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Should you change pressures if you change masks?
#1
Should you change pressures if you change masks?
Hi,

I was wondering if you have to change pressures if you change mask types. For example, if you are using nasal pillows but want to try a full face mask, should you make a modification to your therapy? I know you have to change mask type on the unit but I am not sure if it is enough. And also, theoretically, increasing pressure in a larger volume should require more air to be pumped into the mask, so would that also mean the machine is going to work harder and be more noisy or the volume difference isn't that important.

Thanks...
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#2
RE: Should you change pressures if you change masks?
As best practice according to what I am aware of, no you should not need to edit the pressure settings when changing mask types. However, there is some sort of Mask setting on machines that should be changed when you do that. For example, ResMed has a setting you can choose Full Face, Nasal, Pillows to signify that type change for the mask you use. Respironics DreamStations have a mask X code to edit.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Should you change pressures if you change masks?
It was my understanding from my res-tech that the mask and tube settings were to compensate for the air resistance of various masks and tubes as well as being used to calculate unintentional leak rates.

He didn't have a clue when I asked if the use of EPR changed anything significantly. He pointed me to a mask pressure vs. flow graph for different masks and said that was the best he could do -- because ResMed claimed a proprietary interest in their actual algorithm and would not tell him anything specific.
[removed non-functioning link -- http://medsupplynow.com/pdfs/1016852_pre...er_eng.pdf is from a third-party.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#4
RE: Should you change pressures if you change masks?
(05-26-2020, 07:15 PM)srlevine1 Wrote: It was my understanding from my res-tech that the mask and tube settings were to compensate for the air resistance of various masks and tubes as well as being used to calculate unintentional leak rates.

He didn't have a clue when I asked if the use of EPR changed anything significantly. He pointed me to a mask pressure vs. flow graph for different masks and said that was the best he could do -- because ResMed claimed a proprietary interest in their actual algorithm and would not tell him anything specific.
https://www.resmed.com/us/dam/documents/...er_eng.pdf

That link got me a 404.
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#5
RE: Should you change pressures if you change masks?
You are correct, try a third-party link [commercial DME link removed, see attachment instead].  I added the pdf as an attachment.





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Attached Files
.pdf   1016852_pressure-vs-flow_amer_eng.pdf (Size: 89.98 KB / Downloads: 31)
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#6
RE: Should you change pressures if you change masks?
(05-26-2020, 04:49 PM)SarcasticDave94 Wrote: As best practice according to what I am aware of, no you should not need to edit the pressure settings when changing mask types. However, there is some sort of Mask setting on machines that should be changed when you do that. For example, ResMed has a setting you can choose Full Face, Nasal, Pillows to signify that type change for the mask you use. Respironics DreamStations have a mask X code to edit.

Dave,

I have a DreamStation apap and can't figure out the x code thing.  I use a Resmed Airfit P3i - pillows mask.  Do you know what x code that fits?  My first mask was a Dreamwear FF mask, but I soon switched out the FF mask for the Dreamwear pillows.  Then I got the Airfit P30i.  My machine is set to 1x, but I don't remember if I set it or just found it that way.  I can't figure out what masks the x codes match up with.  Dont-know  I also don't know if it matter a lot or not so much.  Any advice would be welcome.
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#7
RE: Should you change pressures if you change masks?
The pdf demonstrates that at the same pressure levels, a full face mask gets 3-9 l/mn more air compared to a nasal mask depending on the pressure. Then is it possible to conclude that:

1)If a patient's main problem is low oxygen saturation changing to a full face mask, instead of a nasal mask is better,  because it provides more oxygen without a need to increase the pressure, thus a more comfortable sleep?

2)Using a full face mask could result in more central events, as more oxygen is provided, resulting in a lower respiratory rate?
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#8
RE: Should you change pressures if you change masks?
This is an old (2013) chart, so it doesn't show the F30 explicitly, but it sure looks like there's little difference among F masks.

drmaestro, I think I agree with you:

2)Using a full face mask could result in more central events, as more oxygen is provided, resulting in a lower respiratory rate?

My problem is a MND - ALS - and I see a lot (?) of hypopneas, which the Wiki implies might be expected.
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#9
RE: Should you change pressures if you change masks?
Sorry, i'm late in responding to this question. In theory, no changes should be needed with either CPAP or Auto Modes as the devices should self-correct. In theory, running an auto device should not require adjustment when in auto mode either, a theory that obviously many doctors adhere to. We know that the latter is not the case, that these devices, all of them, perform better when adjusted/optimized. I believe that i9f you change the delivery interface, this means anything the air moves through, different geometry of humidifier, different diameter or length of hose, or a different mask, therapy should be reviewed for optimization, and yes this is after making any device setting changes pertaining to these changes.
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#10
RE: Should you change pressures if you change masks?
(05-27-2020, 12:56 AM)Deborah K. Wrote:
(05-26-2020, 04:49 PM)SarcasticDave94 Wrote: As best practice according to what I am aware of, no you should not need to edit the pressure settings when changing mask types. However, there is some sort of Mask setting on machines that should be changed when you do that. For example, ResMed has a setting you can choose Full Face, Nasal, Pillows to signify that type change for the mask you use. Respironics DreamStations have a mask X code to edit.

Dave,

I have a DreamStation apap and can't figure out the x code thing.  I use a Resmed Airfit P3i - pillows mask.  Do you know what x code that fits?  My first mask was a Dreamwear FF mask, but I soon switched out the FF mask for the Dreamwear pillows.  Then I got the Airfit P30i.  My machine is set to 1x, but I don't remember if I set it or just found it that way.  I can't figure out what masks the x codes match up with.  Dont-know  I also don't know if it matter a lot or not so much.  Any advice would be welcome.

As I understand it, X code 0 (zero) is supposed to be good for any non-Philips mask. For Philips brand masks, it will include that X info on their own branded masks on the back of their mask packaging.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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