PR System One Resistance, Aflex and different masks. :(

[signal20gsxr]

I already did a search and found a graph from another post showing the system one resistance settings based off of PR masks. Its only been 114 days that I have been using a XPAP. I have used 3 different masks so far. Swift Nasal FX, Quattro FX and a ComfortSelect. With settings on my machine being the same my numbers are all over the place depending on what mask I use. According to Phillips Respironics I should have medium pillows set to X2, ComfortSelect set to X1 and a FFM set to X1. Currently its off and has always been set to off.

I specifically asked my DME if my PR System one APAP needs any adjustments when using different the different masks. She said no.

The one night I tried the Quattro FX my AHI was 6.85. AHI peaked out at 25 during one point. This is the absolute highest it has ever been!

The first night I used my ComfortSelect nasal mask my AHI was 0.09- I had one OA and two FL's. Lowest it has even been. The second night I used this mask I tried a different chin strap. AHI was 1.2 and I woke up not able to breath at all from my nose. For what every reason my sinuses were full of congestion. However this second night with was my first for using a hose cozy and a new chin strap. I went from a non adjustable Ruby style that I had to wear backwards with a sock folded in half under my chin to keep my mouth half way closed to a PR premium adjustable chin strap which works a lot better.

To me it makes sense that different masks need different settings. Nasal pillows have minimal room for the air to expand before it goes into your nostrils. It also has a smaller hose up to the pillows and vent holes. The ComfortSelect has a medium area for the air to expand once exiting the hose before it goes into your nose and has no vent holes but does leak around the swivel. The Quattro FX is a very large mask with a lot of vent holes.

My DME said that the more area the mask has it allows the air to expand acting like a cushion. I have to agree with this because it explains why my numbers were so high when trying the full face mask with no changes to my machine.

I was having really bad issues with gas and bloating and I thought it was because of my hiatal hernia and 20+ years of GERD. It actually turned out to be mostly Aerophagia. However my new sleep doc lowered my peak pressure down to 9.5. This was my 90% pressure. I do not know if the bloating/gas was just from Aerophagia or Aerophagia and too high of a peak pressure. I have hit 15 once before, 13.5 another time but it usually ran 10.5.-12. If my leak line stays in the 20's my pressure stays around 8-8.5.

I really like the nasal pillows best as far as comfort but the chin strap kind of negates this. However the ComfortSelect has proven to work best as far as numbers but still have to use a chin strap. I wouldn't mind using the Full face mask so I wouldn't have to use a chin strap. Just don't know what the heck to set my machine at to get it to work. I did try taping my mouth for a about week but it tore the crud out of my lips and on one night I lost power for over a minute and never work up, headgear was still on and tape was still sealing. I knew I lost power when I woke up because all of my clocks where flashing and the time was way off.

There are times like when I am sick I am going to have to use the FFM. I can only assume that I need a little more pressure, Aflex off maybe and set the System one resistance to X1 just to start with. I don't even know what the System one resistance does!! How does it act with it off vs 4?

Current settings are System one resistance off, Aflex 1, base pressure 6, max 9.5cmH20, and heated humidifier on 2. Also now that I have the hose cozy does this keep the moisture from condensing in the hose allowing more to get into the air by the time it gets to my mask? Its 100% humidity here currently and even with it on 2 I am getting water droplets in my mask. Should I turn it down to 1. Could to high of a setting be causing nasal congestion?

Any suggestion would be greatly appreciated. Thanks.

[Pugsy]

System One Resistance control explained (sort of) here but it is all we have.
http://systemoneresistancecontrol.respironics.com/
It's not a critical thing. You can play with the various settings if you wish. Won't hurt anything.
I played with them a while back and couldn't tell that it did anything because no matter what setting there was no real change in any of my software reports and data beyond normal night to night variations.

Regarding nasal congestion and relation to humidity. Some people will get congested with higher humidity and some people get congested with less. It's an individual thing. There is no right or wrong blanket setting. Each person has to figure out what works best for them.

[signal20gsxr]

Thanks Pugsy,

The same humidifier settings with the hose cozy does make me more congested for what ever reason. I turned it down to 1 and that got rid of it. Going to try it tonight with no humidifier and see how it does. In the past I tried to have it set as high as possible to help warm the air up. Now it actually feel colder with with hose cozy.

I did mess with the System one Resistance setting. X2 feels the same as it being off. However X1 using the nasal pillows made it feel like the pressure was 8 or 9 instead of 6. Weird.