Review: Respironics Optilife vs. Resmed Swift

[twillson]

I am a long time Resmed Swift user, and I recently started using the Respironics Optilife. (I switched hoping that it would work better on nights that I end up on my side - like when my kids have nightmares and crawl into bed with us.) Since the Optilife is relatively new, I thought the group might want to hear my first impressions (it has been about a week) If any one is interested, I can follow up later with a long-term test report.

I chose the Respironics Optilife over the Respironics ComfortLite 2 because I thought the nasal pillows were a little more comfortable. I am convinced that both would have worked - and really I think the CL2 might be a better option for most people because of the variety of interfaces. I liked the CL2 with the simple cushion but I found the nasal pillows a bit less flexible than the nasal pillows that came with the Optilife. I think the reason for that is that the CL2 pillows have a metal bar than allows you to adjust the spacing between the pillows. My nares are pretty average in size and in spacing, and I get an excellent fit the large size Optilife and the medium size Swift pillows. Unfortunately my DME didn't have the CL2 direct seal interface. Other reviews have indicated that those are more comfortable than the CL3 pillows.

Basically, the Optilife is similar to the Swift in that it is a very light weight, minimalist design with soft, stretchy, and easily adjusted headgear. Both systems use molded silicone pillows in a variety of sizes that are adjustable for angle, but not spacing. The Optilife differs from this Swift in that it has a chin strap and uses the lower part of your face for stabile whereas the Swift has no chin strap and uses plastic reinforcement along your cheekbone. Also the hose attaches to the side of the swift pillow sleeve whereas the hose attaches to the bottom center of the Optilife. The Optilife sleeve is physically narrower and that and the central hose attachment allow you to sleep on your side with your face tilted slightly downward, whereas with the Swift you can't do that unless you carefully arrange you pillow so that it doesn't push on the side of the sleeve or hose. In practice you can use the Optilife comfortable about 15 degrees below horizontal with the pillow whereas the Swift is good to about 20 degrees above horizontal. I have had no leaks with the Optilife caused by turning my head in any direction - although you will want to try all of the "hose management" options to make sure you get one that works consistently. I have been using the "hose loop" method - see the Optilife web site for details.

My initial impression is that the Swift is still a better option for the confirmed back sleeper. The extra chin strap is comfortable and effective, but it is just that - an extra strap that you don't need with the Swift. The velcro adjustments with the Optilife headgear are very secure, but they are not as easy to mess with as the strap adjustments on the Swift. I am still getting use to the different pressure points (side of cheek rather than cheekbone) and I may yet find a more comfortable headgear adjustment, so I can't say for sure that most first time users will prefer the fit of the Swift to that of the Optilife, but I think we can still count the Swift as one of the most non-confining (anti-claustrophobic) interfaces on the market.

The biggest advantage of the Optilife is that it is more versatile in sleeping position and hose management. I love the metal clip and the design of the hose retainer from the Optilife - much, much better than the velcro band that comes with the swift. I find that the Swift works well only when you attach the hose to the headgear and that eliminates one side for sleeping entirely. If you leave the hose dangling on the Swift it is much more likely to pull uncomfortably on the pillow. Although Respironics makes a big issue of the importance of hose management for the Optilife (going as far as to recommend you use their "performance hose" rather than a standard CPAP hose) I think the Optilife is less prone to pulling than the Swift if you let the hose dangle. Of course the CL2 avoids this issue entirely by having the hose attached to a swivel at the crown of your head.

One more thing of note that will disappoint Swift users seeking an alternative design. The Exhaust from the Optilife and CL2 suffers from the same problems as the Swift - it is directed straight out from the pillow area. I found that all three exhaust are fairly quiet, but all three can chill and annoy your partner if you are facing each other. (Why can't other systems emulate the Ultra-Mirage II and direct the exhaust back along the hose line?) Overall I don't find the difference in noise between the Swift and the Optilife to be an issue. My pressure is 14 (CPAP, not APAP) so I would guess that is medium high. I don't think the noise problem with the Swift is the exhaust, but turbulence in the intake often caused by loosely fitting parts. The design of the Optilife seems somewhat more solid, but only time will tell.

So the bottom line is that I still recommend the Swift for people who sleep on their back exclusively, but folks who want the option of back or side sleeping will be well served by either the Optilife or the ComfortLite 2. (Pure side sleepers may prefer the Breeze, but that's not me - so I can't really comment.) Of the two Respironics systems, I would start with the CL2 (if the headgear fits) because it gives you so many options and adjustments. I am a firm believer in alternating between several interfaces so that no one part of your anatomy ends up sore, and the CL2 lets you do that.

I think the Optilife is the system of chouse if you prefer nasal pillows and want a nice light and comfortable system that works on you side and back and accommodates a variety of hose routing options. It would be a great second system for folks that started with good nasal mask. (Hey, that's ME!!)

We'll see if I still feel that way next year, but for now I am glad I have both the Optilife and the Swift.

[rested gal]

Very nice comparison/review, twillson! Thanks.

[Sleepy-eyes]

Yup, I agree. And it's helping me in my interface decision also. Thanks for taking the time to post.

[mecocosm]

My initial impression is that the Swift is still a better option for the confirmed back sleeper. The extra chin strap is comfortable and effective, but it is just that - an extra strap that you don't need with the Swift.

I'm not sure that the extra chin strap of the Optilife is entirely harmless. I've read that chin straps cause a higher incidence of events (especially hypopneas). At higher pressures, you might have to tighten the strap and that may make things worse.

[Guest]

I had an in-service training for the Respironics OptiLife interface and we were trained that the chinstrap was only a stabilizing feature for the interface,and not as a traditional chinstrap, which would keep your mouth closed.

So, don't over-tighten the chinstrap on the OptiLife.

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[mj6gte]

..and love it! I am new to this and couldn't get a regular mask to stay comfortable thru the night. I tried the CL2 nasal and had decent success with it. I started getting leaks, esp. when I would side sleep. The Optlife has been great. Lightweight, and no leaks.......OK, when I roll over, I tweak the fit and THEN, no leaks. I am VERY new at this, I just had my first 3 full nights of good sleep and I feel much better.

Mike

[RichCMH]

I've had the Opti for almost 3 weeks and I love it! Love it!! I've posted on another apnea forum about hose management which is not difficult.

I have the CL2 also, but the straps won't stay in place and I lose the seal.

-Cheers!

[twillson]

Since writing the review I have found a better setting for my Optilife headgear but my overall conclusions are the same. I definitely think the Optilife is a great choice for folks that want a nasal pillow system that lets them alternate between side and back sleeping. I could probably live with this as my only interface, although again, I think you are better off having a nasal mask as a backup.

I don't think I agree that the chin strap is a significant issue one way or the other. It is too stretchy to actually keep your mouth shut and I think it functions primarily to secure the Optilife from side to side motions rather than up an down. In fact I found that I can adjust the chin strap tight or loose and even take it off with little impact on the pressure between the pillows and my nose provided I readjust the rest of the headgear to compensate. In case you are wondering an Optilife without a chin strap still feels slightly more enveloping than the swift. But that my just be a function of my facial structure.

I also want to point out that the Respironics High Performance tubing is much lighter and more flexible than standard tubing. I would recommend it for ANY interface.

[Snoozin' Bluezzz]

Good job on presenting the differences from your point of view. I really appreciate it.

It is clear you feel strongly about deficiencies in Swift for side sleepers but to present another perspective I want to share that I am a hardcore side sleeper tosser/turner and have been very successful with the Swift for the past 13 months. I spend more of my time on my right side so I put the small hose on the left but I do not have a problem with being on the left side either.

The three things that made it work for me are:

• 1. route the hose over the headboard through a hook attached scrunchy.
  2. make sure the head gear is not too tight
  3. keep the pillows clean of facial oils.

If the pillows are squished against the nose they have no ability to flex when pressure is put on them and they slide off breaking the seal.

So, from my experience, side sleepers do not have to dismiss the Swift as a viable solution.

The Optilife and Opus are intriguing enough that I may try one or the other in the not too distant future.

David

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[Snoredog]

if there is one thing I have learned about this sleep mask industry, you can make a crappy interface and someone will come right along and duplicate it

[Rich.CMH]

Please make no mistake, the Opti's chin strap is not, repeat, is not meant to keep your mouth closed!

The strap's only function is to stabalize and counter balance the plastic interface (in the opposite direction of the head straps) keeping the nasal pillows up against the nose.

From Respironic's website:
Chin Support Band
Q: Will the OptiLife chin support band prevent mouth breathing and eliminate the need for a chin strap?
A: No, the chin support band supports the cushion seal and it is not designed to replace a chin strap.

Q: Can the OptiLife be used with a chin strap?
A: Yes. For best results, put on the chin strap first and then put the OptiLife on over top of it.

Q: Can I wear the OptiLife without the chin support band?
A: No. The chin support band is critical in supporting the cushion seal.

[pedroski]

Thanks twilson, I'm a Swift II user and happy with it, but it's always good to know the lay of the land.

Peter

[mecocosm]

Please make no mistake, the Opti's chin strap is not, repeat, is not meant to keep your mouth closed!

The strap's only function is to stabalize and counter balance the plastic interface (in the opposite direction of the head straps) keeping the nasal pillows up against the nose.

From Respironic's website:
Chin Support Band
Q: Will the OptiLife chin support band prevent mouth breathing and eliminate the need for a chin strap?
A: No, the chin support band supports the cushion seal and it is not designed to replace a chin strap.

Q: Can the OptiLife be used with a chin strap?
A: Yes. For best results, put on the chin strap first and then put the OptiLife on over top of it.

Q: Can I wear the OptiLife without the chin support band?
A: No. The chin support band is critical in supporting the cushion seal.

Okay...so if I'm a mouth breather, I have to now deal with two straps under my chin: the chin strap and then the OptiLife chin support band over it???

[RichCMH]

Meco... - yes, unless you can learn to breath thru your nose.

[Yoga]

Twillson,

Thank you for your very nice review.

Will the Optilife Repironics high performance tubing fit and work on the Swift mask?

I am also a Swift user.

Thanks,

Yoga