I hit a milestone last night of 4.4 hours with my P10 mask. I've had my APAP for about a month and a half and that's the longest I've ever kept it on. My P10 mask is rigged with the Swift FX headgear because the original headgear was too flimsy.
I use medium nasal pillows. It works, but after 3-4 hours I start waking myself up to the sound of air blowing out of my mouth from the pressure. Pretty loud sound. I don't want to tape my lips. They already get bright red when I don't sleep well (blood pressure isn't high, but could be in just the face/head when that happens) and toothpaste already makes them chapped to the point of needing chapstick every night before bed. I'm blowing air out of the corner of the lips with my jaws closed, so a mouth strap is just about guaranteed to fail.
My starting pressure and minimum pressure are 5.6. Max pressure is 9 and is always 8.9 when I see it on the machine. I can breathe comfortably with that 5.6 and sometimes my apneas/hypopneas don't even start until an hour or two after I go to sleep.
17L/min leak, 0.4AHI, 0.2AI, 0.0 centrals. The numbers are beautiful. I feel better, but need more sleep.
I've been looking at Philips DreamWear and AirFit F30. One seems to have nasal pillows and the other is open for mouth and nose.
Given the situation, any other suggestions for masks? My unit is like 1.5 feet from my head on a table at the head of my bed, so the hose on top is not an issue at all.
Thinking about this further, I would bring your attention to your results:
"17L/min leak, 0.4AHI, 0.2AI, 0.0 centrals. The numbers are beautiful. I feel better, but need more sleep."
This leak rate of 17 L/min does not suggest to me that mouth leaks are a big issue for you. If the leaks are just an annoyance that wakes you up, then I would still suggest trying tape. The 3M Gentle Paper tape is specially designed to be gentle to the skin. I have never suffered any irritation from it.
I guess I like that the pressure in the mouth would be equalised with the nose, so air won't be blowing out of the lips from the unequal pressure. Also, for the times when I briefly wake up and open my mouth for a second or two, the pressure won't be blowing out choking me.
The biggest issue is that tomorrow might be 1 or two hours before it comes off or I pull it off. Looking for more uniformity and straps/fit so that won't happen. Trying to decide if I want nasal pillows plus the mouth covered or both covered with no nasal pillows. The latter seems better, but not sure of the quirks with either. I want to get back to driving again and I need to be able to focus and not worry about "if the mask comes off" each day. The one I have is just too unreliable to stay on.
"Trying to decide if I want nasal pillows plus the mouth covered or both covered with no nasal pillows."
Functionally it makes no difference. It is just what is comfortable for you. In general a full face mask is much less comfortable than a nasal pillow mask in my opinion. It tends to be bigger, and the sealing surfaces are more extensive. Generally nasal pillows don't leak. Getting a mask to seal to your face is much more difficult. The mask tends to float around, and when the face seal leaks they make rude noises. Many use and like them though. I just couldn't get comfortable enough with them to get a good nights sleep.
I find the nasal pillows comfortable, but they regularly irritate the inside of my nose, so a pillowless full face mask would in theory avoid having to use them and yet also avoid the pressure issue between the nose and mouth so that I'm not blowing air out of my mouth to wake me up from the noise. Don't really want to have to tape every night.
I read where one person was using nasal pillows and couldn't keep it on for over an hour or two, so they switched to the AirFit F30 and said they kept it on for 8 hours straight from day one. Of course, results may vary and my reason and their reason for switching may be different.
You said "irritate the inside of my nose". P10 pillows should be on, not in the nose. This is usually fixed with the next size up pillows.
Tried the large pillows. They don't even seal. The mediums are sitting on the outside edge of my nose and go in just slightly into the edge. They do seal well. It just makes my nose sore when I have to keep my straps tighter to keep it from coming off in the middle of the night.
Your comment illustrates an important point. Much of the difficulty that people have with their CPAP masks stems from the fact the the straps have to be so tight to seal that they cause irritation on other parts of the mask. Airway Management makes a product called the Tap Pap Nasal Pillow Mask. It attaches to the upper teeth and there are no straps. The solid foundation results in no leakage from the pillows and the pillows seal well while still only pressing very lightly against the nose. Much more comfortable and no irritation. Arthur B. Luisi, Jr., D.M.D.
Is there are more study nasal mask with better straps? I like the P10, but the original straps were garbage. I replaced them with the one for the Swift FX. It holds it on for obviously longer, but just wondeirng about other better options. It is very odd that some have better straps than others.
I kept it on last night for 5.25 hours. Still similar numbers.
I have tried the F&P Brevida after reading good reports about it. Yes, the straps are better and are adjustable. I found it irritated the part of my nose between the two nostrils and went back to the P10, now with the Swift FX headgear. I convinced my wife who was using a Mirage FX mask to try the Brevida. The Mirage had to be adjusted so tight that it was leaving large marks on her face from the straps. She had a little trouble finding the right cushion size for her, but after that got sorted out, she really likes the Brevida. I think how a mask fits is quite individual. However, between the Brevida and the P10/Swift FX I think the Swift FX headgear is better. And for me the P10 cushions are better. The other strong point is how quiet the P10 is with the way the purge air is diffused. My wife has a bit of an issue with knocking off the diffuser on the Brevida but so far has found it. We need to order some spares.
The one issue to consider about a nasal pillow is that I believe the reason it works quite well is that it minimizes the contact with the face/nose. Once you start to cover the nose surface I think problems start to increase. I think the DreamWear has kind of a hybrid nasal pillow that does not go into the nostrils, but has an oval hole that kind of covers both nostrils. No experience with it. Not sure if they use that on their full face version of the DreamWear or not.
My solution to the occasional nose irritation is to use some 1% cortisone cream for a few days. Overall I think it is mainly a matter of getting used to it, once the fit is good.