You went from a nasal pillow to a full-face. Respironics has a mask resistance setting.
That may need to be changed.
Since the OAs are mostly during a period when the machine has raised pressure, I do not believe a pressure increase is called for.
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I don't have the wisdom to answer your question well. But I'll share my experience.
When I use the DreamWear mask, my auto-adjusting pressure never goes higher than 11. When I use a FFM (Amara View), my auto-adjusting pressure goes up toward 16.
So now, when I use a FFM, I put my max pressure higher, so it has the room to go higher if need be.
I started with an f10 and my 95% pressure used to go up to 14cm.
With my p10 (and yes, this will be the mask you finally gravitate to because 'resistance is futile'), my pressure never budged from 8cm. That's when I switched and never went back to the FFM. During the days when I have a severe nose block, I just change pressure to 8.5 or 9 for that night. It works well for me.
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.
Since the last post on this thread, I have returned to the Dreamwear Nasal Pillow to see if my AHI and RDI would return to the low levels I had before trying the Simplus and, of course they did. My breakthrough with APAP came on March 16 when, based on a thread suggestion, I changed the FLEX setting on my Dreamstation to C-Flex from A-Flex. I set C-Flex to 2 and, immediately, my AHI fell that night to .14 and my RDI to .55. My 38-day average since then has been AHI at .54 and RDI at .94. The first two weeks AHI average was .24 and RDI .54; since then, AHI average has increased to .76 and RDI to 1.24. I’m not sure why it went up, but the numbers are still very good. I can’t say that the quality of my sleep is better, but I do have more energy at the gym (which is great at age 68). I finally met with a sleep doctor who reviewed my history and commended me for finding this site. We talked about mouth breathing and it was he who suggested a FFM to avoid taping and a chinstrap. He also said that I might not actually feel “better” for some time even though the APAP numbers are great. This is consistent with what I have read on this site.
I’m willing to try the Simplus again. In addition, when I was doing some research on mask fitting, an Amazon ad for the Resmed P10 for $49 popped up on my screen. And, since “resistance is futile”, I bought it. So, I’m ready to try it as well.
I would appreciate some advice and insight. Here are my questions regarding my present arrangement (Pressure range 8.00 to 12.00, C-2 FLEX, Dreamwear mask, chinstrap, taping):
1. Should I even be concerned that my numbers have been increasing slightly above the initial period lows since March 16? Should I increase pressure range slightly? My mask is now 3 1/2 months old; I have replaced the cushion but, not the frame.
2. RERA has been increasing, so should I increase C-Flex to 3?
3. I did try a cervical soft collar and found it as effective as the chin strap. Is there an advantage of one over the other?
4. My average pressure has been 8.21 (min = 8.00, med =8.00). Does this suggest I might have less awakenings with a “fixed pressure”? I don’t think, by eyeballing my Sleepyhead charts, that my awakenings occur with pressure changes, but I’m far from an expert in interpreting Sleepyhead data.
Regarding the P10:
1. Should I give it a go?
2. Sleeprider mentioned in a post on 4/8/17 that most people changing from a Dreamwear pillow to a P10 find they need 2 – 3 cm less pressure with the P10. Where do I start? Do I reduce my current range and increase as necessary (work up)? Or, do I start at my current range and reduce pressure as necessary (work down)?
3. Am I likely to still need the chinstrap or cervical collar? Do I start with or without it?
4. Will leaks be harder to control with the P10?
5. What mask resistance setting on my Dreamstation do I use? Dreamwear is -1.
6. What prong size do I start with? I wear a medium Dreamware pillow.
Regarding the Simplus:
1. Should I give it another go?
2. Chill mentioned in this thread that, typically a FFM will require a 1-1.5 higher pressure. Where do I start? Do I increase my current range and change from there as necessary (Increase and work from there)? Or, do I start at my current range again and increase pressure as necessary (work up)?
3. What mask setting should I use?
4. I didn’t need a chinstrap in my short trial. May I need one with increased pressures?
And finally, am I being foolish in even considering these alternatives? I don’t want to be a number chaser, but I’m really interested in getting the most from this therapy. So, I’m willing to experiment. I most definitely would welcome your thoughts.