I dream of using the VCOM, but I run out of air,... ?

[Albatros]

I dream of using a nasal mask vs my full face mask.
The VCOM device seems to suppress mouth breathing, which forces me to use a full face mask and put on a tape.
My problem is that, with the VCOM, I feel like I'm running out of air, which suspends the experience.
My question: should I increase the min (and max) pressure when I use the VCOM ?
I use the Resmed 11 and I am at P min 11, Pmax 19 and EPR 1.
Thank you very much for your help

[dmoss74]

i use a vcom. it will feel "different" at first. but yes, you should increase your pressure by up to 2cm of pressure when using it. try 1cm for a night, then 2cm a second night and see how that feels. i believe they recommend no EPR when using it, so try that, too.

and use oscar or sleepHQ to see the data.

[Albatros]

Thank you. I will try as you said and feel if it works.

Question:
Regarding the assessment of the situation: with the VCOM, what objective have you achieved?
-no mouth breathing?
-no tape?
-possibility of switching to a nasal mask ?
-better OSCAR and O2 reporting
-other?
-any negative ?

Thank you

[ChicagoGranny]

I dream of using a nasal mask vs my full face mask.

Have you tried increasing your EPR to 3?

[dmoss74]

Thank you. I will try as you said and feel if it works.

Question:
Regarding the assessment of the situation: with the VCOM, what objective have you achieved?
-no mouth breathing?
-no tape?
-possibility of switching to a nasal mask ?
-better OSCAR and O2 reporting
-other?
-any negative ?

Thank you

way better leaking data
lower flow limits
ffm, so no tape anyway.
don't have an o2 meter
no negatives at my end.

i am a back sleeper, so this really helps me. plus, i augment with a caldera releaf cervical collar. i may try a nasal mask, but fear i would need to mouth tape. i don't really want to go that route. i did it before with less than stellar results.

good luck. give it a try.

but i believe the makers state it is best used with no epr. but i am going by memory.

[ChicagoGranny]

caldera releaf cervical collar

Do they expect a person to wait until spring?*



*Yes, Caldera spells it that way.

[dmoss74]

caldera releaf cervical collar

Do they expect a person to wait until spring?*



*Yes, Caldera spells it that way.

???

https://www.amazon.com/stores/page/20A9 ... f_=ast_bln

[ChicagoGranny]

???

[WallyPepper]

I have been using a VCOM for almost two months now. and I can second most of what @dmoss74 has said.

I get no leaks, coming from about 20% leaking every night pre-VCOM
Lower flow limits, I unfortunately have two 0 flow leak days in my OSCAR records because I am an idiot and forgot to put the SD card back in the machine those nights
I was able to switch to nasal pillows from a nasal mask
I tape my mouth although most nights it really isn't necessary, habit I guess.
There is no drop in SpO2, verified on my Samsung watch and a CheckMe O2 Max, which are worn every night.

Most people that try the VCOM ignore or don't read far enough to see that Dr Noah made some very specific suggestions for use.

• It works better in CPAP mode but will also work in APAP, I use APAP but a very tight range
• You should raise the pressure by one or two cm, the higher your therapy pressure the higher you need to make this adjustment
• Set your mask type to Full Face Mask, no matter what type of mask you use
• You can gang VCOM's together if you want, I have personally tried two at once, but found one to be sufficient

The Inspiratory pressure relief is a linear progression as your therapy pressure rises. VCOM was an interim solution, KPAP is the algorythm that will replace VCOM when they release a machine in 2025.

[Albatros]

Great thank you.
I will therefore try to move from:(min Pressure 12 + Full face Mask+ Tape) to : (VCOM + min Pressure 13 (or 14) +pillow mask + Tape ?).

The major benefit I expect is the stop or great decrease in mouth breathing leading to the move to a pillow Mask.
The condition will be that I don't feel a lack in the air during the inhalation.

[WallyPepper]

@Albatros,

I am at 16 cm and there is only really about 2 - 3 cm drop during inhalation. Since your lower you might only see 2 cm drop. During exhalation the pressure remains at the therapy setting (13 or 14 in your case). Make sure you also turn EPR off, if it is on. Please be aware that there will be a bunch of people that will push back on turning off EPR, but IMO, biomechanically it is a dumb setting.

One last note, give it a good chance, more than a night or two. It took me two nights to get used to the new setup. After a fair shake, you might find it is not for you. I have not found that in my case study of one person. I should also have mentioned in the benefits, that I actually fall asleep faster than pre-VCOM and increased my Deep Sleep time by nearly 30% (Per Samsung Watch).

[Albatros]

Thank you again.

I looked at my 12 months statistics:
average min P = 12.2
95 % P = 15.5
which implies that I should have set my min P = Epap close to 12, according to the experts of the Forum.
But I had set it at 10
So It seems that I have had Min P = min Epap too low !

Anyway, with the VCOM, I will go for Min P = 13 and, if inhalation problem, for Min P = 14. EPR =0.

And I will check:
- flow limit (vs my 12 months 95 % Flow limit = 0.11)
- mouth breathing
- comfort
starting with my FFM, and then with a pillow mask.

I cross fingers.