Just got my Oracal II

So far I think I am adjusting pretty good. I lowered my pressure down since I don't get near the leaks. It was easy not to use the nose plugs since I very seldom breath out of my nose. It is a little harder for me than the FF, but my FF started to fall apart and I wanted to try the Oracle so I ordered it instead. I have had it for 2 nights, I wanted some input before I posted. Glad my wife can give me input on how I am sleeping.

Toby

Hey, Toby. Can I ask you a question? Did you find out via some type of testing that you should lower your pressure or did you just lower it on your own to stop leaks? The reason I ask is, you can be causing more harm than good by doing that if you didn't confirm your pressure needed lowering.

When you are titrated at a certain rate, unless you are using an auto, you should stay there so your airways will stay open, the whole point of using cpap. If you are lowering it because it helps your mask not leak, it can be compromising your treatment, which is really something you don't want to do.

Good luck with the Oracle. I had that as my first device back in the beginning of June of last year.

When Fisher and Paykel first introduced the Oracle a couple of years ago, I read where they advised that using the Oracle with its direct oral delivery meant pressure could usually be lowered one or two cm's.

rested gal wrote:When Fisher and Paykel first introduced the Oracle a couple of years ago, I read where they advised that using the Oracle with its direct oral delivery meant pressure could usually be lowered one or two cm's.

My DME said that wasn't so.

LOL...does your DME live in your house, Lori? That was quick!

The link I had to the F&P product introduction information from "back then" is lost in my old computer. Will try to find that sometime.

rested gal wrote:LOL...does your DME live in your house, Lori? That was quick!

The link I had to the F&P product introduction information from "back then" is lost in my old computer. Will try to find that sometime.

When I first went on therapy, I had heard the same thing, too. I asked him if I had to do anything in particular with a mouth device such as this, like lower my pressure with the Oracle, and he said that there was no mask/device that he knew of that you ever did that with. Whether he was right or wrong, I don't know.

Actually I had raised my pressure when I was using my FF. Because of my beard and mustache it always had a small leak. My wife said that I was still doing the stop breathing thing, so I raised it a little each night until she said that I wasn't doing that any more. My Dr put in my tiration report that I needed 7 cm's as long as I stay on my side. If I am on my back I need 15. With the altitude of where I live it bumped it to about 8.Then I bumped it up to 11. I moved it back down to where it felt like the same amount of pressure on my cheeks(you know when you feel like a ballon getting blown up). I had to bump it up a little from there but I think it is close. Will see tonight if my wife say's anything. An autopap would be the best, but hind sight is 20/20. I can't afford another sleep study and am not sure that they can be that accurate in just 2-4 hrs. After all, those with a autopap, do you notice that some days it varies from others?

Toby

I think every mask is different when it comes to pressures. I know that the masks that I have, have little holes in them(premade leaks). Are they the same on all masks? I doubt it. And if your mask leaks a little and is consistent, why can't you adjust for it. Since my Dr sid 7-15, as long as I keep from the stop breathing part, I should be good. I have been more alert and seems that I can't go to bed before 12:00 any more and up at 7:00. Seem to be sleeping thru the night, before I was up atleast every hour having to go to the bathroom. I am even in the same position that I go to sleep in, most of the time.

Toby

Cherokee, hope you get good comfort with the Oracle. I really liked the concept -- enough that I bought the original and the improved. I just couldn't get past the nose snorts. I can see how, for people it works for, it would be a really good interface for easy mouth-breathing.

About the pressure thing, I don't know for sure either, Lori. I still can't find the news interview in 2001 (not a product chat) in which F&P's head of Interface Development, Jillian Gery, mentioned that less pressure often could be used with the Oracle.

Anyway, while poking around some archives, these posts came up:

Dec 07 2004 subject: Oracle, with Autopaps?
Excerpt from a post by -SWS:

The Oracle will work with less pressure because it bypasses the narrow and highly restrictive nasal passages. The sheer volume of air your Oracle passes is vastly different than that passed by your narrow-diameter Breeze which in turn introduces air through your narrow-diameter nasal passages.

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Apr 04 2004 subject: Has anyone tried Oracle CPAP ?
excerpt from a post by Tracy (co-founder of talkaboutsleep.com):

Another thing I experienced was that when I did use Oracle,since the air was delivered directly into the mouth and then into the airway, I found my pressure necessity drastically reduced. I used Oracle on auto and rather than needing my normal bilevel setting at 18 or 20, I found I only need 14-16 as an average. I am not doctor and so could not say everyone would experience this, but it is something for you to discuss with your physician and to monitor with an auto pap if you do decide to get an Oracle!

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Apr 26 2003 subject: Should pressures differ by mask type?
excerpt from a post by Biker (he runs an AWAKE support group; his wife is a sleep lab tech):

Millicent in many cases the pressure needs when using an Oracle are lower do to bypassing any irregularities , obstructions, in the nasal passages.

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Jun 26 2003 subject: Oracle
excerpt from a post by Biker:

Most of the time a retitration is required. In many case your PAP pressure will be lower as you are bypassing any obstructions in the nasal airway.

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Sep 30 2004 subject: Oracle 452
excerpt from a post by rested gal:

sleep talker, your point about a different pressure possibly being needed with the Oracle is well taken. I do recall reading a press release when the original Oracle was introduced, in which the F&P representive (Jillian Gery ?) spoke of a lesser pressure generally being needed when using the Oracle. If the Oracle required higher pressure, I can see where a new titration for straight cpap users would be important. But if a straight cpap machine is still set at its usual titrated level (presumably already safe for the patient, even though it could be set a notch or two lower with the Oracle), that doesn't seem to be as much of a new titration issue to me. For people who are on autopap, that would not even be an issue, of course - since the autopap will automatically adjust its pressure downward (depending on the low limit setting) to whatever gets the job done.
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Rested Gal- thanks for following up on this. Knowing we must contend with OSA and cpap therapy for the rest of our lives, it is reassuring to know you are here with us. Thanks for all the links and research. Makes perfect sense pressure needs could be reduced with the Oracle-- a logical deduction based on anatomy and confirmed by the examples in your sources.

As usual you know whereof you speak.

Toby,

Just didn't want to see you do anything that would compromise your receiving the right treatment. But if your doctor said it was fine, that's a good thing. I know different masks can leak with different/higher pressures, but I never thought you were supposed to adjust the pressure so they wouldn't leak; however, thought you should adjust the mask or don't use it. Also, I never heard before of a doctor prescribing two different pressures, one for the side and one for the back. When you're sleeping, how would you know which way you'll end up positioned? I would have thought it would either be the higher of the two for straight cpap or a varied auto setting. That seems strange to me. But, then again, the more I post, the more I find out how little I have learned.

In any event, hope you end up liking the Oracle. It is a great concept. However, I had a list of problems from it which caused me to discontinue my use of it. But, as we all know with masks/interfaces, what works for one doesn't for someone else.

Best of luck.

[quote="twistedcherokee"]Actually I had raised my pressure when I was using my FF. Because of my beard and mustache it always had a small leak. My wife said that I was still doing the stop breathing thing, so I raised it a little each night until she said that I wasn't doing that any more. My Dr put in my tiration report that I needed 7 cm's as long as I stay on my side. If I am on my back I need 15. With the altitude of where I live it bumped it to about 8.Then I bumped it up to 11. I moved it back down to where it felt like the same amount of pressure on my cheeks(you know when you feel like a ballon getting blown up). I had to bump it up a little from there but I think it is close. Will see tonight if my wife say's anything. An autopap would be the best, but hind sight is 20/20. I can't afford another sleep study and am not sure that they can be that accurate in just 2-4 hrs. After all, those with a autopap, do you notice that some days it varies from others?

Toby

First off, I didn't adjust the mask to stop a leak, I raised it to compensate the leak. Second, my machine is a low end, since I don't have ins to do this and not enough money to probablly do it the right way. It also doesn't compesate for altitude. The Dr told me that I needed the 7 if I sleep on my side(which is what he suggested and told me to put a t shirt on backwards with a tennis ball pinned in the pocket to keep me off of my back). And 15 if I am on my back. So the way that I look at it is more pressure is not going to be a bad thing unless I have more apnea's. So I listen to my wife and she helps me get the machine set up by telling me if I am sleeping with 1 no snoreing 2 I stay breathing and 3 not tossing and turning. I would love to have an apap with all the bells and whistles and a pulseoxymeter. I have thought about using a camcorder to help check on my sleeping.

Toby

Toby,

I'm sending you a PM.

Thanks LoRi