Problem sleeping on side with the aloha nasal pillow

[jpek]

Hi, everybody. I just spent my first night restarting on the CPAP with the Aloha mask. (I had a CPAP a year ago with a different massk, but failed to "comply" with Medicare's requirements.) So far, after 4 hours of use, my biggest and most glaring problem was sleeping on my side.

I am mostly a side sleeper. Because off some neck issues I need to lie perpendicular to the pillow when I'm on my side. I can't be tilting so I'm half way on my back. But when I lie in my comfortable position, I'm resting my cheek on one of the rigid prongs that hold the nasal pillow in place. The prongs come wrapped in a velvety fabric, but the covering is bulky and has some uneven surfaces, so that's not comfortable to lie on. I took the cover off but then I'm just lying on a hard silicone type thing, which is also uncomfortable because it's so rigid. I really couldn't fall asleep onmy side because of that, although I did apparently turn onto my side while sleeping.

I know that the Aloha is a very popular mask and, surely, some of its fans must be side sleepers. So, what do you do to make it work?

[Sleeprider]

If the mask is uncomfortable, do you have the option to return it for a different one? I really like the Resmed Airfit P10 I'm using and it tolerates side sleeping very well, and doesn't blow a cold stream of noisy air.

It would be a shame not to succeed because you're not comfortable, ask for different mask, or if that isn't possible, can you afford to buy? CPAP.com will give you a 30 day return guarantee. Call your supplier and explain your problems with this mask and ask about their exchange policy.

[jpek]

Yes, I have the option to get one more mask. If the second one doesn't work then I'm stuck with the two I have for two or three months I think, until it's time for a new mask. Yes, I guess I can buy one on my own -- thanks for the reminder about the return policy. Can I use it and then return though? Because you never know how a mask will fit 'till you sleep in it.

Anyway, I'd at least like to learn from this experience. The Aloha was touted as an excellent mask. And I see some advantages to it. Notably, my pressure is set pretty high. I have variable pressure CPAP that's set for pressures from 13 to 17. That's pretty high and I was told yesterday by the tech who was setting me up that a nasal pillow would likely not work for me because of the high pressure. But I did with the Aloha at least for those 4 hours and I didn't get nose chafing. I think that's because the very same stiff arms that are getting in the way of my sleeping on my side hold the nasal pillow very steady.

If I can't find a nasal pillow that works I'll have to go to a full face mask, which I'd prefer not to do. I hate being hot while I sleep or having too much stuff on my face and I also wear specially modified glasses in place of a sleep mask while I'm sleeping, which would be harder to do with a full face mask.

[JimP]

jpek

Those pressures you mentioned. Are you on auto, fixed bipap or autobipap?

Reason I'm asking is that the sleep study people originally had me on a fixed bipap of 10 and 16....which prevented me from using a nasal pillow mask.

When I learned how these well intentioned misinformed people often get the pressures wrong, I switched to auto bipap. Well that gave me much lower pressures with good api numbers. Since I found I could do well with lower pressures, I then tried nasal pillows (P10). This one is fairly popular on this forum.

I do want to encourage you to stick with it and try different mask. I doubt I would have had I not found this forum and learned more about how cpap works and what can be done to get the best results which includes the most comfort.

[jpek]

My machine is an auto CPAP. The doctor originally wanted me to have a BiPAP but because of difficulties with the sleep study we weren't able to demonstrate that a BIPAP was needed, so we're trying the CPAP first with an option to upgrade within a 90 day period. I did try a BIPAP in a previous sleep study and found it much more comfortable than the CPAP, but this time around when they put the BIPAP on me it "breathed" at the wrong times for me and the tech wasn't able to adjust whatever it was that was causing it. My breathing being messed with was quite distressing and caused anxiety. I would need this fixed before I'd be willing to go with another BiPAP.

The question remains for me, however, how people sleep on their side with the Aloha. Surely many do?

[kaiasgram]

The question remains for me, however, how people sleep on their side with the Aloha. Surely many do?

I'm an Aloha user and I really like the mask, but you're right that the sides are rigid. On the rare occasions when I'm trying to sleep on my side I punch a little depression into my soft pillow so that there's little to no pressure on the side strap. I think it would be a nuisance if I was a full-time side sleeper. FWIW, someone sent me a Nuance nasal pillow mask and those side straps are completely soft and pliable, laying quite flat against the face. Maybe give the Nuance a try?

[JimP]

My machine is an auto CPAP. The doctor originally wanted me to have a BiPAP but because of difficulties with the sleep study we weren't able to demonstrate that a BIPAP was needed, so we're trying the CPAP first with an option to upgrade within a 90 day period. I did try a BIPAP in a previous sleep study and found it much more comfortable than the CPAP, but this time around when they put the BIPAP on me it "breathed" at the wrong times for me and the tech wasn't able to adjust whatever it was that was causing it. My breathing being messed with was quite distressing and caused anxiety. I would need this fixed before I'd be willing to go with another BiPAP.

The question remains for me, however, how people sleep on their side with the Aloha. Surely many do?

It sounds like the sleep study people had one of those machines that if it detects that you haven't breathed within a certain time, that it breathes for you.

I couldn't tolerate a straight cpap maching because of being not being able to exhale. If you have that experience, you need to revisit getting a bipap machine. Insurance will quibble about paying for it unless the sleep study results show that its needed. Given that the sleep study was screwed up, I'm not sure what you'd have to do to get them to redo it due to their error.

[Guest]

I suggest you go to the padacheeks site and order the Aloha strap pads-- or the original strap pads might be a better investment, because you can use them with different masks. Not cheap, but very good quality.

[SleepyEyes21]

Hi, everybody. I just spent my first night restarting on the CPAP with the Aloha mask. (I had a CPAP a year ago with a different massk, but failed to "comply" with Medicare's requirements.) So far, after 4 hours of use, my biggest and most glaring problem was sleeping on my side.

I am mostly a side sleeper. Because off some neck issues I need to lie perpendicular to the pillow when I'm on my side. I can't be tilting so I'm half way on my back. But when I lie in my comfortable position, I'm resting my cheek on one of the rigid prongs that hold the nasal pillow in place. The prongs come wrapped in a velvety fabric, but the covering is bulky and has some uneven surfaces, so that's not comfortable to lie on. I took the cover off but then I'm just lying on a hard silicone type thing, which is also uncomfortable because it's so rigid. I really couldn't fall asleep onmy side because of that, although I did apparently turn onto my side while sleeping.

I know that the Aloha is a very popular mask and, surely, some of its fans must be side sleepers. So, what do you do to make it work?

Hi jpek,

I have used both the Nuance and Airfit P10, and think of these two - the P10 is more comfortable for side sleeping. I recently received a Swift LT, and have found it to be the most comfortable for side sleeping out of all the masks I've tried.

Another option for side sleeping and mask comfort is to purchase a pillow that is filled with buckwheat hulls, as the hulls conform easily to form a 'depression' for your mask. You can find these pillows on Amazon or Overstock.com

[RogerSC]

Yes, a pillow that's designed to put very little pressure on your mask is very helpful for side sleepers. Buckwheat hulls is one approach, but I found that too firm, myself. There are other pillows that are foam or memory foam that have recesses built-in where your mask would go when you're sleeping, but provide varying amounts of support. I'm a side sleeper and like this one:

https://www.cpap.com/productpage/double ... -cpap.html

On the mask side, while some people do well with the Aloha, I found that it didn't work well for me as a side sleeper. Both the Swift FX and AirFit P10 have worked best for me, but cautions on both. The Swift FX is a bit heavier, and somewhat noisier, with a more concentrated vent air stream. On the other hand, the FX headgear is adjustable, and the AirFit P10 headgear is not. If you can make the AirFit P10 work for you, it's a great nasal pillow mask, lightweight and quiet, and like the FX hangs in really well for side sleepers. However, after about 5 months (I'm persistent), I've given up on the P10 headgear for the moment. But, again, the P10 headgear apparently works for a lot of people, so it's worth trying the P10 to see if it works for you. I believe that the return insurance on the P10 from cpap.com is free, so you get a 30-day trial there. The return insurance on the Swift FX is also free, so there's another free 30-day trial if you have problems with the P10.

[jpek]

Thank you for the suggestions everybody. I had a really hard night with this mask and CPAP yesterday, including heart palpitations, toothache, nose popping and then strange sensations of inadequate air after I took the mask off. Hard to know how much is the fault of the setup and how much of something else, but I'm eager to implement solutions.

The suggestion to create a little dip in my pillow. I found a very particular set of pillows that work well for me and I've used exclusively those for the last 20 years wherever I've gone. They're pretty soft, but I don't quite understand how to make a dip in the pillow without also eliminating support. Wouldn't I "fall in" along with the face strap I'm trying to soften?

I'im also considering other masks as you suggested. My provider doesn't carry either the P10 and I think the tech said they don't carry the Swift LT (which I'm intrigued by) but now I'm not sure. The Nuance was used in my sleep study and I liked it, but it did chafe my nose, because it moves around more than the Aloha, I guess? I'm wondering how most nose pillows prevent the chafing issue.

But at this point I'm also confused about whether I should be using a nasal pillow at the high pressures (13-17). Is it just inherently too much pressure for a nasal pillow? Should I be trying for a full face mask? I don't know anything about them? Are they easier to sleep in? What about side sleepers? I expressed my desire for a light-weight, non-intrusive side-sleep-enabling mask with no central post on the forehead to the sleep tech today and she recommended the Drive ComfortFit: http://www.drivemedical.com/b2b/index.p ... k-358.html. It looks kind of intriguing too, although I'm afraid it will be too hot.

[kaiasgram]

People do use nasal pillow masks with high pressures, even higher than your pressures. You know, the chaffing is pretty common when starting out and it's usually temporary so that might not be a reason to give up on a nasal pillow mask. A lot of people (me too) used a bit of pure grade lanolin (brand name Lansinoh) to heal (or prevent) chaffing. A very tiny dab. Once your skin gets used to the mask you can usually discontinue the lanolin.

As for making a depression in your pillow -- just enough of a divot to accommodate the mask strap, not digging a canyon so your head falls in. You do need a soft enough pillow to do this. Keep in mind that even if you try a full face mask you'll still need to figure out how to sleep comfortably on your side without disturbing the mask and causing leaks. So if you have a preference for a NP mask, I think it's worth some trial and error to see if you can make it work before switching.

[RogerSC]

The suggestion to create a little dip in my pillow. I found a very particular set of pillows that work well for me and I've used exclusively those for the last 20 years wherever I've gone. They're pretty soft, but I don't quite understand how to make a dip in the pillow without also eliminating support. Wouldn't I "fall in" along with the face strap I'm trying to soften?

I'im also considering other masks as you suggested. My provider doesn't carry either the P10 and I think the tech said they don't carry the Swift LT (which I'm intrigued by) but now I'm not sure. The Nuance was used in my sleep study and I liked it, but it did chafe my nose, because it moves around more than the Aloha, I guess? I'm wondering how most nose pillows prevent the chafing issue.

But at this point I'm also confused about whether I should be using a nasal pillow at the high pressures (13-17). Is it just inherently too much pressure for a nasal pillow? Should I be trying for a full face mask? I don't know anything about them? Are they easier to sleep in? What about side sleepers? I expressed my desire for a light-weight, non-intrusive side-sleep-enabling mask with no central post on the forehead to the sleep tech today and she recommended the Drive ComfortFit: http://www.drivemedical.com/b2b/index.p ... k-358.html. It looks kind of intriguing too, although I'm afraid it will be too hot.

First off, yes, many people use nasal pillow masks up to at least 20cm H2O. I had my pressure set at 12-14 at one point, and had no problems with nasal pillow masks. So it's really your choice, I wouldn't go to a full face mask for that reason, but if you breathe through your mouth, then yes, a full face mask can take care of that.

On the pillow, it might be time to consider changing pillows...again, up to you, but if your current pillow isn't working well for you with cpap, and I can see how a soft, somewhat resilient regular pillow wouldn't work well, you could look at what else is out there that might be as comfortable for you and make side sleeping with a cpap mask easier.

About masks, when my DME told me that they didn't have the Aloha mask and had no plans to have them, I just bought one from cpap.com with return insurance. Unfortunately, it didn't work well for me, as I said, and I returned it. My DME does have both the Swift FX and AirFit P10, though. I also tried the Swift LT, but it was a little too rigid and had a bit more structure than was comfortable for me, so I didn't go with that...my DME has those as well. If the Swift LT works for you, it has the added feature of being able to run the hose over your head attached to the mask, so that keeps it out of the way. I've been using a hose holder for a long time now, since I don't use any masks where you can do that, but need to keep the cpap hose under control *smile*.

Anyways, you'll be wearing a cpap mask for 1/3 of your life, so it is important to settle on one or two that are comfortable enough to get a good night's sleep, and don't have severe leak problems. Some leaking is fine, your cpap can compensate for that, but severe leaks are a problem. What this means to me is that even if I need to pay for that mask out of pocket, I'll do that. Cpap.com has very reasonable prices, and is a great company to deal with, so that's where I'd go first if I was buying masks and supplies out of pocket. The expenses aren't overwhelming, you can get away with making a mask last from 6 months to a year, and nasal pillows can last 2 or 3 months, depending on the individual.

On the nose pillows chafing, you haven't seen chafing until you've wrestled with a full face masks. They have a lot more contact with your face, so people use liners, etc. to avoid this problem, but lots of issues with those. For nasal pillows, most people, if their mask is properly sized and adjusted, adapt pretty quickly to nasal pillows. There are things that you can use to deal with the initial chafing that you might get if you need to, and very likely your nose (like mine *smile*) will just get used to some of that and you'll stop noticing it. The ResMed nasal pillows are very soft, and haven't given me any problems. You're only supposed to tighten a mask enough to stop the major leaks, not all leaks, and the pillow inflation itself plays a roll in keeping them in place.

Sorry this ended up so long, tried to provide one point of view on your questions *smile*. Glad to see that you're motivated to make this work, it is important for your overall health. Good attitude, keep it up and it won't be long before this is much easier.

[cnl390]

I struggled with a mask for 2 months and could not sleep with it for over 2 hours a night.
Then I got a a Philips Nuance nasal pillow and a buckwheat pillow which made a world of difference. From the very first night I used it until today I have slept on my side throughout the night without waking up.
I highly recommend trying it.

[SleepyEyes21]

I agree with Roger and suggest you consider trying a different pillow. I'd recommend trying to find a pillow that works with just about any mask and/ or sleeping position, as opposed to buying various masks to fit a particular pillow.

I use a buckwheat hull fill pillow; this type allows you to create a small 'depression' to fit the mask, and you can adjust the firmness of the pillow by adding or removing hulls. I don't know if you can adjust for overall firmness on the shaped pillow that Roger sent you a link for; he may be able to comment on that. Some people use contoured foam pillows (relatively inexpensive), and cut out contours on the sides for their masks.

As for masks, I didn't think I'd like the fit of the Swift LT when I first saw it months ago, but surprisingly it is fast becoming one of my favorites. This type of frame seems to keep the nasal pillow from moving, no matter which way I turn my head. I think if you're comfortable wearing the Aloha, you most likely would like the LT. Yes, you can clip the hose to the frame to go over your head, or not. It is almost as light weight as the Airfit P10, and very quiet.

You can buy with return insurance through cpap.com, or buy the parts to the whole mask on Ebay or Amazon- might be cheaper.