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Problems with AirFit P10 Nasal Pillows (+ResMed AirSense 10)
#1


I am using the Resmed AirFit P10 nasal pillow and am having a few problems. Would appreciate some advice or suggestions.

Background info is that I’ve reset the Resmed S10 “pillow” (from 'mask' I used to use) and it's set for automatic 4-12. More detailed settings at the end.

1. With both small and medium size pillows the device does not automatically stop when I remove the mask. It just continues blowing and stops only when I remove the nasal pillow attachment from the vent/frame of the AirFit P10 (or remove the small tubing from the main device hose). It doesn’t have this problem with the large size pillow.

According to the Clinicians manual, if SmartStart is enabled the device should automatically stop. It says an incompatible mask is being used otherwise. But the AirFit p10 is compatible. The manual also says “If the patient is using a nasal pillows mask with set pressure less than 7 cm H2O, SmartStart will not work and should be disabled.” I am not sure what this means since I don’t have a set pressure; I have a 4-14 range. As an experiment, I turned off auto mode and ramping and set the fixed cpap at 7.2. Still the same problem, so this isn’t the issue either. Then I tried 10 and the blower did stop when the small mask attachment was removed.

All this makes me worry that the ResMed 10S is not detecting changes in mask pressure as well as it should with the nasal pillow — I didn’t have this problem with the full-face mask. This raises the question of how well it’s doing adjusting pressure during the night …

2. In fact I’ve been using the nasal pillow for 4 nights and the last two have been pretty poor. I woke up often and even when I remained awake the machine didn’t drop down to its minimum pressure of 4, which it did do with the full-face mask. I checked the pressure and it was hovering around 7. That was too high for me to get toget back to sleep and I ended up taking the pillows off.

3) How does one decide between pillow sizes? I know large is too big for me because of evident leakage, but are the considerations for choosing between M and S?

I generally more comfortable with the feeling of the pillows than the full-face and would really like them to work.

______

Settings on Resmed 10s

Mode: Autoset
Min Pressure: 4
Max Pressure: 12
Mask: Pillows
Response: Standard
Ramp time: Auto
Start pressure: 4
Smart Start: On
EPR: On, Full-time, level 3
Climate: Auto
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#2
Hi Numari. In my experience the so-called SmartStart and SmartStop features on the S9 machines are erratic and unreliable. I turned them off and don't miss them (it's not so hard to hit the on/off button). Perhaps the A10 machines have a similar issue? I don't think this has much bearing on the quality of the therapy you experience when the machine is operating in a more-or-less steady state situation while you're asleep.

The pillow size obviously needs to be the one which best suits your nostrils. If it's too small it will put pressure on the inside of your nostrils and be uncomfortable, but too big won't seal properly. I think the only way to know for sure is to try them. My P10 came with all three sizes so it was an easy matter to find the best fit - but I ended up tossing the mask anyway - it just doesn't work for me. YMMV.


DeepBreathing
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#3
Numari,
I use the P10 for Her. My DME told me to use the size extra small. Tried it for over a month, but it always felt too tight. Also left red marks on the outside of my nostrils and was sore. So I switched up to the size small (much to DME's disapproval-not sure why they care) but the size small seems to be perfect for me...better seal, no red marks!
As DeepBreathing said, try the different sizes that come with the P10. That is the only way to know what works for you.

Also, I don't know much about the AirSense, so can't help with that!
Best to You!
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#4
The general rule of thumb with the P10 mask size is to use one up from the one that feels best in order to get the best seal.

I'm wondering if the diffuser of the P10 is confusing the machine which is why it is not until you remove it from the frame that it finally turns off. Regardless, I prefer to turn the machine off. It is quieter and immediate.
PaulaO2
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#5
(02-07-2015, 04:59 AM)numari Wrote: All this makes me worry that the ResMed 10S is not detecting changes in mask pressure as well as it should with the nasal pillow — I didn’t have this problem with the full-face mask. This raises the question of how well it’s doing adjusting pressure during the night …

I can't give you much information on your P10 mask. I have never used one. What I will tell you is that the Resmed machine does not control the pressure at the mask. It controls the pressure at the machine and calculates the pressure at the mask in order to give you the set pressure at the mask. Your problem with smart start has no bearing on the ability of the machine to provide the correct therapeutic pressure

Personally I have never used the autostart/stop feature but some people seem to like it.

Best Regards,

PaytonA
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#6
(02-07-2015, 04:59 AM)numari Wrote: As an experiment, I turned off auto mode and ramping and set the fixed cpap at 7.2. Still the same problem, so this isn’t the issue either. Then I tried 10 and the blower did stop when the small mask attachment was removed.

There really isn't anything all that "smart" about "smartstart." The best setting for it is "off." If you're running higher pressures then it should work. But low pressures, especially when your epr is dropping the exhale three more points won't get the machines attention.

The P10 works fine, but I do feel the secret is to use one mask size larger than what you think you should use. I originally thought I should use the medium, then ended up with better results using the large. As a test the other day I swapped back to a medium for a night. They sealed fine, and felt fine however mch more effort was required to inhale/exhale. I finally gave up and put my large pillows back on.
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#7
(02-07-2015, 11:52 AM)PaytonA Wrote: ...I have never used the autostart/stop feature but some people seem to like it.
...

And I am one of them.

As long as we are posting anecdotal evidence, I have an S9, and it always starts within a breath or two, and it always stops exactly 4 seconds after taking off the mask, this with the P10 and the Swift FX. This also at pressures 5-20, 8-14, 10-14, and straight 8.

That is the exact opposite of erratic or unreliable.
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#8
Stop the machine and restart it, this will drop the pressure, if that bothers you and make it easier to get back to sleep.
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#9
(02-07-2015, 04:59 AM)numari Wrote: I am using the Resmed AirFit P10 nasal pillow and am having a few problems. Would appreciate some advice or suggestions.

Background info is that I’ve reset the Resmed S10 “pillow” (from 'mask' I used to use) and it's set for automatic 4-12. More detailed settings at the end.

1. With both small and medium size pillows the device does not automatically stop when I remove the mask. It just continues blowing and stops only when I remove the nasal pillow attachment from the vent/frame of the AirFit P10 (or remove the small tubing from the main device hose). It doesn’t have this problem with the large size pillow.

According to the Clinicians manual, if SmartStart is enabled the device should automatically stop. It says an incompatible mask is being used otherwise. But the AirFit p10 is compatible. The manual also says “If the patient is using a nasal pillows mask with set pressure less than 7 cm H2O, SmartStart will not work and should be disabled.” I am not sure what this means since I don’t have a set pressure; I have a 4-14 range. As an experiment, I turned off auto mode and ramping and set the fixed cpap at 7.2. Still the same problem, so this isn’t the issue either. Then I tried 10 and the blower did stop when the small mask attachment was removed.

All this makes me worry that the ResMed 10S is not detecting changes in mask pressure as well as it should with the nasal pillow — I didn’t have this problem with the full-face mask. This raises the question of how well it’s doing adjusting pressure during the night …

2. In fact I’ve been using the nasal pillow for 4 nights and the last two have been pretty poor. I woke up often and even when I remained awake the machine didn’t drop down to its minimum pressure of 4, which it did do with the full-face mask. I checked the pressure and it was hovering around 7. That was too high for me to get toget back to sleep and I ended up taking the pillows off.

3) How does one decide between pillow sizes? I know large is too big for me because of evident leakage, but are the considerations for choosing between M and S?

I generally more comfortable with the feeling of the pillows than the full-face and would really like them to work.

______

Settings on Resmed 10s

Mode: Autoset
Min Pressure: 4
Max Pressure: 12
Mask: Pillows
Response: Standard
Ramp time: Auto
Start pressure: 4
Smart Start: On
EPR: On, Full-time, level 3
Climate: Auto

Do you have the A10 CPAP or APAP (standard or autoset)? Did you try changing mask settings to Nasal or did you only try full face & pillow?
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#10
I am using the A10 Elite at 9, and it does not stop with that mask either. It does with the wisp and the Pillairo though.
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