A quick review of the Respironics Dreamwear Cushion Mask

A little while back I got the Dreamwear Cushion mask and thought I'd pop back wit a quick review after using it for a bit. A lot of people seem to like this mask, but if I had to desribe it in one word, it would be "inconsistent."

On one hand, the mask is extremely comfortable. The sleeves for the mask are nice and soft, the connector on top is just fantastic, you can sleep in a variety of positions with no hose dangling from your face, and all told it's got a nice fit and feel.

On the other hand... my AHI was all over the place, and despite my efforts I couldn't change this. I got AHI anywhere between 3 and 15+ in this mask. Also, there's a feeling that's hard to shake that the mask is leaking, even when it's not. Maybe a design thing, I dunno. The mask is an X1 type, but I'm not sure it fits well as a "full" mask. My Dreamstation has full/nasal masks as X1 and nasal pillows as X2, but there's no real in-between option.

Maybe I'd have better luck with the pillows, but this cushion wasn't for me. After trying the Dreamwear for a few weeks I'm back on my Wisp. It's still the best mask I've used, despite my complaints with it (so far I've used the Wisp, Nuance Pro, and Dreamwear cushion now). I may try it again with the pillows at some point. It was decent enough that I decided to keep it and not return it. As noted it's really comfortable to wear; it just didn't seem really effective for my apnea, whereas my Wisp has me constantly between 2.5 and 5 AHI.

I'd love to get a lower AHI, but I can't seem to eliminate every event, and higher pressures cause more CAs for me. 2.5-5 is a hell of a lot better than the 26 or so AHI I was diagnosed at, and the consistency with my Wisp is why I stick with it.

If you've got a Dreamwear, feel free to discuss it here. Who knows, maybe I'll learn something that makes it more consistent, or maybe we'll find out people had consistently inconsistent experiences with it.


Edit - btw I was previously posting as t0mkatt. Looks like my account finally got approved.

I wonder what would happen, just out of curiosity if you tried the nasal pillow setting?

Janknitz wrote:I wonder what would happen, just out of curiosity if you tried the nasal pillow setting?

With the Airsense 10 (not sure about the OP's machine) I was told that the setting for pillow/cushion/mask does not change how the machine behaves, it only changes how leaks are recorded.

AMK wrote:With the Airsense 10 (not sure about the OP's machine) I was told that the setting for pillow/cushion/mask does not change how the machine behaves, it only changes how leaks are recorded.

True with ResMed machines.

Not so much with Respironics and the Mask Resistance setting which is what the OP in this thread has and is referring to.
Mask Resistance setting on Respironics machines has nothing to do at all with leak numbers.

I tried the Dreamwear for 4 or 5 nights and do not like it at all. It is compfy to wear and I LOVE the hose attachment at the top of the head--awesome feature--but I sleep on my side and it LEAKS. BAD. It is not for me! I wear a Nuance nasal pillow mask and love it (as much as I can love a CPAP mask). It seals great, has minimal headgear and never leaks when I sleep on my sides.

A perfect example of the importance of trying out various masks for oneself. Everyone has different experiences- what works for one, doesn't for another.

I happen to be one that has had a experience a very good experience with the Dreamwear mask. I sleep probably half the night on my back and half on my side, frequently turning from one to the other. I experience no leaks: for me it's one of the least likely mask to leak as I roll about.

I did find that I needed both the S frame and the S nasal pillow? (not the gel pillow) otherwise I couldn't get a fit.

To all still seaking- good luck.

First of all, glad to see your registration finally went through, and so welcome.

What a coincidence, I just posted a quickie review this morning of my 5-day experience with the Dreamwear.

viewtopic/p1194338/viewtopic.php?p=1194338#p1194338

I agree with many of your observations. While not as drastic, I did note that my AHIs went up a tiny bit, from <1 to <2, to <3 to <4. I know, nothing to complain about, but I couldn't help but notice it. It might be more pronounced for other people, though, as in your case. I also remarked on how it seems to need a bit more fine tuning to find that Goldilocks zone between too tight and too leaky. Also, the exhaust vent in front seems to put out a lot of PSI, sometimes bouncing back into your eyes.

That said, I'm keeping it and putting it into my rotation, because it also has some good qualities, least of which is not the unshackled feeling of having the hose connection out of your face, up at the top of your head.

I'll be trying out the Airfit P10 tonight, in my ongoing experimentations, this time with some homebrew cheek protection. Stay tuned.

I love my Dream wear. I will say you need to get the headgear just right, I found in the beginning I had it to tight and that caused leaking. Once you get the right feel for how it sits under your nose you can properly adjust it as the headgear stretches out. I will also agree it is not for everyone, but for me it’s the best mask I have used.


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Pugsy wrote:

AMK wrote:With the Airsense 10 (not sure about the OP's machine) I was told that the setting for pillow/cushion/mask does not change how the machine behaves, it only changes how leaks are recorded.

True with ResMed machines.

Not so much with Respironics and the Mask Resistance setting which is what the OP in this thread has and is referring to.
Mask Resistance setting on Respironics machines has nothing to do at all with leak numbers.

This. IIRC, on the Dreamstation it adjusts the machine's sensitivity based on the default leak rate and air volume of a given mask. It's probably more art than science, but generally x1 is for nasal and full masks, and x2 is for pillows. I've not seen any other kinds of masks yet.

Sheepish wrote:First of all, glad to see your registration finally went through, and so welcome.

What a coincidence, I just posted a quickie review this morning of my 5-day experience with the Dreamwear.

viewtopic/p1194338/viewtopic.php?p=1194338#p1194338

I agree with many of your observations. While not as drastic, I did note that my AHIs went up a tiny bit, from <1 to <2, to <3 to <4. I know, nothing to complain about, but I couldn't help but notice it. It might be more pronounced for other people, though, as in your case. I also remarked on how it seems to need a bit more fine tuning to find that Goldilocks zone between too tight and too leaky. Also, the exhaust vent in front seems to put out a lot of PSI, sometimes bouncing back into your eyes.

That said, I'm keeping it and putting it into my rotation, because it also has some good qualities, least of which is not the unshackled feeling of having the hose connection out of your face, up at the top of your head.

I'll be trying out the Airfit P10 tonight, in my ongoing experimentations, this time with some homebrew cheek protection. Stay tuned.

I've decided to keep it as well. The Dreamwear is comfortable enough that at some point I want to see if I can work out the issues. I also need to spend more time with the medium nasal attachment. The small was the "proper" fit for me, but I felt like the airflow was better on the medium. If I can get it to not leak on me it may be good, but I haven't spent enough time there, and after more than two weeks of inconsistent sleep I needed a break. Once I get a few more days rest on my Wisp I may go back to experimenting with the Dreamwear. I also would like to give the pillows a shot.

tomkatt wrote: It's probably more art than science, but generally x1 is for nasal and full masks, and x2 is for pillows. I've not seen any other kinds of masks yet.

I am not so sure it isn't more hype than anything else. They say if using a non Respironics mask just set it to 0 which turns Mask Resistance off. I tried all settings with my Swift FX nasal pillow mask including off and I couldn't tell any difference anywhere with anything.

It's more than just full face vs nasal pillow though...it's size of cushions and pillows.
This is a bit dated as it doesn't have the DreamWear shown but it will give you an idea as to how they vary with size too.
I don't have time to go look for a more current chart.

I have only tried 2 masks, the Nuance for my tritration and then I requested the Dreamwear with my machine, so I don't have a lot of experience with different masks.

I sleep in all positions throughout the night (mostly stomach) and the hose attachment at the top is mandatory for me. I have surprisingly few issues with leaks, although the jet blast out the front is quite annoying at times. Mine is the pillow version if that makes any difference. It seems to seal well and stay in place. I can't really comment on comfort, as I have so little to compare it to.

The only real leaks I get are when my mouth gets blown open.

MaxINTJ wrote:I have only tried 2 masks, the Nuance for my tritration and then I requested the Dreamwear with my machine, so I don't have a lot of experience with different masks.

I sleep in all positions throughout the night (mostly stomach) and the hose attachment at the top is mandatory for me. I have surprisingly few issues with leaks, although the jet blast out the front is quite annoying at times. Mine is the pillow version if that makes any difference. It seems to seal well and stay in place. I can't really comment on comfort, as I have so little to compare it to.

The only real leaks I get are when my mouth gets blown open.

I feel you on the hose up top. I hate having a hose dragging from my face. With the Wisp I run it through a loop on top of my head. Part of the reason I couldn't use the Nuance Pro was because the loop on top was on the side of the head, right on the side I sleep on if I roll from my back to my side, and it was just... not good for me.

My Wisp mask isn't ideal in that regard (I'd love a connection up top) but at least with the band loop it works for me. It's the only mask I've been able to get (mostly) consistently low AHI with.

Pugsy wrote:

tomkatt wrote: It's probably more art than science, but generally x1 is for nasal and full masks, and x2 is for pillows. I've not seen any other kinds of masks yet.

I am not so sure it isn't more hype than anything else. They say if using a non Respironics mask just set it to 0 which turns Mask Resistance off. I tried all settings with my Swift FX nasal pillow mask including off and I couldn't tell any difference anywhere with anything.

It's more than just full face vs nasal pillow though...it's size of cushions and pillows.
This is a bit dated as it doesn't have the DreamWear shown but it will give you an idea as to how they vary with size too.
I don't have time to go look for a more current chart.

Interesting point... I've been using the x1 setting on my Dreamstation for my first two masks because I RTFM'ed them and that's what they said, but for the the other two, the Dreamwear and the P10, I didn't RTFM and just left it at x1.

If it's at the wrong setting for those, is it just a matter of time before my face explodes?

What setting do those who use the Dreamwear and the P10 on a Dreamstation use?

Sheepish wrote:If it's at the wrong setting for those, is it just a matter of time before my face explodes?

I think you are pretty safe.

Sheepish wrote:What setting do those who use the Dreamwear and the P10 on a Dreamstation use?

I don't know. All I know is they say to turn Mask Resistance off if using a non Respironics mask.
Respironics didn't bother to do mask resistance settings for the competition brand masks. I am sure they would prefer we use one of their nasal pillow masks. The DreamWear gel pillows was just released last spring.
Mask Resistance has been around since the first PR System One machines...2010 maybe. Respironics has had other nasal pillow masks though.

I do know that I did play with all the resistance settings including off with my Swift FX and I tried really hard to feel any difference or spot any difference in the reports and I couldn't have find anything.

My own PR S1 machine is out on loan right now so I can't compare the P10 to the DreamWear Gel pillows...
my own personal opinion...more hype than actual importance.