CPAPtalk.com

Hi! tl;dr version first:
Is it true that nasal pillows or under-nose masks will make you need higher humidification when compared with nasal (triangular) or full face masks?

The longer version: I've been using CPAP for 4+ yrs and have had great success, with typically <1 events/hr/night. I have a Dreamwear nasal pillow mask that suits me well and doesn't leak. But in the last year, I've had 3 new issues: the need to increase pressure to decrease apnea events, the need to increase humidity, and I've been getting a very uncomfortable belly full of air when I side-sleep.
My local CPAP supply store recommended a chin strap explaining that if my mouth was falling open in my sleep, that might cause the air to re-route into my belly. That's been going well, but unless it's very tight, the problem comes back. So I'm trying to find a better, more comfy chin strap.
I recently switched providers due to distance and trouble with the original provider giving me the right gear, and the new provider suggested trying full face masks, which I'm in the middle of testing. But I've found that while my mouth does fall open, I'm not mouth-breathing, and this is leading to terrible apnea events skyrocketing to 11 events/hr. So I still have problems.
It's also become clear that our local providers are commissioned by certain companies: the first by F&P, current one by Resmed, so I have trouble trusting their judgement. However, she did mention that my increased need for humidity might be because I'm using nasal pillows instead of the triangular nasal mask, and if this is true, I might want to try not a full face mask, but a nasal mask. Is this true, that the pillows require higher humidification than triangular nasal masks?
Thank you!!

kboadway@gmail.com wrote: ↑

Mon Jul 19, 2021 10:34 am

Is it true that nasal pillows or under-nose masks will make you need higher humidification when compared with nasal (triangular) or full face masks?

There shouldn't be any difference in humidity needs between the mask types. That's a new on me.
I would consider that advice as high on the BS meter but a person could experiment easily enough to verify or debunk.

Air in the belly....aerophagia might be related to sleeping position but the root cause is the Lower Esophageal Sphincter being a bit weak and allowing the air to sneak into the stomach. It's supposed to stay closed but it doesn't always do that. Maybe damaged a bit from GERD....or maybe worse because of weight gain.

http://cpaptalk.com/wiki/index.php/Aerophagia

What category of events is composing that higher than you want AHI?
If they are central apneas they won't respond to more pressure and the more pressure will sure make the aerophagia worse.

Thank you for all of that info @Pugsy!! I spoke with her yesterday and she added that the pillows could also makey nightly headaches worse because they shoot air into sinuses that could cause pain. I'm suspicious, but whatever. I'm willing to try different masks!

As for the aerophagia, that it interesting. It only seems to happen to me when my jaw drops open, but I will look further into it.

Unfortunately, I don't know what category of events is causing the higher AHI. I have an F&P Sleepstyle, and this new clinician doesn't have the software required to monitor those details. However, I suspect it's obstructive because it seems to happen when my chin straps isn't tight enough, or when I'm not wearing it because I've been trying out full face masks. (I think I'm not switching to mouth breathing when that happens, and so my mouth puffs up but not enough air is going down my trachea).

I do have an Auto machine, so may try that function out to see if higher pressure may help.
Thanks again!

Why not try a soft cervical collar that would keep your chin up (if lips not sealed) and maybe help the aerophagia?

https://duckduckgo.com/?q=soft+cervical ... =h_&ia=web

kboadway@gmail.com wrote: ↑

Tue Jul 20, 2021 7:43 am

. . . shoot air into sinuses

. . .

Also complete hogwash!
Cpap pressure is not strong enough to inflate a latex balloon--
let alone force air anywhere it is not welcome.
It can waft, but no more.

kboadway@gmail.com wrote: ↑

Tue Jul 20, 2021 7:43 am

I do have an Auto machine, so may try that function out to see if higher pressure may help.

I'd recommend that you gain more insight into what's going on before revising your settings. Please try using the Oscar software (link below). You need a laptop or desktop, an SD card in your machine, and a way to read the card. Let us know if you have questions about any of that. Once you're set up, please post a Daily chart so we can see what's going on.

You might take a look at the Knightsbridge Dual Strap chinstrap, which some people like because it pulls your jaw up and not back.

Wow, I'm so glad I found you folks here on this forum, confirming my skepticism!

Miss Emerita wrote: ↑

Tue Jul 20, 2021 11:39 am

I'd recommend that you gain more insight into what's going on before revising your settings

I will try downloading Oscar and getting that info downloaded from my machine and uploaded here. Thanks also @Miss Emerita for the recommendation of the chin strap. I'd already ordered the Phillips premium one yesterday, but if that isn't comfortable, I'll give the Knightsbridge one a go.
I suspect that a full face mask is not actually what I need, but a decent chin strap that works for me, and maybe that cervical collar. I already have a night mouthguard that seems to have helped a little, since it blocks air when my lips aren't sealed to each other (my bottom lip seals on the guard
Thanks again all!!

kboadway@gmail.com wrote: ↑

Mon Jul 19, 2021 10:34 am

Hi! tl;dr version first:
Is it true that nasal pillows or under-nose masks will make you need higher humidification when compared with nasal (triangular) or full face masks?

I'd be interested to learn what this docs specialty is? TY

SAG wrote: ↑

Tue Jul 20, 2021 5:10 pm

kboadway@gmail.com wrote: ↑

Mon Jul 19, 2021 10:34 am

Hi! tl;dr version first:
Is it true that nasal pillows or under-nose masks will make you need higher humidification when compared with nasal (triangular) or full face masks?

I'd be interested to learn what this docs specialty is? TY

Hi @Sag, it's not the doc I'm dealing with, but the salesperson/CPAP specialist at the CPAP dealer. We don't deal with the docs directly here (Ontario); instead the prescription is sent to a local retailer of CPAP machines and supplies. However, I went to her simply to get a new chin strap. She presented me with a solution OTHER than a chin strap, because her philosophy is, "Why use a chin strap when you could use a full mask that covers your mouth too".
Because they're all in sales, and because it's become painfully obvious that they're in the pockets of certain manufacturers, I have trouble thinking that they truely have the knowledge I'm seeking. The previous dealer at least would check my details and work with me. This one seems hell-bent on getting me into a full face mask by presenting me with all of the BS reasons above why my nasal pillows are causing me trouble. I'm (obviously) highly skeptical. But I also want to learn if there is a good reason NOT to be using a chin strap with nasal pillows.

Yes, IC its all about the money.

kboadway@gmail.com wrote: ↑

Tue Jul 20, 2021 6:01 pm

I'm (obviously) highly skeptical. But I also want to learn if there is a good reason NOT to be using a chin strap with nasal pillows.

I would go with the mouth guard and which ever mask you wish to try. I prefer nasal but everyone is different.

There was a recent thread on here about using a neck collar and training yourself to keep your mouth closed. It's a common problem and a chin strap seldom works.

You're in a good place here with years of wisdom and posts that will help you be successful.

Don't assume that she was only out for money - full face masks are the standard go-to's for mouth breathers, and while chin straps can be helpful and collars keep your head up, I've used a FF mask x 2 decades and so have many others... and straps don't always work plus collars can't keep your lips closed. There are also 'hybrid' masks (one's called the Hybrid) that are somewhere in between, there should be a good FF one to fit you somewhere in the long list available.

Julie wrote: ↑

Tue Jul 20, 2021 6:21 pm

Don't assume that she was only out for money - full face masks are the standard go-to's for mouth breathers, and while chin straps can be helpful and collars keep your head up, I've used a FF mask x 2 decades and so have many others... and straps don't always work plus collars can't keep your lips closed. There are also 'hybrid' masks (one's called the Hybrid) that are somewhere in between, there should be a good FF one to fit you somewhere in the long list available.

Thank you @Julie! I definitely don't think FF masks aren't useful! My husband is having EXCELLENT results with his, being able to decrease his pressure and humidity for the first time in over a year, as is my bro in law, who switched about a year ago. I'm mostly skeptical that it will be helpful for me, because I immediately had spiking AHI events when I first started trying out the ff mask, something that hasn't happened since I started therapy 4+yrs ago. I also wondered about the description of the nasal pillows the clinician gave, and am extra wary because it became clear early in our discussions that she was heavily invested in Resmed while our previous person was all about F&P. She also has dismissed my high AHI results when I remove my chin strap and use the ff mask (actually, I think it is a hybrid: it's the Dreamwear FF mask, so goes under my nose and covers my mouth), so I'm reaching out for more info. I like being as informed as possible about my health. That's why I'm so glad I found you all here!! I'm definitely still trying out the new hybrid/FF mask this week to see if it is any better for me than my nasal pillow Dreamwear. I'll keep you posted!

SAG wrote: ↑

Tue Jul 20, 2021 6:21 pm

I would go with the mouth guard and which ever mask you wish to try. I prefer nasal but everyone is different.

There was a recent thread on here about using a neck collar and training yourself to keep your mouth closed. It's a common problem and a chin strap seldom works.

You're in a good place here with years of wisdom and posts that will help you be successful.

Thank you so much!!! I'll take a look for that thread you mentioned, and am looking forward to learning more!!

Found it
kteague has a lot of helpful posts

viewtopic.php?f=1&t=182510&p=1389565&hi ... e#p1389565