higher pressure needed with different masks???

So I am at a pressure of 5. Which I was told is basically the lowest you can have that is still considered therapy. I started with a nasal pillow but was miserable and would take it off in my sleep without realizing it. I now have a nasal max ( the one listed in my profile) and I feel more tired than I had with the other mask even though I am leaving it on longer. Is this something that can happen? Would a nasal pillow need less pressure because Its in my nose and a regular mask need more pressure since its not as close to my nose?

I found this also to be true with my limited experience. My nasal pillow was okay at 5cm, but the FFM felt claustrophobic unless at 6. It could be due to us having low pressures to start with. Or being new to this thing. Or its a mental thing. I now am using 6-6.5 for base pressure on nasal pillow or FFM with good results. Of course, YMMV.

you are correct. Think of the air distribution over a broader surface area and the pressure exerted is lower as opposed to the same pressure being pushed through a more narrow opening.
Wisp or ResMed nano are as large a mask I would suggest on a low pressure of 5. By the same token, you would not recommend pillows for a high pressure up the nose like 18 cm...
Turbulence. Like pinching off half the garden hose the force to push the water through is greater.
Hope this helps.

Ty!! I honestly don't know how to raise the pressure in my machine and I don't think it is a cool machine that shows or tracks all my data... I do have follow up appointment with dr in a few weeks. I guess I can just leave it and see what they say to change to . At lest I know ok not crazy!!!

michelle679 wrote:I guess I can just leave it and see what they say to change to .

This would be the safest course of action.

The flow dynamics of the situation is actually opposite as discussed. Pressure drop with fluid flow over a geometry will be _less_ for a larger feature size such as in a full face mask than it will be for a pillow or any interface with smaller orifices.

The reason for claustrophobia could be entirely mental or differing intentional vent rates between any two masks resulting in decreased CO2 washout. Most likely it is a combination of the two.

Inquire about the possibility of getting a fully data capable machine such as the Respironics 60 series or the Resmed S9 series. This is, I believe, an almost universal recommendation by members of this forum.

Your follow up appointment with the doctor is for exactly what you describe. That is your opportunity to discuss what you have here, with your physician and make any changes the doctor thinks best at that time. Ask as the previous poster suggested if you might change out your CPAP to a ResMed S-9, more finely tuned machine, (Cadillac versus versus cobalt). do it quickly while you can, in fact you might call and ask in advance of your appointment.

Michelle's machine is a Pro, not a Plus.
The Plus is a minus (no data),
while the Pro has full data, even though it is not an auto.
Sleepyhead or Encore should work.

Aussiegirl wrote:you are correct. Think of the air distribution over a broader surface area and the pressure exerted is lower as opposed to the same pressure being pushed through a more narrow opening. [more garbage deleted]

that's garbage, everybody please disregard (apparently_ everything that 'aussiegirl' spews.

michelle679 wrote:So I am at a pressure of 5. Which I was told is basically the lowest you can have that is still considered therapy. I started with a nasal pillow but was miserable and would take it off in my sleep without realizing it. I now have a nasal max ( the one listed in my profile) and I feel more tired than I had with the other mask even though I am leaving it on longer. Is this something that can happen? Would a nasal pillow need less pressure because Its in my nose and a regular mask need more pressure since its not as close to my nose?

no, the pressure deliery with nasal pillows and nasal masks is essentially the same.

you may be having adjustment issues, many people do.

as tattooed lady says, though, some people do experience a difference with a oral/nasal mask (what is usually called "full face" or 'ffm'. that covers both your nose and your mouth, because they can push your jaw back, and thus close off your airway a little more. this affect is not seen with nasal masks.

I suggest installing sleepyhead software and looking at your data, if you do have a REF460 machine (the number's on the bottom, don't turn it over with water in it!) then you've got full data available.

Aussiegirl wrote: Ask as the previous poster suggested if you might change out your CPAP to a ResMed S-9, more finely tuned machine, (Cadillac versus versus cobalt). do it quickly while you can, in fact you might call and ask in advance of your appointment.

this is *also* garbage, the PR machine is just as good as the resmed s9 series.

That is what mine was doing OP, the aussie explained it is similar to what my doctor said why I couldn't go to a FFM with the low pressure (7) Glad you brought up the question.

palerider wrote:

Aussiegirl wrote: Ask as the previous poster suggested if you might change out your CPAP to a ResMed S-9, more finely tuned machine, (Cadillac versus versus cobalt). do it quickly while you can, in fact you might call and ask in advance of your appointment.

this is *also* garbage, the PR machine is just as good as the resmed s9 series.

Aye to that. Anyone who says one brand is better than the other without providing at least a few paragraphs of technical reasons to justify this position is isn't providing very good advice.

Aussiegirl wrote:Wisp or ResMed nano are as large a mask I would suggest on a low pressure of 5. By the same token, you would not recommend pillows for a high pressure up the nose like 18 cm...
Turbulence. Like pinching off half the garden hose the force to push the water through is greater.

More garbage. I see/use pressures exceeding 20 cm often during the night and I have no problems at all using nasal pillow mask.

Are you a RT? Do you use cpap therapy yourself?

Depends on the sleeping pattern noted at the time if the sleep study.

Both machines will respond to snoring, flow limitations, and clusters of OAs and Hs by increasing the pressure. Both machines will attempt to determine whether a given apnea is a clear airway apnea or an obstructive apnea. Both machines will lower the pressure back down after the algorithm is satisfied that your breathing is now stable.
There are some real differences in the algorithms and for a small minority of patients, the subjective way the two machines feel will make a difference in their comfort while using the machines.

System One's algorithm provides less overall variation in pressure and a quicker return to the baseline pressure after a series of "events" and attempts to locate a meaningful baseline pressure through the hunt-and-peck algorithm. The S9's algorithm provides a quicker response to clusters of events, a gentler decrease in pressure going back down to baseline, and a stronger effort to use the min pressure setting as the target baseline pressure.

aussiegirl is completely wrong.

In general, the mask has no effect on pressure needed.

A full face mask may push your jaw back a bit. For some people, this means they need more pressure.

You may feel the pressure differently with different masks and find a different pressure range is more comfortable with a different mask, but it shouldn't affect your therapy that much.