VCOM Strategy help - Mask? Pressure?

Hi all,

I'm trying to optimise my CPAP therapy, and am currently trialling a VCOM.

I use a Resmed Airsense 10 Elite with a Resmed Hybrid FFM. Pressure of 13 with EPR on 3, humidity on 6. Data looking fairly good, AHI averaging around 0.5, but flow rate morphology is still a bit off indicating various different types of collapse of airway. I struggle with nasal congestion, possibly related to allergies and also nasal structure due to old sports injuries, I do lots before sleep to help with this. I also struggle with awful aerophagia, hence the VCOM trial.

So, I've found the device to significantly reduce aerophagia to almost zero, and in general my flow rate morphology is much improved. However, AHI was 2.2 with a combination of hypopneas and CA's, though I think most if not all of the CA's were false CA's while awake playing around with pressures and breathing.

My main issues with the VCOM were getting used to the exhalation pressure, though managed that OK in the end, but inhalation felt like sucking air through a straw, I felt I was really struggling to get a full breath. Not a good feeling.

I tried pressures from 11 through to 14 with the Hybrid FFM and just couldn't get over that sucking air through a straw feeling. In the end I swapped to a full face mask and put the pressure up to 15, which was more tolerable.

Has anyone managed to overcome this issue with the VCOM? How did you do it, what combination of masks and pressures worked for you?

I also understand that really EPR needs to be off, but has anyone had any success with the VCOM and using a bit of EPR?

Thank you, and advice much appreciated.

Flow limitation?
WTF!
Oh, HELL NO! your cpap has been ENGINEERED to be effective--as is.
Adding crap will prevent it from working properly.
I'm sorry, but somebody screwed you.

Looking back at your posts, I am shocked that while you complain
about congestion, YOU HAVE NO HUMIDITY!
Humidity helped ALLEVIATE my congestion!
Results may vary, but it might help to get a tank and wet your airway.
It's worth a shot--and not a big ask where you are.