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Difficulty Exhaling with Nasal Pillows?
#1
Question 
I've been using the F&P Simplus FFM and the Eson nasal mask for the past few months. I have the Flex setting turned off and don't use the ramp. I find this very comfortable. Today I got an AirFit P10. Yes, yes, I am a mask connoisseur. Wink "Ah yes, P10 2016 vintage, that was a most excellent year!"

I have found that exhaling is much, much more difficult than with the Eson or Simplus at a pressure of 12+.

I will turn on and turn up mil Fex, but i am wondering if this is a normal sensation for experienced CPAP users.

Cheer,s
Chuck

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#2
yep, that's why I can't use it. some don't have a problem exhaling into pressure, you and I do. I am even on BiLevel and still can't use it
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#3
When I moved from a F10 FFM to a P10, my pressure needs dropped. My 95% pressure dropped from 14 to 10. And most of the night the apap stayed below 9.

Depending on your nasal and throat anatomy, you may need less pressure than your current starting pressure of 11. You may want to experiment with changing your range to 9-14 for a while and see if it helps the exhale problem and keeps AHI in check.
Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#4
I didn't notice a problem with exhaling when I switched to the P10s, but what I did notice that felt really weird was that, the first few nights I used them, I could feel the pressure trying to move my tongue forward. After a week or so, I no longer experienced that.

I saw a reduction in the breathing waveforms that indicate "lip leaking" after I switched to the P10s.

I do use Flex. I just lowered it to -1 a couple of nights ago, after using the P10s for around two months.

How do you like the sensation of almost nothing on your face? It felt pretty amazing to me when I first switched, and I still like it. I also appreciate not needing to adjust the nasal cushion of the mask every time I switch from my back to my side (I think I had started doing this in my sleep with the nasal mask.)
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#5
I've never used anything but the P10. Have tired a couple different nasal masks, but that didn't last long.

As far as exhaling against pressure, I'm ok as long as I use a Flex setting. I have been using AFlex1 for awhile now, and it is very comfortable. I have tried switching AFlex to off, but noticed right away that I would have some difficulty exhaling. So switched back to AFlex 1.
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#6
I have found that I had problems at first, but eventually figured out what worked for me - that was to pull the pillow away from my nose and let it settle back several times until it was easier to breath. It seems with the P10 the angle it sits again the nostrils is very important - wrong angle means hard to exhale - for me, just saying, maybe, maybe not, who knows, worth a try, couldn't hurt...
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
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#7
I agree with FrankNichols. The pillows need to fit right and his method is the same one I employ. Use EPR or AFLex to reduce exhale pressure. I use EPR of 1.
Coffee
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#8
(07-28-2016, 08:57 AM)FrankNichols Wrote: I have found that I had problems at first, but eventually figured out what worked for me - that was to pull the pillow away from my nose and let it settle back several times until it was easier to breath. It seems with the P10 the angle it sits again the nostrils is very important - wrong angle means hard to exhale - for me, just saying, maybe, maybe not, who knows, worth a try, couldn't hurt...

I think the size of the pillow makes a difference too. I have still not figured if I need a medium or a large. The large allows more air and I do not feel like I am fighting to breath.

The DME suggested a small for me which lasted one night.
Dont-know  I am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
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#9
Thanks everyone. I did not use them last night, I needed to sleep. Smile I think that Frank is probably right. I had tried some before and the first night was great and then a week later I could not exhale with the same mask. I will report back when I figure it out.
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#10
Some nasal pillows need a higher exhale relief while adjusting to them. I think you already tried that but if not, increase the exhale relief to as high as it can go. Also sit up with it on during the day so you can figure out the angle and the pressure needs.

But, really, the P10's diffuser makes it hard to breathe out against. I hated it. I've switched back to my Nuance due to Demon Machine issues and I'm loving it during this heat wave.

OH! Did you change the setting from FFM to Pillows on your machine??
PaulaO2
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www.ApneaBoard.com


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