HELP New P-10 Use=Blow Fish Cheeks

[REDHEADED LIL]

Hi..Got my P-10 For Her Nasal gear yesterday. Yes, I read where I was to go from the biggest (Med.) which I did use....to smallest (XS) & change the mach. setting to Nasal..plus I did lower the pressure from 7-12 to 6 then down to 4. I was on it for maybe 3 hrs. all I could feel was that my cheeks were expanding & eventhough my mouth was taped I had to expel thru my lips large amts. of air. I didn't use the Xsmall or small which might be better? Plus should I have gotten the mach even to lower pressure & put it on Pillows?? I did like the way it felt on my face..can someone help???? TIA..Lil

[Sylvia54]

Hi..Got my P-10 For Her Nasal gear yesterday. Yes, I read where I was to go from the biggest (Med.) which I did use....to smallest (XS) & change the mach. setting to Nasal..plus I did lower the pressure from 7-12 to 6 then down to 4. I was on it for maybe 3 hrs. all I could feel was that my cheeks were expanding & eventhough my mouth was taped I had to expel thru my lips large amts. of air. I didn't use the Xsmall or small which might be better? Plus should I have gotten the mach even to lower pressure & put it on Pillows?? I did like the way it felt on my face..can someone help???? TIA..Lil

Hi, I've been on xpap, using the P-10 for Her since last April. I still have issues and I've been working through them one by one over the months. So in other words, don't expect complete relief within days because it probably won't happen. For many people here, that did not happen. Yes, I've also gone through feelings of getting little to no help from xpap. I've been through the puffed up cheeks, air leaking from corner of mouth, and now thats mostly gone and using a chin strap helps somewhat.
My sleep doctor said those things would resolve on their own eventually and I kept that in mind. I also deal with congestion, itchy, runny nose and adjusting the humidifier has help some. This treatment takes lots of patience and determination. There are setbacks. Fitting the nasal pillow isn't that hard, just try the different sizes for the one that doesn't leak, you need a snug fit.

I don't know how you can breathe with turning your pressure down to 4, I can't get enough air on 4 or 5cm. My ramp is set at 7 (for 15 minutes) so pressure can gradually go up to 8 and my maximum pressure is 12 to control apnea. Mine apnea is worse when I shift to my back and it might be the same for you since your prescribed pressure is similar. Anyway, I wouldn't start out any lower than 6 as the puffed cheeks should resolve on its own as you keep using your machine. Again, it probably won't resolve right away. Look for a quality chinstrap on cpap.com. I use the "Halo", it's stretchy, comfortable enough but may not be a complete fix.

My treatment still isn't perfect by any means but I do sleep longer, my restless legs disappeared, and I feel better than when I first started. Hope this helps.

[chunkyfrog]

In the first few days fish cheeks or chipmunk cheeks is not unusual.
If you practice talking while the air is blowing, you will soon learn how to talk with the mask on.
The same muscles in the back of your throat will stop your cheeks from inflating.
With luck, this will become automatic.

[REDHEADED LIL]

Thank you Sylvia54 & Chunkyfrog for your help...Maybe I need to practice during the day to build up my muscles for talking while I am in bed isn't ideal. I most likely will need to go down to XSmall instead of the Med. pillow (less air to expel)??? I will try to do a practice run today..fiddeling around with the machine at 1:30am isn't fun. I wound up with my Amara View for the rest of the night. The P-10 would be a big improvement & I could try a heavy duty chin strap & also tape. Hope for more ideas...Lil

[palerider]

Hi..Got my P-10 For Her Nasal gear yesterday. Yes, I read where I was to go from the biggest (Med.) which I did use....to smallest (XS) & change the mach. setting to Nasal.

the P10 is a Pillow mask, set machine accordingly. (P10, pillow, N10 Nasal, F10 FullFace)

(less air to expel)???

no, just smaller holes, more resistance to airflow.

[REDHEADED LIL]

Thank you so much Palerider...I will change it to Pillow...I did take another turn with the P-10 for 1/2 hr. today..with the smallest pillow XS instead of the the Med. & I had it at 5.6 pressure - 10. I had a tiny bit of the fat cheek & it seemed acceptable....also had the lanolin on. It is going to take patience & to keep at it I guess..Lil

[REDHEADED LIL]

Well I had used the Small sz last night & I feel wretched this a.m. I think it was too tight & was in my nostrils..even with the lanolin my nose is sore. There was some noise from the hose also that kept me awake. The leak rate wasn't any better then my ffm. I will try again tonight making sure it isn't too tight, adjusting the head bands more & maybe the Med. again. I did use a chin strap & mouth tape. Any other suggestions??? Please!...Lil

[palerider]

Well I had used the Small sz last night & I feel wretched this a.m. I think it was too tight & was in my nostrils..

probably best to go back to the medium.... whichever one is most comfortable sitting ON your nostrils.

[rohdej]

If it is inserting it self over night into the nostrils it is definitely too small. The pillows are to rest on the outside of the nares. The larger the pillow the more surface area that the pillow can rest and seal on the better (for me). Don't just put the mask on, get the air moving and pick the pillows off your nose and reseat them under pressure, to center them on the nairs. When I started, I thought I was a medium because with the large the lip of the pillow cone felt like it was cutting the inside of my nose. After learning to recenter, my nose was the most happy with the larger pillow.

The chipmunk cheeks should disappear over time as you learn to seal your tongue to the roof of your mouth. Practice makes better.

[chunkyfrog]

Your nose should rest on the upper side of the pillow like your butt would rest on a saddle.
Never try to enclose the cantle in your hiney.
If that happens, you need a bigger saddle, maybe even a bigger horse.

[palerider]

Your nose should rest on the upper side of the pillow like your butt would rest on a saddle.
Never try to enclose the cantle in your hiney.
If that happens, you need a bigger saddle, maybe even a bigger horse.

Chunkyfrog's guide to CPAP fitting: Get a bigger horse!

<3

[REDHEADED LIL]

Hi All...I did sleep last night with the Med. pillow & adjusted the straps to fit a little loser. 2 hrs. in I awoke feeling that one of my nostrils was being blown out of the water..what an odd feeling can hardly explain correctly..it didn't hurt just felt very weird. So I changed out to my Amara View at 2:30 a.m. The pressure for the pillow was 5.6-10..is this too much? My orig rx for Amara View is 7-12. I don't know what else to do as the pillow felt good at first. TIA..any help appreciated & btw I am a city girl who never rode a horse nor seen one up close except when I went to NYC & saw a policeman riding one near Central Pk....Lil

[Pugsy]

The pressure for the pillow was 5.6-10..is this too much?

2 hrs. in I awoke feeling that one of my nostrils was being blown out of the water.

Use available software to see what the pressure was when you woke after 2 hours.
The starting pressure doesn't mean anything...it's what the pressure was doing right before you woke up that might be meaningful.

for software information go here
https://sleep.tnet.com/equipment

FWIW when I first started using apap/cpap therapy my minimum pressure was 10 cm and it would often go to 16 to 18 cm during the night and I have used nothing but a nasal pillow mask for well over 7 years now.
No chipmunk cheeks...no blowfish syndrome..ever.

[REDHEADED LIL]

Thanks for your reply. Of course, I forgot to put in the SD card last night so I don't have Sleepyhead only MyAir to read. MyAir for 2:20 hrs. was awful for me at Leak Rate 26..& Events 3.8 (which is rather high norm is under 1). The pressure for the pillow was 5.6-10..maybe I should try again tonight with 5.6-8 or something lower????
TIA for any help for the pillow seemed to be very comfortable...Lil

[Pugsy]

If your prescribed pressure was 7 to 12 and you are continually lowering the starting pressure then you can expect the AHI to increase.

.maybe I should try again tonight with 5.6-8 or something lower????

What is your goal with this idea?
Just to get used to the nasal pillows and keep the pressure from increasing so much that it causes leaks that may or may not wake you up?
You don't know that your pressure was a lot higher when it woke you up because you don't have the detailed data since the SD card wasn't in the machine. You are assuming it was higher but you don't know for sure.
It could also just as easily been a big leak that caused you to wake up.

If the goal is to just get used to the nasal pillows..then yeah you can try a lower pressure with a really tight range but you have to understand that in doing that your OSA may not get optimal therapy. So don't be surprised if the AHI goes up...and that would be okay for now since the goal is to just get to a point where you can sleep all night with the nasal pillows and then you can start increasing the pressure so that the therapy is no longer sub optimal.

The leak rate you see on the machine...that's the 95% number which means for 95% of the night you were at OR below that number...it is NOT where the leak was at for 95 % of the night.
95% numbers aren't good measuring sticks...they are too easily skewed by short periods of big numbers.
You would be better off using the software to see exactly when the big leaks happen and how long they happen.