Pillow mask problems

Posted this in the P10 thread but don't think it got much exposure!

Finding it impossible to get good sleep with this mask and wondering if I can adjust anything or have to give up on it.

I have often worn FF masks but can breath through nose, just have to tape my mouth to stop leaks at night or I wake up with air blowing through lips.

Best nasel mask I tried was Wisp which can give me an AHI below 1, but could find that it would slip at night and leak or otherwise move and reduce airflow. I briefly tried the Swift LT but can't really remember what happened that night, it just seemed a bit uncomfortable.

Got P10 on Friday and the first night I was getting chipmunk cheeks all over, trying to put tongue in different positions but gave up that night after maybe 4 hours. Next night got 2-3. Last night I kept waking up after just falling asleep with small sensations of air going in mouth and went back to FF. I have tried turning EPR off and putting pressure right down. Think I am also getting some aerophagia. The seal on P10 is very good with just about no leaks, could it not be venting enough and pushing too much air into me?

When I looked at two nights of data a few times in both nights it decided to ramp pressure up near maximum 18 on one night then 15 on the other. My usual max is about 13. Also most of my events were centrals which pushed AHI up to 3+.

Overflow wrote: The seal on P10 is very good with just about no leaks, could it not be venting enough and pushing too much air into me?

that's not possible. all modern machines (including the autoset) have pressure sensors in them, they don't run the fan at a set speed for a pressure, they run it at whatever speed is needed to achieve that pressure, constantly compensating for leaks, and inhales and exhales.

if you put your ear to the autoset blower and listen to it, you'll hear the blower motor spooling up and down as you breath constantly adjusting speed to maintain the desired pressure.

also, you were talking about tongue positions, your tongue really has nothing to do with it, with some practice, you can put on the p10, crank up the machine, and open your mouth and stick your tongue out and have no air come out, it all has to do with the position of your epiglottis in your throat, that's what controls whether you breath through your nose or your mouth.

same thing if you practice breathing exercises, in through the nose, out through the mouth sort of thing.

palerider wrote:

Overflow wrote: The seal on P10 is very good with just about no leaks, could it not be venting enough and pushing too much air into me?

that's not possible. all modern machines (including the autoset) have pressure sensors in them, they don't run the fan at a set speed for a pressure, they run it at whatever speed is needed to achieve that pressure, constantly compensating for leaks, and inhales and exhales.

if you put your ear to the autoset blower and listen to it, you'll hear the blower motor spooling up and down as you breath constantly adjusting speed to maintain the desired pressure.

also, you were talking about tongue positions, your tongue really has nothing to do with it, with some practice, you can put on the p10, crank up the machine, and open your mouth and stick your tongue out and have no air come out, it all has to do with the position of your epiglottis in your throat, that's what controls whether you breath through your nose or your mouth.

same thing if you practice breathing exercises, in through the nose, out through the mouth sort of thing.

K.

All I know is that the P10 is the only nasal type mask that has such an effect, it's weird really. Pity, as it is very comfortable and would probably provide great therapy if it didn't keep waking me up with the chipmunk type vents.

While I'm far from being an expert on these matters, it sounds to me, like your pressure is too high. I got the P10, back in May. I switched from the Swift FX and other than being more comfortable to wear, quieter and the lack of a jet stream coming from the vent, I couldn't tell a difference. Since that time, I've lost more than 10% of my body weight and I'm experiencing similar symptoms to what you describe. I'm very certain that my OSA is weight related (didn't have any sleep issues, 6 yrs ago before putting on 80 lbs), so I believe that my weight loss caused my pressure setting to be too high. I lower my pressure from 11 to 9 for last night and saw a significant reduction of air coming into my mouth, from my sinuses (and slept much better than any time in the past 2 weeks). I've lowered it another point for tonight and plan to continue lowering it until the air leaking from my sinuses stops.

In your case, it sounds like your pressure is fine, if you use a FF, so it might not make sense to try lowering it, but if you want to get the P10 to work, it might be worthy of an attempt.

bv1800 wrote: In your case, it sounds like your pressure is fine, if you use a FF, so it might not make sense to try lowering it, but if you want to get the P10 to work, it might be worthy of an attempt.

they've got an autoset, that should be taken care of automatically.

palerider wrote: they've got an autoset, that should be taken care of automatically.

Oops. My apologies.

With that in mind, it makes no sense that he would have that experience.

bv1800 wrote:

palerider wrote: they've got an autoset, that should be taken care of automatically.

Oops. My apologies.

With that in mind, it makes no sense that he would have that experience.

puzzles me too...

Overflow wrote: All I know is that the P10 is the only nasal type mask that has such an effect, it's weird really. Pity, as it is very comfortable and would probably provide great therapy if it didn't keep waking me up with the chipmunk type vents.

are you setting the autoset to 'pillows' ?

the p10 isn't a nasal mask, it's nasal pillows. it might make a difference for you, the machine uses the mask setting for part of it's pressure calculations.

Can you breathe freely in and out through your nose with the P10 on and lying down? I have had what you describe but ONLY when congested and until the drier air blasts my sinuses open (can take up to 5 mins I've found).

The seal is so good on the P10 that it might be the worst for congestion - compared even to the Nuance which does not seal to the nose as well in my experience.

Thanks for the tips. Yes the machine is set to nasal pillows and pressure has been reduced to 6 from 8. I put EPR from 0 to 3 last night to see if that would make any difference. Still had multiple wakes with the air intrusion. Also when I gave up and took the mask off the machine still kept blowing even though it is set to auto off which it shouldn't do, I better have a look at the data and see what went on.

I can breathe ok when lying down with them, unless my airways aren't as clear as they need to be. But you'd think being able to breathe ok through either nostril would be sufficient wouldn't you.

Auto off takes a bit longer than I like, so I shut it off manually.

The SmartStart auto on and auto off function doesn't work so great with pressures below 7 when nasal pillows are used. It has trouble sensing breathing or absence of breathing at lower pressures for some people and some nasal pillow masks.
That's why it didn't turn off when you removed the mask.

The problems you are having with air going up the nose and down the airway and then it entering the mouth would likely happen with any nasal interface mask. Normally the tongue can be used to block the doorway (the tongue to the roof of the mouth thing) to prevent this from happening but there is another way to get it blocked and the tongue isn't involved. I can open my mouth and stick out my tongue and not have air enter my mouth from my airway but I can't tell you how I do it as it is just something I can do and I don't know how to explain it.

Sounds like some sort of chipmunk cheek going on with or without the cheeks inflating.
If you only have it happen with this P10 mask...and not other nasal masks then it is just something specific to you and not something that is a common occurrence. I use the P10 as well as many others and this is not a common problem with a lot of people having this same issue as you are having. Chipmunk cheeks are common but they happen with any nasal mask and not just one model.

Well I went back to Wisp last night, and it still happened.

I have no idea why but my body is reacting differently to nasal mask air coming in than it was 2 weeks ago. Guess I have to FFM it for a while, lame.