Problems with AirFit P10 Nasal Pillow (+ResMed Airsense10)

I am using the Resmed AirFit P10 nasal pillow and am having a few problems. Would appreciate some advice or suggestions.

Background info is that I’ve reset the Resmed S10 “pillow” (from 'mask' I used to use) and it's set for automatic 4-12. More detailed settings at the end.

1. With both small and medium size pillows the device does not automatically stop when I remove the mask. It just continues blowing and stops only when I remove the nasal pillow attachment from the vent/frame of the AirFit P10 (or remove the small tubing from the main device hose). It doesn’t have this problem with the large size pillow.

According to the Clinicians manual, if SmartStart is enabled the device should automatically stop. It says an incompatible mask is being used otherwise. But the AirFit p10 is compatible. The manual also says “If the patient is using a nasal pillows mask with set pressure less than 7 cm H2O, SmartStart will not work and should be disabled.” I am not sure what this means since I don’t have a set pressure; I have a 4-14 range. As an experiment, I turned off auto mode and ramping and set the fixed cpap at 7.2. Still the same problem, so this isn’t the issue either. Then I tried 10 and the blower did stop when the small mask attachment was removed.

All this makes me worry that the ResMed 10S is not detecting changes in mask pressure as well as it should with the nasal pillow — I didn’t have this problem with the full-face mask. This raises the question of how well it’s doing adjusting pressure during the night …

2. In fact I’ve been using the nasal pillow for 4 nights and the last two have been pretty poor. I woke up often and even when I remained awake the machine didn’t drop down to its minimum pressure of 4, which it did do with the full-face mask. I checked the pressure and it was hovering around 7. That was too high for me to get toget back to sleep and I ended up taking the pillows off.

3) How does one decide between pillow sizes? I know large is too big for me because of evident leakage, but are the considerations for choosing between M and S?

I generally more comfortable with the feeling of the pillows than the full-face and would really like them to work.


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Settings on Resmed 10s

Mode: Autoset
Min Pressure: 4
Max Pressure: 12
Mask: Pillows
Response: Standard
Ramp time: Auto
Start pressure: 4
Smart Start: On
EPR: On, Full-time, level 3
Climate: Auto

1. Most people find that 4 as a minimum setting doesn't work out for them very well. It is so low, that people tend to feel suffocated, and it doesn't do much for most therapy wise either. You could try setting minimum to 7, that might help.
2. I don't have any experience with your particular machine, but for most machines you would need to turn it off then back on to get the ramp to start over. There may be a better way to do this on that machine that I don't know about. Most tend to turn ramp off after a while, as they get used to the pressure after a bit.
3. I think the auto start note is pretty clear. It won't work very well when using nasal pillows at low pressures. Probably not enough delta in the flow for the machine to recognize a "mask off" condition. If they make this too sensitive I would guess your machine might shut off from leaks.

So, in your shoes I would just change minimum to 7. And then if I woke up and needed ramp again, I would just try shut down then turn it back on. Stick with that about a week if you can and see results.

And get your software set up and figure out how to get your data. See stickies at top of forum for details on this.

Good luck!

ETA
Pillow size is very individual. Trial and error I am afraid!

numari wrote:s an experiment, I turned off auto mode and ramping and set the fixed cpap at 7.2. Still the same problem, so this isn’t the issue either.

Try 7.2 and 7.4 and 7.6...etc until you find where it will work with the nasal pillow size you need.
It is the issue.
You may simply have to be happy with manually turning the machine off...after all it only takes a millisecond of effort to push the button.

It's not automatically shutting off because it is still sensing some back pressure at the pillows due to the circumference of the pillows. Releasing the tubing connection, between the short and long tubes will allow the auto stop feature to work.

Pugsy wrote:You may simply have to be happy with manually turning the machine off...after all it only takes a millisecond of effort to push the button.

I think this is probably sound advice for the automatic start/stop. I prefer pressing the button. Plus I think if I get up in the middle of the night, the machine would shut itself off in that mode by time I got back to bed. Not that I can't restart it but at 3am, it's best for both the machine and myself if I just have to plug the mask back in.

pulls nose up in the air....slide up on back of head....tighten up and pulls nose up in the air....don't they test these things?/