty awful night again, but I think I actually slept pretty well from about 11:00p - 3:30a. After that, all the water from the humidifier built up in the mask and then when I rolled from my side to my back, it poured onto my face and woke me up. I disconnected the humidifier, but I never really got to sleep after that (as best I can recall).

JimInAL · Post by **JimInAL** » Fri May 25, 2007 7:48 am

I'm probably stating the obvious, but FF masks don't work so well for folks with a beard like me.

I tried the Fischer and Paykel HC431 for a week, but there was a constant leak under my chin. I was spending over 80% of the night registering a "large leak". The machine reported my AHI as being very low, but I think that was because it never registered an event during a large leak.

Fortunately I'm not a mouth-breather, so the Optilife pillow is working fine.

I haven't tried, but I suspect that a nasal mask would have problems with a moustache.

roster · Post by **roster** » Fri May 25, 2007 12:13 pm

[quote="InSearchofSlumber"]............ I imagine part of the magic of CPAP is that you are breathing a higher % of CO2, which forces you to breathe more often (keeping your airway more patent).

.................After that, all the water from the humidifier built up in the mask and then when I rolled from my side to my back, it poured onto my face and woke me up. I disconnected the humidifier, but I never really got to sleep after that (as best I can recall).

Wulfman · Post by **Wulfman** » Fri May 25, 2007 12:15 pm

InSearchofSlumber,

What's your pressure set to?

Den

Guest · Post by **Guest** » Fri May 25, 2007 12:56 pm

The Hybrid also seals under the chin and does not give nose bridge sores like the other FFMs.

Yes, but the Hybrid also has three seals to worry about, compared to just one for the FF masks. And nose bridge sores can be prevented in various ways, although yes, when they occur they do suck. I have no experience with the Hybrid, but it looks more complicated and less stable than a good FF mask like the F&P 431/2 with the under-chin design, crown strap, glider straps (especially those, they rock!), etc.

I can see the point about the beards and other assorted facial hair though... that'd be a problem with FF mask seals.

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