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Suprised by results with pillow mask.
#1
I have been really stable for a really long time on the nasal mask. So switching over to the pillow mask showed a few surprises for me. Well, on the first night in. Not that the overall result were BAD, just when you are used to seeing tight data with little variation, and great control and then you start seeing deviations on a broader scale and frequency, it is curious. I acknowledge that one night is not "data". Well, not actionable data. I guess technically it would be a datum.

Results on the P10 pillow mask vs. prior results w/ Mirage FX nasal mask -

AHI - up from a monthly average of 0.69 to 3.60 for the night
Obstructive index - up from .034 to 2.62 for the night
Average pressure - up from 8.55 to 10.24 for the night
90% pressure - up from 10.00 to 14.30 for the night

Pressure with the nasal mask almost NEVER went above 12.

Now, as noted, that is one point in time and is not in and of itself data, but it is not a welcome result. I don't really understand how a mask change would change the need for pressure changes or cause higher AHI values. Unless it is related to the calibration on the resistance factor or whatever that setting is on the PRS1. Still wouldn't, I think change the AHI numbers unless the machine is topping out on the pressure range and not providing effective treatment. Now, looking at SH data, it got CLOSE to my max of 15 a few times, but never actually got to it. Now, the slower Al Gore rhythm of the PR machines may just not have totally caught up.

I can think of a couple of things that might help. I can bump the max pressure up to 20 and see if my AHI numbers come back in line and see where my 90% pressure is. That would provide for protection and if they do come back in line while my 90% pressure and average pressures stay high, I would think it would indicate a calibration factor and a need to fart around with the resistance factor settings.

I am not one that normally would change anything based on one night's use, but I think bumping up the max pressure may be a prudent thing to do.

OMMOHY
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#2
Well, my motto has always been that of the hungry vulture - "Patience hell, I am going to go kill something!".

But, in this case I would consider waiting a couple days to see if it is an anomaly. I see bumps when I switch between my P10 and F10, I haven't figured out why, but it happens. Your numbers are still good (better than mine on average) so, I think it is safe to just wait a few days and see if you "get used to it" or your body adapts.

Just my NSHO...

Frank
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
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#3
What size nasal pillow did you use?
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#4
My first thought is- Did you check your machine to switch it to pillow mode? I don't know if your machine has such a mode - my Resmed ones do. If you are still on nasal masks and switched to pillow without changing it in the machine options, everything goes all wonky.
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#5
Shut off the mask resistance. I think, but not sure, that PR recommends a setting to off if your not using a PR mask.

I tried using it a couple times, and AHI went up, plus I just didn't like the difference of air flow that I was feeling.
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#6
Thanks for the input, guys.

Sleepy - I used the L pillow. M pillow felt "pinchy".

Skeeter - Yes, I tried to change to pillow mode. PRS1 machines do not have the same settings as do the ResMed. No joy. Whole other thread on that I started.

Rosie - Since the PR1 does not have pillow mask mode, I looked at the System ONE Resistance settings. They are currently set to OFF.

I think I am going to open up the top end just in case the machine thinks it is at 15 when it is really at 10 (90% pressures on pillow vs nasal mask) - 15 is currently the top setting. That will give it a little headroom. No harm if it doesn't need it. Run like that for a few days and recheck. And then if stabilized, go back and start monkeying around with the X-1, X-2, X-3 resistance settings to see if I can tweak them into making the machine's reported numbers come back in line with the nasal mask.

OMMOHY

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#7
Al Gore rhythm, bwahahahaha! That's such a good description of the PR algorithm's dynamics.

If, for whatever odd reason, you do need higher pressure with the nasal pillows, you're now asking the PR algorithm to handle a pressure increase from 8 to 15, and from my auto-trial mode experiments with my machine, it isn't so good at that. It can usually handle a 2 cm increase, maybe 3 if it's having a good day, er, night.
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#8
Anytime I change masks, from FF to pillow to nasal mask, it unsettles things for a bit.
FFM is gonna need more pressure, thats a given.
For me, nasal uses less than FF and pillows use less pressure than nasal mask.
Best pillows ive ever used was the nuance with fabric headgear. Set the machine for the mask and everything clicks.
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#9
OK - last night was betterer.

AHI just over 1.06 and 95% pressure of 10.00 - max pressure of 11.10 - so maybe appears back to "normal" for last night. I think I am going to try the medium pillows as the large sometimes seem to rub and put pressure on my upper lip ...

OMMOHY
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#10
Anytime I make a change, even a small one like a .5 pressure increase, or a change on the AFlex setting, my AHI numbers go a little crazy for a few days. It goes against logic, but the numbers settle down. It's almost like the dang machine is alive and doesn't want to be messed with.

I've always used a nasal pillow mask, but when the Dreamware mask came out, I tried it. Well my AHI went from <1 to almost 3. After a few days, we were back to normal.

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