Nasal Pillows, hybrids, papcap... which combo?

[frazzled-snoozer]

Hi all you awesome hose-heads! Once again, I'm in a quandary.

A few weeks ago I met with the RT to check on my progress. At that time I was having trouble with the ComfortGel Nasal mask creating a sore on my nose bridge. I also reported that I was having mouth leaking problems. So, she tried me out on several FF masks and we found that the Mirage Quattro was the best bet in that department. She also tried me out with a nasal pillows system and chin strap that were quite comfortable. I was leaning toward that. But they only had the Quattro on hand and I'd need to order the nasal pillows from their main office. Since I have to try out a mask for 2 weeks before they'll let me try the next mask it seemed fine to just go with the Quattro for now. But then she gave me a sample of a nasal pillows systems she had so I could see if I liked the whole nasal pillows thing. (I always thought they'd be the worst thing imaginable.) It's not as good as the one she'd order for me, but I could decide if I liked that style. The sample is a Respironics OptiLife. I didn't note which brand the one was that she'd tried on me. (It's in her notes though if I decide to order it.)

So.... I tried the Quattro that night. It was a disaster. Leaks every time I moved or relaxed. So, the next night I tried the nasal pillows. That was much better. I've been able to use it most of the time for these past few weeks while taping my mouth. But, now my nares are very sore. As I'm preparing to order the other nasal pillows system, I'm wanting to make sure I understand what contributes most to that problem and which system will address all my concerns. Could it be from having it strapped to tightly? Or is it that I should be using a smaller or larger pillow? Or could it have something to do with the angle? I just can't figure out what's the main contributing factor. The pillows feel very soft and flexible to me so I don't think it's that they're too hard.

I've been looking into hybrids. I could only find two brands of them. Is that right? Are they more likely to make my nares sore than other pillows? Does the mouth portion really work to manage mouth leaks?

Would I be better off going with the very nice nasal pillows system the RT tried on me and then get the papcap?

Thanks.

[Muse-Inc]

...The sample is a Respironics OptiLife....

Ahh, my beloved former mask! I wore it almost 2 yrs until I started losing therapy air.

...past few weeks while taping my mouth. But, now my nares are very sore....Could it be from having it strapped to tightly? Or is it that I should be using a smaller or larger pillow? Or could it have something to do with the angle? I just can't figure out what's the main contributing factor. The pillows feel very soft and flexible to me so I don't think it's that they're too hard.

Might be too tight. I was supposed to use the Mediums but I hated 'em, so went to the Large and was pleased with 'em...some hafta go down a size to get comfortable -- experiment and see if the size change works for you. Hmm, the angle, you can change that on the Optlife...I had to position the pillows every time I put it on. Make sure you wash the pillows daily; you did soak them in soapy water for 30-45 mins before using...right, if not so it now.

...looking into hybrids. I could only find two brands of them. Is that right? Are they more likely to make my nares sore than other pillows? Does the mouth portion really work to manage mouth leaks?

I moved to the RespCare Hybrid when I started mouth leaking...no more losing therapy air wearing this mask. You're right, there are just 2: the Hybrid and the Liberty...they fit much differently. If the OptiLife is a good fit, then the Hybrid will fit well too. The Hybrid pillows are softer than OptiLife's.

...Would I be better off going with the very nice nasal pillows system the RT tried on me and then get the papcap?

I have never tried the PapCap because I get hot while I sleep, it looks like it'd get too warm for comfort.

[dtsm]

Muse

I'd be interested in your experiences, if any with the mirage swift II nasal pillow. I've just started cpap (third wk now) n using comfortgel nasal mask, also trying the new easylife nasal mask. But DME said many of her clients are very happy with mirage II and I have two sets at home which I will eventually want to try out, once I'm done with first 4-6 wks of cpap.

Also, someone recommended either papcap or a premium chinstrap (from cpap.com)

Thanks,

[Muse-Inc]

...interested in your experiences, if any with the mirage swift II nasal pillow...

Only worn the OptiLife and the Hybrid, so can't comment on other masks. Maybe some will come along and comment.

[letchworth]

I use the OptiLife (have for about a year and a half). The sore nose could be any of the three things you mention:
Size of pillows: Muse is correct, it could be either too large or too small-- for me the problem was trying to use a large felt like it was trying to pull my nostrils apart (Perhaps that is a bit dramatic)-- but a medium was a good fit. The pillows want to be at the end of the nares (not into them).
Tightness of headgear- If too loose you lose air, but if too tight you can collapse the pillows (which can also lose air, but makes them uncomfortable). Too tight also leaves lots more marks on the face.
Angle of Pillows- Like you, I adjust mine every time I go to bed. By morning the angle seems to fit like a glove (it must self-adjust a bit in the night??)

I had difficulties keeping the mask on at first- so fashioned a strap (in the spare hole on the standoff piece) to hold the mask more firmly against my face. It has made all the difference in the world.

I might also note that the OptiLife has not only pillows, but a choice to use comfort cushions in their place. They have one much larger hole and sit below the nose- the air inflates it into contact with the nose. I have used both systems, and at times I much prefer the one over the other-- but then switch for awhile. Generally I like the comfort cushion best- but since I have both on hand, I have seemed to switch when one wears out. Right now I am using the comfort cushion.

Good luck in your search-- and let us know what nasal mask you RT suggested
letchworth

[frazzled-snoozer]

Thanks everyone for your input on this. I switched to smaller pillows and the soreness is gone!!! YAY!!!! So, I think I'm definitely going to stick with pillows. I talked to the DME today and they're going to send me out the Liberty mask to try. The guy agreed with me that I've got to address the mouth issue. He worried that I might find the Liberty uncomfortable but it's worth a try. If this doesn't work I can get the pillows mask that the RT wrote on my file and a chinstrap. If all else fails I'll always have my Optilife which is working very well.

I do like how the Optilife is really no-fuss. It's easy to clean and use. I just think it would be nice to have something I can detach from the front given my long hair that must be pulled through the back. It's just hard to take on and off in the early morning when I get woken multiple times by my husband and children as they have questions or are saying goodbye. I usually just take the mask off between 4 & 6 then turn it back on when I go back to sleep when they're all gone. (I get to sleep in since I work from home.)

The Liberty looks like a great idea to me though. The guy had to agree that I'd probably like it better than taping my mouth shut! He noted that I'd probably appreciate any improvement over that! And when I explained why I didn't think a strap would work well he had to agree. My jaw doesn't drop at all... it's just my lips poofing the air out. If this doesn't work I'm definitely going to order the papcap.

So... I'll give you an update after I try the Liberty.