Full Face Masks that go under chin

Last week I got a F&P Forma FFM. I was a bit hesitant to get it due to the ratings on cpap.com, but it was the only FFM my DME had in stock that went under the chin and I wanted to give one of those a try since I still can't get the Quattro to be comfortable with out leaking.

Overall, I am very pleased with the Forma. I can turn from sleeping side to side and it doesn't shift and leak. I how it goes under the chin a lot as it is more comfortable than right under the lower lip and with the chin support, it acts like a chinstrap. I've only been using it since Friday, but I haven't woken up with a dry mouth yet, and I did every morning with the Quattro and Comfortgel Nasal. The bridge of the nose is still taking a beating, but I guess that is par for the course for a PAPer. I would also prefer it have a quick hose disconnect like the Resmeds do, but oh well you can't have everything.

What do others think of FFM that go under the chin? Are there other models you prefer than the Forma? I'm specifically interested in comfort, ease of use, and of course effectiveness. For the Forma i'd give comfort and 6 out of 10, the bridge of the nose is just sore every day and wearing glasses doesn't hurt i'm sure. For ease of use, it's a 8 out of 10. The chin support has an extra strap that was a little tricky at first, but once figured oui the straps work okay. For effectiveness, I don't know, I need to go get re-titrated because my numbers are still high. I'll probably go next month.

I stuck with the BiPAP for now rather than switching to the APAP. Apparently i'm on BiPAP because normal CPAP gave me centrals. What's the normal protocol of what to go to next if the BiPAP doesn't work? The doctor said something about a machine that would monitor breathing patterns and if it didn't count one during a certain period of time it would initiate breathing for me? That sounds sort of like a ventilator to this un-educated fellar which sounds positively unpleasant.

You can add this quick disconnect to any mask:

https://www.cpap.com/productpage/hose-q ... nnect.html

As for BiPAPs, the base models don't try to initiate breathing if you don't. More sophisticated (and expensive) models do.

Mask2sleep wrote:I stuck with the BiPAP for now rather than switching to the APAP. Apparently i'm on BiPAP because normal CPAP gave me centrals. What's the normal protocol of what to go to next if the BiPAP doesn't work? The doctor said something about a machine that would monitor breathing patterns and if it didn't count one during a certain period of time it would initiate breathing for me? That sounds sort of like a ventilator to this un-educated fellar which sounds positively unpleasant.

Not that unpleasant. I went from cpap to bipap then ventilator in record time (less than 3 months). Mine initiates a few breaths for me each night, several of which are usually before I fall asleep. I've gotten used to it and it's not that bad.

Seriously, if you need something like that, the most unpleasant part about it is the cost. Beyond that, it is so much more versatile and adjustable than the cpaps or bipaps.

But keep in mind that I am pretty certain that are other options available that might be able to provide you with proper treatment that are not ventilators. My condition is a little unusual and made my doctor go straight to ventilator after failing on bipap. You may have other, less invasive and expensive, options.

Mask2sleep wrote:... The bridge of the nose is still taking a beating, but I guess that is par for the course for a PAPer. ...
What do others think of FFM that go under the chin? Are there other models you prefer than the Forma? ....

The Hybrid mask, https://www.cpap.com/productpage/RespCa ... -Mask.html , does not touch the nose bridge and has a chin flap.

I use the F&P flexifit 431, and there's also the 432 which is padded. The chin shelf is great for my mouth breathing (I used to have a bad habit of chewing on my blankets in my sleep and it's taken care of that, too).

If the BiPAP doesn't work, the machine you are thinking of is the ASV. I'm probably heading in that direction myself. I was on CPAP for three weeks, been on auto BiPAP for three nights, and my AHI is not good.

Bons wrote:I use the F&P flexifit 431, and there's also the 432 which is padded.

I also use the 431 as well and have pretty much stopped trying other masks. I did try the 432 which I had high hopes for, but something about the extra foam padding did not work for me. I'm guessing I had it a little too tight because it gave me a nasty blister on my face! I gave up on that after one night and went back to my trusty 431!

Thanks for the info!

Mask2sleep wrote:Apparently i'm on BiPAP because normal CPAP gave me centrals. What's the normal protocol of what to go to next if the BiPAP doesn't work? The doctor said something about a machine that would monitor breathing patterns and if it didn't count one during a certain period of time it would initiate breathing for me? That sounds sort of like a ventilator to this un-educated fellar which sounds positively unpleasant.

Probably the doctor is thinking about a BiPAP S/T instead of a simple BiPAP. S/T stands for spontaneous/timed.

Spontaneous means regular bilevel mode, like the BiPAP Pro you're on uses... following your lead. Using the higher IPAP pressure when you start to breathe in. Using the lower EPAP pressure when you start to breathe out.

Timed means the machine would be set for your same IPAP/EPAP pressures, but a "timed backup rate" would be set. If the machine sees that the number of breaths you are initiating on your own isn't going to meet the "breaths per minute" -- like 14 bpm, or 10 bpm, whatever the doc prescribes the timed backup rate to be set for -- the machine will switch between IPAP/EPAP regardless of whether you yourself happen to be breathing out at the moment. The timed switching up to IPAP is supposed to nudge you into taking more breaths. Can feel rather disconcerting to be breathing out and feel the machine suddenly start delivering the higher IPAP, if you're awake. And perhaps could be disruptive to someone sleeping.

As long as you were breathing in and out at a rate that meets or exceeds the "breaths per minute" timed setting, an S/T machine won't do that switching on its own. Even with a timed rate set, it would work (and feel) "spontaneous" just like your BiPAP Pro works... following your lead as long as the number of breaths you were taking were meeting or exceeding the "timed" setting each minute.

The doctor could, as Bons suggested, have in mind an ASV (adaptive servo ventilator) machine which is very different from a bilevel S/T machine and is probably much more effective than using an S/T machine for treating centrals. But I think most doctors still think of "S/T" when thinking about how to treat persistent "centrals." My guess is your doctor is most likely thinking "bilevel S/T" next. Me, I'd want to skip S/T and get on an ASV if centrals were a problem that really needed treating.

I have F&P Forma which has the chin support and it is a good mask, but I found the fore head support was annoying me and moving the mask when I tossed and turned. Went to the Resperonics FitLife because it had no forehead piece and it doesn't leak, but I am using the silicone nose cushion which helps to seal the bridge of the nose. I also just got my S9 Auto which shows all leak info which is very good. The FitLife does not leak and I am a belly sleeper so my face is half in the pillow. I am going to be testing my Forma again with my S9 auto and the silcone nose cushion to see if I can get a good seal. But will probably stick with my FitLife as the forehead piece was the issue.

As to your question the chin support is good for keeping your mouth closed, but I am on a higher pressure around 15 which was set by my doctor to compensate for mouth breathing. My second sleep study they were looking for this. One problem I had was the fact that if I was yawning it did shift the mask a bit if I did not tighten it down.

Hope that helps

Out with the Forma... two reasons.

One, It's beating the heck out of the bridge of my nose and I was starting to get an actual wound there from use. Second, halfway through the night air starts leaking out the bottom of the chin area and sounds like a outboard boat motor... my wife actually went downstairs and slept on the couch two nights ago it was so bad.

So now i'm going to try a wholly different kind of mask, the Mirage Liberty. No forehead straps, no mask on the bridge of the nose.... here's hoping! The DME has shipped it and a return box for the Forma, so i'll hopefully have it by the end of the week. I am really hoping this works as this is getting very frustrating, there's got to be a mask out there that works!