Nasal mask with high pressure?

I have been trying to use my cpap for about 5-6 weeks and it is hit or miss with getting a proper seal with a full face mask. If the seal is too tight I feel like I'm not getting air in. Usually I need a slight leak in order to get the air (the manual said this is normal). The problem is that when I turn over in my sleep, the seal breaks and sometimes it takes me an hour to get a good seal so I can hopefully go back to sleep. My question is on a pressure of 14 would a nasal mask work? The therapist said nasal pillows wouldn't work with that high of a pressure.

People using 18 cm pressure, and more, use nasal pillows and nasal (over the nose masks) all the time.
I see 16 to 18 cm often on my reports and I never know it till I see the reports and my leaks are minimal 99% of the time and the times I have some leaks aren't because of the pressure. It's an old wives tale that high pressures won't work with nasal masks. A pressure of 14...isn't really that high anyway. If you want to try a nasal mask...try one...there is no reason at all that you couldn't use one based on your pressure needs. My IPAP pressure on my bilevel starts out at 13 every night and I saw 17 on my report from last night. No problems at all.

I use a Nasal mask and my APAP pressure is set to 14 cmH2O - 18 cmH2O. I have been as high as 18 cmH2O (happened about 4 - 5 months ago when I had one of 'those nights', according to SleepyHead) and my leak rate was still with-in my normal range for my mask and did not have a negative effect on my therapy or sleep.

John

Thank you for your responses. I found out that I am a mouth breather. Since using the cpap I have woken up many times because of extremely dry mouth. I have just about solved it with the humidifier at 4. However there are still nights that I have dry mouth. At the hospital, the therapist said if I am a mouth breather that I should use a full face mask. I've heard of chin straps. Would a nasal mask work if I wore a chin strap?

Chin straps are sufficient for some people to keep their mouths closed and not sufficient for others.
Can you normally breathe through your nose just fine during the day or do you have some sort of nasal problem that causes mouth breathing during the day also. If so, chin strap is not likely to help much because they aren't vises and one can usually open the mouth if they try. They are designed more to be gentle reminders to keep the mouth shut.

If you normally breathe through your nose just fine during the day and the mouth breathing is perhaps just a habit at night from maybe repeated gasping for breath because of apnea events, then you might be able to unlearn that habit. I did. It took me about 2 months. I opted to tape my mouth though. I tried a few chin straps but I have a small head and they just weren't snug enough to "remind" my mouth to stay shut very well. They tended to slide off my head..
After about 2 months I got lazy and kept forgetting to tape until lights were out and I was comfortable so I sort of blew it off more and more often. I watched my reports and my leaks weren't excessive.
I rarely see any evidence of mouth breathing enough to maybe impact therapy. I know that on a rare occasion I might wake up, usually on my back, with my mouth open and mouth as dry as the Sahara but when I check my reports I don't see any evidence of huge leaks. In fact..no real leaks to speak of so I assume that the time I have spent with mouth open was very minimal since it doesn't even show up as a leak spike on my reports. It doesn't take much mouth breathing to dry out the mouth. For me when it happens now I just shrug my shoulders and move on. If it isn't long enough to even show up on a report then it is very short lived and won't impact my therapy all that much if at all.

Some people have found that they thought they had to mouth breathe due to nasal congestion but once using a nasal mask that the air and the moisture actually helps open up the nasal passages and they breathe just fine and love the nasal mask because of that added benefit along with the comfort.

Unless you have major nasal congestion that just won't clear up enough to breathe through your nose only...there is no reason not to try some sort of nasal pillow if you want to. You won't ever know unless you try.
If you want to try a nasal pillow mask and your insurance is not yet time for replacement, there are ways to get a new mask and not break the bank. Ebay allows replacement parts to be sold because replacement parts don't require RX.
Buy the replacement parts and build your own mask. I know one person who got the headgear and short hose assembly for the swift FX for $35...nasal pillow another $15 and she had a brand new Swift FX nasal pillow mask. Gotta know your parts though to do that...also not all masks are common to EBay...just the most popular ones.

I have no problem breathing through my nose day or night. In the past I never woke up with dry mouth. My dentist just prescribed a mouth guard because she said I am grinding my teeth at night. If I truely am a mouth breather, how could I be grinding my teeth? Tonight I will try sleeping with a mouth guard AND the face mask!

I will call the DME and ask about switching to a nasal mask. The first time the respiratory therapist came to my home with the equipment, I tried both masks. I liked the face mask because that is what I was comfortable with during the sleep study. So the therapist said something like, "OK you just used your mask switch...." I take it that meant I won't be covered if I try to switch again. I'll ask. I'll also look into what you said about online purchases. Thank you!

Most mask manufacturers allow 30 days for each mask as a trial.
DMEs often come up with their own "in house" rules about switching masks and how many "free tries" you get. They do it so they don't have to keep doing repeated paperwork to get credit for the returns. The mask manufacturers are the ones who offer the 30 day thing.. DMEs often keep that little tidbit under wraps. My DME had a 60 day time frame for swapping out masks. That was their own "in house" rule. Didn't need it because my original mask choice the Swift LT ended up being perfect and I only switched to the Swift FX because it came out later and wasn't available when I first started therapy.
I did purchase some others on my own (used to have the cpap auction here where we could buy and sell gently used masks) to try but of all the nasal pillow masks I ever tried...the Swift LT was the best until the Swift FX was released.
Recently I did try the Aloha...nice mask and it ranks right up there with the Swift FX for me...I just like the FX a little better.

merhaba12 wrote:My question is on a pressure of 14 would a nasal mask work?

Hi,

I am on BiPAP at 14 exhale, 20 inhale. I successfully use a Swift LT nasal pillow mask. The bigger question on a nasal pillow mask is the shape of your nares (the holes in your nose). The more round they are, the better a nasal pillow works. Mine are half way between round and slotted, and I still do OK. The Breeze mask has an option to use a type of pillow called a "dilator", which is a little more sturdy, and it helps with people who have slotted nares.

BTW, you said that you already used up your chance to exchange your mask. I'd like to suggest that you go and buy a 2nd mask yourself. Masks wear out and they can break. It is never good to be without a spare. Also, if you happen to get sick (cold or flu), having a 2nd mask available is nice in case your primary mask doesn't do well. For example, I keep a full face mask handy incase I get a cold because the nasal pillow mask just doesn't do well when my nose is totally plugged.

-john-

I was able to switch out the Quattro FX full face mask because I wasn't getting much sleep because of major leaks. Two days ago I received a Softgel Nasal mask (with a chin strap - which I didn't the first night).I'm sure I did a lot of mouth breathing because I had horrible dry mouth. Last night I tried it with the chin strap and I was surprised how comfortable it was. The problem was that I woke up in the middle of the night and felt very little air coming in. I felt like I couldn't breathe (pressure of 14). So I got up and found out one of my nostrils was blocked completely! I did a nasal rinse and actually went back to sleep.

When I go into the hospital on Tuesday I will talk to the RT and request nasal pillows (because I can take the mask home when discharged). Or because of what you said, maybe I should ask for a different full face mask for nights like last night when I had difficulty breathing through my nose. I also guess it is an option to have all three if I purchase one online.

If getting the hospital to supply a mask...let them supply the most expensive mask..save the buy your own mask selection so that it is the cheapest.
Nasal pillow masks are typically the least expensive and depending on which one you want you might check EBay.
While EBay doesn't allow sales of the whole mask setup because that requires RX...there is no RX requirement on replacement parts. So EBay sellers now just separate the parts. You can build your own mask quite reasonably sometimes.
Shop smart and know which replacement parts are needed and often you can build yourself a brand new mask for about half of online costs.

Thank you Pugsy! I am so glad you are still able to view your posts.

I have fantastic news (I think!). The PA for my doc who is on vacation emailed him with a request for an APAP. He replied and said, "yes!" According to his nurse he never Rx's an APAP!

I told the nurse exactly what I wanted and the PA will Rx that machine! PR System One DS560 with all the bells and whistles!

We'll see what the DME tries to do with that! Then the next step is getting it authorized by my medical group. They check to see if it meets the criteria for my insurance and then they OK it and the DME has to fill the Rx!

If it all goes through, I would love to see the face of that @#$%^! at the DME. So much for a profit!

I also use nasal pillows at 15/18 sometimes going up to 20-21cm. The secret is learning to breath thru your nose.
After several years I still get a dry mouth, I just keep some Propel at bedside to wet my mouth.

The script should be written specifically for a machine make & model. Many docs do NOT know how to write them so do your research here BEFORE hand. As mentioned many times before it should include the words "Do NOT substitute". Write down an example.

Be sure you get a copy of that prescription in your hand so you know what it says AND can then use it online or at another DME.