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High Pressures Possible w/ Nasal/Pillow Mask?
#1
Are any of you using a nasal/pillow mask with high pressures and don't have problems with it?

I'm not having any luck with my now my second mask (first was F10, now F20). Once it gets to high pressures I get too many leaks. It seems to stay around 12-15cmh2o, but my DME said that would be too much air in my nose, especially since I'm always congested and have a deviated septum pretty much. But I've seen some comments that high pressures in the nose can work fine. 

Anyway, just trying to figure this out and see if I should risk buying a nasal or pillow mask since I can't return my current useless mask.
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#2
(09-14-2017, 01:25 AM)JonnyCPAP Wrote: Are any of you using a nasal/pillow mask with high pressures and don't have problems with it?

I'm not having any luck with my now my second mask (first was F10, now F20). Once it gets to high pressures I get too many leaks. It seems to stay around 12-15cmh2o, but my DME said that would be too much air in my nose, especially since I'm always congested and have a deviated septum pretty much. But I've seen some comments that high pressures in the nose can work fine. 

Anyway, just trying to figure this out and see if I should risk buying a nasal or pillow mask since I can't return my current useless mask.

Interesting comments by your DME

I have the Dreamwear nasal mask and run it at a starting pressure on APAP of 13 with a max of 20. I have no issues with major leaks and usually get a good nights sleep with good numbers. I would think that high pressure, if it was treating your apnea, would be very good for you.
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#3
(09-14-2017, 03:26 AM)holden4th Wrote:
(09-14-2017, 01:25 AM)JonnyCPAP Wrote: Are any of you using a nasal/pillow mask with high pressures and don't have problems with it?

I'm not having any luck with my now my second mask (first was F10, now F20). Once it gets to high pressures I get too many leaks. It seems to stay around 12-15cmh2o, but my DME said that would be too much air in my nose, especially since I'm always congested and have a deviated septum pretty much. But I've seen some comments that high pressures in the nose can work fine. 

Anyway, just trying to figure this out and see if I should risk buying a nasal or pillow mask since I can't return my current useless mask.

Interesting comments by your DME

I have the Dreamwear nasal mask and run it at a starting pressure on APAP of 13 with a max of 20. I have no issues with major leaks and usually get a good nights sleep with good numbers. I would think that high pressure, if it was treating your apnea, would be very good for you.

Good to know, thanks. You don't feel like it's too much direct air going into your nose with your pressure numbers? Does the humidifier do the job or do you get really dried out.
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#4
I use the ResMed P10 pillows and my Minimum pressure is 20cm and goes up to 25cm. I don't have any problems. You won't have any problems at your pressures.
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#5
I use an ASV machine with p10 nasal pillows, and my inspiratory pressure can range from 12cm-21.   I get a few small leaks, but have no major leak issues. I found that as you get more comfortable with the pressure, you won’t notice it as much.   In my opinion the biggest issue for nasal masks is mouth breathing, because they usually seal well around the nose.

I can’t speak to the deviated septum, but I find that nasal pillows can really help with congestion. I sleep better with colds now than I ever have!
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#6
my prescription is for 16-25 cmH2O
been running 11.4-21 cmH2O with my dreamwear gel pillows
any leaks are thru the mouth, but very, very infrequent and nowhere near enough to impede treatment.

I could NOT run my prescribed pressures with a FFM without MAJOR leaks no matter what I tried. (Simplus and F10 masks)
suffered from aerophage at those pressures.
switched to a nasal mask, was able to lower pressure (from observing Sleepyhead charts).
I get a good nights rest with an average AHI of 1.44
Aside from the Dreamwear, I also have a Brevida mask. the Brevida is also a great mask and very quiet.

Check around, there are online vendors that have 30 day return/exchange policies.
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#7
The Resmed Airfit P10 pillows has shown good results for people at high pressures, and I have used it up to 18 without leaking. Nasal pillows actually have the easiest fit and least surface area to seal, so tend to leak less. Your pressures are not so much higher than mine. Try it, you'll like it! If your DME tries to give you a single pillow size, ask for the next size up to try...he is poorly informed and will get the nasal pillow size wrong too. BTW, I have deviated septum and often have congestion that clears up under PAP pressure as soon as I mask up.
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#8
I use the Nuance at range of 15-20 and average of 18.5 - 19.5. I have no leak issues with this mask. It is very comfortable and, unlike the P10, it has adjustable headgear so it fits almost anyone's head. I had decent luck with the Simplus but only buy using liners.
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#9
Great info, thanks everyone! I think I'll definitely give the P10 a shot.

Do any of you use a chin strap and without problems?

Another reason my DME changed my mind on using a pillow mask was that I'm probably a mouth breather because I drool a lot when on my sides and they said with a pillow mask I would need to use a chin strap then and that they don't really keep your mouth closed all that well.
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#10
Hello Johnny CPAP,
I was using a FFM, the F-20 but would get dry mouth, I read some posts about a thing called "Tongue Sucking" putting your tongue up to the top of your palate behind your teeth and slightly sucking to keep your tongue in place, I practiced this for a few nights and was quickly able to put it to use, I no longer mouth breath and while my jaw may open i still have the seal behind my tongue, I now use the dreamwear nasal cushion mask with great results.
My pressures are not that high but with an ASV machine the pressure jumps from normal breathing to enough to start a breath for me, and it is a sudden surge. I have had no problems yet.
Keep trying and learning what works for you, we are all different and different things work for each of us.
Shift Worker
Sleep-well
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