Take A Chance With Nasal Mask? Or Not?

[KarD786]

Hello all. I am heading in to the DME in a few days to get my CPAP and equipment. Before getting diagnosed, I always slept on my back and could only breathe in the supine position by mouth breathing. If I sleep on my side (which I first started doing after diagnosis), I am able to fall asleep with my mouth closed. I am not 100% sure if it stays closed throughout the night. At my titration, I used a nasal mask, and refrained from opening my mouth in both the supine and side position. However I am not sure if I open my mouth after falling asleep on a normal night while on my side. Sleep apnea has really hit me hard, and my apnea was unmasked right after coming from being very hypER thyroid for about 9 months. I attributed the extremely early morning awakenings to my thyroid, and did not realize there was a problem till I addressed that. Therefore I am need for some serious recovery sleep as my body has been in stress mode and I have been unable to heal from some of the effects of being hyperthyroid long term.

I am wondering if it may be wise to take the full face mask initially to ensure that I have the best chance of preventing leaks, atleast for two or three months. I want to give my body some sure time to recover, and then was thinking of getting a nasal mask out of pocket later on in about two months or so (can't hurt to have both). To be honest the combination of conditions one after another and the inability to receive optimal sleep for repair has made me fatigued beyond belief. One problem that I may run into later is that almost every night I fall asleep watching Netflix on my phone. I know the beams can be bad before nighttime, but I have absolutely no trouble falling asleep with it. It actually puts me to sleep. With a full face mask, I found my vision to be quite obstructed. Any advice on what route would be advisable is welcomed. Also, the machine I am getting will be data-capable.

[LinkC]

Have you considered a nasal mask and a chinstrap to prevent mouth breathing? Might be worth a try...

[KarD786]

Have thought about it strongly, but I keep reading on how it is very uneffective for many people. I guess I should give it a try before dismissing the notion. With a chin strap, if you need to open your mouth every so often to get a deep breath while waiting to fall asleep, does it allow for that?

[Sheriff Buford]

Here's my two cents: the mask-search (finding one that is comfortable that doesn't leak ) is the key to successful cpap treatment. I went thru 6 masks until I stumbled on to the Respironics Fitlife Total mask. I wore it for two years before trying the Mirage Quattro. I was able to wear the Quattro all night, but deep down, I wasn't happy with it. Then Jencat (thanks Jen!) pointed me to the new Airfit F10. I went to cpap.com and paid for it out of my pocket. I have never been so happy with my mask! The Fitlife was getting sorta noisy for the wife, and F10 is much quieter. It is less intrusive, and a much better cpap experience.

Once you had it with a mask, you know it. A nasal mask is less intrusive and if you can afford it it, I would give it a try. You don't know unless you try.

Sheriff

[49er]

KarD786,

Unfortunately, I erroneously assumed I couldn't wear a nasal mask and went through months of what I call Full Face Mask H-ll only to realize that the cloth Sleep Weaver Elan listed in my profile worked the best. Now leaks haven't been pristine but I have stayed within the speed limit:) Unfortunately, my sleep got worse due to possibly not finding the right mask although I can't totally blame that since I have other issues.

My point in a round about way is to keep your mind open to wearing any mask even if you think you might not be able to wear it. I think one reason I thought a nasal mask couldn't work was when I tried on another brand in a sleep lab, I was gasping for air. But it was at a lower minimum pressure which I now realize was set too low.

Of course, I wouldn't be saying this if it was clear to me that you needed a full face mask. But it sure doesn't sound like that is a definite in your case.

49er

[Cowboy Casey]

I have gone through 4 masks in the last month, I started out as a mouth breather also 4 years ago and trained myself to breath through my nose.. The mask I have now works and works great for me, as the "balloon" inflates it grips my nose and stops the leaks.. My pressure changes from breath to breath and this mask rolls with it

[ChicagoGranny]

At my titration, I used a nasal mask, and refrained from opening my mouth in both the supine and side position.

Given this, the standard practice is to start with a nasal mask.

Yes, you could find out that you actually need a FFM. But making adjustments has been part of this process for many of us and it pays to be open to them.

What is your prescribed pressure?

And more importantly, what is the exact model of machine you are picking up?

[Cereal Killer]

My pressure changes from breath to breath and this mask rolls with it

You create an impression of a dirty old man with an offensive avatar of a young girl.

[chunkyfrog]

As long as you can breathe through your nose, and normally do so while awake;
it is possible that mouth breathing may be a habit carried over from years of untreated apnea at night.
(Someone else has brought this up previously--I agree completely)
After months of struggling with full face masks (I'm hard to fit) and various schemes to keep my lips together,
(tape, chin-up strips, chin straps, poli-grip) I started cheating, and realized my leak rates were improving.
The hope is that many mouth-breathers lose the need to sleep slack-jawed as they get used to therapy.
Keeping an eye on leak data may help in deciding when one could ditch the shin strap.

[Pugsy]

I would suggest that you start with simple basics first and then decide if there is any mouth leaking/breathing that warrants doing anything about it. You might not even need a chin strap with the nasal mask (which is what I would start with).
Wait until you have evidence of a problem before trying to figure out how to fix the problem because the problem may not arise.

[archangle]

If you can make it work, a nasal mask is better than a FFM in several ways.

As for leaks, the FFM has to fit over a much larger and more varied area of your face. This can make leaks more of a problem. Because the same air pressure is spread over a larger area, there is more force on the mask and you have more mechanical problems with leaks. It's healthier to breathe through the nose than the mouth due to the filtering and humidifying effects of the nose. There are even some "feedback" mechanisms in your body triggered by airflow in the nose.

Nasal masks, especially nasal pillow masks are much less obstructive of your view. You can sip water, cough, talk, etc. without removing the mask.

The FFM pushes on your lower jaw, which can cause it to slip back and worsen your apnea.

I think, in general, people should start off with a nasal mask of some kind, and only use FFM if they can't make a nasal mask work.

That said, a FFM is much preferred over leaking air out of your mouth all night long. Or not being able to breathe well due to a clogged up nose.

[KarD786]

Thank you guys so much for all the replies. I just got a call from the DME, and they will be dropping by tomorrow to set up the machine. Thank god, I am ready for a good nights rest. I think I will try the nasal mask first. However if it doesn't work I think I'd rather resort to a FFM. My biggest concern is making therapy the most effective for atleast the first two months while I recover and then I can have a more clear mind about everything. Someone mentioned the nasals being blocked, and it's always the case with me. 95% of the time, one nostril is completely blocked while the other has an open airway. And it always rotates nostrils, but it's usually only one. If I can fix that, nasal mask will be much easier for me. And to the person who asked above, my prescribed pressure is 8, so not very high.

[KarD786]

Ok so I just called the doctor's office to ask about writing patient preference for mask on the prescription. She said that they don't do that because a lot of the DMEs tend to push the cheapest masks on patients, so they require me to go in for a fitting and then will send over the prescription for the exact one. Fair enough, she was extremely kind, and has squeezed me in for a fitting at 3:00PM today. She said that the mask I have now (Mirage Activa) is a great mask, but is more durable than I would really need for a pressure of 8. She said I could easily get away with a smaller mask on the nose, which is one of my complaints. So I am going to go in later today and try a few on. One of these masks that she said she likes for a pressure of 8 is the Eson Nasal CPAP. Never heard of it, but I will keep my mind open and try other masks as well.

[SleepDisturbed]

OK, the following is just my opinion and experience, it is probably worth what you are paying for it!!

The order of preference for masks should be as follows:
1. Nasal Pillows
2. Nasal
3 Full Face
4. Specialized masks for individual, unusual requirements, such as oral, hybrid, total face, etc.

The reason for my ranking is that the less area of contact on the face, the less trouble you will have with leaks. If I use a Nasal pillow, I can often get negligible, often zero leaks. As I move down the list, leaks get worse, until with the FFM it is usually very bad. The primary result of increased leaks for me is bad sleep quality, as the leaks keep me from sleeping well, waking me up frequently, or requiring me to sleep in uncomfortable or unusual postures.

If you should start with a nasal pillow or nasal mask, and you have issues with mouth opening, the next step is NOT a FFM, but to try and use something like a Chin Strap. I use a nasal pillow now (the AirFit P10) and still occasionally use a chin strap. After a few night of using the chin strap, I seem to get "retrained" about keeping my mouth closed, and can go for weeks without it. Eventually I have to use it for a few nights again, to "retrain" myself, but this, for me has been a vastly superior solution to attempting to fight the FFM issues.

All of the above aside, all of us are different and may need to approach this differently, but I would suggest you try this approach. If you CAN use nasal pillows, the experience should be good! From my reading on this forum, those who can successfully use a nasal pillow or nasal mask seem to have a better experience with their CPAP overall.

And BTW, if you do want to try the nasal pillows, drop by Walmart and get some Lansinoh. You may want to put a very small amount around your nares the first few nights, for comfort. After a short adjustment period, you will probably be able to drop that.

Good luck!

[Uncle Sigh]

OK, the following is just my opinion and experience, it is probably worth what you are paying for it!!

Agreed.