Difficult first experience with the nasal pillow P10 ?

[Albatros]

I just started, 3 nights, with the P10 nasal pillow mask.

Great pleasure!

but I have two concerns:

-I read a lot that this mask had a very good seal. But I'm experiencing the opposite: huge leaks of 25/30 lmn. Even if I think I'm doing things right. Where is the bug ? What would be your advice?

-besides, maybe it's due to the fact that the air arrives directly and doesn't pass thru a cushion, I have a very big mouth breathing effect, significantly more than with a nasal mask. That I only contain thanks to two layers of tape + the placement of the tongue on top of the palate

Thank you for your input, always much appreciated

[jlsmithseven]

I just started, 3 nights, with the P10 nasal pillow mask.

Great pleasure!

but I have two concerns:

-I read a lot that this mask had a very good seal. But I'm experiencing the opposite: huge leaks of 25/30 lmn. Even if I think I'm doing things right. Where is the bug ? What would be your advice?

-besides, maybe it's due to the fact that the air arrives directly and doesn't pass thru a cushion, I have a very big mouth breathing effect, significantly more than with a nasal mask. That I only contain thanks to two layers of tape + the placement of the tongue on top of the palate

Thank you for your input, always much appreciated

I'm done with the mask because of the leaks. It always shifts around on my head. The strap is the main fault of this mask. It wears out very quickly and hard to keep a good seal. You have to really tighten it down or have no hair for it to really work I think. That's just my experience. I just got the Knightsbridge Chin Strap and I think it works fantastic at stopping my mouth leaks. Maybe combine that with the P10 and it will help stop the shifting around and stop your leaks, all in one.

[Pugsy]

-I read a lot that this mask had a very good seal. But I'm experiencing the opposite: huge leaks of 25/30 lmn. Even if I think I'm doing things right. Where is the bug ? What would be your advice?

The P10 is a great little mask but it isn't perfect. It has minimal headgear and that minimal headgear can cause the mask to slide around and leak.

So there are 2 places for a nasal pillow mask of any kind to leak....
either mouth opening leaks or mask/pillow movement leaks.
To fix it you have to figure out where the leak is coming from....mouth or mask movement.

Sounds like you tape your mouth shut....is that correct? If so, is the tape still secure in the morning or is it loose which could allow for mouth opening leaking to happen.
If the tape is secure then the leaks are likely mask movement leaks....so maybe the wrong pillow size is being tried or maybe you need to tighten the straps a bit.

Also...say say "huge leaks of 25-30 L/min"....where did you get those numbers? Off the machine's LCD screen or the OSCAR reports?
How bad they might be is going to depend on what number that represents...and how long you were at that level of leaking.

But I will be honest...I don't even consider that much leak as "huge"....the machine can easily compensate for that amount of leak.
You might want to read what I wrote about leaks in this thread.
viewtopic/t185666/Therapy-thread--a-few ... l?start=15

Finally if these are numbers off the machine's LCD screen they are what we call 95% numbers and the definition of a 95% number is where a person was AT OR BELOW for 95% of the night. People often don't know or they forget about the "or below" part of the definition.
It is NOT where a person spends 95% of the night.

[Albatros]

Thank you Pugsy for your reply and your thread (which I am copying and saving).

The leaks that I indicate come from the mask because my mouth was double closed (Somnifix tape + Cover roll stretch band).

The "huge leaks" of 25/35 l?
This figure comes from the screen of the Resmed air sense 11. I don't know if it's 95% numbers.

I invented the word "huge" (but I hadn't read your thread yet !).

Are these leaks disturbing my sleep?
Probably not ?

What does affect my sleep a lot though, is the strong mouth breathing that puts a lot of pressure on my taped mouth.
So strong that I have to use my tongue stuck to the palate. Otherwise, I have the impression that my mouth become so swollen that it might "explode" . This little game prevents me from sleeping.

My mouth breathing experimented with a nasal was much less powerful than with the P10. I wonder if the difference is not related to the fact that the air with the nasal pillow does not go through a receptacle as with the nasal.

I loved the lightness of the P 10 and I would like to keep doing things not have to retreat, too quicly, to a FFM.

Thaank you

[Pugsy]

The "huge leaks" of 25/35 l?
This figure comes from the screen of the Resmed air sense 11. I don't know if it's 95% numbers.

It's a 95% number....that's a certainty because that's the unit of measure that the machine reports on the LCD screen.
I suspect if you use OSCAR or some other software and actually look at the leak graph that you will see a lot of the night without large leaks and a relatively short period of time up over 24 L/min.
If they don't wake you up...shrug your shoulders and move on. Not enough prolonged really large leak to worry about as long as it isn't disturbing sleep.

95% numbers (either leak or pressure) are notorious for not always conveying the big picture..
Read this thread.
viewtopic.php?f=1&t=108724&p=1036669&hi ... t#p1036669

What nasal mask (not the P10) did you try that seemed to be less problematic for you. If you mentioned it I have forgotten and I don't have time to go back and read all your thread.
I am having a hard time understanding why you feel the nasal pillow mask is more forceful or causing problems when a nasal cushion mask didn't. I don't doubt you but I have to understand or try to understand your side of things to be able to maybe offer ideas.
For me and what I sense....the pressure from the P10 or my Eclipse or the N30 all feels the same to me and doesn't cause any mouth problems.

It does sound like you probably are experiencing some chipmunk cheek issues (discussed often on the forum) and that is more from air entering your mouth than it is whatever mask a person uses.

[robysue1]

Thank you Pugsy for your reply and your thread (which I am copying and saving).

The leaks that I indicate come from the mask because my mouth was double closed (Somnifix tape + Cover roll stretch band).

The "huge leaks" of 25/35 l?
This figure comes from the screen of the Resmed air sense 11. I don't know if it's 95% numbers.

The leak number on the LCD is the 95% leak rate. Your leaks are AT or BELOW 95% leak rate for 95% of the night.

In order to really tell whether that leak rate is genuinely problematic, it would help to look at the data in Oscar or over at SleepHQ (freebie version is fine). Or at least tell us if Mr. Green Smiley Face shows up in the morning on the Sleep Report.

What does affect my sleep a lot though, is the strong mouth breathing that puts a lot of pressure on my taped mouth.
So strong that I have to use my tongue stuck to the palate. Otherwise, I have the impression that my mouth become so swollen that it might "explode" . This little game prevents me from sleeping.

The tongue position you describe is the natural, normal position for the tongue when we are breathing through our noses and not using our mouth to talk or eat.

The reason you have to keep the tongue up there is that when the tongue is in that position, it naturally seals off the oral cavity from the nasal cavity and the upper airway. This prevents the pressurized air from flowing through your nostrils and into your mouth. When the tongue comes off that position, the pressurized air can flow into your mouth and cause the sensation of your mouth beings swollen and worthy of a potential explosion. (I used to call it "chipmunk cheeks"). Sometimes you start swallowing the trapped air (often in your sleep) and that can lead to some pretty bad aerophagia and stomach swelling issues.

What's the fix? Well, you might want to consider not taping the mouth quite so tightly. That would let some of the air leak out of your mouth. (Yes, there's that pesky word, "leak".) The question is whether allowing the mouth leaking (so you can get and stay asleep) creates leaks that are so long and so big that they compromise your therapy or the leaks themselves wake you up.

And if you are really a dedicated mouth breather, you may need to consider a full face mask---that kind of a mask allows you to open your. mouth and breathe through it without losing xPAP pressure. Because you can open your mouth, the probability of too much air getting trapped in the mouth is minimized.

My mouth breathing experimented with a nasal was much less powerful than with the P10. I wonder if the difference is not related to the fact that the air with the nasal pillow does not go through a receptacle as with the nasal.

I loved the lightness of the P 10

If the P10 didn't work out for you because it was simply too unstable and slid around too much, you might want to try the Resmed Swift FX nasal pillows mask. Or the Bleep or the Eclipse masks which are stuck directly on your nose with an adhesive.

[Miss Emerita]

I just wanted to underline that the way you're positioning your tongue is just right. You can practice this position during the day. You should be able to breathe through your nose only with your mouth wide open, so long as your tongue is in place.

I wonder whether your tongue moves out of position due to your jaw sagging a little. The Knightsbridge strap already mentioned would be one helpful option; another might be a soft cervical collar.

[zonker]

...another might be a soft cervical collar.

came to see this, left satisfied.

to the op: this is what i use and has helped tremendously. the one slight drawback is that the firm foam cervical collar has a tendency to slowly collapse. i find i can get it to last roughly 8-10 weeks before i have to replace it as it just loses it's firmness and no longer works well.

in fact, i'm at that point now and need to change out!

[lynninnj]

I just started, 3 nights, with the P10 nasal pillow mask.

Great pleasure!

but I have two concerns:

-I read a lot that this mask had a very good seal. But I'm experiencing the opposite: huge leaks of 25/30 lmn. Even if I think I'm doing things right. Where is the bug ? What would be your advice?

-besides, maybe it's due to the fact that the air arrives directly and doesn't pass thru a cushion, I have a very big mouth breathing effect, significantly more than with a nasal mask. That I only contain thanks to two layers of tape + the placement of the tongue on top of the palate

Thank you for your input, always much appreciated

does your p10 have adjustable strap that might need readjustment? I wash mine with hot water 1-2x weekly to shrink it a bit and then helps snug it up.

Lansinoh is 100% lanolin and a teeny bit helps create a tacky seal.

If you have mask on and cover small hose, then breathe out, the leaks near the nose become far more apparent and potentially addressed. When no leaks your nostrils fill up and puff out.

Hth

ps i do all three of these nightly with my n30 and it’s near perfection. can be done with p10 also

[Jlfinkels]

I just started, 3 nights, with the P10 nasal pillow mask.

Great pleasure!

Welcome to the wonderful, maddening, frustrating, world of CPAP! Note the bolding of your first sentence. CPAP is a journey with many frustrations and discoveries along the way. It takes time, sometimes months or longer, to really get comfortable with things. You will likely have to make some small and big tweaks along the way, so patience is critical to success.

-I read a lot that this mask had a very good seal. But I'm experiencing the opposite: huge leaks of 25/30 lmn. Even if I think I'm doing things right. Where is the bug ? What would be your advice?

Anything above 24L/min is considered a large leak, but any leak that wakes you up is bad and wrong. Call it baddong. It needs to be dealt with using a variety of techniques. Tongue placement (as you noted), appropriate mask and fit for your comfort, mouth tape or a soft cervical collar to help keep you mouth closed whilst asleep, and many, many more.

-besides, maybe it's due to the fact that the air arrives directly and doesn't pass thru a cushion, I have a very big mouth breathing effect, significantly more than with a nasal mask. That I only contain thanks to two layers of tape + the placement of the tongue on top of the palate

You will learn over time to keep your tongue properly placed, but that is only one of a number of variables that you will learn to manage. A cervical collar will help with positional apnea issues, in addition to keeping your mouth closed.

When you can post some OSCAR charts for those schooled in divination to help adjust your settings. That will guide the recommendations folks make.

[jlsmithseven]

I’ve had the p10.
Like someone else said, try the dreamports/halo solution. Very similar to p10 in terms of nose weight, but the difference is they won’t slide around or leak. I’ve found mouth taping to be too much pressure on mouth breathing also, which is why I changed to the Knightsbridge cap. Don’t bother with standard chin straps they’re not good. You don’t need to keep them super tight either.

[ozij]

What does affect my sleep a lot though, is the strong mouth breathing that puts a lot of pressure on my taped mouth.
So strong that I have to use my tongue stuck to the palate. Otherwise, I have the impression that my mouth become so swollen that it might "explode" . This little game prevents me from sleeping.

My empasis.
Ouch.
That sounds very familiar.

It happened to me after some happy years with a pillows mask and taping, and I had no choice but to switch to full face (actually hybrid mask). It's my large tongue relaxing away from the back of my palate - and had nothing to do with my chin dropping to open my mouth. I used an FFM (Hybrid) for years -until I somehow tried a pillow mask again, and discovered that my cheeks were not blowing up so badly and it didn't disturb my sleep - so now I'm using nasal pillows masks again, and firmly taping my lips.

The newer, modern, hybrid FFM's are not that heavy -- and they may even release some of that mental tension caused by "I have to keep my tongue up "or else".

[Albatros]

Ozij, you give me hope. I have started the Dreamweare face, last night. Lot of leaks (44 l), painful and lot of awake. I will shrink a little bit the head gear.

[DayDreamBeliever]

I may be getting mixed up, but I think I read somewhere that the N30 headgear, which is adjustable, is compatible with the P10?
Also I noticed on Amazon adjustable headgear from 3rd parties which claim to be P10-compatible.
Might be worth looking at.

[Dog Slobber]

I may be getting mixed up, but I think I read somewhere that the N30 headgear, which is adjustable, is compatible with the P10?

Yes, the N30 Headgear works with the P10.

P10 now uses the N30 headgear.