Twenty years on cpap and now at 19 setting and problems

tvfrfireguy wrote:In 1994 started out with a pressure of 7 and nasal pillows. Now, all these years later I have a bipap with a setting of 19 David

How was this IPAP setting decided? From a titration sleep study? If yes, did you try to sleep on your side for a while during the study, to compare results with the period when you were sleeping on your back?
Did the RT doing the study use an auto-titrating machine, or decide manually which settings to try out?
What is the EPAP setting on your bipap machine?
As for nasal pillows my experience with a high IPAP was the pillows shot off my face and when I finally woke up, the noise from them blowing the air in the void had been so bad that I had a loud tinnitus for one hour, really scary.
Of course I do not know how serious your real need of a setting of 19 really is, and I really sympathize with your reality as it may be. But some doctors, especially insecure types, want to go all out to the max IPAP when it is not absolutely necessary... Sometimes it may be better to weigh all parameters and circumstances of therapy against each other, and to settle for a less than ultimate force of inspiration (and an OK but not perfect oxygen level?) to accommodate the simple possibility, and basic need, of sleep. (I guess it may be nearly impossible to sleep with the mask problems you described).
Wishing you the best of luck

tvfrfireguy wrote:To those of you who think I should use nasal pillows, I did. The result was air flowing out my mouth even with a chin strap. Nineteen is a lot of pressure. My original post had the question of the mouth pieces made by dentists that move the chin forward and help open the airway. Would this help and maybe my pressure could be lowered? Have any of your tried this? Thanks

I'm not wearing the type of dental appliance you are referring to, but I am wearing a dental appliance. I think you may be on to a possible solution, or at least a tool to help. About whether it could allow for your pressure to be lowered, I'm not sure. I think it might help keep your mouth closed at your higher pressure.