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angeltink wrote:I am a newbie who started therapy 7/10/17. I was given the wisp mask at my titration study and the tech told me the most important thing for me would be finding a mask I am comfortable with when I go to the DME. At our local DME I was told a pressure of 13 was too much for nasal pillows, but I see here that is not true. She kept trying to push me to full face mask saying that is what most people have the best luck with. I told her no way that if I could not get the nasal pillows I wanted the wisp that worked for me during my sleep study. So I have been using the wisp and love it but really want to try pillows next time. I am hoping she doesn't tell me I can't use them with my pressure again so will have to find the info saying they can be used with a pressure of 13 and will bring that in with me.

Goodness gracious!! If you can wear nasal pillows... by all means wear them! I wish I could. They have to be the least intrusive mask out there. The DME works for you and you are the customer. When I order the Respironics Fitlife Total Mask, the DME also tries to talk me outta' of it. I am real nice, but firm. Stick to your guns!

Sheriff

Many NP masks have been tested up to 20 cm of pressure, some higher.
Most levels of pressure is not a barrier to using these masks; but fit, mouth breathing,
and DME prejudice are!

A nasal mask is a better choice unless there are problems such as mouth breathing, clogged nose, claustrophobia, or air leaks. They're easier to stop mask leaks. Nose breathing is better than mouth breathing. With a nasal mask, you can talk, sip water, take a pill, etc.

However, if you have problems with a nasal mask, a FFM may be the right solution.

DME's push FFM's because they don't want to go to the expense or effort of doing it right. They push FFM's for their own benefit, not the patient's benefit.

The right way is to start with a nasal mask as the default, discuss it with the patient, check the data for evidence of mouth leaks, try chin straps if necessary, then go to FFM if necessary.

archangle wrote:A nasal mask is a better choice unless there are problems such as mouth breathing, clogged nose, claustrophobia, or air leaks. They're easier to stop mask leaks. Nose breathing is better than mouth breathing. With a nasal mask, you can talk, sip water, take a pill, etc.

However, if you have problems with a nasal mask, a FFM may be the right solution.

DME's push FFM's because they don't want to go to the expense or effort of doing it right. They push FFM's for their own benefit, not the patient's benefit.

The right way is to start with a nasal mask as the default, discuss it with the patient, check the data for evidence of mouth leaks, try chin straps if necessary, then go to FFM if necessary.

I disagree. The default should be to ASK what the customer wants. If I had to start with a nasal mask of any kind, I would never last an hour. I tried to breathe through my nose Once while wearing my full face mask. I hated the feeling of air blowing through my nose.

Maybe the new patient should be fitted with one of each; to go home and try whatever feels best.

chunkyfrog wrote:Maybe the new patient should be fitted with one of each; to go home and try whatever feels best.

Makes too much sense CF.

I forgot the most important reason. FFM's push on your jaw. This may move the jaw back and make apnea worse for some patients. It's like a dental device, but it makes it worse, rather than better.

archangle wrote:I forgot the most important reason. FFM's push on your jaw. This may move the jaw back and make apnea worse for some patients. It's like a dental device, but it makes it worse, rather than better.

That has got to be what is happening in my case. When I have worn a full face mask at the same pressure for the same amount of time, the AHI greatly increases. I do realize that my experience is only anecdotal and perhaps with a full face mask that truly fit, I would have different results.

It would be interesting if a real study was conducted to see what the results would be.

49er

Hello All!
Looking for advise. I was diagnosed with mild obstructive sleep apnea about 8 years ago. I used the cpap machine with mask once at home and felt like I was drownding and never used it again. When I was taking the overnight sleep study, I could not stand the nasal 'sticks' that were put up my nose. Recently, I have been waking up gasping for air and know I need to address this issue. In all reality, I am a newbie at this and am looking for suggestions on the best method for air flow-nasal, oral, face mask...Please advise????

My sleep doctor started me on the Swift FX, because I have a beard. The DME included a chin strap in case I turned out to need to breathe through my mouth at night, but with the caution "don't use it unless you have to". So I guess experiences vary according to your circumstances, doctor, DME, and so on.

kathypfmp wrote:Hello All!
Looking for advise. I was diagnosed with mild obstructive sleep apnea about 8 years ago. I used the cpap machine with mask once at home and felt like I was drownding and never used it again. When I was taking the overnight sleep study, I could not stand the nasal 'sticks' that were put up my nose. Recently, I have been waking up gasping for air and know I need to address this issue. In all reality, I am a newbie at this and am looking for suggestions on the best method for air flow-nasal, oral, face mask...Please advise????

Welcome back, kathy.

In theory, you should probably get a new sleep study.

In the past 8 years, CPAP machines have improved enormously, probably as much as cars improved from 1980 to now. A new machine would be a great idea.

If you start back, even with the old machine, there are a lot of people here who can help you over the rough spots in terms of using your CPAP. With help, CPAP can still be a pain in the neck, but it should be tolerable. Unfortunately, the medical system is often not much help.

What type is your old machine? Tell us all the words it says on the top of the machine.

Read the links in my signature line for help on not getting screwed by the system if you go back to the doctor.

You should probably sign up for an ID on the system so you can log in, send messages, and do other things on the board.

kathypfmp wrote:I used the cpap machine with mask once at home and felt like I was drownding and never used it again.

I'm sorry.... Most people wouldn't be using cpap if they only tried it one night and never tried it again because they had an issue. Cpap like most things in life take some effort.

I would create a new thread, include the equipment you have so that others can help you get through the issues.

The previous message was spot on about a new sleep study etc, 8 years is a long time.

Both the sleep study lab and my DME have encouraged me to use FFMs only as a last resort. The sleep study used both a WISP and ESON, the DME gave me an ESON, since then I've migrated to a Swift FX and most recently to a P10. I do have a Quattro FX for those congested nights, which have been few since starting therapy.

Pugsy wrote:

angeltink wrote:At our local DME I was told a pressure of 13 was too much for nasal pillows, but I see here that is not true. She kept trying to push me to full face mask saying that is what most people have the best luck with. I told her no way that if I could not get the nasal pillows I wanted the wisp that worked for me during my sleep study. So I have been using the wisp and love it but really want to try pillows next time. I am hoping she doesn't tell me I can't use them with my pressure again so will have to find the info saying they can be used with a pressure of 13 and will bring that in with me.

Stick to your guns and make them give you a nasal pillow mask if that's what you want. That "nasal pillows can't be used with higher pressures" thing is just an old wives tale started by someone who didn't have a clue. There are people successfully using nasal pillow masks with pressures exceeding 20 cm. I myself often see pressures up to 22 cm and I sleep right through it and only know I hit those pressures when I see the reports.

Contrary to what some people will say those nasal pillows won't go flying across the bedroom like a balloon deflating...at the higher pressures. Yeah, maybe a little more of a challenge to get to seal but so's sealing a full face mask at higher pressures.

Pressure of 13...walk in the park for nasal pillows.

If you have the money and the mind to you can get your own nasal pillow mask. EBay is a good source for the most popular nasal pillow masks...just have to know which parts to get so you can build your own mask.
Send me a private message if you are interested in going that route and I will point out which parts you need.

Thanks Pugsy. I have actually been doing just as you say and used cpap.com to see the parts and am watching prices on ebay. I may just buy the whole setup from cpap if I cant get it less on ebay. Thank you so much for your offer to help me. I get so much information just reading these forums that I have been able to figure out what I think will work best and how to get what I want.

I agree with RogerSC that it probably varies for everyone what they experience. For me it has been the sleep center that did my study that has been pushing me toward a FFM. The tech that did my titration told me "it's usually best for people to start out with a FFM." And since I didn't know any different I didn't push to try anything else. Then the DME told me that the doctor wrote my script specifically for the mask I used during the study, so they had to start with that. The RT did tell me that if it were up to here she'd start me on nasal pillows. Especially since my pressure is only 7.

When I decided to switch DMEs and to try to order a nasal pillow, I had to try to get a new RX that didn't specify FFM. When I called the sleep center they really fought me on it. And the tech I spoke to on the phone tried to tell me it was because they saw during my study that I was a mouth breather. But I tend to think he was blowing smoke, because there was absolutely no mention of it in my reports. He finally agreed to write me a new script for a nasal mask, provided I got a chin strap too.