Switched to full face mask last night. Flow limitation increased

[obstructedairway101]

New here. I usually use nasal pillows but last night I switched to F20 because of stuffy nose. Flow limits increased significantly. I have noticed even with nasal pillows I've been having some Flow limitations. I have been increasing my min and max pressure to help overcome the Flow limits but last night I switched to full face mask and Flow limits increased more than usual. I read that adding EPR may help with Flow limitations?if so how does it affect these airflow limitations? I also do use vcom as well. Obviously shouldn't use that if I turn on EPR right?

[Deborah K.]

Your leaks are not enough to worry about, even now.  Full face masks generally leak more than the others, nasal masks less, and nasal pillows masks the least.

I suggest you change your pressure settings to 12 to 15.  Your median pressure is almost 13, so 12 is a good place to start.  You need a little headroom, that's why I suggest 15.  You may need more later, but try this out and see how it goes and how you feel.

Also turn EPR on full time, set at 3.  This will be more comfortable and will lower your flow limits.

Again, welcome, and good luck!  

[obstructedairway101]

Should I take v com out or doesn't matter ?

[staceyburke]

This is the first I have heard of v-com.  I look for it and watched the video, I don't see what help it would give.  If it works for you fine but I don't understand how it would help.  I would use EPR 3 as suggested.  Your flow limits were high.  Be sure to turn on EPR to full time also.

[obstructedairway101]

Yeah I read about it and saw a few videos on it and I was a sucker and bought one. It's mostly to help with adherence, comfort, and leaks by decreasing inspiratory pressure without affecting overall apap therapy.I'm not completely sold on it yet. May do without. Thanks for input much appreciated

[staceyburke]

I just did a search on vcom on this site. A couple of people did say they did better with it but a majority said it did NOT work.  I also read that EPR is not to be used with vcom and also read it is used with cpap and not with an auto...  So it is not a for sure either way.  I would try a night with EPR with Min and Max settings and a night in cpap mode with the vcom.  But which ever one you do it needs to help your flow limits.

[Phaleronic]

Should I take v com out or doesn't matter ?

Leave the v-com in, and TURN EPR OFF please.

I use a v-com sometimes and you do need to turn EPR, FLEX, SOFTPAP off for it to function correctly. I also suggest turning EPR off and turning min pressure down too, as it has a delay in inspiration return pressure (none of the other vendors have that issue, only resmed).

Try it tonight for 30 minutes before bed though please.

[obstructedairway101]

Can you explain Flex and Softpap? Never heard of those settings?

[obstructedairway101]

Also here is typical night for me even though i just started using oscar and lost my sd card and had to get a new one (would post more nights if I HAD the data). Flow limits minimal but a few OA events. I used pillows with v com and epr off. Also if i zoom in there is def some flattening of inspiratory wave forms that may not be picked in the FL section. Just to clarify should i still try out increased pressure setting even though flow limits are minmial in the Flow limit section?Also noted is MED pressure was 10.8 which is nowhere near my max unlike the first post i posted. So its confusing because i still feel like crap.

[Phaleronic]

Can you explain Flex and Softpap? Never heard of those settings?

Those are other vendors' forms of expiration pressure relief (notably better since they do not delay the return of inspiration pressure).  

Please turn Resemd's form of EPR (EPR) off for the v-com.