A patient interface device includes a cushion member, a frame member, and nasal pillows. A first side of the cushion member forms a seal with a patient's mouth. The nasal pillows are structured to form a seal with the patient's nares. The nasal pillows are attached to the frame member. The frame is attached to a second side of the cushion member. The frame member includes a connecting portion, a first aperture, and a second aperture. The nasal pillows include a first nasal pillow element and a second nasal pillow element. The first nasal pillow element is at least partially removably disposed in the first aperture. The second nasal pillow element is at least partially removably disposed in the second aperture. The connection portion is connected to the second side of the cushion member.