Full face or nasal mask?

Hi All,

I would be appreciative of any advice anyone could give me. I've been using CPAP for about 5 years. I was using a Resmed S9 elite up until week ago when I decided to purchase an APAP (Resmed Autoset 10). My prescription is for 12.6cm. Using a nasal mask (dreamwear), I set the pressure to be between 11-16cm, and noticed from the graph below from sleepyhead, that it often would hit the maximum pressure of 16. My girlfriend said she could hear air rushing past my lips when I slept, so I tried a chinstrap and taping but it didn't seem to help.

I then pulled out my full face mask again (Amara view full face), but noticed that I'm getting a lot more apneas and that I had to increase the maximum pressure because it often hits the maximum, even at 20cm. There's screenshots below of the nasal mask and the full face mask. I know there is some leakage happening with the full face mask, I'm trying to address that as best I can with cpap pillows and mask adjustments before going to sleep.

I seem to be having a lot of apneas even when leaking isn't occurring. Should I stick with the nasal mask? I'm getting less apneas but I still feel sleepy all of the time and am trying to find the cause.

The Amara View is a full face mask...not a nasal interface only mask.
It can't be both.

So I don't know what you are using as a nasal mask...but it's not the Amara View.

ozzyblood wrote: ↑

Thu Dec 20, 2018 12:26 pm

Using a nasal mask (amara view)

ozzyblood wrote: ↑

Thu Dec 20, 2018 12:26 pm

I then pulled out my full face mask again (Amara view full face),

Respironics doesn't have a nasal interface mask with Amara in the model name.

But it is quite common to need more pressure when using a full face mask after using a nasal mask.
I think it is because of the straps needed on the full face mask pulling the jaw back a little and altering the airway making it harder to hold open with the pressure.

You have omitted needed details as to your settings (you cropped the stuff on the left side off) but I suspect you need more minimum pressure with the full face mask.
Easy fix...increase the minimum pressure if you want to use the full face mask.
Probably around 14 cm or so just going by the way the pressure line moves on the graph shown.
Your minimum pressure is your most critical setting...not the max. You have to give the machine a good enough head start in the first place to better hold the airway open.

Thank you very much for the response.

Whoops - Nasal mask is a dreamwear, not sure why I said Amara view again - I've updated the OP to reflect that change.
I've included screenshots to include the left hand data.

I've raised the minimum pressure to 14 and left the maximum at 20 - I'll see how things go tonight.

ozzyblood wrote: ↑

Thu Dec 20, 2018 1:10 pm

So setting the minimum pressure to maybe 14 might be a good idea? I thought I had read that the pressure would be the same whether full face or nasal, is that not the case?

In theory if all things are equal whatever pressure works with nasal "should" work with full face but I have seen too many time where theory doesn't always work out to real life.
What happens I think is that the way the full face mask has to fit and what it does to the lower jaw alters the airway a bit..so things aren't equal in terms of the airway position itself. Full face masks have lower straps needed to secure the bottom of the mask...those lower straps tend to pull the jaw backwards ever so slightly and I think that slight backwards movement constricts the airway just a little and the end result is the airway tissues simply need a little more pressure to hold them open.

Pugsy wrote: ↑

Thu Dec 20, 2018 1:20 pm

ozzyblood wrote: ↑

Thu Dec 20, 2018 1:10 pm

So setting the minimum pressure to maybe 14 might be a good idea? I thought I had read that the pressure would be the same whether full face or nasal, is that not the case?

In theory if all things are equal whatever pressure works with nasal "should" work with full face but I have seen too many time where theory doesn't always work out to real life.
What happens I think is that the way the full face mask has to fit and what it does to the lower jaw alters the airway a bit..so things aren't equal in terms of the airway position itself. Full face masks have lower straps needed to secure the bottom of the mask...those lower straps tend to pull the jaw backwards ever so slightly and I think that slight backwards movement constricts the airway just a little and the end result is the airway tissues simply need a little more pressure to hold them open.

That makes sense. I appreciate the explanation. I will try again tonight with the range set to 14 - 20 and see what happens.
Thanks for the help!

Pugsy wrote: ↑

Thu Dec 20, 2018 1:20 pm

... Full face masks have lower straps needed to secure the bottom of the mask...those lower straps tend to pull the jaw backwards ever so slightly and I think that slight backwards movement constricts the airway just a little and the end result is the airway tissues simply need a little more pressure to hold them open.

A little off topic, but I've always wondered about this. It's the same reason I'm leary of the Lifesource Ruby, PR Premium and the dreaded AG Industries Universal chinstraps.

Here's a screenshot of last night. I'm still having some leaks that I'm still trying to adjust, but I'm still seeing a large more amount of apneas outside of leak times.
Pressure range is set to 15-20

ozzyblood wrote: ↑

Fri Dec 21, 2018 12:52 pm

Here's a screenshot of last night. I'm still having some leaks that I'm still trying to adjust, but I'm still seeing a large more amount of apneas outside of leak times.
Pressure range is set to 15-20

Still nasal mask or back to ff?