Does type of mask affect pressure needs?

[tiredmama]

Since I don't have an APAP to play with auto-titrating, I wondered if those who do find certain masks tend to use certain pressures.

My in-lab titration was with a full-face mask and seems to work at home with that pressure. When I try nasal pillows, and change the machine setting accordingly, it feels like there is much less air flow. Sometimes I feel like I'm suffocating before I even get to sleep (or maybe I've dozed off, I'm not sure), and I switch back to the FF. The one night that I managed to keep the pillows on all night, my numbers were horrible. I suspect my mouth was not staying shut despite attempts to keep it that way. The machine data combined with the suffocating feeling made me wonder if the mechanics of breathing only through my nose might require a higher pressure to keep my airway open?

[Pugsy]

Normally it is the other way around when people report needing different pressures when going between FFM and nasal pillow mask..meaning less pressure is needed for taking care of the events.
Technically pressure is pressure and shouldn't make any difference in treatment but there have been a few people who were able to say they used less pressure with nasal pillow mask and still get great therapy.

What is your pressure? Feeling like not getting enough air is common if pressures are on the lower side and/or ramp with lower pressure is used.

More likely the not so great data with the nasal pillows was related more to general overall bad night, restless night, etc.

[tiredmama]

My pressure setting is 6. I don't use ramp. I felt almost like I was using ramp with the pillows which is why I wondered if a little higher pressure would have helped.

I was told I have very small nostrils and was given XS pillows. The holes really are tiny, and I wondered if having size small would give me more airflow, or if the size of the holes doesn't matter. Looking at those tiny holes and at my nares, I think I could do something a little bigger without a problem.I tend to flare my nostrils a little when breathing through my nose, so maybe that XS pillow was giving me a straw effect?

I love the concept of the nasal pillows and wish it would have worked better for me. At this point I think the only way I could make it work is a lot of stuff strapped to my head to keep my mouth firmly shut and I'd just as well wear a full face mask. The DME has a liberty hybrid on order for me though...perhaps the best of both worlds.

[Pugsy]

You should have been given 3 sizes of nasal pillows.
XSmall, Small and Medium.
Yes, the small would offer you more perceived air movement and be more comfortable for you. This happens to a lot of people especially when they are using relatively low pressures (your 6 cm is low because the lowest the machine will go is 4 cm).
If they didn't give you 3 sizes...they kept something that you paid for and they should offer you the additional sizes for free.
All new complete mask setups include all the sizes.

[tiredmama]

I wondered if the masks were always shipped with more pillow sizes since they are sold that way on here and many people seem to have extras. The RT threw the extra pillows in a drawer full of them in various sizes and took out an extra XS pillow as a replacement to send home with me. I'm pretty sure she billed the insurance for the replacement, which is so kind of the DME if they are just giving me pillows they didn't send home with other mask users who used larger sizes.

If I had the size S at home, I would have tried them to see if it helped, but I wasn't too excited to deal with the DME to get them. I really do think the hybrid will be the best thing for me at this point but wonder if I could use a nasal mask later. I'm training myself more and more to breathe through my nose while awake and hopefully it will get easier while sleeping too. (I had a severely deviated septum corrected earlier this year and could NOT get sufficient air through my nose before the surgery.)

I know my pressure is low but when I had my titration the tech said that small amount made a HUGE difference, and just going from 4 (starting pressure) to 6 helped a lot. She also suspected I would have needed more pressure before my surgery, but we held off on titration until after it because my ENT thought it would change things. My primary issue on my initial study was hypopneas and not obstructive apneas. The hypopneas caused me to wake to breathe so were very disruptive to sleep, in addition to whatever else the low oxygen was doing to my body. I had a LOT of daytime sleepiness and fatigue before treatment started. I guess that makes me one of those people who has a more mild case but strong symptoms and I really do notice the difference when I have a good night with my mask on.

[chunkyfrog]

The DME STOLE those extra cushions from you! (Apria does that where I live.)
They know that if you try to trade with other patients, you will end up HERE
and they won't make nearly so much dirty money.

[Goofproof]

Leaking masks effect pressure, you need the software to tell when and where the leaks are happening. Jim

[avi123]

My I suggest that you stay with your FF mask and start raising the pressure on your S9 Elite one cm at a time, up to 10 cm,
and keep a log the way I did when I started CPAPing:


Done in 2011.





During logging the above data I used several FF masks (including the Quattro FX) but mostly F&P FF #431 and #432 which caused lots of leaks.
My next step was to disregard tests with leaks above 24 L/Min. I have noticed that the results events- wise were better as the Pressure rose. So I settled on a pressure of 10 cm, no ramp, EPR =2, full time. After 6 months I bought an S9 Autoset which verified that my optimal pressure was around 11 to 12 cm. A sleep study done later found that my optimal pressure was indeed 13 cm on CPAP.

After switching to my present mask with a CHINSTRAP I achieved unbelievable good results. See here a full month average results: