First 4 nights switching to F20 mask from P10. Review and questions.

Hi.

I've been using a p10 mask for a year and until recently decided to try a full face mask. (I'm tired of trying different methods to solve mouth leak/chipmunk chin).

So I order a ResMed airfit F20 mask (LARGE size) and try out.

The good news is that firstly I don't have claustrophobia and secondly the mask seal perfectly (mask leak is even lower than P10, amazing) and I felt comfortable wearing it.

The bad news is that as soon as I put on F20 for the first time, I could clearly feel that it does not blow enough air into my lung compared with the nasal mask-- it felt like the air from the tube firstly blow into the space btw the mask and my face, which "diluting" the pressure. I heard before that a Full face mask typically requires a higher pressure setting than a nasal mask -- so I dial up the pressure setting from APAP 11-14 to APAP 12-20.

3 nights in, I could see some patterns by reviewing my oscar data.
1. There are tons of FLOW LIMITS in my oscar chart but the pressure never went up beyond 15 mmh2o. (I never have any flow limits when using nasal mask)
2. There is 1-2 RERA per night which rarely occur when I'm using a nasal mask. I could remember I woke up several times a night but could remember why.
3. I feel ok for one night and suboptimal for the other nights. The overall sleep quality correlates well with if and how many times I woke up during the night.

I tried to figure out what the heck is Flow limits and RERA and into the rabbit hole of Upper airway resistance syndrome. I'm still confused that if the machine sense there is resistance from "flow limits' why dont it just increase the flow pressure to overcome it? And is it bc my mask is too big that there is too large a space under it that the air is diluted before reaching my nose?

first night 2nd night 3rd night

ah, it says I have reached my board attachment quota and I could not attach another pic here in the reply.

Three attachments PER POST is the limit.
You should be able to add another attachment in another post unless the forum storage is full again.

You are using the for Her apap mode. You might try the regular auto mode instead of the for Her mode.

Pugsy made a good suggestion to switch out of the For Her mode. But beyond that:

Beat OSA wrote: ↑

Fri Apr 29, 2022 11:02 pm

And is it bc my mask is too big that there is too large a space under it that the air is diluted before reaching my nose?

No. Basic physics shows that within an enclosed space, the pressure is the same throughout. Could it be that your mask is pinching the nose slightly?

Beat OSA wrote: ↑

Fri Apr 29, 2022 11:02 pm

I heard before that a Full face mask typically requires a higher pressure setting than a nasal mask

This is misinformation that gets spread repeatedly. FFMs are used because the patient cannot keep his mouth shut. In human anatomy, when the mouth opens, the lower jaw moves back slightly. This tends to restrict the airway. So, it's the open mouth that causes a need for higher pressures.

Give yourself some time to get used to it. On a different note, consider turning on EPR and set it to 3 to get some control over the flow limits that are driving up the pressure.

ChicagoGranny wrote: ↑

Sat Apr 30, 2022 5:29 am

Beat OSA wrote: ↑

Fri Apr 29, 2022 11:02 pm

I heard before that a Full face mask typically requires a higher pressure setting than a nasal mask

This is misinformation that gets spread repeatedly.

Because it's true.

ChicagoGranny wrote: ↑

Sat Apr 30, 2022 5:29 am

FFMs are used because the patient cannot keep his mouth shut. In human anatomy, when the mouth opens, the lower jaw moves back slightly. This tends to restrict the airway. So, it's the open mouth that causes a need for higher pressures.

Then why, praytell, is the *natural* reaction to not being able to get enough air the process of opening one's mouth to gasp?

If it really narrowed the airway as you claim, then people gasping for breath would get less than if they kept their mouth shut.

Some thing that is patently false.

My pressure needs dropped a couple CMs when I switched from a FFM to nasal pillows, many *many* other people have had the same response.

My mouth was not open with my FFM, because when I would open my mouth purposefully, the lower part of the mask would end up in my open mouth.

You're welcome to your unsubstantiated theories, however, I just wish you'd quit trying to spread them.

OP, did you change the setting on your machine to full face mask instead of nasal? I'm not sure what that changes but it might be needed.

figby wrote: ↑

Mon May 02, 2022 8:54 pm

OP, did you change the setting on your machine to full face mask instead of nasal? I'm not sure what that changes but it might be needed.

He did, Oscar reports it on the bottom left, in Machine Settings

palerider wrote: ↑

Mon May 02, 2022 5:38 pm

My mouth was not open with my FFM, because when I would open my mouth purposefully, the lower part of the mask would end up in my open mouth.

I had the opposite experience with the FFM mask I used for the past 10 years ( FP 431). If I purposely opened my mouth the mask still captured the flow from my mouth. Perhaps because the 431 has a small shelf that fits under the chin - resisting dropping the mandible.

In any event, my personal experience with “mouth breathing while relaxed / sleeping ) is where I part my lips (opening the oral pathway) perhaps a quarter to three-eighths of an inch without perceptibly lowering the mandible.

Of course gasping or heavy breathing after exercise is a whole different matter.

palerider wrote: ↑

Mon May 02, 2022 5:38 pm

Then why, praytell, is the *natural* reaction to not being able to get enough air the process of opening one's mouth to gasp?

Opening one's mouth to "gasp" has nothing to do with sleep apnea. The gasper is awake and flexes the airway muscles open to take in more air. This is very different than a sleeping person.

If it really narrowed the airway as you claim, then people gasping for breath would get less than if they kept their mouth shut.

Same answer.

palerider wrote: ↑

Mon May 02, 2022 5:38 pm

My mouth was not open with my FFM, because when I would open my mouth purposefully, the lower part of the mask would end up in my open mouth.

So, your FFM was not functioning as an FFM. It's a logic-fail to think an FFM that is not functioning as FFM has anything to say about differing pressures in mask types.

ChicagoGranny wrote: ↑

Tue May 03, 2022 12:26 pm

palerider wrote: ↑

Mon May 02, 2022 5:38 pm

My mouth was not open with my FFM, because when I would open my mouth purposefully, the lower part of the mask would end up in my open mouth.

So, your FFM was not functioning as an FFM. It's a logic-fail to think an FFM that is not functioning as FFM has anything to say about differing pressures in mask types.

It's pretty clear that you have no idea what you're gibbering about.

Are you losing it? You no longer know how to use the quote function.

PR, I hope you are OK.

ChicagoGranny wrote: ↑

Wed May 04, 2022 11:13 am

Are you losing it? You no longer know how to use the quote function.

PR, I hope you are OK.

Missed a ], fixed.

We've been worrying about you, and your absurd fixation trying to deny all the people who've reported lower pressure needs with nasal/pillow masks vs FFM...

Of course your:

ChicagoGranny wrote: ↑

Tue May 03, 2022 12:26 pm

So, your FFM was not functioning as an FFM

was somewhat concerning.

One does not have to open one's mandible in order to breath through, or leak through, one's lips, so your assertion was ridiculous.

palerider wrote: ↑

Wed May 04, 2022 3:25 pm

trying to deny all the people who've reported lower pressure needs with nasal/pillow masks vs FFM...

Like you and three other people who post it repeatedly. That's far from convincing evidence.

ChicagoGranny wrote: ↑

Wed May 04, 2022 3:49 pm

palerider wrote: ↑

Wed May 04, 2022 3:25 pm

trying to deny all the people who've reported lower pressure needs with nasal/pillow masks vs FFM...

Like you and three other people who post it repeatedly. That's far from convincing evidence.

Facts is facts, your denial notwithstanding.
It's been many more than 'three'.