Has anyone switched from a FFM to nasal pillows successfully

I'm doing really well on my Liberty hybrid FFM but feeling claustrophic with the full mask...I talked to my doctor to switch to nasal pillows. He thinks I should go for it - my AHI with the FFM is 0.0-0.2 and even though my mouth opens when I sleep - he thought I should give it a go since I have such low AHI with the FFM.

I tried the nasal pillows last night and my AHI went up to .6 and I did feel myself waking up due to air leaking out of my mouth, etc. I felt tired today - I nearly fell asleep during an executive presentation but really, to be honest - he was an incredibly bland speaker. I'm a little unclear now because my doctor did want me to try nasal pillows for a 'few days in a row' to see if I could adjust. I'm on the fence about doing the nasal pillows again tonight - I'd like to be a little less tired tomorrow at work - but thinking maybe I could do the nasal pillows tonight then switch to my FFM in the middle of the night if I don't feel like I am getting good sleep.

All of this to say - has anyone here successfully transitioned from a FFM to nasal pillows - and happy with it? Please share - I could use some encouragement here...on one hand, I may just stick with the FFM since I am doing so well on it but it's just SO MUCH STUFF on my face....but then I feel bad complaining...my life could definitely be a lot worse!

Some of us former mouth breathers put a lot of time and effort into being able to use the nasal pillows. Tried everything from taping my lips, securing them with denture adhesive, c-shaped pillow and later cervical collar to support neck and hold chin up, facial tape to hold chin and jaw up, chin straps galore... is that enough? Yeah, I was determined to make it work, and at some point I quit mouth breathing and have no need of Figured if I can breathe through my nose any other time, why not at night? Was it worth maybe a year at least of hassle? I'd like to think so, especially since I've been using the treatment for over ten years now. Got a family member who has no desire to make any effort to getting away from a full face mask. It's a no brainer for her - she throws the mask on and doesn't have to worry about mouth breathing. If your FF mask is working well for you, it's up to you if you want to experiment. If you are watching your data, observe your leak statistics and see if there's any sign of trouble.

mint0101 wrote: has anyone here successfully transitioned from a FFM to nasal pillows

Yes - people who can keep their mouth closed.

If you can't keep your mouth closed, use the FFM.

Yes...it can be done.
I know of one in particular that comes to mind because I had to really twist his arm to at least try nasal pillows.
I can't seem to find his post about his success at the moment but I will continue to look for it and will post a link to it if I can find it later.

Like any mask change...it can be a bit awkward the first night or two. Perhaps try it on the weekend???

Yes, it can be done. Could be me Pugsy was referring to. But it may not be as simple as "keeping the mouth closed". Some have a poor seal at the oropharynx which allows pressurized air from the cpap to leak into the oral cavity. This can occur regardless of the mouth being open or closed. If the lips are taped shut, no air can escape and the cheeks can become inflated (chipmunk cheeks) from the pressure. This can be as disturbing as the air leaking past the lips. Learning to minimize the leak by improving the seal can help. Keeping the tip of the tongue at the roof of the mouth just behind the teeth helps to close the seal. Making a "K" sound closes the seal. I think the brain can learn these things while sleeping, but it takes a while and a person may have to accept some leakage while doing so.

I was one of the ones that thought it couldn't be done, but when a FFM became intolerable do to nerve irritation at the back of the head, I had no choice. I changed to pillows over a year ago (after six or so years with a FFM and unsuccessful prior attempts) and the transition has been successful. I still get some leakage, but it doesn't affect therapy and it doesn't wake me or cause dry mouth.

I now use the ResMed P10 and switch off with the Dreamwear. I have not worn a FFM once in well over a year.

I found it.
Look for post by Perrybucsdad
viewtopic/p663440/Mouth-Breathers.html#p663440

Jay & Pugsy- thank you!

I had .7 AHI last night and my leak rate was all over the place...strange enough, I feel better this morning (2nd night with nasal pillows) than yesterday...the median leak rate for last night was 3.8 and the first night (two nights ago) media leak rate was higher, 8.6.

The 95% leak rates are still pretty high (26.4 last night vs 31.2 for the first night w nasal pillows)

Since I feel better I thought I noticed that I woke myself up less with the mouth leaks last night...compared to the first night so that's something..?

Any further advice would be appreciated, folks - there is hope I guess, to moving to nasal pillows...yay!

Pugsy, I'll read the thread you sent shortly...need to get ready for work!

mint0101 wrote: The 95% leak rates are still pretty high (26.4 last night vs 31.2 for the first night w nasal pillows)

Remember that 95% numbers are by definition where a person was at OR below that number for 95% of the night and they can be easily skewed to look worse than they really are. People seem to forget the "or below" part of the definition.
So be sure to look at the leak graph itself for overall leak evaluation to see just how much time might have been spent in large leak territory. It would be real easy for a relatively short time in large leak to elevate that 26 L/min 95% number.

I have a good example of how the 95% numbers are easily skewed in this thread.
viewtopic.php?f=1&t=108724&p=1036669&hi ... t#p1036669

Pugsy - first of all - thank you - that previous thread on mouth breathing was so enlightening - I always wondered if the FFM did pull back on my lower jaw to make apneas worse - it totally makes sense. I got the RF nasal turbinoplasty a few months ago which has been so incredibly helpful in my daytime breathing, which makes it easier to breathe at night too. I am not sure what a "good" leak graph looks like so I guess I'll just keep on tracking the trends and seeing how I feel....the 95% leak rate doesn't seem very accurate, as you said - will definitely keep that in mind.

I feel better today so I'll just keep on using the nasal pillow and adjusting as needed - trying to stay away from the chinstrap because I grind my teeth at night...I'll see how long it'll be before I miss the 0.0 AHIs I used to get with the FFM....wish me luck!

A "good" leak graph for me doesn't always look real pretty.
As long as I don't spend much time in large leak territory AND the leaks don't wake me up then I don't really care how "pretty" the leak line is.
I also factor in just how far I might go into large leak territory (if I go there) because a little bit past 24 L/min probably isn't going to affect the machine's sensing and reporting but way deep into large leak territory will affect the machine's ability to do it's job.

So my first criteria is
do the leaks wake me up or not...if they don't then I look to see just how much time I might have spent deep in large leak territory (I use 35 L/min as my "deep" line because up to that amount of leak the machine will still do a decent enough job reporting events).
5 minutes in deep large leak territory isn't the end of the world....now 50 minutes is a different story.

If leaks wake me up then they need to be fixed no matter how bad they are...so the "do they wake me up" thing is my starting point for evaluation. Anything that wakes me up is unwanted and needs to be worked on.
After that then I don't really care how pretty that leak graph is...it's nice to see a nice low straight leak line with minimal leaks but I won't worry if it isn't real pretty.
Also remember that not all leaking is for sure from the mouth....we can have mask movement leaking as well and it's not always easy to know what the cause of the leak might be.

I switched from a Mirage Quatro FFM to an AirFit P10. The quatro caused too many leaks when on my side. The AirFit resolved that issue and my numbers on the ResMed site are consistently in the 98 range with events being in the .05 and below. I am completely satisfied with the change (about 7 months ago).

I hope this helps.