Newbie Question: Does mask type affect pressure need?

[Mask2sleep]

I apologize if this has been asked before.

On Wednesday afternoon (8/11) the DME is coming to my house and setting me up with my BiPAP, mask, & etc. I am both looking forward to this and apprehensive as that means tomorrow I start my lifelong membership in the hose-head brigade and I will start my education in learning how to sleep a new way. This will be complicated by the fact that my 7-month old baby girl is currently beginning to teeth and currently has a cold, so I’m up a couple times a night regardless of sleep apnea.

I will have the PR System One REMstar BiPAP Pro with Bi-Flex and System One Heated Humidifier. My prescribed pressures are 11 / 7. During titration I briefly wore Quattro FFM and most of the night a ComfortFusion nasal mask. The prescribed pressure was determined while I was wearing the nasal mask.

Anyways, on to the question –

I will be trying on multiple masks tomorrow – nasal pillows, nasal masks, and full face masks. If I can get one that is comfortable with minimal leaks I’ll likely choose a FFM to start with and then get a backup from cpap.com. Does the mask type have any effect on the pressure needed for therapy? I may be thinking too much about this, but it seems to me that since there is more space/volume in a FFM than a nasal mask that more pressure would be needed than was prescribed using the nasal?

Thanks very much!

[jamieay]

Nope - I don't think the mask type should matter. Both the sleep study people and the DME people told me to simply get one that's comfortable.

Jamie

[happysleeper]

Hi Mask2sleep, welcome to the forum!

I don't have a PR System One REMstar BiPAP Pro, but on my machine there is are separate settings for pillows vs. nasal mask vs. full face mask. I suspect that this is true for most machines, since, as you postulate, the mask interface can affect flow. The DME rep will set the air flow numbers to 11/7 for you, and then additionally add what type of mask you use, if your machine allows.

If you are going to be changing mask types at home, I would suggest that you find your machine's clinical manual (others on this site can help you find the link, if you can't find it by searching on line). The clinical manual, as opposed to the user's manual which is usually handed out by the DME company with each machine, tells how to change mask and flow settings. That way, when you change masks types to tweak what works for you, you'll be changing your machine's settings without having to go back to the DME company. You will also then have the option to continue to find the settings which lower your AHI to the lowest possible for you.

Most DME companies can't give out the clinical manuals, as they fear legal repercussions of suggesting that their client have control over machine settings. You may enjoy searching out discussion threads about this on this forum.

Best of luck, Happy Sleeper

[Mask2sleep]

Great, thank you! Dreamon suggested that I find the clinical manual as well. Alas, so far my google-fu has not been up to the task.

[Emilia]

Here is the link to the page on which you can get your clinician manual. Your machine is listed at the bottom (scroll down to list of large manuals). Here you will need to request this manual by mail since it is so large.
http://www.apneaboard.com/CPAP%20Adjustment.htm

[Bearcat42]

In some caes the mask is determined by the pressure. Mine are 21/17 so a FFM just will not ever seal so I use a nasal instead. Trial and error.
Good luck with your visit!

[DreamOn]

I don't have a PR System One REMstar BiPAP Pro, but on my machine there is are separate settings for pillows vs. nasal mask vs. full face mask. I suspect that this is true for most machines, since, as you postulate, the mask interface can affect flow.

Happysleeper has a ResMed machine. The ResMed machines subtract the mask's expected vent rate (the air that's expelled to get rid of CO2) before it reports the "Leak Rate." That's what the ResMed machines use the Mask Setting (pillow, full face, etc.) for. It doesn't have anything to do with adjusting the machine's air flow to fit the mask type.

So, with a ResMed machine, the "ideal" Leak Rate is zero, and anything under 24 L/min (0.4 L/sec) is considered "acceptable." Respironics machines don't report leaks the same way. With those machines you have to know the mask's expected vent rate for your pressure, which is listed in the user guide that comes with each mask.

I hope that all goes smoothly tomorrow when you get your equipment, Mask2sleep! I wouldn't be concerned about the pressure setting when selecting your mask. Choose a mask that's comfortable and fits properly (doesn't leak). If mouth-breathing tends to be a problem for you, then you may be better off with a full-face or hybrid mask, unless you want to try a chin strap and/or mouth-taping with a nasal or nasal pillows mask. Take time to try on masks while lying down with your machine on at full pressure, moving your head around on your pillow to test for leaking.

As for getting up during the night to tend to your little one, if you're going to be up only briefly, you can turn your machine off and just keep the mask on your face (disconnecting it at the hose). You'll be able to breathe for a while that way. Then, when you return to bed, just hook the hose back on and restart the machine. If you'll be up for longer periods (or don't want your daughter playing with your mask ), then you may want to remove the mask. Some headgear have quick-release clips, so you don't need to remove the headgear by opening the Velcro. If you get a Respironics mask that doesn't have the clips, there are quick-release clips that you can purchase that work with some of them. It may be a bit awkward at first, but it'll all become second-nature quickly!

[happysleeper]

Thanks for the clarification, DreamOn! Happy Sleeper

[kteague]

For the benefit of anyone reading and wondering if the mask type affects pressure need, while this won't likely apply to you, Mask2Sleep, anyone with lower pressures should know their mask's minimum recommended pressure so as to assure proper venting of exhaled air.

[usmccop]

I apologize if this has been asked before.

On Wednesday afternoon (8/11) the DME is coming to my house and setting me up with my BiPAP, mask, & etc. I am both looking forward to this and apprehensive as that means tomorrow I start my lifelong membership in the hose-head brigade and I will start my education in learning how to sleep a new way. This will be complicated by the fact that my 7-month old baby girl is currently beginning to teeth and currently has a cold, so I’m up a couple times a night regardless of sleep apnea.

I will have the PR System One REMstar BiPAP Pro with Bi-Flex and System One Heated Humidifier. My prescribed pressures are 11 / 7. During titration I briefly wore Quattro FFM and most of the night a ComfortFusion nasal mask. The prescribed pressure was determined while I was wearing the nasal mask.

Anyways, on to the question –

I will be trying on multiple masks tomorrow – nasal pillows, nasal masks, and full face masks. If I can get one that is comfortable with minimal leaks I’ll likely choose a FFM to start with and then get a backup from cpap.com. Does the mask type have any effect on the pressure needed for therapy? I may be thinking too much about this, but it seems to me that since there is more space/volume in a FFM than a nasal mask that more pressure would be needed than was prescribed using the nasal?

Thanks very much!

Do the FFM. I just changed over. The nasal pillows began to leak like crazy after 3 days of treatment. I just got my new FFM today.

[breakfast]

I apologize if this has been asked before.

On Wednesday afternoon (8/11) the DME is coming to my house and setting me up with my BiPAP, mask, & etc. I am both looking forward to this and apprehensive as that means tomorrow I start my lifelong membership in the hose-head brigade and I will start my education in learning how to sleep a new way. This will be complicated by the fact that my 7-month old baby girl is currently beginning to teeth and currently has a cold, so I’m up a couple times a night regardless of sleep apnea.

I will have the PR System One REMstar BiPAP Pro with Bi-Flex and System One Heated Humidifier. My prescribed pressures are 11 / 7. During titration I briefly wore Quattro FFM and most of the night a ComfortFusion nasal mask. The prescribed pressure was determined while I was wearing the nasal mask.

Anyways, on to the question –

I will be trying on multiple masks tomorrow – nasal pillows, nasal masks, and full face masks. If I can get one that is comfortable with minimal leaks I’ll likely choose a FFM to start with and then get a backup from cpap.com. Does the mask type have any effect on the pressure needed for therapy? I may be thinking too much about this, but it seems to me that since there is more space/volume in a FFM than a nasal mask that more pressure would be needed than was prescribed using the nasal?

Thanks very much!

Do the FFM. I just changed over. The nasal pillows began to leak like crazy after 3 days of treatment. I just got my new FFM today.

Ah see, I'm the opposite. I had ridiculous leaking with my FFM. One night was something like 40l/m, and I have no clue how I slept like that but I woke up the next morning with extremely dry eyes and feeling like garbage. No leaks now with the hybrid I have (and the ulcer on my nose from the Quattro is almost healed). Just goes to show that everybody really is different.

PS, mask2sleep, my 10-month-old gets cold-like symptoms whenever he's teething. We've made it mostly painless (for mum & dad, at least) with Tylenol and Hyland's Teething Tablets right before bed.

[usmccop]

My mouth mask w/ nasal pillows worked great too, but after 3-4 days it just leaked like crazy. I kept waking up from the shhhhhhhhhhh noise. I tried everything to correct it with no avail (head straps, different size pillows, medical tape, duct tape , etc. You're right- different strokes for different folks. Hopefully this new FFM works.