Pillow size / Air intake

I currently use a ResMed Elite S9 with Bella Loops (love them!) and medium pillows.

When I'm trying for "fit", I think the small or even extra small pillows actually fit better (and going by the website, I should be using these sizes instead of the medium) but when I try to run the machine with the S or XS on, I feel like I don't get enough air in and end up taking the mask off and gasping for air. When originally "fitted" at the supplier, they set me up with the small pillows.

I sleep well enough with the medium because it's the only way I get enough air intake but feel like the small or xsmall would just *fit* better.

Has anyone else come across this?

What pressures are you using? If you have the ramp on, you may feel you aren't getting enough air to start with. Also, some advice from this forum that helped me was that when it feels as if there is no air, put your hand by the exhaust. The air pouring out helps my brain realize that there is plenty going up my nose and I can calm down.

What pressure do you use? Are you using the ramp for a little while?
I can easily use the XSmall but my pressure starts out higher since I don't use the ramp and my pressures aren't low.
If you use a low pressure then it and the combination of the smaller space in the smaller pillow might make it seem like not enough air is moving.
You aren't the first to say that with smaller pillows you feel like not enough air is moving.

I *do* use the ramp feature so perhaps I'll turn that off tonight and try the smaller pillow. Thanks for the suggestion! I can't recall what my pressure setting is, I know it's not high... I'm thinking it's a "9".

Firekeeper66 wrote:I currently use a ResMed Elite S9 with Bella Loops (love them!) and medium pillows.

When I'm trying for "fit", I think the small or even extra small pillows actually fit better (and going by the website, I should be using these sizes instead of the medium) but when I try to run the machine with the S or XS on, I feel like I don't get enough air in and end up taking the mask off and gasping for air. When originally "fitted" at the supplier, they set me up with the small pillows.

I sleep well enough with the medium because it's the only way I get enough air intake but feel like the small or xsmall would just *fit* better.

Has anyone else come across this?

I to noticed this right off when I started my APAP therapy a little over a month ago and even re-visited the "Small" pillows one attempt about 2 weeks ago and immediately switched back to the mediums. There is a MAJOR difference in the feeling of the air being restricted via the "smalls" which actually do feel to fall right into place much easier than the "mediums" which still fit but I usually have to manually tweak them into place. Pugsy helped me initially discover this oddity and if I would have had to keep to the "smalls", I'm afraid I wouldn't have been able to tolerate it at all. I've just come to the conclusion that over all comfort including being able to breath correctly is more important than just the "fit" alone so if you're case is like mine, you may just have to live with the "medium" pillows. Actually I've also found over time that when I now put the mask on, they usually line right up as opposed to before.

Firekeeper66 wrote:I *do* use the ramp feature so perhaps I'll turn that off tonight and try the smaller pillow. Thanks for the suggestion! I can't recall what my pressure setting is, I know it's not high... I'm thinking it's a "9".

Ahh...using the ramp it starts out at 4 cm and that isn't much pressure so not a lot of air movement and it can seem stifling to some people especially when using a nasal pillow with a small volume. Also might make a difference how long the ramp takes to get to your pressure. If it takes a long time it stays at low pressure much longer so greater chance for the suffocating feeling to occur. Heck, even my titration study started out at 5 cm and I thought that was nothing pressure.
FWIW...I used auto adjusting pressures but I started out with 10 cm minimum. Never needed a ramp. I used to make a game of it to see how long it would take me to get used to exhaling against 10 cm. Just for fun to see if I could better myself. I would count my breaths to see how long it took me to be comfortable and have things feel like normal....Took me about 2 months to get to where it was only 5 or 6 breaths down from 100 or so. Now...2 breaths and I don't even notice the pressure.
It's amazing what the body can become accustomed to. What starts out when we first turn the machine on feels like a hurricane and by morning it feels like a gentle breeze and we are putting our hands over the vent holes to make sure it is even on.

If you still feel there are problems with air moving without ramp...then you likely just need the larger volume pillow but I suspect you will notice considerable improvement.