FFM Vs. Nose Pillows - Is there a pressure difference?

[Tsparky]

RESMED Airsense 10 Autoset with Fisher & Paykel Simplus Vs. RESMED P10 Nasal Pillows:

With a FFM my mouth opens in the mask and air escapes into the mask and exits out the larger mask port holes - feels like less pressure delivered to my sinus, throat, lungs, etc., with the NP, smaller port holes, I receive the same pressure up the nose with no air escaping my mouth but the NP pressure feels much stronger to my sinus, throat, lungs, etc..

Is anyone using similar equipment? Similar experience?

[palerider]

Fisher & Paykel Simplus Vs. RESMED P10 Nasal Pillows:

With a FFM my mouth opens in the mask and air escapes into the mask and exits out the larger mask port holes - feels like less pressure delivered to my sinus, throat, lungs, etc., with the NP, smaller port holes, I receive the same pressure up the nose with no air escaping my mouth but the NP pressure feels much stronger to my sinus, throat, lungs, etc..

since the pressure in front of your nostrils and in front of your open mouth with a FFM is the same, there's no air 'escaping' from your mouth, it doesn't really matter whether your breath in through your nose, or mouth with a FFM, that's the whole point of a FFM. you breath in, you breath out, air is flushed out through the vents constantly no matter how you're breathing.

the smaller holes in the nasal mask increase *resistance* to flow, and that's why there are settings in the resmed machines, (and sort of) in the respironics machines, to compensate for pressure irregularities caused by this added resistance. are you setting your machine appropriately?

[Tsparky]

Machine is set correctly. Thanks for the quick response.

[jjhall]

that's why there are settings in the resmed machines, (and sort of) in the respironics machines, to compensate for pressure irregularities caused by this added resistance. are you setting your machine appropriately?

I don't see any settings in my Respironics machine that appear to be directly related to mask type, unlike the obvious choice in my wife's AS10. What "sort of" setting should I be looking at when I switch back and forth between mask types?

[fdw]

I was just wondering about the same question.

It sure seems as though the pressure is much higher using the Nasal Mask compared to my Full Face Mask. In fact the other night i was using the Nasal Mask and my nose was burning on the inside like someone was stabbing hot pokers in my nasal passages, about half way through the night I had to switch back to the FFM.

[palerider]

that's why there are settings in the resmed machines, (and sort of) in the respironics machines, to compensate for pressure irregularities caused by this added resistance. are you setting your machine appropriately?

I don't see any settings in my Respironics machine that appear to be directly related to mask type, unlike the obvious choice in my wife's AS10. What "sort of" setting should I be looking at when I switch back and forth between mask types?

SYSTEM ONE resistance- This setting allows you to adjust the level of air pressure relief based on the specific
Respironics mask. Each Respironics mask may have a “System One” resistance control setting. System One resistance
compensation can be turned off by choosing the setting “0”

only respir masks have a number on them, you have to either guess for non respir masks, or do what it says and leave it on zero.

[jjhall]

Thanks Palerider. I'll take a look and see if it is set to a non-zero value. Both masks I have are ResMed Airfit. I assume the DME left that setting at zero, but we all know what it means to assume...

[jjhall]

Thanks Palerider. I'll take a look and see if it is set to a non-zero value. Both masks I have are ResMed Airfit, so no number of course. I assume the DME left that setting at zero, but we all know what it means to assume...

[Tsparky]

RESMED Airsense 10 Autoset has settings for 3 types of masks: FFM, NP, and Nose Mask not sure how or if the pressure delivery is set for each type mask - any thoughts? It also has Expiratory Pressure Relief (EPR) which maintains the optimal treatment for the patient during inhalation and reduces pressure during exhalation. My question references the anatomy and physiology of the nose and throat in relation to the same pressure of 14 CM delivered but the holes in the FFM are larger letting out more air volume faster while incoming air enters both the mouth and nose - constant stream of air is always exiting the mask holes. Seems the NP delivers air only through the nose and with the smaller relief holes it would create more back pressure - again thoughts? The NP only lets out air through the smaller relief holes when I exhale. To me it feels like a LOT more pressure with the NP in both my nose and sinuses. No leaks with either the FFM or the NP.

[palerider]

the holes in the FFM are larger letting out more air volume faster while incoming air enters both the mouth and nose - constant stream of air is always exiting the mask holes. Seems the NP delivers air only through the nose and with the smaller relief holes it would create more back pressure - again thoughts? The NP only lets out air through the smaller relief holes when I exhale. To me it feels like a LOT more pressure with the NP in both my nose and sinuses. No leaks with either the FFM or the NP.

to put it kindly, you're mistaken.

all masks vent air, all the time. you can google up the specs for each mask, they're in the back of the manual, however, most all masks vent at approximately the same rates, somwhere around 20liters/minute at 4cm/h2o, up to around 50lpm@20cm.

the machines have a pressure sensor and they vary the speed of the impeller constantly as needed to create the desired pressure compensating for the variations in flow as you inhale and exhale.

put your ear up against the machine and listen to the rising and falling sounds of the motor as you breath.

[Tsparky]

Thanks for the feedback.

[QualityDMEGuy]

I always call it the garden hose effect. If you have a hose without nozzle and have the water flowing freely, it just pours out the end. Take your thumb and block part of the hose, and you have a nozzle spraying water with force. But you didnt change the water pressure from your house, right? Nasal pillows are the thumbed garden hose, full face would be the open end hose. By the time either of them get to the airway, they're still going to maintain your pressure setting from your device.

The settings on the ResMed machine are for the purposes of data tracking. As Palerider mentions, all masks have a base leak value. Changing the setting on the machine only adjusts what the data tracking is considered to be that base leak value. So they won't actually have an affect on how much pressure is being provided. A good way to know what will effect it and what won't is this: If it's a patient-adjustable feature, it's not affecting the pressure setting/therapy output. That's a prescribed setting so it would not fly for the manufacturers to let it be adjusted freely.

System One Resistance is essentially a more custom EPR - it further adjusts the exhalation based on what they suggest the setting be for each of their masks. C-Flex is similar to EPR but much more advanced. I could go into all the details of what's different and why, but it'd be a long day.

[palerider]

Nasal pillows are the thumbed garden hose, full face would be the open end hose. By the time either of them get to the airway, they're still going to maintain your pressure setting from your device.

this is in error, the critical difference being that there's no pump on the other end of that garden hose that is measuring the pressure and adjusting the flow rate to attempt to maintain that flow rate. you have a pressure that varies greatly due to flow restrictions at varying points between the water source and the end of your hose.

The settings on the ResMed machine are for the purposes of data tracking. As Palerider mentions, all masks have a base leak value. Changing the setting on the machine only adjusts what the data tracking is considered to be that base leak value.

I believe that this too is in error, for one thing, there is no correlation between the leak values of the different types of resmed masks and the mask type setting. however, there *IS* a correlation between the stated mask resistance values and the different types of masks. in addition, setting the mask type wrong will in some cases prevent smartstart from recognizing a mask off situation and stopping the machine. specifically in my experience, having the machine set to 'full face' and using a nasal pillow, the machine never turned off, however, setting the machine to 'pillow' and smartstart works properly.

the evidence points to the mask type setting having the same function as the hose type, compensating for the different resistances to the flow that are caused by the mask and hose so as to deliver a more accurate pressure to the patients airway.

If it's a patient-adjustable feature, it's not affecting the pressure setting/therapy output.

again, wrong, the hose type setting makes a *noticeable* difference in pressure delivery if it's set wrong, set the hose to slimline while using a standard diameter hose... first time I did that, I thought the machine was broken.

System One Resistance is essentially a more custom EPR - it further adjusts the exhalation based on what they suggest the setting be for each of their masks. C-Flex is similar to EPR but much more advanced. I could go into all the details of what's different and why, but it'd be a long day.

and, again, wrong. System one Resistance is documented as compensating for the different resistance profiles of the different masks, to deliver the desired pressure profile.



and cflex is not "a much more advanced EPR" like EPR.

of all the things that archangle says, his tagline is very appropriate for this:
"If it's midnight and a DME tells you it's dark outside, go and check for yourself."

[palerider]

To me it feels like a LOT more pressure with the NP in both my nose and sinuses. No leaks with either the FFM or the NP.

I'll bet you a dollar that the reason that it feels like there's a LOT more pressure with the pillows is that when you're wearing pillows, you have more pressure on the inside of your nose than you do on the outside, effectively blowing it up like a balloon.

when you're wearing a FFM, you've got the same pressure on the inside, and outside of your nose, so the feeling is quite different.

[Tsparky]

To me it feels like a LOT more pressure with the NP in both my nose and sinuses. No leaks with either the FFM or the NP.

I'll bet you a dollar that the reason that it feels like there's a LOT more pressure with the pillows is that when you're wearing pillows, you have more pressure on the inside of your nose than you do on the outside, effectively blowing it up like a balloon.

when you're wearing a FFM, you've got the same pressure on the inside, and outside of your nose, so the feeling is quite different.

With NP the increased pressure points are inside my sinuses, throat, lungs not in my nostrils at all - so no ballooning effect to the nostrils. There is more air coming out of the FFM port ALL the time and less out of the NP all the time with almost no air out the NP port when inhaling. I'm trying to understand the physics of CPAP so no explanation would be too technical for me... I searched this site and the web but found no data discussing my issue. Thanks again for your time.