Should pressure settings be lower for nasal masks?

[ellen1159]

I read somewhere that pressure settings are sometimes made higher for full face mask-users. I recently switched from a full face mask to a nasal mask. Should the doc/RT have lowered my pressure settings (they are high, 25/15, I did my sleep study in a Quattro full face mask and I only showed improvement when settings were 20 or higher)?

[Pugsy]

No, typically pressures aren't lowered (or increased) when changing mask types. Not everyone will see a change in pressure needs with a change in masks. It's done more on a case by case consideration.
Not everyone that uses a full face mask will see a reduction in pressure needs with a nasal mask or nasal pillow mask. Now some people do get to use less pressure but it isn't something that is an accepted standard to go by.
It's one of those situations where you may or may not have different pressure needs with different mask types...BUT it hurts nothing to give it a try to see. Especially with your history of difficulties adjusting to your pressures.
What's the worse thing that would happen with a little lower pressure? Maybe a few events slip past the defenses and maybe not...that's a whole lot more preferable than only using the machine for an hour or two.....some pressure and therapy all night is better than no therapy for the hours you sleep without the mask.

You aren't sleeping well for any length of time with your mask and machine...is that right?
In your situation....some pressure is better than no pressure and I find it mind blowing that no one wants to give you that option.
Option being to start with a lower pressure and work your way up to the higher pressures and all the time monitor your data..heck, might get lucky and find out you don't need as much as they first thought.

[ddk]

25/15? Do you mean 25cmH2O?

If so, that's higher than most machines will go and it requires a special machine with a custom setting from what I understand.

I'm on 20cmH2O and I use a Swift FX. I was told that I should be using a FFM. I'm not 100% sure if it will make a difference as I've used a FFM for a solid week and found it intolerable compared to the pillows. The only problem I seem to have with the pillows is that if I end up turning onto my back as I sleep, I tend to get leaks and breath through my mouth. On the side I don't seem to have problems with it.

Then again, I'm still tired all the time so it's possible that the pillows aren't working very well. I tend to get good numbers from the machine but I also recently found out that the numbers can be inaccurate.

If you have the resources to try different masks, I say go for it. Find what works for you and what gives you the best result. From everything I've gathered in terms of learning about CPAP therapy, treatments can be wildly variable so it's really a matter of determining what is best for your needs.

[Pugsy]

25/15? Do you mean 25cmH2O?

If so, that's higher than most machines will go and it requires a special machine with a custom setting from what I understand.

The bilevel pressure machines will go to 25 cm..that's what Ellen has...and they aren't that special. I have one also.
They are fairly common.
You might be thinking of the higher end bilevel machines in the ASV model range...now those are indeed more custom in regards to the settings but the BiPap machine that Ellen has works pretty much just like your machine except it goes to 25 instead of 20 for the Inhale pressure.

[ellen1159]

I like the Wisp nasal mask better than the FFM's I've tried so far. I don't use pillows. My main issues right now are throat dryness interferes with falling asleep, and getting comfortable on my right side with the Wisp headgear. I'm waiting for delivery of fleece covers for the headgear plastic pieces, maybe that will help.

I'm not scheduled to see the sleep doc until aug. 6 but perhaps I should call them to discuss lowering the pressures to see if I can at least fall asleep with the mask on.

[Pugsy]

Don't put off calling them any longer or you won't have much to talk about during that Aug 6 visit.
Gotta get the sleep to see if it is working and 1 or 2 hours of sleep that is highly fragmented isn't a good gauge of therapy.

You might get lucky and not need so much pressure with the Wisp. You would not be the first to get lucky in that regard.

[Pugsy]

I just saw in another thread that you aren't using the humidifier right now with the warm weather?

You have a 760 machine....do you have the heated hose with it or just the regular hose?

The not humidified air could sure be making the dry throat issue worse. There are ways to get added moisture without adding a lot of warm air blowing on your face if that warm air is a problem.

Depending on which hose you are using you can have some moisture added without a lot of heat (that would be the regular hose) or if you have the heated hose we can set it for cooler temps and more individualized humidity delivery so that you don't have to use higher temps to get more added moisture.