Moving from a FFM to Nasal Pillows

I'm a 56 year old male who always snored loud, periods of stopped breathing, breathing through my mouth, not sleeping throughout the night.... all that sleep apnea type stuff. I finally got off my butt. Got a physical, started taking blood pressure/cholesterol medication, lost 55 lbs., had a home sleep study in Dec 2016, Lab Sleep study in Jan 2017, started using my CPAP in Feb 2017. I was initially prescribed with a Fixed CPAP at 18cmH2O of pressure. I started reading this board at the end of 2016 to educate myself. I got a DreamStation Auto CPAP (humidifier and heated hose) with a ResMed AitFit F20 FFM, fixed it at 18cmH2O with a ramp starting at 9cmH2O for 30 minutes. I did this setting for a month and a half. Had good results, felt great, low AHI's, pretty much no mask leakage, although the FFM is pretty bulky. Then I switched my machine from fixed to auto and started to "experiment" with the mins/maxs and comfort settings. I always had a good mask fit. In May 2017 I had Septoplasty Surgery. In June 2017 I found myself sleeping throughout the entire night with my mouth closed. I had 100% mask fit, AHI's well below 1.00 and I felt great. I settled on a pressure setting of min 12cmH2O - max 20cmH2O. My Auto CPAP was doing it's job.

Then......for the last two weeks, I have been using the DreamWear Gel Nasal Pillows. I have had 100% mask fit and various AHI's ranging from .08 - 3.8. I'm sleeping good and feel great the next day. I have experimented with pressure min settings of 7cmH2O - 12cmH2O all with a max of 20cmH2O. Even though it's only been two weeks, I'm thinking about min of 8cmH2O max of 20cmH2O.

Here is my question.....I know it varies from person to person, but in general, when a person switches over from a FFM to Nasal Pillows how does that affect the pressure settings in AUTO mode. Would the minimum pressure be lower, stay the same or increase with nasal pillows over FFM?

Pressure needs can change between nasal pillows and a full face mask. In theory it should not happen but in real life it does. I have seen too much documentation by way of reports to discount it.
Seems like full face masks sometimes need more pressure than nasal pillow masks...not with everyone but with enough people that I consider it fairly common. Sometimes as much as 2 or 3 cm less with nasal pillows.
I suspect that the reason might have something to do with the positioning of the airway when using a full face mask and those lower straps needed to secure the bottom area of the full face mask.

So...pressure needs can change for some people but not all people. It comes with that same big YMMV sticker that comes on all this cpap related stuff.

Mr. REM wrote:Here is my question.....I know it varies from person to person, but in general, when a person switches over from a FFM to Nasal Pillows how does that affect the pressure settings in AUTO mode. Would the minimum pressure be lower, stay the same or increase with nasal pillows over FFM?

iirc Dr. Park explained that when breathing thru the nose the pressure forces the tongue out of the way but when mouth breathing the tongue can reduce the size of the airway. So he recommends breathing thru the nose whenever possible.
IMO a FFM also covers more surface area and is more likely to leak and reduce the effective pressure on the airway.

There is no doubt that nasal pillows are much easier to seal and much more comfortable. Always use a dab of Lansinoh on the nares and pillows every nite to help reduce friction and help the seal. Lansinoh can be found anywhere baby bottles are sold.