Full face and pillow masks -> different pressure and AHI

Hi,

I have recently been diagnosed with apnea (AHI ~60) and started to use a ResMed AirSense A10 Autoset (range set to 5-20). I have the Resmed Airfit F10 full face and P10 pillow masks as well as the Respironics Wisp nasal mask.

I found the Wisp less useful - it comes with the disadvantages of both the full face mask (covers my nose) and the pillows (leaking if I open my mouth).

Both the P10 and the F10 work fine. I found the F10 has a slight edge as I can open my mouth, even talk with this mask on, and it does not irritate my nose like the P10. I found it easier to breath with it, too. (in the other hand at higher pressures - ref. below - it does leak if I don't tighten it really hard)

However, checking the data on ResScan, the machine registers much more AHI event with the F10 mask (AHI ~5) than with the P10 mask (AHI between 1-2). The pressure is also significantly higher with the F10, it goes up to 13 at times, while with the P10 it never goes above 6-7 tops...

Ref. below the ResScan graph for the P10 and the F10 one day apart, otherwise under the same conditions.

F10 full face:


P10 pillow (next day):


So I wonder whether the machine fails to record a bunch of events with the pillow mask, or is the P10 pillows really that much better in maintaining much less AHI event with significantly lower pressure.

What do you think about it?

Thanks and BR,

Rudy

Its not really possible to draw conclusion with only one night on each mask. Therefore, it can be misleading.

I'd suggest that you use the same mask for at least three days to be sure that you didn't have some fluke with single night readings.

Another point worth mentioning is to ask yourself if you sleep better with one mask versus another.

Glad you did so well with the F10. I couldn't get a good fit which caused all kinds of leaks during the night. Wound up with the P10.

Hi,

Thanks for the response. Of course I studied this issue for a good two weeks, the posted graphs are just the latest ones. The conclusion is the same for every night: significantly higher pressure and more AHI event with the F10.

I personally find it easier to breath in the F10 (I assume because there is some room in the mask to breath into). The P10 however is less restricted/obstructive.

In the end I'm fine with both, but if the P10 can provide so much better result (i.e. much less AHI event at a significantly lower pressure) then the choice is obvious.... I just wonder if this is really the case or it is just the machine records data differently with the two masks. I mean the P10 comes with so much better result which makes me suspicious...

BR, Rudy

It's not uncommon to need a little more pressure with a full face mask than with a nasal interface mask.
While in theory X amount of pressure should work the same no matter which way it gets to the airway I have seen too many reports like yours to say it can't happen.
Sometimes as much as 2 to 3 cm difference.

I usually tell people to use the mask that they can sleep the best with and let's them feel the best during the day and if they prefer a FFM and need a little more pressure then use a little more pressure. In the case of people using apap mode...a little more minimum pressure will usually do the trick.

I actually posted the same type of question.

viewtopic/t106964/Full-Face-Mask-and-hi ... ments.html

So the big question for me is:

Being on straight CPAP and titrated at 13.0 using a Nasal mask (Ultra Mirage™ II Nasal CPAP Mask) and switch to a Full Face mask like the AirFit F10 would I increase the pressure to 15.0-16.0, and if I switched to Nasal Pillow mask like the AirFit P10 would I need to lower the pressure to 10.0-11.0.

fdw wrote:So the big question for me is:

Being on straight CPAP and titrated at 13.0 using a Nasal mask (Ultra Mirage™ II Nasal CPAP Mask) and switch to a Full Face mask like the AirFit F10 would I increase the pressure to 15.0-16.0, and if I switched to Nasal Pillow mask like the AirFit P10 would I need to lower the pressure to 10.0-11.0.

There's no black and white answer...there's the "it depends" answer.
Not everyone sees any change in pressure needs no matter what mask they are using.
It's some people need more or less pressure...we have no way to know which category you will be in.
While it is common to need more pressure when going to a FFM from nasal pillows...just as many people don't see a need for pressure change. It's another one of those cpap things that come with the big YMMV sticker.

All we can tell you is try it and see what happens.

Pugsy wrote:

fdw wrote:So the big question for me is:

Being on straight CPAP and titrated at 13.0 using a Nasal mask (Ultra Mirage™ II Nasal CPAP Mask) and switch to a Full Face mask like the AirFit F10 would I increase the pressure to 15.0-16.0, and if I switched to Nasal Pillow mask like the AirFit P10 would I need to lower the pressure to 10.0-11.0.

There's no black and white answer...there's the "it depends" answer.
Not everyone sees any change in pressure needs no matter what mask they are using.
It's some people need more or less pressure...we have no way to know which category you will be in.
While it is common to need more pressure when going to a FFM from nasal pillows..

I like the "a ffm pulls your jaw back, narrowing the airway a bit" theory.

personally, when using pillows, I've noticed a lot of times when I wake up, that my lower jaw is pushed forward a little from (I guess) the air pressure. so much so that my lower teeth are even, or a bit in front of my uppers, whereas when I had on the ffm, my lower front teeth were in their normal resting position just behind upper front teeth. it's not much difference, but it is a little.

palerider wrote:I like the "a ffm pulls your jaw back, narrowing the airway a bit" theory.

I could see it happening/doing that. Over on the sleep tech board they used to talk about that a lot.
Given I have only used a FFM a grand total of one night...and it has been so long ago that I forgot what it might have done to my jaw...I really can't do more than "maybe" but if I decide to try out the new Amara View I might go off the Adapt and back to plain bilevel auto just to see what happens with my pressure needs if I can stand it for more than 1 night.
It is logical though and I think maybe even more so if someone ends up on the back.