Best Nasal Pillows for high pressure?

[cby1]

I know this has been discussed, but I didn't find a lot of folks with pressures over 20 cm using nasal pillows. Has anyone successfully used nasal pillows (mainly I'm thinking about leaks) with pressures above 20 cm? I'm having a rough time keeping my F&P Simplus from leaking at night, and was wondering if something with less surface area would be better for me. Plus, I could conceivably get the FFM straps off my neck - I've always wondered if they could reduce blood flow when adjusted very tightly (which mine are).

Don't know how to set up a poll, but I'm curious which Nasal Pillow brands people think would hold up to high pressure the best. Thanks in advance!

[BTS]

I am on ASV with high pressures and the P10 works great, no complaints and little to no leak issues . It did take about a week at first for it to feel comfortable but after that it was smooth and not going to switch anytime soon ...

[palerider]

I know this has been discussed, but I didn't find a lot of folks with pressures over 20 cm using nasal pillows.

A lot of people don't understand the simple equation of force=area*pressure... and that pillows obviously have the second least force possible required to hold them on (nasal prongs being the least).

"Health care professionals" are still propagating the falsehood that pillows don't work for higher pressures, so people are discouraged from using them... and people who they work for have little cause to complain and write about it... ergo, few comments.

[BTS]

That goes for my DME telling everyone that Pillows will not work on BiLevel machines .. Complete B.S.... they refused to give me a pillow mask with the ASV so I had to go and order one myself and seriously works so well, don't listen to the ignorant idiots saying they won't hold up, it's not true...

[cby1]

Good info guys - thanks. And the PR argument makes sense to me - just trying to figure out if one brand is better than another for this application.

Then again, if DMEs discourage this combo, I won't get a lot folks using pillows/prongs with high pressure .

[Pugsy]

Higher pressures will create additional challenges no matter which mask a person uses.

Contrary to what some people might think the pillows won't go flying across the room at the higher pressures like balloon you stuck a pin in.
When I was using ASV I regularly saw pressures ranging from 8 ish to 22 ish at times.

I was using the Swift FX first and then the P10 when it was released and a brief time even with the TapPap.
All worked well for me.

Pick one that looks interesting to you and try it. You won't know how well you do with one until you try it but you can't go wrong with either of the ResMed nasal pillows. Minimal headgear and lightweight.
Between the 2 the Swift FX has more adjustable headgear and thus might be a little more forgiving and stable than the P10 which has that pesky back strap that likes to slide up.
BUT...the P10 diffused venting is essentially silent and to feel the vented air you have to have your hand about an inch from the vent holes and that makes up for a pesky back strap that occasionally wants to slide up for me anyway.

If you want silent venting with minimal air blowing on you or your bed partner....the ResMed AirFit P10 is the one to try.

[raisedfist]

The p10 pillows work pretty well, and when i am in a variable/auto mode, sometimes the IPAP goes above 20 cm h2o and I don't have any leak problems really. When I do have a leak, I think it's due to mouth breathing, not necessarily the pillows. I've never woken up with the pillows not in their place, or with air flying out of me.

[SewTired]

Pillows ARE harder for a lot of people at high pressures, but don't let that stop you from trying them! As mentioned, some people are very successful with them and it's worth the try.

[BTS]

Pillows ARE harder for a lot of people at high pressures, but don't let that stop you from trying them! As mentioned, some people are very successful with them and it's worth the try.

Why do you say that, what makes them "harder"? Pillows are the same as any mask it comes down to comfort and preference . I find straight up Nasal masks the hardest and the worst for leaks in my case that is . I could never get the N20 to work without having it so tight leaving marks so switched it up to pillows, much easier and less claustrophobic...

[TedVPAP]

I am on ASV with high pressures and the P10 works great, no complaints and little to no leak issues . It did take about a week at first for it to feel comfortable but after that it was smooth and not going to switch anytime soon ...

My pressure peaks at 20 for eight years. Been using Swift and now P10. I love the P10.
I am curious to know what are you doing to avoid lip leaking.

[BTS]

Sleeping on my back I don't have any issues with lip leaking... But when I do and if I move to my side I will get some also if I get a cold and am stuffed up I'll have to use a little tape on my mouth ... it's rare but nothing's perfect ...

[chunkyfrog]

I would happily wager an acre of swampland (prime real estate)
that most of the people subscribing to the notion that nasal pillows
are not good with high pressure/bilevel, etc, etc,
HAVE NEVER USED A CPAP MACHINE THEMSELVES.
Ignorance is like that . . .

[BTS]

I would happily wager an acre of swampland (prime real estate)
that most of the people subscribing to the notion that nasal pillows
are not good with high pressure/bilevel, etc, etc,
HAVE NEVER USED A CPAP MACHINE THEMSELVES.
Ignorance is like that . . .

So true ... I even asked at the DME if they were on xPAP themself the one working and the answer was no and that they just know that Pillows will not work with high pressures.. total B.S. with no evidence to back them up...

[Goofproof]

To do poles, I dig the hole 2 foot below the frost line and fill the hole with concrete, never had one fall over on it's own yet. Jim

I like poles, big Brass ones!

If a DMEs lips are moving they are lying....

[cby1]

OK, reviving my own old post. As predicted, the DME gave me all kinds of crap about pillows and pressure over 14 cm. I simply continued to demand that I try the pillows. He made me initial a statement about "patient request" to cover his ass. I was happy to do so. .

Just spent the second night with Airfit P10 pillows at 21-25, PS=4 (needed 1 more cm of exhale relief). I have No large leaks, and the same great AHI under 1, and lower Flow Limitation (95% = .08 vs. 0.16, max = 0.34 vs. 0.70). The FL and leak graphs are quite striking. Time will tell if I feel better - I thought that "great" AHI was kind of meaningless with the massive leaks I was getting on the FFM.

Only problem is the sore nose deal. I already have some K-Y (Oh! TMI!) so I will try that tonight. I have seen the Lansinoh vs. Astroglide "discussion" already . I also will try Large pillows vs. the Mediums - maybe that'll help. Will try them one at a time, scientific method and all.

I wish the headgear was adjustable, beyond splitting the straps. I have 2 questions:

1. When you pillow folks look in the mirror when fitted correctly, does it tend to make your nose look more "bulbous" or "scrunched up"? Or is that an indication of the headgear being too tight?

2. I am using a chinstrap - not certain I need it, but - I was putting it on first - I'm assuming I ought to put the mask on first, then use the chinstrap to keep the 2 headgear straps where I want them - thoughts?

Thanks,
Chris