Unable to exhale against nasal pillow pressure?

[jle323]

I received my ResMed Airsense 11 autoset almost a month ago.  I had been trying to use the Aifit F30i but I could never breathe through my nose while wearing it and there was huge air leak at the top. It’s a small mask, but I have a very petite face and I think it’s just too big.  Yesterday I received the P10i nasal pillow.  When I put it on last night I was excited because it fit my nostrils perfectly and I felt no air leak.  But I ended up ripping it off after 5 minutes in frustration because I couldn’t exhale against the pressure.  I had to keep breathing in through my nose and out through my mouth. I can’t understand why I was having such difficulty.  I changed the mask choice on the machine to pillow.  Is there anything else I can do?

[sunsaffron]

I recently purchased a P10 and noticed extreme difficulty exhaling as well. I took the mask off and tried plugging the hole for the tube connection, literally no air came out the vents. I did some searches and this seems to be a fairly common problem with no good solution. I have purchased a Fisher&Paykel Brevida mask and see if that's any better. Otherwise I'll just continue using my P30i which is a "meet in the middle" mask.

[staceyburke]

We might be able to help if you put up your daily Oscar Charts. We give advise using data and that data is through Oscar. Download is totally free at the top of the site. I also have information on Oscar and which chats to post in my signature about charts.

[sfr79]

I'm relatively new to CPAP myself, but I'll offer some suggestions nonetheless based on my experience thus far. Do you have EPR on? This is likely just called "Pressure Relief" in the user menu of your machine. It can be Off, or set to 1, 2, or 3.  The highest setting of 3 will provide 3cm of pressure relief when you're exhaling (with the caveat being the pressure will never drop below 4cm, so if your inhalation pressure is at 6, the machine will only drop 2cm, down to 4, when you exhale. Hope this makes sense).

Further, do you have ramp ON, and if so, what is the ramp pressure and duration? This is another comfort feature you might consider, especially if your treatment pressure range is on the high end.

Posting a chart of your OSCAR daily detail will allow those with more experience to better assist you. It would be helpful to know your min and max pressure, EPR, and ramp settings at the very least.

[jle323]

Thank you all for responding! I have an ipad, so I can’t use the Oscar software. I do use a Ramp setting; it’s set for 30 minutes, pressure 4. The pressure relief is on.

[LindanHotAir]

You are not receiving therapy during the ramp period, so you lose 30 minutes every time you restart the machine. You may want to shorten or eliminate the ramp.

[CorruptAlligator]

Yes, please show OSCAR screenshot.

I also felt the same when I first got it and tried a larger opening size and it helped some. So, you are on ramp start pressure of 4? That's not so high. Do you have difficulty from the start?

Trying raising your minimum pressure to 7, with EPR to 3. This will change inhale and exhale pressure so that it will feel like exhale pressure is relatively lower, and this may work for you.

I agree with Linda, please turn off ramp if you can.

Also, if pillows are too strong of pressures for you, give nasal masks a shot (N20 or Wisp). Pillows don't work for me, and I find nasal masks work best for me.

[Sleeprider]

jle323, are you using EPR (exhale pressure relief)? Your machine allows the pressure to be reduced by 1-3 cm during exhale. It requires that you go into the clinical settings, and turn on EPR full-time and choose a setting of 1, 2, or 3. The higher the setting the more pressure relief.

[jle323]

The EPR is already set at 3. I have the ramp set to 30 minutes because I was wearing the F30i face mask while reading to get used to it. I can’t use the Oscar software; I use an iPad.
I have a follow up appointment with my sleep doctor in a few weeks. I’m hoping he’ll have some suggestions, as I haven’t made it more than 2 hours using the cpap.

[Sleeprider]

What are your pressure settings?