The best FFM?

[Starlette]

Good evening all.

Just thinking ahead for co-worker. He says he's a heavy snorer. So, should they suggest a FFM, any suggestions on what to get?

Thank you all.
Starlette

[archangle]

Is there some reason heavy snorers need FFMs?

In my opinion, nobody should start with an FFM unless they simply can't breathe through their nose. Try nasal masks, chin straps, whatever and only do FFM if you can't make a nasal mask work. 30 day mask exchange is part of why local DMEs can charge so much.

[MidnightOwl]

I'm not sure why you're asking about FFMs. It has nothing to do with snoring. And I agree they should be a last choice. But with any type of mask the best one is the one that fits HIM. Which nobody here can determine.

[bdp522]

Everyone is different, what works for one won't work at all for another. The only way to find the mask that's right is to keep trying and working with masks until you hit the 'right' one. Some people prefer a full face mask to a nasal with chinstrap or tape, and that's fine. But no one can pick a mask for another person. We each have to figure it out for ourselves. I have always said that the mask is the hardest part of this. Start by checking cpap.com and looking at the possibilities, look for something that you/he may want to try. Then try it. Hopefully, with a good DME, there will be a few options.

Brenda

[Starlette]

Yes, you're all are correct. With all the reading of the forum I've done, it just appears that FFM were especially used with heavy snorers.
I was just wanting to gather some options. I told him I'd help him get started on the right path as best as I could. Want to help him avoid much of the pitfalls that I and so many of us initially had is all.

I did email him the link to cpaptalk.com and suggested that he get started reading before his sleep study. Now that is the BEST advice a friend could offer

Thank you.
Starlette

[Bobby269]

For me the quatro fx has been the best mask. What's strange in my case my DME, my sleep Doctor, my personal Doctor ,and the nice people who did my
Titration test didn't seem to think that starting with and using the FFM was a negative thing. I mean no offense to people who use the other kind of masks or
think differently. It seems unfair to people new to this forum to be told constantly that the FFM should not be your first choice. It would confuse me if I were just starting out again.
I have been on Cpap since Nov of 2010. when I switched to the FFM my AHI'S dropped to 0.1 on a sleepy night. The other two nights of the week 0.4. The
people that I mentioned above seem to think that the FFM is one of two excellent choices . They also mentioned that the mask that works for you is the best choice regardless of what category it fits into. They were 100% correct in my case.

[archangle]

It seems unfair to people new to this forum to be told constantly that the FFM should not be your first choice.

DMEs and therapists like FFMs because it's less work for them. It's not the best first choice for the patient.

Patients should be started with nasal masks and only get an FFM if they have problems with the nasal mask. Some people will have problems with a nasal mask, and need to be switched to a FFM. Most manufacturers have 30 day exchange policies with new masks. DMEs don't want to do the work to process a return or to take the extra trouble to try to give the patient the best mask.

Why is a FFM a bad first choice?

1) It's more invasive. Your mouth is covered, not just your nose. You can't sip water if your mouth gets dry. You can't talk. It's probably more claustrophobic. It's probably more traumatic to a new patient. You have a bigger thing on your face.

2) It's probably harder to fit. The length of the seal is longer. It has to conform to fit at more points on your face.

3) It pushes back on your jaw. If it pushes your jaw back, it can make your apnea worse. It's like a dental appliance in reverse.

4) You need more pressure on the straps because there is more cross sectional area and the length of the seal is longer.

5) I can wear my glasses with my nasal mask. Most FFMs I've seen stick up too far to allow me to use my glasses. I often read or watch TV while CPAPing.

Now, if you have mouth leaks, or difficulty breathing through your nose, by all means get an FFM if that solves your problem. I just don't think anyone should live with the obvious disadvantages of an FFM unless they've tried a nasal mask and had problems.

Even if your FFM mask fits and works well for you, they have significant drawbacks that a nasal mask doesn't have.

[LSAT]

It seems unfair to people new to this forum to be told constantly that the FFM should not be your first choice.

DMEs and therapists like FFMs because it's less work for them. It's not the best first choice for the patient.

Patients should be started with nasal masks and only get an FFM if they have problems with the nasal mask. Some people will have problems with a nasal mask, and need to be switched to a FFM. Most manufacturers have 30 day exchange policies with new masks. DMEs don't want to do the work to process a return or to take the extra trouble to try to give the patient the best mask.

Why is a FFM a bad first choice?

1) It's more invasive. Your mouth is covered, not just your nose. You can't sip water if your mouth gets dry. You can't talk. It's probably more claustrophobic. It's probably more traumatic to a new patient. You have a bigger thing on your face.

2) It's probably harder to fit. The length of the seal is longer. It has to conform to fit at more points on your face.

3) It pushes back on your jaw. If it pushes your jaw back, it can make your apnea worse. It's like a dental appliance in reverse.

4) You need more pressure on the straps because there is more cross sectional area and the length of the seal is longer.

5) I can wear my glasses with my nasal mask. Most FFMs I've seen stick up too far to allow me to use my glasses. I often read or watch TV while CPAPing.

Now, if you have mouth leaks, or difficulty breathing through your nose, by all means get an FFM if that solves your problem. I just don't think anyone should live with the obvious disadvantages of an FFM unless they've tried a nasal mask and had problems.

Even if your FFM mask fits and works well for you, they have significant drawbacks that a nasal mask doesn't have.

I agree with bobby...most of these issues mentioned are not relivant. I tried a nasal pillow mask which I quickly dismissed. Then tried a nasal mask (comfort gel) which I found comfortable but mouth breathing made me add a chin strap.. The mask and chinstrap worked, but were clumsy to attach each night. I tried the FF Quattro and...vola...it was great from day 1. I have had no problems with leaks and I can put it on each night with no adjustments. I see more messages here relating to leaks with nasal masks and pillows than I do with FF masks.

[islandboy5150]

For me it's the Mirage Quattro, but I had to labrat the hell out of it to get it to where I needed it. Now, I cant imagine using anything else.

[jimnsc]

I use nasal pillows and am glad I do/can but I started with a FFM (Quattro) and I don't think that was such a bad move. Knowing what I do now that would have been an F&P Flexfit 431 just because it goes under the chin to help with chin drop. Eventually I may have not liked a FFM but I would at least 'know' for sure I didn't and wouldn't wonder eternally if I would have.

As reported earlier I had 30 days to decide. Probably, only the minority of XPAPers stayed with their original mask for any length of time. If a newbie did not know for sure they breathed through their nose normally, I'd be hard pressed to start them on pillows or nasal mask for several reasons. You may be introducing them to some future decisions and expense of chin straps, taping their mouths shut, etc.

Also, it's already been said that what is good for one might stink for another. Lastly, I am of the opinion that starting the average person on a FFM isn't a bad decision at all if they breathe through both their nose and mouth - or are not sure. JMO having done so myself.

[DoriC]

Starlette, I think I understand your question. Speaking from experience, my husband was a heavy snorer and his mouth was always open at the same time. He doesn't snore half as much now that he's wearing his FF mask which needs very little nightly adjustment, and even if he does snore or open his mouth, he's covered with the FF and I would consider it quite a disadvantage to have to use a chin strap, tape and other measures that many need with the nasals or pillows. JMHO.

[damonreavis]

I started with a nasal pillow mask and a chin strap, finally I trained myself (somehow) to sleep with my mouth closed.

[avi123]

Yes, you're all are correct. With all the reading of the forum I've done, it just appears that FFM were especially used with heavy snorers.
I was just wanting to gather some options. I told him I'd help him get started on the right path as best as I could. Want to help him avoid much of the pitfalls that I and so many of us initially had is all.

I did email him the link to cpaptalk.com and suggested that he get started reading before his sleep study. Now that is the BEST advice a friend could offer

Thank you.
Starlette

Also, why can't he/she post here directly without you as a go between?

Where is the recent post about Dr. David Rapaport of NY Med Sch saying that you can train yourself to keep your mouth closed when you sleep? Doing so would allow you to use nasal masks which have less leaks b/c of the smaller face area that they cover (the face seal is shorter).

[Starlette]

@ Avi - Thank you for responding. I'm sure he could and sincerely hope he does. I'm not attempting to be a go between, just being a friend in gather information to give to him is all.

[MidnightOwl]

@ Avi - Thank you for responding. I'm sure he could and sincerely hope he does. I'm not attempting to be a go between, just being a friend in gather information to give to him is all.

Starlette,

That's great. It would have been wonderful if I'd had a friend to help me when I was getting started.

Midnightowl