New user, switching to nasal pillow...

I am a new cpap user and have the Airsense 11 and started with the full mask. I've only worn it a couple hours a night, then removed it just to be able to sleep. Today, I was given a N30i by my supplier, but no changes were made to the machine.

My pressure with the mask was 16...will it be the same with the nasal pillow? or should my machine have been adjusted?

bassadict69 wrote: ↑

Fri Jun 17, 2022 8:01 pm

My pressure with the mask was 16...will it be the same with the nasal pillow? or should my machine have been adjusted?

Your pressure needs can only be determined by analyzing data after you have slept with the new mask for at least one night. Please sleep with the new mask tonight so that some data can be recorded. Since you were prescribed a pressure of 16 with the full face mask (FFM), it's a good place to start with the nasal pillows.

Which model machine do you have? Do you know how to enter the clinician's menu to look at the reports?

Machine is an airsense 11 and I do know how to enter the clinicians menu thanks to youtube, but that isn't something my provider showed me how to do.

I tried using the new nasal pillow last night and I am unable to exhale through it. I will play with it more today and try a different size pillow.

Exactly what are all your settings showing on that setup menu?
There is likely a clue as to why you had a problem exhaling somewhere in the settings.

Were you given the N30i or the P30i?
The N30i is the under the nose cushion version and the P30i is the nasal pillow version.

The only settings I have access to is the ramp up time, heat/humidity, and mask type, which I did change to nasal.

It is the N30i, so I guess its a cushion rather than pillow.

The feeling I had when exhaling through the nasal cushion is like my nose was stopped up...yet when I pulled my nose out of the cushion, my nose was clear.

What settings in terms of pressure and exhale relief (EPR)????

If you are using the ramp then that means the pressure likely is starting out at 4 cm which is quite low and EPR doesn't function at 4 cm...and often people say they can't exhale at that pressure. It's not so much that they can't but that they don't feel like they are actually moving air enough to be comfortable.

You should be able to get into the clinical setup menu area so you can see what all the settings are.
The manual will explain how and also show you what the various settings are.
https://media.resmed.com/sites/3/202106 ... ER-ENG.pdf

So we need to know...
Model of the AirSense 11
Mode of use
pressure setting(s)
EPR being used??? If used at what setting??
Ramp setting??? Is it being used???

The manual that came with the machine does not mention how to get into the clinical menu...I was fearful of doing something I was not supposed to do, but what the hell! Since when have I followed rules! LOL!

I will dive deeper into it later today when I get a chance and post back. I do know my ramp starts at 6 and I have it set for a 15 minute ramp time.

Looking doesn't mean that major changes will need to be made.
Just looking lets us know what you are dealing with and then we can maybe offer ideas to try to get you where you are comfortable breathing with the mask and machine.

You got the typical "user" manual which doesn't tell you much.

What model machine???
Model name should be clearly shown on the face of the machine.
Important to know exactly which model because then we can know if the software available would be something good to use.

Off hand based on what you have said so far...I would look to see if EPR is turned on and if it is turned on at what setting.
Ramp starting at 6 cm shouldn't be all that hard to exhale against especially if we have a bit of exhale relief plugged in.

AirSense 11 Autoset is all I see on it...

Mode CPAP
Set Pressure 15
Ramp time 20 min
Start pressure 6
EPR off
Humidity level off
Mask Setting pillows
Tube slimline
B/V filter off
Patient view simple
Smart start off
Smart stop off
Care checkin off

Thanks...

Okay, I have some issues with the settings but I sense you aren't probably quite comfortable making changes at this time.
So lets just target the features which will affect your comfort and ease of breathing first.
We need you to be comfortable first of all.

My responses to the settings in a different color text.

Mode CPAP one of the things I sort of have an issues with but lets leave it alone for now
Set Pressure 15 Did you have a sleep study done in a lab to come up with this setting???
Ramp time 20 min are you able to fall asleep within 20 minutes????
Start pressure 6 (this is the ramp starting pressure...in 20 minutes it goes up to 15 gradually but that much of a change even if gradual is going to move fairly quickly)....leave this for now as is
EPR off......This I want to change...turn it on and then you will get a choice for setting and I want you to set it to 3
Humidity level off....where do you live? Are you using water in the water chamber?
Mask Setting pillows....Actually I think that pillows is probably the correct setting even if using the cushion....I need to check to confirm but it isn't a reason for your problem exhaling
Tube slimline
B/V filter off
Patient view simple....I think this relates to what is available on the sleep report screen....change this to "Advanced" to get more details on the sleep report on the LCD screen.
Smart start off ....this just lets the machine start on its own once you breathe into the mask 2 or 3 times....I would turn it on
Smart stop off .....this just lets the machine turn itself off instead of keeping on blowing if you remove the mask...takes about 10 seconds before it turns things on. I would turn this on as well.
Care checkin off.....nosy questions...leave it off

Make the EPR change for sure and test it while awake just to see if you can now exhale more easily.
Report back on status of your experience after that change.

Enable EPR and set it to 3...full time.

If it means it make it so I can actually use it, I'll make any changes needed...

Mode CPAP one of the things I sort of have an issues with but lets leave it alone for now (what should I change it to?)
Set Pressure 15 Did you have a sleep study done in a lab to come up with this setting??? ( I had the regular sleep study, then another using the mask to determine a pressure to start at)
Ramp time 20 min are you able to fall asleep within 20 minutes???? (usually asleep in 10 or less, without cpap)
Start pressure 6 (this is the ramp starting pressure...in 20 minutes it goes up to 15 gradually but that much of a change even if gradual is going to move fairly quickly)....leave this for now as is
EPR off......This I want to change...turn it on and then you will get a choice for setting and I want you to set it to 3 (will do)
Humidity level off....where do you live? Are you using water in the water chamber? (I am in Louisiana and so far I have not used any water)
Mask Setting pillows....Actually I think that pillows is probably the correct setting even if using the cushion....I need to check to confirm but it isn't a reason for your problem exhaling (I don't recall seeing another option when I changed from the mask, but will double check)
Tube slimline
B/V filter off
Patient view simple....I think this relates to what is available on the sleep report screen....change this to "Advanced" to get more details on the sleep report on the LCD screen.
Smart start off ....this just lets the machine start on its own once you breathe into the mask 2 or 3 times....I would turn it on (will do)
Smart stop off .....this just lets the machine turn itself off instead of keeping on blowing if you remove the mask...takes about 10 seconds before it turns things on. I would turn this on as well. (will do)
Care checkin off.....nosy questions...leave it off (of course! )

bassadict69 wrote: ↑

Sat Jun 18, 2022 10:14 am

Mode CPAP one of the things I sort of have an issues with but lets leave it alone for now (what should I change it to?)

I don't know yet. Gotta start somewhere though and if you had a sleep study done in a lab to figure out pressure needs and the 15 was the starting point...might as well start with it.
There's a lot we don't know yet about how they came up with that setting and that mode.
It would potentially be very helpful if you had a copy of those sleep studies...so it's always a good idea to have a copy of any of your reports. Make the formal request for a copy of both the sleep studies.

What might we change to??? I like auto mode because while I need higher pressures in REM stage sleep...I don't need them in other sleep stages. At this point we don't know if maybe you would be like me or not. Maybe you need higher pressure when on your back and you slept on your back in the sleep lab because of all the stuff attached to you but at home you prefer side sleeping and maybe not need as much pressure.

So...there's a lot we don't know right now and it will take some time to figure out (and get those report copies) so I am not going to worry about that right now.

The main important thing right now is getting you comfortable with any pressures so you can actually sleep with the machine and THEN we can start thinking about any other changes...or not.
If you can't fall asleep with the mask at any pressure then it's darn near impossible to figure out anything else.

Thanks for all your help! I will make the changes and play with the mask once all the grandkids leave and things calm down around here.

Pugsy: you are correct about the Mask Setting. "Pillows" is the correct setting for the N30i.

I have made all the changes to the settings and its much better than it was, but I still cannot get full exhalation flow through my nose when wearing it. It isn't a machine or cushion problem, but rather a problem with out it presses slightly on my nostrils, thereby blocking the flow. I may ask to try the pillows that actually go into my nostrils.

I want this to work for me, I really do, but at the moment I just don't see it happening!