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Of Nasal vs FF vs total face and titration.
Happy Holidays all. Smile

This is just my personal experience so please take it as such though it may help some others in the same odd situation I was and am.

Diagnosed with moderate to severe OA. O2 levels drop into the low 60s very fast with only a few close events. At the lab faster than they had ever seen before so they said. But on the machine and titrated O2 stayed in normal range. Titrated pressure was 15 using a fitlife total face mask.

Doc sets me up with an auto and I get a PRS1 series 60 auto aflex. Docs settings 6 min to 15. I request a bit higher min because Im smothering at 6 in the Fitlife so Doc ups BOTH min to 8 and max to 18Huh This is all months ago at the start of the trip down cpap lane.Grin

Fast forward a month. I am gifted a old nasal mask and after that a Simplus FF. I nasal a few nights and find AHI goes WAY down and so does the pressure the auto is running. Like a reduction in max pressure from 15 to 16 at times to never going over 11.Huhsign

Try the Simplus FFM. Love the mask. AHI goes up a bit and pressures go back up, with the machine saying start at 10.5 min. Might have done that with the Fitlife also but I didnt know how to turn on the Opti start feature when I used it.

Still Fitlife goes in a bag and I go with the Simplus for several reasons. Nasal is too small so wife starts trying it but doesnt get along with it so it goes in the bag too LOL.

Then Doc says ok you know you can use a nasal so thats what we do. And I get the Eson which is perfect. Seals loose, no leaks, if its tight enough to stay on your head itll seal so im sold on it.

And now the interesting part of my little cpap trip. With every mask my pressure requirements are different. Max needed is way less with a nasal than with a FFM And FFM is less than with a Total face.

Point im driving at is if you were as I was titrated with say a Fitlife or the like or even a FFM and then you switch to nasal and you are on straight cpap its entirely likely you titration pressure for the FFM or TFM is much higher than it needs to be with a nasal mask or pillows. Or vice versa if your titration was done with nasal and now you use a FFM it could be to low. Auto it wont matter much except that your min pressure could likely be set lower also or need to be set higher.

I realize this is one persons experience and everyone is different. But with me and the wife the change in pressure and AHI vs nasal FFM and Total Face is as predicable as clock work. And consistent as the sunrise.

Just something I thought Id toss out there in case it happens to be of use to anyone.Sleep-well

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Thanks. I haven't used anything but FFM. I had very uncomfortable feeling with both nasal mask and pillows at my fitting. I will keep this in mind, though, when many others have great AHIs and I am lucky to get under 5.
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I have found masks can be an extremely personal thing. For me, the leaks were more my issue than the pressure. I'm blessed in that I can pretty much run whatever I'd like for a mask....pillows, nasal (<-though only if my nose is clear for these), ffm and tfm (FitLife too). I can tolerate a slightly lower starting pressure with a nasal interface, but I typically find that my leak rate is higher.

A ffm or tfm usually gets me much lower leak rates (pretty much zero unintentional for the FitLife) but needs the higher starting pressure to avoid the feeling of air starvation.

I am fortunate, though, in that I have found a pressure range that...regardless of mask type...gets me my minimum AHI.

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(12-28-2014, 12:42 AM)quiescence at last Wrote: Thanks. I haven't used anything but FFM. I had very uncomfortable feeling with both nasal mask and pillows at my fitting. I will keep this in mind, though, when many others have great AHIs and I am lucky to get under 5.

If your AHI is not where you think it should be, you have the luxury or viewing your data and correlating events to pressure. If a disproportionate number of flags are occurring when your machine is at minimum pressure, then you might consider increasing the minimum and seeing what that does for you. I was having a significant number of hypopneas at my minimum of 8.5 cmH2O, and eventually self-titreated up to 10. My max pressure remains 14, but the changes dropped AHI in half.

When I started in 2008, I had a nasal mask, and quickly progressed through the Swift LT, Swift FX, and hope to use the AirFit P10 soon. I have always made minor adjustments as needed for comfort and effectiveness, and never consulted a doctor on it. I recently changed from a M-Series to PR System 1 Auto and that actually provided enough data to cause me to change pressures a couple points.

So I think masks and machines might cause us to review settings, and just changes in ourselves over time demand we pay attention.
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FFM's are said to push back the jaw on some people and make AHI worse. Sort of a reverse dental device.

Yet another reason everyone should have a fully data capable APAP and competent monitoring.
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(12-28-2014, 10:51 PM)archangle Wrote: FFM's are said to push back the jaw on some people and make AHI worse. Sort of a reverse dental device.

Yet another reason everyone should have a fully data capable APAP and competent monitoring.

That may be the case on me with the Fitlife because it has to have some tension on it, but the Simplus just sort of hangs there and seals anyway.

Sometimes and this is a wild guess Ive come to believe that the direct shot up the nose and less volume to fill with the nasal may have something to do with it, on me at least. My events tend to come on without much warning for the machine to react too. So maybe the narrower range because of less pressure needed to head them off might have something to do with it and maybe that the machine doesnt need to fill as much volume too raise the pressure.

Dont really know why though just that if I ran a straight cpap with nasal set on my titrated with a Fitlife mask Id be running 15 cm when I only need about 11 max with the nasal.

Could be the wife and I are just weird too Laugh-a-lot

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