Need to change CPAP pressure?

[warrain]

I was using a nasal pillows mask with pressure setting of 7cm. I'm predominently a side sleeper which resulted in the pillows often being dislodged resulting in major leakage.
I'm now trialling the ResMed Mirage Activa LT. The pressure setting remains at 7cm. I've been using it only for a few days, however, there has been a significant increase in Apneas using the Mirage.
I'm wondering whether the pressure setting should be increased. With the nasal pillows the air shoots more directly up the nose than it does with the Mirage which encircles the nose.
Any experience or thoughts on this please?

[SleepyGrant]

I think I agree with you. I was tritrated with a nasal pillows mask at 8 cm but I chose to use a full face mask and over a weeks time I watched my AHI's climb steadily from 7 to 14. I then talked to my RT and they put my machine in auto mode and it settled out at 10.8 cm. I think it may have climbed in part because I am a mouth breather also. Another factor may also be that when a person sleeps at home they are more relaxed without all the wires and familiar surroundings which increases the likelyhood of more events to occur. But this is only my opinion and you should talk to your doctor about changing your pressure.

[KatieW]

When I changed from nasal pillows to a nasal mask, my AI went up the 1st 2 nights, but then it settled down again. Now that I look back, there may have been other factors, so changing from pillows to nasal mask was the most obvious cause, but might not have been the actual cause. Who knows? (Rhetorical question)

[rested gal]

I'm predominently a side sleeper which resulted in the pillows often being dislodged resulting in major leakage.

You might want to try adding a homemade strap around the front of a nasal pillows assembly (you'd have to figure out a way to keep the homemade strap from covering the exhaust vent) and tie it behind your head.

It's pleasantly surprising how often just a simple, soft, stretchy homemade strap (like the leg cut off a pair of pantyhose tights) steadies a mask, especially nasal pillows) better than any adjust of the mask's own straps can do. Much like holding one's fingers lightly pressing against the front of the pillows. I wouldn't be able to use my nasal pillows mask at all if I didn't add a homemade strap. Without the strap, leaks like crazy for me. With the strap, perfect.

The drawings below are of the Headrest nasal pillows mask (my personal favorite) to give you an idea of various ways to route one or two homemade straps to stabilize the pillows:



Best way to tie a homemade strap behind (or above) one's head is with a "doublestart knot" -- lays flat, easy to adjust, stays secure yet easy to take off in the morning:
DoubleStart Knot How to tie a flat knot behind head when using a homemade strap.
http://www.fieggen.com/shoelace/doublestartknot.htm

Hanging the main air hose up out of the way, so the weight of the main air hose doesn't tug at a mask when you move your head or turn over can help quite a bit:

LINKS to Hose hangers and methods of managing the air hose
viewtopic.php?t=10640

[jmelby]

Did you remember to change the mask setting on the machine? On ResMeds, some have a specific setting for Activa, otherwise use Standard for that mask.

[warrain]

Thank you all for your helpful suggestions. I've gone back to the nasal pillows with addition of a home made strap (pantyhose leg) that secures the pillows in place allowing me more freedom to sleep on my side. Many thanks to rested gal for this suggestion.

[DoriC]

You might need a different bed pillow or special cpap pillow for side sleepers. You can do a Search here for that topic. Good Luck.

[GumbyCT]

I completely removed the headgear from my headrest and use only a knee-high and a scrunchie to hold it on. Not only does it work better - it is soooo much cooler.

I wonder if leaks were your problem. Don't forget to try some Lansinoh to help with the leaks too.