Nasal mask vs. nasal pillows

[Nemo_]

I just finished my first week with my CPAP machine. My titration study had me using a Mirage FX, and it felt pretty comfortable that night relative to what I was expecting... So that is what I requested from my DME.

Trouble is, the thing leaks on me. I can see this both in the data (thank you, SleepyHead) and in how I wake up multiple times every night needing to shift the mask around, play with the straps, etc. Also in response to the leaks my APAP tends to crank up the pressure, which makes it harder to stop the leak. I usually have to turn the machine off and on to regain my seal and get back to sleep.

Obviously I would like to try some different masks, but I have a question first: In general, what are the pros and cons of a nasal mask versus nasal pillows? I think I understand the difference between these and the ones that cover your mouth, but in general why would I prefer a nasal mask vs. pillows or vice-versa?

I assume the pillows look and feel less "intrusive", but I do not particularly care about that. (I do not have claustrophobia and appearances are a completely secondary concern for me.)

I do care about general comfort. Nasal masks appear bulkier, but having my nostrils stretched all night does not look like too much fun, either.

I also care about getting a good fit (no leaks).

Anyway, is this totally a matter of personal preference, or is one of these styles of mask generally better than the other by any of these criteria? Or by other criteria I am overlooking?

My APAP is set to the 6-10 range if it matters.

Thanks!

[Starlette]

I'll put my 2cents in. You can see I'm using 3 masks. To answer your question, I'll answer with my Mirage and Swift FX in mind:

Nasal:
Not dependent on hair length. Now that I've returned to having my hair length as a bob (as in my photo), I'm having a wing ding of a time trying to anchor the back strap. So, I went to Walmart today and purchase some Velcro as others on the forum have suggested. Just can’t get a good ponytail happening with a bob. Currently, it’s a “dink” ponytail and it aint working. Last night, I had an increase in leaks.
Best to use when I have a stuffy nose.
Less leak concerns.
I can flick my hose over my head with my nasal whereas I don’t feel comfortable doing so with my pillows.

Pillows:
For me, it appears I have lesser events which is a very good thing.
Less intrusive.
Air has a more direct hit to me rather than a nasal which may be the reason the AHIs are less.
Con – to avoid rainout I have to keep the bedroom at a higher temperature during the winter. Hense, I use a space heater when I decide to use the pillows. Hubbs gets a tad cranky on that.
Con – don’t feel comfortable using my snugglehose on my hose to avoid rainout during the winter when I use my pillows because of the added weight involved.
However, I did purchase the Pad-A-Cheek pillow cover to avoid rainout. Need to revisit this situation this winter.

Gasp…After seeing on black and white what I’ve written, I’m seeing where my vote seems to be going. Never quite thought of it before. This is an eye opener.


More 2 cents on your post:

Comfort – I think that is a personal preference. What may feel comfy for you may not be comfy for me. Case in point:
Mirage vs. ComofortGel Blue: Mirage won by a landslide. Mirage is bigger and weightier however. Less skin irritation. Base upon the vote from my skin, I chose Mirage. However, to override skin irritation, I purchased Pad-A-Cheek for Blue which now allows me to use Blue.
Pillows – Can’t comment, I’ve only used one brand, I’ll stick with it.

Nare stretching – Not necessarily. Pillow mask comes with 3 size pillows for you to chose from. You can try what best suites you and causes less leaks. Me? I use small. Then you can post on forum and trade pillows for your size, I’ve done that.

Starlette

[Pugsy]

I have used nothing but nasal pillow masks for over 2 years now.
My nostrils are not larger. They don't stretch out. I don't have piggy nose (upturned).
Only the teeny tiny part of the pillow cone fits into the nostril and then just barely, the pillow rim rests against the nostril. It takes very little tension to maintain adequate seal. If it hurts...it is too tight or wrong size.

I wouldn't use any other type of mask. It is so much easier to seal..less surface to mess with sealing.