AHI Higher AFter Switch from Nasal Pillows to Full Mask

[Sleepypokey]

New to the forum and relatively new to C-Pap therapy. I recently switched from nasal pillows to a full face mask, per recommendation of my doctor because of sinus issues and a limited amount of mouth breathing, mostly exhaling. My average AHI with pillows was .46. With the mask it's above 4. Nothing else has changed. I had no trouble adjusting to either. Thoughts?

[OpalRose]

Hi SleepyPokey and Welcome to Apnea board!

The first thing that comes to mind is...did you change the setting on your machine from pillows to full face?

The other thing is that sometimes you may need a slightly higher pressure when going from pillows to full face.

What machine are you using? Auto Cpap or straight Cpap?

Can you tell us what pressure your machine is set at? You don't list this on your profile. Also, look on SleepyHead report to see what you 90% pressure reading is.

[Sleepypokey]

Thanks. I was in the process of updating my profile right after I submitted my question. I did change the setting to full mask when I switched. It's an auto Cpap machine. I see a 95% pressure setting. With the pillows it was anywhere from 11.02 - 11.54. With full mask it was from 11.94 - 12. I will talk with the therapist who set me up with the machine this week. When I switched masks, it was a different therapist and she didn't mention anything about increasing the pressure.

[OpalRose]

Thanks. I was in the process of updating my profile right after I submitted my question. I did change the setting to full mask when I switched. It's an auto Cpap machine. I see a 95% pressure setting. With the pillows it was anywhere from 11.02 - 11.54. With full mask it was from 11.94 - 12. I will talk with the therapist who set me up with the machine this week. When I switched masks, it was a different therapist and she didn't mention anything about increasing the pressure.

Your AHI may settle down in time, but now that you have filled in your pressure range, I can tell you that a minimum pressure of 4cm is just too low for most people.
You can tend to feel air starved.

With a 95% reading of 11 to 12, your minimum pressure should be a bit higher.
Try starting it at 7cm. Even that may be too far from the 95% number.

Your therapist also has your maximum pressure set to 12. That should be a bit higher too.

A good rule of thumb for setting your pressure range is:
Minimum should be 2 to 3cm beflow the 95% number and the maximum 2 to 3cm above.

[Sleeprider]

I agree, the low pressure is too low for most of us with obstructive apnea. I'd like to ask what is the distribution of your AHI? Can you look at the data and see the obstructive, hypopnea and clear apnea index? Changing from a nasal pillow to a full face will usually require more pressure, so I would guess your minimum pressure is too low. Once you can post data, we can perhaps do a better job of assessment.

[trish6hundred]

Hi Sleepypokey,
WELCOME! to the forum.!
Good luck to you with your CPAP therapy.
Hang in there for more responses to your post.m

[Jimsp1]

After using it for 6 months when I changed from an Amara View FFM to a Dreamwear nasal mask my AHI changed from an average AHI 3 to an average of 1. Essentially the OA's disappeared leaving me with only with hypopneas. After giving it a lot of thought I believe the difference was a result of the Amara View putting a little pressure on my jaw and moving it slightly backward encouraging the OA's .

[Sleepypokey]

Yes, I can see all the data and will post it when I'm able to do so. Thanks.

[Kadenz]

New to the forum and relatively new to C-Pap therapy. I recently switched from nasal pillows to a full face mask, per recommendation of my doctor because of sinus issues and a limited amount of mouth breathing, mostly exhaling. My average AHI with pillows was .46. With the mask it's above 4. Nothing else has changed. I had no trouble adjusting to either. Thoughts?

Some masks work better for you than others, but changing from nasal pillows to a FFM means you've altered two variables at one - a change of mask and a change of mask type (nasal pillows to FFM).

So its unclear whether your AHI would have gone up by as much (or not all or less) if the switch had just been from one make of nasal mask to another.

That said, a switch to a FFM is more likely (other things being equal) to result in an increase in mask leaks, which I suppose (I'm no expert) could result in a higher AHI.