UPPP and Nasal Pillow Mask

[Sleepyinpdx]

I've been on cpap for several weeks and I'm so glad I found this site as members' insights into this new way of life have been very helpful and reassuring.

According to my sleep lab results, I have moderate sleep apnea. I'm sleeping much better since I've been on cpap.

I'm using a Mirage Quattro full face mask. I've managed to get it to fit right so I don't have any leaks without it being too tight, but I've developed huge bags under my eyes which don't go away! I know this isn't the end of the world, but I guess I'm feeling a bit down about it if this new look is here to stay!

I also have a Swift FX for her nasal pillow mask which I find very comfortable but I've not been able to use very much as I seem to get an awful lot of air in my stomach with it. Last night I did a test by wearing it for a couple of hours before bed but I still got a lot of aerophagia even though I was awake with my mouth closed. My pressure is set at 10. I've tried with and without a ramp and it doesn't make any difference. I don't seem to get much aerophagia with the full face mask.

I had UPPP surgery and septoplasty about 15 years ago (for snoring - didn't work) so I'm wondering if this has affected the structure of my throat in such a way that some of the air goes down the "wrong way".


Has anyone else had a similar experience? If so, do you have any tips? I'd really like to be able to wear the pillow mask. Thanks.

[Pugsy]

I don't know. Not many UPPP forum members here but here are a few.

What would happen to your AHI if you used a lower pressure all the time and not just the EPR? Like if you tried 9 cm instead of 10 cm.
Maybe a little reduction wouldn't blow the bell up so much and still give you decent therapy.

[Sleepyinpdx]

A little background about my pressure setting. My original sleep doctor prescribed 16cm for mild/moderate apnea and didn't even meet with me after my study to go over my results. She said I should just try cpap for a couple of months before she would see me again. Strangely enough she told me I could get mad cow disease from my Nature Throid thyroid prescription medication (which I've taken for 10 years with good results), which is weird because it's made from pig thyroids! She also didn't order a titration study, so I looked for a new sleep doctor.

I had purchased my Resmed S9 privately after my first sleep study and set the pressure at 8. This was working fine for me (less than 1 ahi/hr according to my Sleepyhead software), but after my titration study, prescribed by my new sleep doc, he insists I need to be at 10cm. I've been trying to get used to the higher pressure but felt much better at 8cm. I don't want to get on the wrong side of my new doc as the first one was much worse. There are not too many other sleep specialists in my area and I don't want to burn my bridges!

I get the distinct impression that changing your pressure settings is frowned upon in the medical community!

[Pugsy]

I get the distinct impression that changing your pressure settings is frowned upon in the medical community!

Well...yeah, I guess it is frowned upon because we are supposed to be too stupid to understand numbers..

There have been some reports from a few forum members that they were able to use less pressure and get great results when using nasal pillows instead of their full face mask. I know that theory says that pressure is pressure no matter which mask is used but I saw the reports with my own eyes. AHI was better when using nasal pillows at 2 cm lower than he was using with his Quattro.

Why not try the lower pressure...see if it helps you be able to use the mask you want without the aerphagia and without giving you horrible AHI... if it works...then call him up and don't mention that you changed it but just tell him that you can't tolerate 10 cm and it means "no sleep due to belly pain" and get him to make the suggestion of lowering the pressure.
If he thinks it is his idea no one has to know that you already knew it would work.
If it doesn't work you need to talk to him about things anyway...you should be able to use the mask you want and not blow up like a puffer fish.

[woodworkerjunkie]

I get the distinct impression that changing your pressure settings is frowned upon in the medical community!

Well...yeah, I guess it is frowned upon because we are supposed to be too stupid to understand numbers..

There have been some reports from a few forum members that they were able to use less pressure and get great results when using nasal pillows instead of their full face mask. I know that theory says that pressure is pressure no matter which mask is used but I saw the reports with my own eyes. AHI was better when using nasal pillows at 2 cm lower than he was using with his Quattro.

Why not try the lower pressure...see if it helps you be able to use the mask you want without the aerphagia and without giving you horrible AHI... if it works...then call him up and don't mention that you changed it but just tell him that you can't tolerate 10 cm and it means "no sleep due to belly pain" and get him to make the suggestion of lowering the pressure.
If he thinks it is his idea no one has to know that you already knew it would work.
If it doesn't work you need to talk to him about things anyway...you should be able to use the mask you want and not blow up like a puffer fish.

My Dr. has 4 locations, so he is never in the same office. When I started going to him, I had to schedule it on my day off, which meant I had to travel 48 miles to a different office. Now I'm on call and it don't matter what day I schedule my appointments anymore. So, I called the sleep lab here in town to find out how hard it would be to switch everything to this office. The tech. that I was talking to got to asking me about my treatment and how it was going. When i told him that I had switched from a FFM to nasal pillows, he asked me If I knew i would probably have to adjust my pressure down some. He was saying that a nasal mask or pillows air is more direct than a FFM and would need to be lowered.

I have experienced the same thing, I didn't have a problem while using the FFM. Now that I've switched to the pillows I get aerphagia really bad. I have a hard time passing any gas to start with, so now my stomach cramps most of the day, if not all day. I even get it bad enough that I have some of the trapped air move into my chest sometimes and starts my chest to hurting, which in turn starts an anxiety attack. I had adjusted my pressure down 1 cm. from 10 down to 9 with little difference in stats, so I may look at lowering it another 1 cm. to see what happens.