AHI bad with nasal pillows but good with FFM...

My AHI is always much worse with nasal pillows and there are about half as many events when I use a FFM. My pressure is the same with each, I have not adjusted it. It is 10-16 autoset. I think I end up sleeping on my back in the middle of the night and maybe the nasal pillow cannot keep my airway open on my back? I cannot continue to use a FFM, i was using the Airfit F20 and Airtouch F20, because I have to crank down the straps so tight that it is uncomfortable and makes indents and red marks on my face that last most of the day. I have been using the Philips Nuance nasal pillows and occasionally the Airfit P30i. Unfortunately I do not have access to Sleepyhead or any software, but I can tell you my data off of my machine. Any ideas? Thanks!

Joel

joeljjk11 wrote: ↑

Thu Oct 06, 2022 8:58 am

My AHI is always much worse with nasal pillows and there are about half as many events when I use a FFM. My pressure is the same with each, I have not adjusted it. It is 10-16 autoset. I think I end up sleeping on my back in the middle of the night and maybe the nasal pillow cannot keep my airway open on my back? I cannot continue to use a FFM, i was using the Airfit F20 and Airtouch F20, because I have to crank down the straps so tight that it is uncomfortable and makes indents and red marks on my face that last most of the day. I have been using the Philips Nuance nasal pillows and occasionally the Airfit P30i. Unfortunately I do not have access to Sleepyhead or any software, but I can tell you my data off of my machine. Any ideas? Thanks!

Joel

If you can use sleephq.com to upload data and create a link to that data for a night or two or three (maybe one from each mask/night) you could get more help.

Once a sleephq account is created hit the data upload tab and there’s a square there that shows where you drag and drop EVERYTHING from the disk, then select upload. Give it time to finish UL and then navigate to dashboard. You won’t be able to access a particular night until it finishes uploading. Once it does, pick a night and follow the bar without the calendar/date to the right and see three dots to select “share” which creates a link you can post here. We can only see whichever page you choose to share.

Edit: the above directives are only for it you have an SD card in the machine when you slee. If you don’t have one, get one and put it in if you have a slot for one. Also get an sd card reader if you don’t already have a slot on the computer. It’s worth if and should cost less than $20 for both.

Are you mouth breathing? Do you notice increases leaks with the nasal mask?

Joel,

As others have suggested, we need some more specific data. Using Oscar or SleepHQ would be best, but even some more specific data from the machine would help.

You've said that your AHI is about twice as high with nasal pillows as a FFM and that you have to "crank down the straps so tight that it is uncomfortable and makes indents and red marks on my face that last most of the day" to use the FFM.

What do your leaks look (and sound) like with each mask? Unfortunately, there's not much leak data from the machine itself. Unless things have changed from the old S9 to the AirSense 10 series, I think the only leak data available off the machine is your 95% leak rate and whether Mr Red Frowny Face or Mr. Green Smiley Face shows up each morning.

But even that little bit of data would help.

If the leaks are worse with the nasal pillows mask, you could very well be losing some therapeutic pressure through your mouth if you open it up at night. And that could lead to more events. But it's hard to say what's happening without more leak data.

Also you really should not have to "crank down the straps so tight that it is uncomfortable and makes indents and red marks on my face that last most of the day" in order to use a FFM.

The AirFit F20 you have been using has an air cushion seal, and if you tighten the straps too much, that can actually make the leaks worse. The straps need to be loose enough that you can pull the mask away from your face slightly while the machine is on. If you then let go, the mask should resettle and reseal on your face. It also helps to fit the mask while you are lying down in your usual sleep position and with the machine running at full pressure rather than when you are sitting up and before you turn the machine on for the night.

I'm not familiar with the fitting instructions for the AirTouch F20, which has a memory foam seal.

Finally, you may want to try one of the newer full-face masks that use a nasal cradle that only covers the tip of the nose rather than covering the whole nose the way the AirFit F20 and the AirTouch F20 do. Have you looked at masks like the Philips Respironics DreamWear Full Face CPAP Mask or the ResMed AirFit F30i Full Face Mask?

Does the machine do anything differently with the two masks and does it require a change in setting when going back and forth between the two types?

(sorry if i got the wrong thread)

lynninnj wrote: ↑

Thu Oct 06, 2022 6:48 pm

Does the machine do anything differently with the two masks and does it require a change in setting when going back and forth between the two types?

(sorry if i got the wrong thread)

There is a mask type setting but if we forget and not change it when we change mask types it really isn't that big of a deal.
Leak numbers might change ever so slightly (actually when I forgot to change mask types when experimenting I saw a maybe 3 L/min leak number difference which is so slight it could also simply be normal night to night variances) but it's not that critical of an issue.

Failure to make the correct mask selection in the machine menu......not the cause of elevated AHI.
And when going to pillow mask from FFM....if anything at the same pressure the AHI should be lower and not higher anyway.

Really need the breakdown of the AHI into each category and that is available on the LCD screen to offer ideas as to what is going on with the OP.

The experts here are data driven, absent which they are shooting from the hip in the dark. I don't mean to bad mouth the experts, but rather to suggest that you use their expertise via data.

I hope that means whatever you are using, it can't hurt to try something else.
Some of us get way better data with pillows--others with larger cushion masks.
Yes, it costs a few bucks; but it just might be worth it.
Worried about wasting money--cpap.com has free mask insurance,
so you can switch within the time limit.