22 over 15 pressure

I am fighting with having to strap down my mask to the point of it being uncomfortable. I asked several DME people and all I hear is that there is no mask that will retain this kind of pressure with out high amounts of leaks. Does anyone have a suggestion for what I can do. I am using the Airfit F20 Memory foam mask right now with a Resmed Aircurve 10 Auto. Thanks in advance.

Not sure if this is helpful, but I stick moleskin to my nasal pillows and it reduces leaks completely. Not sure if it will help with your model of course.

F&P Simplus is the only mask for me that works well enough for high pressures

I have successfully used the Simplus, Amara View, and Resmed F20 (regular silicone cushion) at high pressures. Most masks will handle the pressure. The only mask I have found that will not handle high pressure is the F20 with the memory foam interface. I was running high pressure when I tried the foam interface. I took it off after two hours and went back to the regular cushion. The memory foam interface works fine under 15 cm pressure. When my wife's pressure was raised to 16 cm, her foam interface cushion started leaking badly. She went back to the regular cushion and has had no problems since.

Thanks guys I am using the foam because it is the only one that hasn't broke my face out but am using a different liners now so that may make a difference so may try the old F39

This is a topic that I think is greatly misunderstood.

Nasal pillows seal on the nose nares so the seal improves as pressure increases. The pressure pushes the pillows outward against the nares. Positive sealing. All other mask types are negative sealing (pressure makes sealing worse requiring greater strap tension).

Force is equal to pressure times area. Nasal pillows have the smallest area so the force caused by pressure is smallest. My pressure ranges between 17 and 20 and my straps are loose.

Then the challenge becomes managing mouth leaking.

Seven years ago my DME told me that pillows don't work well at high pressure. Fortunately I knew better and disregarded his expert advice.

TedVPAP wrote:Seven years ago my DME told me that pillows don't work well at high pressure. Fortunately I knew better and disregarded his expert advice.

That's an old wives tale still being told to people and I have no idea how or why it ever got started.
Maybe someone had one go flying across the room like a deflating balloon or something.

When using a bilevel machine I often saw pressures up around 22 or 23 and with the ASV those were some pretty rapid changes at that and I never knew it happened until I saw the reports...slept right through it and no leaks either.

I think DMEs do a huge disservice by continuing that old wives tale without at least giving someone the option of trying nasal pillows at the higher pressures. Instead they get told "oh at your pressures you just HAVE to use a full face mask because pillows won't work" and they get started trying to seal a mask with much larger real estate needing to seal.

Unless someone simply has to mouth breathe for reasons related to nasal congestion that can't be cleared up...there is no reason to not at least try the nasal pillow mask at the higher pressures. They can work and work quite well.
I have a couple of friends using bilevel with both EPAP and IPAP over 20 cm who are using nasal pillows and not having anymore leaks than someone using 5 cm.

PEMJ wrote:I am fighting with having to strap down my mask to the point of it being uncomfortable. I asked several DME people and all I hear is that there is no mask that will retain this kind of pressure with out high amounts of leaks. Does anyone have a suggestion for what I can do. I am using the Airfit F20 Memory foam mask right now with a Resmed Aircurve 10 Auto. Thanks in advance.

Any special reason you are using a full face mask?
Have you ever tried any other type of mask like a nasal cushion or nasal pillow mask?
Do you have some really bad nasal congestion issues that force you to mouth breathe and you can't ever clear up the nose well enough to just breathe primarily through your nose.

If you just have to use a full face mask because of nasal issues...consider using a mask liner to help tame the leaks.
You can make your own or buy them ready made.

Masks can be used at higher pressures...higher than what you are using and seal quite effectively and not be so tight that it causes discomfort.. It can be a challenge but it can be done.

TedVPAP wrote:This is a topic that I think is greatly misunderstood.

Nasal pillows seal on the nose nares so the seal improves as pressure increases. The pressure pushes the pillows outward against the nares. Positive sealing. All other mask types are negative sealing (pressure makes sealing worse requiring greater strap tension).

This is patently incorrect. All one has to do is look at the conical shape of the nasal pillows to realize that there's no way it can stretch to push 'outwards against the nares". Don't believe me? put your fingertips against the openings and turn on the machine, the shape of the pillows doesn't change.

Nice theory though.

TedVPAP wrote:Force is equal to pressure times area. Nasal pillows have the smallest area so the force caused by pressure is smallest.

This, however, is spot on correct.

palerider wrote:

TedVPAP wrote:This is a topic that I think is greatly misunderstood.

Nasal pillows seal on the nose nares so the seal improves as pressure increases. The pressure pushes the pillows outward against the nares. Positive sealing. All other mask types are negative sealing (pressure makes sealing worse requiring greater strap tension).

This is patently incorrect. All one has to do is look at the conical shape of the nasal pillows to realize that there's no way it can stretch to push 'outwards against the nares". Don't believe me? put your fingertips against the openings and turn on the machine, the shape of the pillows doesn't change.

Nice theory though.

TedVPAP wrote:Force is equal to pressure times area. Nasal pillows have the smallest area so the force caused by pressure is smallest.

This, however, is spot on correct.

As I correctly stated, pressure aids sealing. Sealing occurs as the tips of the pillows flex outwards against the nares (inside of the noise).
Your belief that silicone does not flex is of no concern to me.

TedVPAP wrote:

palerider wrote:

TedVPAP wrote:This is a topic that I think is greatly misunderstood.

Nasal pillows seal on the nose nares so the seal improves as pressure increases. The pressure pushes the pillows outward against the nares. Positive sealing. All other mask types are negative sealing (pressure makes sealing worse requiring greater strap tension).

This is patently incorrect. All one has to do is look at the conical shape of the nasal pillows to realize that there's no way it can stretch to push 'outwards against the nares". Don't believe me? put your fingertips against the openings and turn on the machine, the shape of the pillows doesn't change.

Nice theory though.

As I correctly stated, pressure aids sealing. Sealing occurs as the tips of the pillows flex outwards against the nares (inside of the noise).
Your belief that silicone does not flex is of no concern to me.

Your belief doesn't change reality.

All it takes it for you, or anyone else with a pillow mask to *TRY THE EXPERIMENT*.

Now, I'll admit that perhaps there are some masks out there with *exceptionally* floppy silicone at the pillow tips, but, since a standard bilevel at full pressure doesn't generate enough pressure to even inflate a standard rubber balloon, and since silicone is LESS flexible than that... it doesn't take much to figure out what the results will be.

palerider wrote:
All it takes it for you, or anyone else with a pillow mask to *TRY THE EXPERIMENT*.

Your experiment is flawed. At rest the pillows are at or near max size. In your nares part of pillows might push against nose and with pressure it will seal. I believe the recommendation is for pillows not to be too big for nares but there does seem to be some sealing effect for me. I guess my pillows are about the same size as my nares and not smaller.

I just tried this — removed straps and my pillows stayed on with pressure. It didnt take much to pull it off but clearly there was some sealing. YMMV

Doublev wrote:

palerider wrote:
All it takes it for you, or anyone else with a pillow mask to *TRY THE EXPERIMENT*.

Your experiment is flawed. At rest the pillows are at or near max size. In your nares part of pillows might push against nose and with pressure it will seal. I believe the recommendation is for pillows not to be too big for nares but there does seem to be some sealing effect for me. I guess my pillows are about the same size as my nares and not smaller.

I just tried this — removed straps and my pillows stayed on with pressure. It didnt take much to pull it off but clearly there was some sealing. YMMV

I like your experiment.
Hey palerider, you are silent. Are you still doubtful???

Okie bipap wrote:I have successfully used the Simplus, Amara View, and Resmed F20 (regular silicone cushion) at high pressures. Most masks will handle the pressure. ...

Good heavens. The Amara View should be recommended with a qualifier - especially when recommending it under high pressures. If the person has glaucoma, they need to discuss it with their doctor before using the Amara View. If anyone does not believe me, call ResMed and ask them yourself. (crap, I mean Philips Respirionics )

Why this is not more widely known is beyond me. I've had 2 DME's recommend the Amara View to me and had never heard of this. I feel concerned for people with glaucoma that have never been given the chance to make an informed decision.

TedVPAP wrote:

Doublev wrote:

palerider wrote:
All it takes it for you, or anyone else with a pillow mask to *TRY THE EXPERIMENT*.

Your experiment is flawed. At rest the pillows are at or near max size. In your nares part of pillows might push against nose and with pressure it will seal. I believe the recommendation is for pillows not to be too big for nares but there does seem to be some sealing effect for me. I guess my pillows are about the same size as my nares and not smaller.

I just tried this — removed straps and my pillows stayed on with pressure. It didnt take much to pull it off but clearly there was some sealing. YMMV

I like your experiment.
Hey palerider, you are silent. Are you still doubtful???

Since whatsisnuts hasn't specified the type of mask he has, it's irrelevant, we also don't know if mr newbie has it fitted properly, he may be one of those people that erroneously thinks that nasal pillows should fit IN the nose, instead of resting against the opening of the nose. We have no way of knowing.