Sierra

It is good to hear that you are getting some help and some choices in masks. It is probably the most critical component of the CPAP treatment. Believe it or not, with all the masks and names, ResMed does have some logic to at least some of them. In general Full Face masks have a "F" in the name, Nasal mask a "N", and Nasal Pillow masks a "P". Not always but most. For that reason I suspect your nasal mask is likely the AirFit N20 not F20?. See link below:

AirFit N20

If so it looks like a well made mask with very good headgear. The issue with it, and the full face F20 is that while the headgear is substantial and should hold the mask in place, the mask itself sticks out quite a bit from the face and is still quite susceptible to being moved, and unsealed. I find that the AirFit P10 nasal pillow mask, see link below, to have a much lower profile on the face and is less susceptible to moving. You don't mention what your pressure is, but I have used it up to 14 cm or so, and it does not leak from pressure at that point. ResMed rates it as suitable up to 18 cm. The headgear on it is not the greatest, but it may work for you. I find wearing a chin strap helps keep it in place.

AirFit P10

SnuzyQ, a contributer here, has posted that she and her husband use the ResMed Swift FX mask. Despite the letters it is a nasal pillow mask, and quite similar to the P10. but with a more substantial headgear setup. It may have a slightly higher profile than the P10, so hard to say which may be better to address your stay in place issue.

My suggestion is to try and convince your provider to let you try both the P10 and Swift FX to see which one works the best. As for letting air out of your mouth, you can try a chin strap. What I have ended up doing is using both a chin strap and paper medical tape (3M millipore) over my mouth. It may seem surprising but I have found that using tape on my mouth to be the least invasive/annoying component of my CPAP setup.

One last thing is the setting in your CPAP for the different masks. You should be sure to ask your provider to set up your machine so you can select the correct mask type as you switch them around. Assuming it is a ResMed CPAP here is a link to a chart showing the correct setup for each machine and mask combination. Surprisingly the N20 mask should be set to pillows, not nasal.

ResMed Mask Setup

I suffer from nasal congestion too. Must be allergies or something. In any case, what I find is that if I can get decongested before I put the mask on, I will stay that way all night. I use the ResMed P10 nasal mask, and I think the air flow directed to each nostril helps. With an AHI of 12 you probably will not need too much pressure from a CPAP and that certainly makes mask use easier. Almost for sure, a CPAP will reduce or stop the snoring. My snoring has gone from pretty bad to zero. The ResMed machines, and probably others measure snoring and use it to initiate pressure increases.

It probably would be helpful if you gave a little more information about your issue. What brand and model of mask is it? How long have you been trying to get it to work? Do you have a provider that is obligated to help you out with the problem? What are the pressures that you are running the mask at?

Mask leaks are probably the most common and most annoying problem with using a CPAP. You can be sure that you have a lot of company with others that are struggling to get their mask to seal consistently. I was not successful in using two full face masks (Mirage Quattro, ResMed F20), but others certainly have been. It probably comes down to getting the mask tight enough but not too tight. That is a trial and error process. I also find your pillow type and how you use it makes a difference. My son uses the Mirage Quattro, and likes it. He tells me that when he side sleeps he sleeps with the mask off the side of the pillow so he does not disturb the position of it on his face. I have also tried a softer pillow like a down alternative and that seems to help a bit. The pillow does not push back on the mask as much. I also think using a satin pillow cover helps some too. It allows your head and mask headgear to slide around on the pillow more easily without disturbing the mask position.

If you provide some more detail, perhaps you will get some more suggestions. Each mask is a little different, and all masks do not suit all people. It can be a combination of finding the best suited mask to you, and then adjusting it properly.

Thank you for the suggestions. I will consider the Swift FX mask. On a quick look, the mask part seems quite similar to the P10 with the dual wall nasal extensions. It has the air exhaust on the hose like the Brevida, while it is built into the mask on the P10. I suspect I could tolerate it, and the headgear does look to be better. What I would like to do is just buy the headgear and fit it to the P10, but that looks pretty difficult. Perhaps when it is time for a mask change I will buy the whole thing. It is a shame that the mask manufacturers at least within their own brand would not standardize on how they attach the headgear to the mask. Each mask seems to have a unique attachment method.

I am a bit burned out on trying new masks at this point, and I think I will take a break from the new mask merry go round for a while. So far I have tried the Mirage Quattro, and even with the help of a good blog titled something like Taming the Mirage Quattro, I couldn't make it stop leaking. It just seemed to walk around on my face. I tried my wife's Mirage FX, and while it was better I couldn't stop the leaks and the rude noises the leaks make. They wake me up. Next I tried the AirFit F20 full face. It is probably better than the Quattro and Mirage FX, but still leaks, and when I finally gave up, it was causing a blister on the bridge of my nose. My sleep quality was bad, because I kept waking up. The latest purchase was the F&P Brevida, and while I think I could get to the point of tolerating it, the batwings part seem to stick out and make it easier to push out of place when side sleeping. I get more leaks with it than I do with the P10. The Brevida also irritates my nose more, but that I suspect would go away over time. I will keep it as a spare, but doubt I will ever use it regularly.

I would have thought with the popularity of the P10 and the poor quality of the headgear that someone would have come up with a new and improved after market version. Doesn't seem to be so...

I find it very helpful to have a Clinical Guide Manual for the AirSense 10 AutoSet as well as the user manual. While many are not comfortable making their own adjustments to their machine, others do. And, even if you have no interest in making changes, ResMed includes a lot more detail in the Clinical Guide as to how the machine actually works and what the various features are about. If nothing else the first dozen pages or so are a good read. The only issue is that the guide is kind of hard to come by. I just stumbled on a link that has a copy of the guide (see below). I would suggest downloading it and saving it as a PDF for future reference. The other thing the guide does is explain the difference in how the For Her version works compared to the standard version. The interesting part is that the For Her is just another option in your Mode selection, so you can buy the For Her version, and make it operate like the standard version. I was not aware of that when I bought my standard AirSense 10. If I had known I would have bought the For Her version, even though I am male. And now I know how it works, and what my needs are, I would probably operate it in the For Her mode instead of the standard mode.

ResMed AirSense 10 - Clinical Guide

NiyaNiya, if you are still checking in, can you explain how you posted a graphic image? I have tried, and can't figure it out...

The Essentials tab is in the Clinician Menu. Hold down both the round knob and the Home key at the bottom for 3 seconds minimum at the same time. That will put you in the Clinician Menu. Scroll down to the Essentials item under Options, then push the round button and select Plus instead of On. You may have to rotate the round knob to switch from one option to the other, then push it to select it. When you return to the standard patient menu you should now be able to see the additional sleep report details. You will also get access to a few extra settings from the Patient Menu.

"by enabling Essentials Plus you can allow highly engaged patients to access additional features for control over more of their therapy settings, including changing their mask type, EPR (if available), SmartStart and Run Warmup (if water tub available)."

If the municipal water supplier is doing their job, there will be no bacteria in the water. They typically chlorinate it to kill all bacteria, and then leave a residual chloramine in the water to prevent any bacteria growth. Bottled water is probably nearly as good, but the risk might be slightly higher, because bottled water suppliers often filter out the chlorine and chloramine with activated carbon filters. They USUALLY replace the chorines with ozone to prevent bacterial contamination, but not always. Tap water from a reliable municipal water supplier is almost always the safest. There is no good reason to use bottled water over tap water, but if you do, check the label to ensure they have ozone, chlorine, or chloramine in it to prevent contamination.

That is a good point. I wonder where this device was bought, and if it was setup properly. If I go into the menu, and right near the bottom under the "About" heading there is a Provider, Type, Service setting. Mine is set to Telus (a Canadian wireless provider), 3G, and 10 (no idea what that means). These machines have a communication port right below the SD card slot. I wonder if they have to be set up at a more basic level than can be done with the Clinical Menu. Perhaps it was never set up to use a Canadian wireless provider, only US...

"I'm trying to find out if the machine can only function as a BiPAP or also as a CPAP. Does anyone know for sure?"

To get back to your original question these steps should tell you for sure:

1. Plug in your machine to power it up.

2. Rotate the round knob until the Setup or wrench icon is highlighted.

3. Hold the round button down and at the same time the ramp button a little below and to the right. Hold them both for more than 5 seconds until you hear a quick double beep. The Provider screen should appear.

4. Rotate the round knob again until the Setup or wrench icon is highlighted. Press the knob to bring up the Provider Setup menu.

5. The first item on the list should be the Mode. Rotate the knob to highlight the Mode line, and take note of what mode it is in. The manual is not totally clear on how to select options, but assuming it is similar to ResMed, you would press the button while the Mode line is highlighted, and it should either rotate through the various options, or bring up a list that you can select from by rotating the knob. Check to see if one of the options is CPAP. It it is there then your basic question is answered. If you want to make it operate like a CPAP press the knob again to select it.

6. Rotate the knob to bring up the last option which should be Back which you would select to return to the Provider Menu. Rotate the know to highlight Exit, and then select that. That should take you right back out to the Patient menu. Then you can power down the machine.

Hope that works in definitely answering your question. And, like I posted before, even if you don't have the CPAP option, you should still be able to simulate that mode by using the BiLevel Mode.