Mask for higher pressure?

I am trying out nasal pillows (Resmed P10) after using my full face mask (Resmed F20) for the past 9 months, I realised that the pressure is a bit troubling when it goes up to 15+ as it wakes me up from a sound sleep particularly if I have a clogged nostril. I did not have that happen in a long time with my FFM once I had it properly set and realise it may be just an adjustment period.

As background my settings are: pressure of 8-18, EPR 3, no ramp, med 10, 95% 16, max 17, humidity 4, temp 27c. I can post OSCAR images if needed. My typical pressure does not seem high when using a FFM and hope it is just an adjustment period. I'm knackered as a result of not getting my usual sleep, but may just need to work through it over time.

I have not changed anything except the mask setting from pillow to FF. I am looking for advice/suggestions before I decide on the mask working/not working for me.

The P10 (original strap) had no real ability to tighten the straps.

The recently updated P10 strap now has a clasp where the strap can be tightened. Not sure which strap your using, but if you like the P10 and you're using the older strap, try it with the adjustable strap. You can buy the strap separately.

Yes, please post a detailed OSCAR report from a recent night.
Include the usual stuff on the left side and ONLY these graphs on the right side (for now anyway).
Events
Flow Rate
Pressure (not masked pressure)
Leak
Flow Limitations
Snores...only needed if there is much activity showing.

Some questions.
How many times are you waking up?
How long does it take you to go back to sleep when you do wake up?
The clogged nostril(s)...how often does that happen...one nostril or both? If one nostril is it the side that is down if laying on your side??? How long does it take the congestion to clear up??? Does it clear up in the middle of the night?

Something to do during the night so we can try to correlate pressure, FLs and wake ups to try to isolate a cause for the wake up is when you wake up reach over and turn the machine off and then right back on again.
This gives us a known awake time to evaluate what was going on just prior to the wake up.
While you may assume it is the higher pressure causing the wake up it wouldn't be impossible for the reason the machine wants to go higher to actually be the reason for the wake up and you wake up and see a higher pressure and want to blame the pressure but it might be what was going on to cause the increase that was actually the underlying cause of the wake up.

The P10 can easily handle higher pressures. There are people using the P10 with ASV machines or other bilevel machines with pressures exceeding 20 cm. So it's not so much the mask as it is your response to the higher pressures or whatever is causing the higher pressures that is maybe the problem.

And is it possible that it is the congestion itself that is causing the wake ups? I know that I wake up with the least little bit of congestion because I simply don't sleep well if I can't breathe through my nose.

CyberSpiff wrote: ↑

Thu Nov 11, 2021 9:53 am

I am trying out nasal pillows (Resmed P10)

just to chime in-that's the mask i use at a min of 18.4 and max of 20. no problems for me. in fact, it just feels like breathing.

let's see what you come up with in answer to pugsy's questions.

good luck!

Dog Slobber wrote: ↑

Thu Nov 11, 2021 10:09 am

The P10 (original strap) had no real ability to tighten the straps.

The recently updated P10 strap now has a clasp where the strap can be tightened. Not sure which strap your using, but if you like the P10 and you're using the older strap, try it with the adjustable strap. You can buy the strap separately.

Thanks mate. It's the new strap. I don't think it is a setup problem as I tested with 'mask fit' all the way to max pressure, more of a comfort thing.

It is not uncommon for dealers to push more expensive masks
"because only some masks work on high pressures."
I hate it when DMEs lie.

Thanks Pugsy. Answers below in red...

How many times are you waking up? a few times, enough to remember waking up
How long does it take you to go back to sleep when you do wake up? usually not long. except last night I said bugger it and took it off.
The clogged nostril(s)...how often does that happen...one nostril or both? If one nostril is it the side that is down if laying on your side??? How long does it take the congestion to clear up??? Does it clear up in the middle of the night? it's fairly often but usually controlled by prescription nasal sprays. It has not been a problem so far as in the past I would end up mouth breathing. I have not thought about whether it cleared up during the night but will test the theory next chance I get.

Something to do during the night so we can try to correlate pressure, FLs and wake ups to try to isolate a cause for the wake up is when you wake up reach over and turn the machine off and then right back on again. Brilliant. Will try to remember tonight.
This gives us a known awake time to evaluate what was going on just prior to the wake up.
While you may assume it is the higher pressure causing the wake up it wouldn't be impossible for the reason the machine wants to go higher to actually be the reason for the wake up and you wake up and see a higher pressure and want to blame the pressure but it might be what was going on to cause the increase that was actually the underlying cause of the wake up.

The P10 can easily handle higher pressures. There are people using the P10 with ASV machines or other bilevel machines with pressures exceeding 20 cm. So it's not so much the mask as it is your response to the higher pressures or whatever is causing the higher pressures that is maybe the problem.

And is it possible that it is the congestion itself that is causing the wake ups? I know that I wake up with the least little bit of congestion because I simply don't sleep well if I can't breathe through my nose. It has not been a reason for awakening in the past, so I think it is likely not the real issue but will ponder this a tad.

Pugsy wrote: ↑

Thu Nov 11, 2021 10:27 am

Yes, please post a detailed OSCAR report from a recent night.

Attached as requested. First one is a typical night with the FFM and the second typical of the nasal mask. Thank you for taking the time to review.

I'm obviously a bit daft from lack of sleep. I meant the one from 04/11/2021 is a typical night with FFM and the second from 10/11/2021 is with nasal pillows.

Following up, it seems to be settling down with the P10's. Last night was very good with low AHI, some good quality sleep time, and not having it blown off my face with high pressure. The moral of the story is give things time to settle down and one's body to adjust when making a change.

Ta everyone who responded for their suggestions.