Size matters - but which size?

[SleeplessInBrussels]

Hi everyone - I've been on the nasal pillow for a few nights now and it's been driving me nuts because it keeps on leaking from the top end. I called the nurse at the sleep clinic and she said I might need a bigger or smaller size (mine are medium). How's that for a scientific answer? I suppose my nose is larger than average but I never thought of my nostrils as big! But ok, so do I need to get a larger size nasal pillow? Does larger mean it will plug my nostrils tight? Won't it just sit on the outside of my nostils and thus create more air leakage?

Another question ... my headgear comes with 2 straps - one that is made of fabric and goes round the back of the head and another which is plastic (adjustable like a belt) which I'm not sure where this one should rest - top of my head? or closer to forehead?

Thanks - zombie in Brussels

[mayondair]

Hi sleepless, nasal pillows are in individual thing, use small fx or Xsmall lt, go figure, it should rest on your nares, not be pushed into your nose, not really size of nose, but more fit in your nares., the angle makes a difference, have your DME send a smaller and larger one to try. As for the top strap, not near your forehead, or even directly on top of your head, but slightly back. Or you might try a different nasal pillow mask, Swift FX or Swift LT or whatever it takes to be comfy and have a good seal. Have patience, most go through more than one mask to get it right. It's not bad to have more than one mask in case you just need a change, Kathy

[NCHawk]

When I got my new CPAP last February my supplier switched me from a nose mask to nasal pillows. It took me a little while to get used to them but I found them much easier to sleep with than the mask I'd been using for the past five years. The kit they gave me had three different size pillows (small, medium, and large) and I started out using the medium, then switched to the small after a few days because the pillows seemed to be irritating my nose. But the small were leaking too much so I went back to the medium, and didn't have any more problems with them. I was having a little problem with nasal congestion at the same time I got the new CPAP, and I think that may have been part of the problem with the initial adjustment.

[DaveLP]

The right size is comfortable and provides a good seal. You can check the seal by moving the mask around side to side and up and down to detect leaks. Find the one that leaks the least (or not at all) and then find the strap adjustment that allows slight movement with no leaks and the most comfort.

Straps that are too tight can cause irritation and promote leakage as the pillows are compressed and distorted. Experiment and find the sweet spot.

[77Godspeed]

get some lansinoh and put a little on each nostril it provides a seal, just a dab not to much.

[xenablue]

I have very small nostrils, however the XS or Small pillows don't seal as well as the Medium - for ME. I've tried both with and without Lansinoh or KY and find a better seal without. I do swap the Med. out occasionally with the Small if my nares are getting irritated.

IMHO, you need to try them all, and even swap them around every now and then, just so your nares don't get irritated from the constant placement of the one size.

Cheers,
xena

[robysue]

I called the nurse at the sleep clinic and she said I might need a bigger or smaller size (mine are medium). How's that for a scientific answer? I suppose my nose is larger than average but I never thought of my nostrils as big! But ok, so do I need to get a larger size nasal pillow? Does larger mean it will plug my nostrils tight? Won't it just sit on the outside of my nostils and thus create more air leakage?

Nasal pillows are SUPPOSED to sit on the outside of your nostrils: Only the smallest tippy-tip part of the cone is supposed to be inside your nostrils. If your current pillows are fitting inside your nostrils, they are TOO SMALL.

Another question ... my headgear comes with 2 straps - one that is made of fabric and goes round the back of the head and another which is plastic (adjustable like a belt) which I'm not sure where this one should rest - top of my head? or closer to forehead?

I use a different pillows mask that's made by the same company. My Swift FX's top strap naturally lies closer to the top (crown) of my head than it does my forehead.

[rested gal]

If you can figure out a way to use a homemade soft, stretchy strap (like the leg cut off a pair of women's "tights") to cradle the nasal pillows as if they're in a sling, that can sometimes help steady nasal pillows against the outside of the nostrils better than a mask's headgear alone.

This drawing below is with a different mask than the Swift you're using, but will give you an idea about how to "cradle" nasal pillows with an extra strap tied high at the back of the head. The extra strap doesn't have to be particularly snug...just "being there" stabilizes the pillows better, much like holding a finger against them to keep them steadier. Might take a bit of thought about how to cradle the pillows without interfering with the exhaust vent on some nasal pillows masks.





It can also help to rig a way to suspend the main air hose overhead, so the air hose won't tug at a mask when you turn over:

LINKS to Hose hangers and methods of managing the air hose
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