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caffeinatedcfo wrote: Has anyone else experienced less pressure needs on pillows vs. ffm?

Yep, not unheard of at all. In theory it shouldn't make any difference but in real life it often doesn't go along with what theory says it should.

I know several people who have noticed a reduction in pressure needs...sometimes 2 or 3 cm reduction.

YES!
When I was wearing a total face mask, my pressure needs ran around 16.
Now that I'm using pillows...it averages 11 or 12.

Hey there caffeinated,

I have been on CPAP pillows since February. I average between 21 to 26 on the leak scale. I don't have any large leaks. My events are under 2. So, what I am gathering is that yes, I mouth breath sometimes, I chipmunk cheek a little. However, it's not enough that the machine is not able to do it's job.

If your AHI is good and you are sleeping good, I think you have it made in the shade I am still new here..but I think that is correct. Otherwise, someone correct me here

Enjoy your pillows,
Dreaming

Pugsy wrote:

caffeinatedcfo wrote: Has anyone else experienced less pressure needs on pillows vs. ffm?

Yep, not unheard of at all. In theory it shouldn't make any difference but in real life it often doesn't go along with what theory says it should.

I know several people who have noticed a reduction in pressure needs...sometimes 2 or 3 cm reduction.

Now you now several +1 people. With the Quattro my APAP mode was ranging 11-13cm. Now I'm ranging 9-11. Thanks for the info.

With my Quattro I needed 16cm minimum pressure, with nasal or pillows it was about 2cm less.

You can experiment with setting your minimum a bit lower and see if it works for you. Sometimes setting EPR at 3 will affect things (AHI), so you have to kind of play it by ear...

So that makes me curious. Do we think the lower pressure requirement with pillows has to do with leaks on the Quattro and the machine not having to work as hard to maintain therapy pressure, or is it something else?

NotLazyJustTired wrote:So that makes me curious. Do we think the lower pressure requirement with pillows has to do with leaks on the Quattro and the machine not having to work as hard to maintain therapy pressure, or is it something else?

We don't know. We have seen Quattro reports with essentially minimal to none leaks and change to nasal pillows resulted in still a decrease of about 2 cm in pressure needs to get same results. So leaks weren't the cause of the higher pressure needs.

The older technology machines used to chase leaks with more pressure so it was sort of expected with those machines but the new machines rarely every chase leaks like that anymore.

In theory...X amount of pressure with a FFM should yield the same results as X amount of pressure with nasal pillows because in theory X amount of pressure is X amount of pressure no matter how it is delivered.
But not everyone wins a pressure reduction when going from FFM to nasal or nasal pillow.

Best I can come up with is that this theory doesn't always stand true and this is another one of the many things related to xpap therapy that comes with a big YMMV stick.

I asked my ENT about this and his response was that with a nasal mask or pillows you are sending x amount of pressure into 1 airway. With a full face mask you are sending the same amount of pressure but diffused through 2 airways, which can account for the difference in pressure need.

A well-respected forum member here commented that from a physics perspective (as in pressurizing a tire) that x amount of pressure should be the same whether it's one or two airways.

I noticed the phenomenon when I was using the same APAP range but alternating between a Mirage FX nasal mask and the Mirage Quattro full face mask. The pressure needs for the Quattro were ALWAYS about 2 cm higher....

But there you are.

RandyJ wrote:A well-respected forum member here commented that from a physics perspective (as in pressurizing a tire) that x amount of pressure should be the same whether it's one or two airways.

Yeah, this is why I say "in theory"...going by the laws of physics...once the pressure level is obtained...it should not matter because the pressure obtained isn't cut in half with half going to nasal and half going to mouth with FFM. That's not how the Physics works and if it did...we would be able to get by with a 50% reduction if we went to nasal interface and that simply doesn't happen..
Maybe the oral cavity sucks up a lot more than 50%...after all it is bigger.

But then we have those people who need the same pressure no matter which mask.

Then there are the people that say nose pressure is better because nature meant for us to breathe through our nose and not our mouths...well that's all and good to say but if a person can't breathe through their nose...we don't breathe through our skin so great so we have to use our mouths.

It is a puzzler for sure. I have often wondered about the 2 airway entrance thing myself. Logic tells me that it makes sense....but physics tells me it doesn't. So the best I can come up with is sometimes it matters and sometimes it doesn't and if a person is lucky enough to be able to reduce the pressure needs with a switch to nasal mask...hey just another check mark in the plus column for nasal masks in general. But as sure as I start telling people that they will be able to reduce the pressure needs with a nasal pillow mask...Murphy's Law is going to reach up and bit me in the butt and prove me wrong.

there is quite a bit engineering behind this

Using the Quattro- the air is fed straight from the resmed slimline hose into the mask... the air has to fill a larger area to finally get the required pressure into the throat.

Whereas when using a nasal mask, the air from the same resmed slimline hose gets compressed into smaller tubes that are then split into the 2 nasal pillows of the mask.

Thus increasing the pressure applied into the passageway.

Thus needing less original pressure from the machine

...or an easier explanation. Putting your thumb partial on the garden hose nozzle makes the water squirt farther

Kenwood wrote:...or an easier explanation. Putting your thumb partial on the garden hose nozzle makes the water squirt farther

Makes sense - simple physics. Still luvin this mask.