"please keep me updated about oximeters "
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Full Face Masks that do well at High Pressure?
I am a person who resumed CPAP after a hiatus of nine years. I have been back on CPAP for about 45 days now.
To my chagrin, my new titration came in at an eye-popping 19 over 15. I am using the ResMed Quatro Full Face Mask, (Large), The Resmed Autoset 25 VPAP on auto, their heated humidifier and a chin strap (otherwise I'm a persistent mouth-breather and I wake up with dry mouth). The Quatro is right at the edge of comfortable; this is not surprising given how tight the velcro straps need to be to withstand that pressure. Has anybody found another mask that works well for them at a comparable pressure? I am reluctant to try nasal pillows -- even with the chin strap I mouth breathe on occasion.
I am doing well if the machine's scoring is to be believed (not quite so well if I look at daytime fatigue)l. Most nights my AHI is under 5 (typically between 3.5 and 4.5) and my AI has been 0 more than half the time and no higher than 0.1 90% of the time so I don't want to tamper with success unless there is something out there screaming to be tried...
Thanks in advance.
Clueless (and/or sleepless) in Redwood Shores
Has anybody
To my chagrin, my new titration came in at an eye-popping 19 over 15. I am using the ResMed Quatro Full Face Mask, (Large), The Resmed Autoset 25 VPAP on auto, their heated humidifier and a chin strap (otherwise I'm a persistent mouth-breather and I wake up with dry mouth). The Quatro is right at the edge of comfortable; this is not surprising given how tight the velcro straps need to be to withstand that pressure. Has anybody found another mask that works well for them at a comparable pressure? I am reluctant to try nasal pillows -- even with the chin strap I mouth breathe on occasion.
I am doing well if the machine's scoring is to be believed (not quite so well if I look at daytime fatigue)l. Most nights my AHI is under 5 (typically between 3.5 and 4.5) and my AI has been 0 more than half the time and no higher than 0.1 90% of the time so I don't want to tamper with success unless there is something out there screaming to be tried...
Thanks in advance.
Clueless (and/or sleepless) in Redwood Shores
Has anybody
Views: 137
Replies to This Discussion
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Permalink Reply by RockRpsgt on
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Unfortuanately I think your are going to have trouble with any full face mask above 15cmwp. The Resmed Quattro is my favorite mask. I have been hearing quite a buz from the techs on the new fisher paykel full face. Respironincs just put a new one out. It is very light. Personally I like it because it looks like something out of Star Wars.
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Permalink Reply by Dan Lyons on
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Hey Clueless,
I also use a Resmed Mirage Quattro FF, size M, and my pressure setting is 18 with CPAP.
I guess I am one of the fortunate folks who have had no problems with leakage from day one and the mask seals for me every night and I have little to no leakage issues.
Based on the numbers you give, I would say you are just repaying your current sleep debt, having just been re-titrated.
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Permalink Reply by Saz RPSGT on
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Welcome back from hiatus!!
ResMed Quattro is awesome and very easy to adjust. Respironics Comfort Full is not too shabby.
Fisher Paykel is....not so good in my opinion.
Just to throw it out there. Best nasal mask.......drum rolllllllllllllllllllllllllllllllllllllllllll
ResMed Vista. I have a non-sexual mask crush on the Vista. It makes me quiver with delight.
You shouldn't have to be tightening that much. An EPAP pressure of 15cmH20 isn't really all that high. (said the guy who doesn't wear CPAP) BiPAP patients I fit will have EPAPs of 20-24 and we obtain great seals with Quattros. Is it possible that a medium would be a better fit?
There should be a 1/4 to 1/2 inch space from the mask to around your mouth. If it's closer or farther away then you may benefit from a different sized mask.
Jason
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I am not a big fan of the Respironics Comfort Full. That thing weighs like 10 lbs. My favorite nasal is the Resmed Micro. I have never had an issue with it.
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I'm not a big fan of it either, but the patients seem to like it. 95% take the quattro over the comfort full if given a choice though. I've never seen the Micro in person. We'll have to see about getting a sample from ResMed.
Rock Hinkle said:I am not a big fan of the Respironics Comfort Full. That thing weighs like 10 lbs. My favorite nasal is the Resmed Micro. I have never had an issue with it.
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Permalink Reply by Mike on
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I've used the ResMed Mirage Micro nasal mask and the ResMed Mirage Activa nasal mask. The Micro sits tighter against the face than the Activa. I prefer the Activa, but think both are very good cpap masks.
J. Sazama RPSGT said:I'm not a big fan of it either, but the patients seem to like it. 95% take the quattro over the comfort full if given a choice though. I've never seen the Micro in person. We'll have to see about getting a sample from ResMed.
Rock Hinkle said:I am not a big fan of the Respironics Comfort Full. That thing weighs like 10 lbs. My favorite nasal is the Resmed Micro. I have never had an issue with it.
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Nothing seals like a Micro. It is the only mask that I can get a consistant low leak at >15 pressures. I have had leaks as low as 32L on a pressure of 18. It was not long after I started at my new lab before I had all of the techs hooked on them. From a tech stand point the adjustment capabilities of the Resmed's make them the superior mask. Just my opinion. I also do not use PAP therapy so what do I know.
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Permalink Reply by sleepycarol on
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Well geez Rock, we would love for you to join us -- what about a pressure of 4?
Oh wait, your one of the smart ones and will know that you won't be able to breathe very well at that pressure!!! Better leave well enough alone!! LOL!!
You're still a keeper!!!
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Permalink Reply by Wendy Huffman on
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Fisher Paykel makes a nice line of masks that "float" on your face. I do not believe you would do well with nasal pillows at those pressures. there is, however , a hybrid mask that has BOTH an oral interface and nasal prongs to keep the majority of your face clear to read or if your just plain claustrophobic. if you still have problems with daytime sleepiness I would recomend a nocturnal oximetry with the bipap on, if your AHI is where the MD wants it to be then its possible a little oxygen bled into the cuircut may relieve some of the daytime sleepiness. hope this helps.
wendy
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Permalink Reply by Clueless in Redwood Shores on
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Thanks Wendy (and to the rest of you who replied),
Are you a patient or a practitioner? Would you suggest looking at the HC431 or the 432? Jason -- is your negative Fisher and Paykel experience specific to either of these masks or just a general observation?
I am not inclined to push hard about the oximetry because I am inclined to hope that Dan Lyons is correct and I'm just repaying deficit. (Having to add supplemental oxygen would further clutter already clutttered medical routines -- its not something I hope to wind up doing.) My wife is clastrophobic, I have had a relatively easy time accepting both the air pressure (thank God for heated humidifiers) and the mask pressure. I just worry that the Quattro is so crushed into my face that it will suffer a shorter useful life than were it leaking less when looser.
I am getting lots of comfortable REM sleep -- Rocky does that provide any indication one way or another about adequate oxygenaton?
I obtained a black market BIPAP machine before the prescription was issued! The total cost was equal to the first month's rent that Apria wanted to charge! For the first couple of weeks I had used the Autoset feature rather than the ultimately titrated numbers. In essence the machine chased itself all night, never hitting a pressure in excess of 12. The Quattro was looser but the leaks were at roughly a quarter of the level I experience currently! (Old leaks averaged about 15 l/s; current average is about 60 although in the last week its been more around 40.)
Again, I am using chin strap and mask just to avert mouth breathing. It looks like the design of the HC series may not permit a separate chin strap -- my experience is masks over chin straps leak.
Incidentally, the reason for my hiatus was that I had had "successful" surgery in 2003 which culminated in a "clean" sleep study. I had had at least five years of lower pressure CPAP treatment on dinosaur machines, so I am both a newbie and a veteran all at once.
I had no further study until this year; an MD ordered it when another health issue which had been well controlled in the interim suddenly was much tougher to control! Based on the lag between that symptom's resumption and the BIPAP titration I would not be surprised that I'm still chipping away at sleep deficit.
Wendy Huffman said:Fisher Paykel makes a nice line of masks that "float" on your face. I do not believe you would do well with nasal pillows at those pressures. there is, however , a hybrid mask that has BOTH an oral interface and nasal prongs to keep the majority of your face clear to read or if your just plain claustrophobic. if you still have problems with daytime sleepiness I would recomend a nocturnal oximetry with the bipap on, if your AHI is where the MD wants it to be then its possible a little oxygen bled into the cuircut may relieve some of the daytime sleepiness. hope this helps.
wendy
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I have a couple of questions Clueless. How do you know that you are getting REM sleep? REm sleep does not always mean good o2. You need uneventful sleep to obtain good REM or stage 3 sleep. Why are you wearing a chin strap with a full face mask? Chinstraps are for people that breathe through their mouths while wearing a nasal mask. There is no need to wear one with a full face mask as they are made for mouth breathers.
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Permalink Reply by joshua akers on
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try the fisher and paykel 432 flexfit, it has a foam cushion under the seal, and I have several patients that have pressures above 18cmh20, and it works great. The other mask to try other than the quattro is the flexfit 431 that has all 3 sizes in the box. the f and p masks fit below the chin, where as the quattro is above the chin, but thats only a difference in how it fits, not a negative. there are other differences, and someone did mention the new f and p mask, but i have not tried that one on patients yet. I have used it, but I have moved to a nasal mask. the f and p 432 would be my suggestion to try if the quattro didnt work. I am a big fan of resmed as well.
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