Experiment: FFM + Mouth Tape

I am missing the reason that you are taping with a FFM like the Quattro; theoretically it should not be necessary to do so. Also, am wondering if I would be throwing a monkey wrench into your research by suggesting that you consider including the infamous PAPCAP PLUS 4 in the mix. It is supposed to raise the flesh on the front of the chin along with the lower lip by up to one cm. and reduce or eliminate mouth breathing. Not being a fan of taping for personal reasons, I have been having good fortune with the Mirage Activa LT (almost zero leakage unless I 'smoosh' it against the pillow while sleeping) and I expect that with the supposedly improved headgear provided by the PAPCAP PLUS 4 and its chin gear I will find that the combination results in (hopefully) zero mouth breathing plus a better seal simply due to the distribution of the forces on the Mirage Activa LT from the PAPCAP PLUS 4's straps.

I have also ordered a Quattro with headgear and am going to try it out with the PAPCAP if it works with it.... an interesting combination as theoretically one should not need to eliminate mouth breathing with a full face mask and in fact may wish to make mouth breathing easier for those with sinus issues. So my trial of the Quattro and the PAPCAP FOUR PLUS will be purely from a curiousity standpoint; i.e. does it hold the Quattro against my face any better than the regular headgear. I have really ordered it for use with several nosebags and nose pillows to see what I can see.

I enjoyed using my nose pillows when I had them but had major issues with leakage and flow stoppage when they were 'smooshed' against the pillow. With the nosebags like the Mirage Activa LT, no flow stoppage of course, but I did experience minor leakage when 'smooshed' against the pillow unless the mask was well tightened down to the point of discomfort.

I will watch your thread here with interest. My next hurdle is the mask thing and while I am not doing too badly with masks I seek perfection for my ugly face. (Got hit by a brick when I was a kid).

The blower thing seems to be under control with the S9 Auto and its accoutrements.

Next hurdle to attack will be the RVing thing. We have been out looking at RV's and trailers and want to be ready to buy one and use it half the year in about 18 months time. That means varying climates and humidities and elevations and power requirements and so on. This is great fun for a techie with a portable soldering iron.

torontoCPAPguy wrote:I am missing the reason that you are taping with a FFM like the Quattro; theoretically it should not be necessary to do so.

I was getting bad results with the Quattro and good results with the Activa+tape. If I Quattro+tape, then:

1) If my results are bad (like with the Quattro alone), then the problem was the Quattro;

2) If my results are good (like with the Activa+tape), then the solution isn't the Activa, it's the tape.

Maybe.

What were your conclusions? I didn't see them posted.
In the interests of science, I'd like to share my experience.
After months of nearly a perfect fit, I started to have major leak problems with my Quattro (seal wasn't too old, but changed it anyway), so I drug out my old Swift Lt nasal pillows which I had abandoned years ago because of mouth leaks. The swift was so light and unobtrusive, I thought, wow, I gotta go back to this.
So, I tried it. Only made it a few hours and I had to switch it out because mouth leaks were waking me up. Put on my Quattro, changed the machine setting and went back to sleep. Leaked a little, but didn't wake me up. On review of the data, the results were about the same. Both masks produced a leak rate, at times, well above .40 L/s. and AHI's above 6 (high for me).
Determined to make the nasal pillows work, last night I used a tape chin strap (just in front of one ear, under front of chin to just in front of the other ear) with Polygrip seal strip between my lips. Well, I made it almost 3.5 hours until I became so uncomfortable I had to switch out the masks again. At the time, I wasn't sure why I was uncomfortable, I just knew I had to get that thing off my face. So, back on went the Quattro (tape strap and seal still in place) and I slept rather well another 3. 5 hours or so.
The data were remarkable. Leak rate ave for pillows: =0.36L/s, many above 0.40, max=0.60, AHI=6.7 For the quattro: Ave=0.01L/s, max=0.10, AHI=2.6 (a significan drop across the board from the night before)
I was not aware of either mask leaking around the seal. I was aware of the some back of the throat leakage with the pillows and the pillows leak rate was the highest preceeding and up to the point of wakening, as was the AHI
From this I conclude ( though, I know one can't draw conclusions from one data point): I can not stop mouth (throat) leaks while wearing pillows. FFM reduces or eliminates mouth leaks. Chin strap prevents FFM from leaking.

brain_cloud wrote:Leak info is as follows: Leak is negligible when using the Quattro, with and without tape. Leak with the Activa happens, but not on a scale to cast the data into doubt. Leak is not a factor here.

Obviously, you are not supposed to need tape or any other artifice to ensure mouth closing when using a FFM. In theory, theory and practice agree; in practice, they don't.

I also found that taping under a FFM yielded lower AHI. At 8mm pressure, my AHI w/ an FFM and no tape was 1.8-3.3, average 2.4 (sd 0.45). w/ an FFM and tape, range was 0.4 - 2.3, avg 1.3 (sd 0.6). It's not a lot of data points, but the ranges hardly even overlap, it was a clear drop of 1 in my AHI (untaped AHI < 2.0 1 of 8 nights, taped AHI < 2.0 6 of 7 nights).

Clearly opening the mouth has negative effects besides leak & loss of pressure - ie changes in jaw/tongue position, airway shape, etc. So if you are using an FFM, please try mouth sealing and see if it helps you. (This supplements Velbor's advice that if you are using a nasal mask, please try mouth unsealing and see if it helps you ).

since you have activa results that i would kill for, why are you bothering with trying to get a different mask to work?