Different settings for FFM and Nasal Pillows?

The geometry: My head and neck are practically flat in the back— straps around the back of my neck won’t stay down; they will usually slide up. The top of my head is very pointed—a simple chin strap (and some no so simple) will stop stay on the top of head.

FFMs usually wreck the bridge of my nose. The best I have found is the Quattro Air, but even with it two or three nights in a row is all that I can handle. I have to go to pillows. Using pillows means taping my mouth—even if I could keep my lower and upper in firm contact my lips would purse open and leak like the proverbial sieve,

I have no trouble breathing normally through my nose. If I put my lower jaw forward and then close my teeth together, my lower lip will come up over my upper lip, making a good seal. Apparently my air passage opens up some because I am moving more air than during normally breathing. If I now open my mouth and breathe, I move even more air with each breath.

I do have trouble swallowing and can’t swallow large pills. The throat doctor says there is nothing he can do for me.

The best success that I have had had with the S9 VPAP Auto and the Quattro Air is using the Auto Mode with max pressure 13, min pressure 9, pressure support 2. Usually pressure range for a session is the high end of the range, 11 to 13. AHIs are usually in the 2 to 5 range, centrals and hyponeas about the same, no OAs. Doing nothing but raising the max pressure to 14 results in the pressure envelope being 12 to 14, an AHI of 12 to 15,mostly OAs and hyponeas--and more leaks

I really don’t know, but I suspect that even “moderate” leaks raise hell with the numbers.

Using a nasal pillow at any pressure setting results in more OAs and hyponeas being reported than when using the FFM—but I am going to try a Tap Pap. The less on my face and head the better—will have to experiment on how to keep my lips sealed.

I do not expect a perfect solution. If I can’t have quarters and dimes, nickels aren’t bad.

Any helpful comments or suggestions would be appreciated.