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AHI Much Higher With Full Face (even when lips are taped) than Nasal Mask - Can't Figure Out Why - Please Help?

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BrianC302 +0 points · almost 4 years ago Original Poster


I have fairly mild apnea but I definitely sleep much better using my machine. I was in denial for a while as I am 6 feet, 175 pounds, and do a ton of cardio and such.... but I for sure have it. I used to wake up in the night from nightmares sometimes with loud hissing noises when I thought I was being attached and I would wake myself up (and scare the hell out of my wife who sleeps in a different room now lol).

Anyway, my sleep doctor is about useless and gets upset when I adjust the pressure (but the only reason it got dialed in correctly is because I made adjustments myself). During my sleep study they said 7 was my optimum pressure but it actually seems to be 12 or 12.5. I am currently using 12 on my Dreamstation with the auto feature set for up to 15 and my AHI went from in the mid teens down to around 1-3 (sometimes slightly higher or lower) and this seems to be the lowest I can get it which is OK as I sleep well.

I use a Phillips nasal cushion and am really happy with it except I have to tape my mouth or I leak badly and can't use the mask. The leaking was somewhat mild (but still not something I could deal with at a pressure of 7 but at 12 I 100% have to tape). I don't mind the mouth taping (other than I have to use 3M barrier cream or it tears my skin up) but wanted to be able to use a full face mask at minimum when I am sick but possibly all the time. My first full face mask was a Phillips Dreamwear and I could never get it to seal that well throughout the entire night even when adjusted correctly. Worse than that, my AHI's using the mask would typically be around 8-16. I tried many different pressure settings (mainly higher but lower too) and while it helped bumping it up around to 14, it didn't help much (brought it down to 8-16 from say 10-18).

I was really disappointed but figured about half a year later I would try a different full face mask and upon much research, went with the Resmed F30i. I really like this mask... I cannot imagine it being much better (for a full face mask) by my pressure issues are the same as with the Dreamwear full face. I don't know if this is just something about my anatomy or if some of the experts here can help. My sleep Dr. said when I was using the Dreamwear mask that there is no difference, she has never seen a difference between full and nose cushions in the 5,000 people she has treated over the years, and it must be something with the fitment but offered no more help... got annoyed when I told her she was wrong and that the data clearly shows there is a big difference for me.... and she sent me off with her assistant. Her assistant was helpful and saw I was adjusting the mask correctly and looked at the data and said she sees what I am talking about but was unsure why I was having such drastic differences. I figured maybe it had something to do with breathing more through my mouth so I tried taping my lips while using the full face F30i and my AHI was still really high! I am totally confused now!

So, below are some OSCAR printouts from a typical night with my mouth taped and a Dreamwear under the nose cushion and several of the Resmed F30i (anything with an AHI over 4 is always a full face for me). Like I said, my nose cushion works best at a pressure of 12 or 12.5 with a limit of 15 but the full face.... I have tried anything from 10 to 16 as a base pressure with higher upper limits and I just can't get it much below 10 no matter what I do. I feel tired after wearing the full face. Sucks, I feel I wasted a lot of insurance money at this point but I haven't given up! I posed this on a different forum like a half a year ago but nobody could figure out what my issue is.... was hoping somebody here might be able to help.


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