change of mask=change of pressure?

I recently changed from a FP432 to a Quattro and have not had much success with my AHI. I have managed to get the mask dialed in for reasonably good leak free performance. I do not have an auto machine so have resorted to small changes. 11 has worked well for quite some time and as a result of AHIs between 4 and 8, I have adjusted as high as 12. In the past 12 generally got me into the realm of centrals or so I think. Tonight, I think I will explore 10.5.

Has anyone seen a relationship between required pressure and the mask they are using? The Quattro is very comfortable and does not squeeze the sides of my nose like the 432 does making breathing much more easy than with the 432. Might this suggest that the higher pressures used for the 432 were needed to get past the resistance of a squeezed nose? My original titration 2 years ago was 10 cm.

people often increase the pressure when they can, but its not needed for a new mask, you may now be due for another sleep study

I thought I may have answered my own question in posing the post. I tried 10 cm last night. Of course the respironics detailed data curse hit last night and I didnt get detailed data. I did show an AHI of 6 but can't correlate it across leak information.

So I have a very similar AHI across 10, 11, 11.5 and 12 cm all with a change of mask and despite good leak performance. Wish I had an auto.

According to a sleep doc I fired - changing the mask should require no change in pressure. Of course that is the theory and all things being equal. If you have to tighten any mask so much that it closes off your nasal passages, I think that may have some impact, in real life practice.

I have also heard many here report differences in AHI's when changing masks.

One way to avoid the Missing Data is to Erase or Format the card.

I am experimenting with another - which is to make sure you don't have any sessions longer than 8 hrs. Try breaking them up into smaller sessions by momentarily removing the card from the machine if/when you get up in the middle of the nite. Taking naps esp. 15 - 20 min sessions is another way.

I also have a feeling that my bipap may be recording a bit more data than an auto and require just a bit more space for data storage, just enuff to cause a problem.

HTH

GumbyCT wrote:According to a sleep doc I fired - changing the mask should require no change in pressure. Of course that is the theory and all things being equal. If you have to tighten any mask so much that it closes off your nasal passages, I think that may have some impact, in real life practice.

I have also heard many here report differences in AHI's when changing masks.

One way to avoid the Missing Data is to Erase or Format the card.

I am experimenting with another - which is to make sure you don't have any sessions longer than 8 hrs. Try breaking them up into smaller sessions by momentarily removing the card from the machine if/when you get up in the middle of the nite. Taking naps esp. 15 - 20 min sessions is another way.

I also have a feeling that my bipap may be recording a bit more data than an auto and require just a bit more space for data storage, just enuff to cause a problem.

HTH

I do believe sessions greater than 8 hours in duration does have something to do with the detailed data drop. This morning's and yesterday's sessions were both greater than 8 hours.

So now I need to decide whether to stay pat on the pressure, drop it some, or explore higher pressures I have not yet explored. I wish I had an auto.

I've used the Simplicity simple nasal cushion for quite some time w/pretty consistent results. When I tried the Swift LT for Her I noticed no change in the "feel" of the pressure - BUT - when I changed to the OptiLife simple nasal cradle cushion I noticed a BIG difference. It really felt like I was receiving quite a bit more pressure.

I went back to the Simplicity for a couple of months and just recently tried the Zzz-Mask full face. Ha! A BIG pressure difference! And I quite likely AM going to need a new titration if I stay w/the Zzz-Mask!!! My previous titration I had been titrated w/the OptiLife the first half or better of the night and then switched to the Simplicity and my pressure was dropped from IPAP 13, EPAP 8 to IPAP 10, EPAP 5. Yet at home again w/the Simplicity the IPAP 10, EPAP 5 wasn't cutting the mustard. We were "getting there" w/the Simplicity at IPAP 12, EPAP 7. Then w/trying this Zzz-Mask ..... IPAP 12, EPAP 7 isn't cutting the mustard. *sigh* So if I opt to stay w/the Zzz-mask ... its been a year, I'll have to decide what mask I am going to stick with and then maybe need a new titration once I've decided. We shall see what the sleep pulmo says. *sigh*

I tried 9.5 last night and my AHI dropped to 4 - 3.1 OA. Will try 9.0 tonight.

Here is what I believe. There is a difference in pressure requirements between masks when one mask squeezes your nose making it more difficult to breath. This resistance to flow is pressure drop. So the 11 that worked with my fp432 worked because I took a pressure drop across my squeezed nose and the actual therapy pressure was less than that delivered at the mask. The Quattro does not squeeze my nose at all and the breathing is so much easier. This equates to no or little pressure drop across the nose resulting in a higher apparent therapy pressure than I was receiving with the FP432.

Ultimately, the higher apparent pressures with the quattro were resulting in centrals. I know that when I tried pressures as high as 12 with the fp432, my index did indeed rise. I think I finally have this licked. I still need to get more consistent leak performance. My buckwheat pillow arrives on Thursday.