Nasal Pillows for Mouth Breathers

Going on 3 months treatment. After going thru several full masks, I have settled on the AirFit F20. My therapist said that since I was mouth breather that I could not use nasal pillows. I would like to know if there are any people who changed successfully & which nasal pillows they found that worked best. Also, did the change help your comfort & AHI results?

People do change from full face masks to nasal pillows or nasal cushion mask and have good success.
It's going to depend mainly on how much mouth breathing you do and why do you do it.

Do you normally breathe through your nose just fine during the day and even at night for the most part or do you mouth breathe because you have to from nasal congestion that you can't clear up enough to be comfortable with just nose breathing.

If your mouth breathing is sporadic and maybe out of habit there's a good chance you can use a nasal pillow mask.
Now if your mouth breathing is because of significant nasal congestion issues...unless you can clear up the nose you won't be able to keep the mouth shut.

I thought I was a mouth breather when I first started therapy because I would wake up with dry mouth and sore throat (bad snoring) but I normally breathe through my nose just fine. No nasal congestion at all. My mouth breathing was more out of habit from gasping for air because of the apnea events. Once the apnea events weren't happening the mouth breathing decreased somewhat but there was still a habit.
I opted to tape my mouth shut for a couple of months and broke the habit of opening my mouth.

I still do a little mouth breathing every now and then but it's not much and I watch my leak graph to see how bad it is and it's rare I even get into large leak territory.

There are other ways to help try to keep the mouth shut besides tape...if taping scares you and it does some people.

Look at the mask I have in my profile...The ResMed P10 nasal pillows....pretty sweet little mask and very popular.
Currently I am trying a brand new nasal pillow mask called the Respironics DreamWear Gel Pillows...the pillows have a gel cushion. It's pretty sweet too.

What I usually suggest when people are wanting to try a nasal pillow mask is that they try it without anything to keep the mouth shut...get an idea if the mouth breathing is really bad or not....and if it is then go down the chin strap or tape or cervical collar road.

So yes...if you can comfortable breathe through your nose you have a good chance of being successful with nasal interface masks.
Hopefully you have a full data machine so you can use available software to watch your leaks closely.
Don't know about the software?
Here ... https://sleep.tnet.com/equipment

Which model machine are you using? Brand and model?

I know of one forum member in particular that made the switch. I kept bugging him to try it and he finally did.
Not only did he really like the pillows he found he was able to use 2 or 3 cm less pressure to get the same results...and since his pressures were in the mid teens it made things more comfortable. I will see if I can find his story and post a link to it.

Check this thread...scroll down until you see the post from Perrybucsdad.
viewtopic/p663440/Mouth-Breathers.html#p663440
He documented things pretty well.

I started with a FFM because I have trouble breathing through my nose during the day. But I found that after a few months I was using the FFM with my mouth closed once the pressure got high enough to open my nasal passages.
So decided to give it a try. Now I use nasal pillows with a higher starting pressure (9 cm H2O). I don't use a chin strap, but I have to be careful about back sleeping or I get mouth leaks. YMMV

Thanks for the advice. Funny I have had less sinus congestion since cpap than any other time in my my life. I do not breath thru my mouth during the day. You are probably right about the gasping for air. My sleep study showed severe sleep apnea with an AHI of 72. I am on 14 using a Resmed 10 auto but Dr. did not want to start with auto. My event avg after about 80 days is 3.1 or there about with 100% compliance. I do not think I could handle either mouth tapping or chin strap. Maybe I should just try nasal pillow.

I have always said that if someone wants to try something then they should try it. "Want" is a good enough reason in my book.
You always learn something by trying new stuff...now sometimes all you learn is "what a bad idea that was" but you learn.
The AirSense 10 AutoSet (if that is what you are using) is a full data machine and it works great with SleepyHead.
Give it a try and see the leak graph I was talking about.
Mouth breathing will show up as a leak...the machine just knows leak...it doesn't know how or why.
The machine can compensate for some excess leak no matter what the cause and even if you do some mouth breathing it may not be all that much or last very long.

Here's an example of one of my SleepyHead detailed reports. I woke up one morning and I was mouth breathing..gently mouth breathing. No massive loud swooshing of air exiting my mouth...just gentle breathing.
I was awake and it was time to get up anyway so I decided to lay there and continue the mouth breathing so that I could see just what type of impact it showed on the leak graph. So I continued to mouth breathe for 15 to 20 minutes.
I circled the time at the end of the sleep session where I was mouth breathing and I didn't go back to sleep. As you can see it barely made a blip on the leak graph. ResMed machines can handle leaks up to 24 L/min excess leak...I never got close...
Actually they do quite well handling leaks up to 30 to 35 L/min excess leak...after that things get a bit iffy.

Can you use a heated hose on the ResMed P10 nasal pillows or the Respironics DreamWear Gel Pillows.?

I certainly would have considered myself a mouth breather. I have been using the P10 nasal pillows for about three years now, shortly after they were introduced. For me, it is almost like wearing nothing. Initially, there was some of the "puffer fish" effect, but that disappeared long ago. My AHI is under 1.0 99% of nights with frequent "shutouts" (that is what I call an AHI of 0.0).

I believe that subconsciously I do something with my tongue to block mouth escape of the air. (Don't ask me any details of this, I'm not sure!). But what is even more remarkable, I have not had a stuffy nose that prevented use of the nasal pillows for even one night in three years. I carry a full face mask with me on longer trips just in case, but never have had to use it.

Mr. REM wrote:Can you use a heated hose on the ResMed P10 nasal pillows or the Respironics DreamWear Gel Pillows.?

Sure...there's no reason at all not to. That's an odd question...did someone say you couldn't?
The P10 has been by primary mask for 2 or 3 years I guess now.
About 2 months ago I got the new DreamWear Gel pillows to try and I am still trying them.
I have used a heated hose with both those masks without any issues at all.
In fact I have used a heated hose of some sort for 5 years now.

RobertS975 wrote:what is even more remarkable, I have not had a stuffy nose that prevented use of the nasal pillows for even one night in three years.

I started therapy in May 2009 and I started with nasal pillows because I decided I didn't want a full face mask.
In 8 years I have never had my nose not be clear enough to use my nasal pillows....even with a bad cold or flu.
Plus even when I have had a cold I often will wake up with my nose being clearer than when I went to bed. The humidified air seems to help clear the nose up even with a cold's congestion.
I do now have a full face mask (have had it for 2 years) and still haven't ever used it beyond trying it for a few nights just to make sure I could successfully sleep with it.

Well, received P10 & last night was my first shot! Sleep 9 hrs, 2.1 AHI but 25% leak rate! Used Med pillows. Fit ok. Thought that I would try small tonight for maybe less leaks....any suggestions would be appreciated. Actually, surprised at results!

RedRooster wrote:Well, received P10 & last night was my first shot! Sleep 9 hrs, 2.1 AHI but 25% leak rate! Used Med pillows. Fit ok. Thought that I would try small tonight for maybe less leaks....any suggestions would be appreciated. Actually, surprised at results!

Always start with the largest pillows in the pack/kit. Then go smaller until you get leaks.

Pillows seal on the nares, the outside rim of the nostrils, NOT inside the nostrils.
Use Lansinoh (pure lanolin) for irritation of the nares and to help the seal.

The nares in time will get used to this but think about any movement, the rubbing, each time you breath thru out the night there is a lot of back n forth rubbing and that is where the Lansinoh helps.

Lansinoh is for nursing mothers and can be found anywhere baby bottles are sold.

I love pillows and use ultimate chin strap to minimize mouth leaking.

I breathe through my nose just fine during the day, but most of my life that wasn't true. I had a septoplasty about 15 years ago and that cleared up my problems breathing through my nose. However, I was still breathing through my mouth at night. I use nasal pillows and the Resmed chin strap (a very minimal chin strap) that I wear just tight enough that it takes a conscious effort to open my mouth. That got rid of the vast majority of my excessive leaks. I've tried going without the strap from time to time and leaks come back.

I have been using the Quattro FX for 4 years now. I decided to try a nasal mask with a chin strap as I was getting very bad pressure marks from the Quattro. I ordered the Resmed P10. I absolutely loved how the mask felt on my face. It was almost like not even wearing a mask. However I was not able to continue using it. I developed sores in both my nostrils and the air blowing directly up my nose gave me sinus headaches the next morning. I also tried using a chin strap with the mask to help with keeping my mouth closed. However, when I tried the chin strap on even with it quite snug around my face I could still easily open my mouth. I am so disappointed as I really loved the mask. I just got the Airtouch F20 in the mail today. Hoping the memory foam will not give me those awful pressure marks.