In Defense of the Full Facemask

[AfibApnea]

I’m posting this thread in the hopes that anyone having trouble with their face mask AND anyone who avoids trying a full face mask because of unpleasant preconceptions they may have about one will continue to read on. I don’t know that this will get to many of those people because I believe (having read many of the polls on this forum) that most people who have stuck with CPAP are pretty well accustomed to their mask. Maybe the thread will be important enough to people just coming to the site that it can be made available to them.

Initially I had a very easy time adopting my nasal mask and nasal pillow (mask). From the getgo I found my CPAP experience comfortable and rewarding (I seem to adapt to new things fairly easily).

After about four months I found the experience untenable. Every time I donned a mask my nose immediately became congested and I experienced intense problems maintaining a comfortable/continuous airflow. I was convinced there would be no way I could continue to use the machine. I tried everything: humidity, heat, various nasal sprays, neti pots, raising the air delivery tube; alternate nasal units; etc. Nothing helped. I stopped using the unit for months.

Eventually it came to be that Central Events (in addition to Obstructive events) were noticed on my meager readings and I was scheduled for a sleep study. Again I tried all the approaches—all to no avail.

In studying my response to a CPAP ‘incident’ I noticed that what typically happened was that I would be nasal-breathing normally;…in response to my nose becoming clogged or some similar dilemma I would respond by taking a breath or two through my mouth. Since the mouth was outside the air-flow scope (i.e., the nasal mask) breathing through my mouth would effectively ‘break’ the flow seriously enough that I would feel compelled to turn off the machine; sit up and remove my mask; and regroup before settling down to try again. This happened multiple times hourly.

It occurred to me that if I adopted a full face mask—one that would confine both my nose and mouth—that I would be taking the mouth-breath interruption out of the equation and might not have to do the sitting up…regrouping thing as often. Previously I’d been proud of using the lower profile (nasal) masks and felt that a full face mask represented the worse of all situations. I worried that a full face mask would be big, bulky, heavy, and unbecoming.

I asked to be fitted for a full face mask. It was none of the things I had feared and using it proved an immediate pleasure and success. (In fact, I never even was tempted to breath in through my mouth, though doing so is easily possible and doesn’t interrupt the process.) In my inimitable way I put myself through a week of ‘training’ (using the mask while awake and reading; scheduling short naps; etc.) and after 5 days I was able to comfortably use the CPAP machine for 7+ hours/night. I was ready to go for the sleep study (there I used another full face mask, (because I was curious to know what their full face mask would be like) and (though there were differences I preferred and ones I found better about my home mask) I found it equally accommodating.

I hope to return to a situation where I can switch between the different masks I have. That’s the situation I find most preferable.

If you are having problems with your CPAP experience because of your mask, please do not reject trying a full face mask.

[Ford Guy]

WOW...It took 7 paragraphs to say that you switched to a full face mask because you were congested?

[snuginarug]

I'd like to point out something about full face masks. It has been said, over and over, that full face masks don't deliver proper therapy, that somehow the basic design is a flawed one. Then all kinds of things are cited, except the results people regularly get in practice, not in theory.

My numbers are good and it is comfortable. It suppresses events and I can tolerate wearing it. THAT'S ALL IT NEEDS TO DO. It may not theoretically be the most, best, newest, superlative, tested by rocket scientists style of mask. But it is not inherently NONFUNCTIONAL. It works fine, and that's all it needs to do.

So i would urge new people who find it impossible to tolerate nasal masks or pillows to not entirely rule out FF masks. A nasal or pillow mask my be absolutely the best theoretical ideal, but that doesn't matter if it spends all its time on the floor, having been ripped off in a panic attack.

[englandsf]

Hey afibapnea, have you tried really low humidity? All my congestion was made worse by higher levels.

[chunkyfrog]

Before we get sidetracked by a debate on which mask is best, (like Ford vs Chevy--really?)
let's remember that all our faces are different--as well as our other parts. (thank goodness)
Trial and error, along with experimentation, is often our only solution.
Kudos to afibapnea for thinking outside the box--or simply kicking out the side of it.

[snuginarug]

Before we get sidetracked by a debate on which mask is best, (like Ford vs Chevy--really?)
let's remember that all our faces are different--as well as our other parts. (thank goodness)
Trial and error, along with experimentation, is often our only solution.
Kudos to afibapnea for thinking outside the box--or simply kicking out the side of it.

I wholeheartedly concur that no one mask is the best, nor that one type of mask is inherently better. I have been repeatedly told I shouldn't use my 432 F & P because there is some inherent design flaw, despite my good numbers. That is a disservice to the community as new people, struggling with mask choice, may rule out one type of mask entirely because of the words of theroreticins. I weighed in on this topic to prevent that from happening.

[Krelvin]

I love my F&P 432.... just got my 4th one... used the 431's before it.

Is it true that most sleep studies use FFM's ? Almost everyone that I know of that has had a sleep study had it done with a FFM. Not sure if it is just easier for them to do it with a FFM or what, but many of those people were then forced to get a nasal mask by their DME because their RX didn't say otherwise.

In my case during the studdy they tried two FFM masks, the first one leaked all over the place and lasted 10-15mins.. the second a Comfortfull 2 was used next and I slept almost 3 hours without waking after they put that one on. That is what I used as my first mask for a couple years thought the DME gave me a 431 first because they had to special order the one I wanted when I got my first machine. The mask used was in the sleep study report.

[Denial Dave]

my sleep doc took one look at my nose & observed my mouth breathing and knew I had a deviated septum.

It was pretty obvious that FFM was the way to go for me....

I love my Quattro!!

[MagsterMile]

I've been using the Quattro F 10 (fullface) for about a month or so and have noticed improvements in quality of sleep. I'm getting less leakage and the AHI usually runs from 0.0 to .5 (knock on wood!). I did try out the 'pillows' and though they didn't bother my nose initially, the added chin strap didn't work for me. Sometimes with the pillows, I felt like huge amounts of air were somehow getting into my sinuses. The 'pillows' experience was not a very positive one for me. I do have congestion and deviated nasal problems which probably make 'pillows' not a good choice for me. I recommend a cloth sleeping mask to wear with your mask. It helps keep your eyes warm and free from any air that might escape from the venting systems on the masks.

[archangle]

I think the FFM should not be the default first choice that a doctor, respiratory therapist, or DME chooses for all patients.

I think many DME's choose the FFM first because they're too lazy to go to the effort to try to find the right mask. I think they often get chosen for the benefit of the DME, not for the benefit of the patient.

However, many people have mouth leaks, difficulty nose breathing, or other problems with nasal masks and need a FFM. Some people just find them more comfortable.

A working FFM is much better than a poorly working nasal mask.

Use what works best for the patient. What I object to is when the FFM gets chosen for the benefit of the DME.

There are significant drawbacks to FFM. It has to seal over a larger area of your face, so leak control may be harder. The larger area means more force, so there is more force on the straps. It makes it more difficult to wear glasses for those of us who may watch TV or read in bed. You can't take a pill or sip water while masked up. It makes it harder to talk. Comfort may be a problem.

FFM's push on your chin. This may make apena worse for some people and cause you to need more pressure.

[library lady]

You can take a pill or a sip of water while masked up with a full face mask... it does take creativity however, and I have actually done both. Pop the connector off the mask, and with a flexible straw in most cases will allow you to drink water. Once when I forgot to take a pill, I decided to see what I could figure out... pair of tweezers to pick up the pill, stick your tongue out, push the tweezer end with the pill into the space, let it go on your tongue... need I say more? I wouldn't want to make a habit of this, and it's only happened once... but goes to show that it can be done. More work because you have to wash the tweezers, etc.

I do wish that I could wear my glasses with my F10; I haven't been creative enough to figure that one out. It's pretty easy to talk with the mask on in my experience.

As for sleep study masks, when I went into the room that was assigned to me for my study, the technician took two masks out of a drawer, a nasal and a FF - he put the nasal mask on me, turned the machine on and my cheeks puffed up instantly. I kept opening my mouth to let the air out, so he took it off and tried the FF- I said "I like this better" and that was the end of that. When it was time to mask up after the diagnostic portion of the split-study, they put the FF on me.

I think it is best to go with the one you're most comfortable with as long as it is effective for your therapy...

[Semily]

I'm only about 3 1/2 weeks into therapy, but I've been pretty content with my Amara Gel. The tech that performed my titration study did recommend I start with a FFM, so this is what I used then and what the prescription was written for. So the DME said that was what I would have to start out with, but within the 30 day comfort exchange period I could switch to whatever I wanted. In fact the respiratory therapist that dispensed my machine said she would really rather put me in a nasal mask. I did just pick up the next size larger in the Amara today, but I don't feel the need to try to switch to a nasal mask right now. This way I can just focus on settling into a routine of healthy sleep without worrying about mouth breathing issues or anything like that.

[lido14]

I find that the ffm is beneficial when my nasal mask begins to make the bridge of my nose really sore or I'm congested. My favorite masks because of the quietness are my fisherpaykell flexit fit 406 and zest nasal masks.

I have to use chin straps with any typ of mask I use so its not a factor in my decision-making of what works best.