Do pressure needs vary by mask type?

Has anyone found that their pressure needs change as a function of mask type?

I thought that when someone is titrated to a particular pressure, it is the pressure they will need regardless of whether they are using a full face mask, a nasal mask, or nasal pillows.

I am in the middle of an experiment and had collected data at 4cm using a nasal mask. Last night I tried to do the same with pillows. However, I felt like I couldn't breathe with the pillows. It just seemed like I couldn't draw enough air into my nose with the pillows stuffing them up as well. Can I assume that once I titrate myself up to an ideal pressure that minimizes my respiratory events and FLs on a nasal mask, that same pressure will suffice with pillows?

Your titrated pressure is the "delivered" pressure. Within reason, your machine will compensate for mask type, minor leaks, barometric pressure (including altitude change), etc.

As to your experiment at 4cm. Try breathing normally with your mouth open. Now close your mouth but don't change the effort, depth or rhythm of your breathing. You should feel "suffocated" to some extent.

Okay, everyone regained consciousness now?

That happens because you've eliminated more than half your available airway. Same thing with a nasal-only mask. You need more effort to produce the same airflow at that pressure, but your machine should compensate at a "real-life" pressure setting.

I had a stuffy nose, went to bed wearing my quatro, woke in the middle of the night and switched to my fx. I use APAP 9.5 -15, the mornings report clearly showed a 1-2 cm difference between the quatro and fx, quatro range was higher. Was quite a striking difference on the report, wish I had saved it.OTOH, I had a few glasses of wine that evening, maybe that wore off also. maybe more research is called for

For the most part, no, it usually does NOT make a differnce. However, "real life" doesn't always follow the rules. You may experience more leaks w/one mask or type of mask than another the "can" affect your pressure need.

AND, I'm not sure I remember which masks now, but there was one full face mask that felt like I was getting a lot less pressure than w/my nasal cushion. There was one nasal pillows that felt like I was getting a lot more pressure than w/another nasal pillows I was using. Obviously I stuck w/the masks that were most comfortable at my titrated pressure.

I would SUFFOCATE at 4 cms of pressure!!! I need AT LEAST 6 cms -7 cms to be able to breathe w/a mask and PAP.

In my opinion there is a unique pressure vs. flow rate for each mask type. See these charts:

http://www.resmed.com/us/assets/documen ... sa_eng.pdf

But some masks are grouped.

Due to the influence of unknown variables, you might need to try more nights--
You want to approximate representative sampling, even with one subject.
I wish I could help more, but maybe we have a statistician on board?

I have used the Quattro mask for approx 8 months and have kept monthly data printout. I have recenly 9approx 3 weeks) been using the new Quattro FX and the 90% pressures are down by 2-3 each night. Nothing else has changed - just the mask.

SleepingUgly wrote:Has anyone found that their pressure needs change as a function of mask type?

I thought that when someone is titrated to a particular pressure, it is the pressure they will need regardless of whether they are using a full face mask, a nasal mask, or nasal pillows.

. . . Can I assume that once I titrate myself up to an ideal pressure that minimizes my respiratory events and FLs on a nasal mask, that same pressure will suffice with pillows?

Pressure needs change from moment to moment, and any change can affect therapy. So you can't assume anything, really.

A lot of docs will throw an extra 2 cm on the top of a "titrated pressure" just for good measure, for a plain vanilla OSA patient, since it was just one night that might not have been one of the worst for the patient.

I need about 8 cm to feel like I can breathe through nasal pillows most nights, more than that if my allergies act up.

avi123 wrote:In my opinion there is a unique pressure vs. flow rate for each mask type.

Yes, of course there is. But that wasn't the question The OP was asking if a patient's pressure need varies with mask type.