Question about Nasal Pillow vs Nasal Mask

[SmilingSharon]

Hello!

I've been using my CPAP only since December 2012. Right away, I was able to use the Nasal Mask. But, it's a bit difficult to completely sleep on my side because of the Nasal Mask. I tried the Nasal Pillows and am able to sleep on my side much better, however, I find it much harder to breath out against the air flowing into the pillows. The odd thing is that I don't have a problem blowing out when wearing the nasal mask.

I have changed the ramp on my machine and the setting for nasal "pillow" or "Mask" each time I have worn one or the other. Is it "normal" to have the difficulty breathing out through the nasal pillows and not the nasal mask? I really want the pillows to work. My problem is that no matter what mask I wear, I wake up throughout the night. So, when wearing the pillows, I wake up with the high air blowing and have to turn the machine off and then on again to start the ramp all over just to be able to go to sleep.

The masks and pillows are all Resmed for Her. I also have the Bella's to wear around the ear with the pillows.

Thank you in advance for taking the time to offer me some wisdom.
Sharon

[Pugsy]

Are you using EPR? If so, at what setting?

If not using EPR then by all means turn it on. That is what it is designed for...to help during exhale. Your machine can drop the pressure on exhale up to 3 cm for exhalation. Makes a huge difference in comfort for a lot of people. It's a comfort feature and you should be able to use what feels best to you.

What is your ramp pressure? Do you have trouble exhaling against the ramp pressure or are you having problems with maybe feeling like there isn't enough air moving?
How long do you use ramp?

What is your prescribed pressure?

Try going up one size in the nasal pillow and see if it helps with the exhaling issues.

Have you got the software up and running yet so we can see your reports and make sure that you aren't having events that might be waking you up?

[Summer Rain]

Well, my ignorance is really going to show ,here...... as I just started on Cpap and I hardly know enough to even ask a coherent queation.....but what is a "nasal pillow" ? I couldn't find it in Cpap definitions? Would love to see a picture? Maybe I can go on the internet and find one?

[teachcsg]

Hi Summerrain,
A nasal pillow is the mask that just sit under the nose and a nasal mask is a mask that goes around the nose. A good example of a nasal pillow (and very popular one) is the Resmed Swift fx. A nasal mask would be like the Respironics Comfortgel. I'm sure you can find these on our host website cpap.com

As for the question on this forum...I agree with Pugsy...try EPR and try the larger size pillows...it does make a difference.

Good Luck!

[Pugsy]

This is what I use....nasal pillow mask. I don't know why they call them "pillows" but everyone does.
https://www.cpap.com/productpage/resmed ... dgear.html
There are lots of different styles of nasal pillow masks.

Then there are what we call nasal masks...just something that covers the nose and leaves the mouth open.
Like this one
https://www.cpap.com/productpage/Resmed ... dgear.html

Then there are what we call full face masks...nose and mouth are both covered
like this one
https://www.cpap.com/productpage/resmed ... dgear.html

Can we get your equipment sorted out? You don't have a machine listed and the humidifier you have chosen was discontinued over 5 years ago.
See if this thread helps you sort it out.
viewtopic.php?f=1&t=72302&p=665165#p665165

I just started on Cpap and I hardly know enough to even ask a coherent queation.....but what is a "nasal pillow" ? I couldn't find it in Cpap definitions? Would love to see a picture? Maybe I can go on the internet and find one?

[SmilingSharon]

Hi Pugsy! Thank you for your help.

My machine says my EPR Full Time, EPR level 2

My Ramp pressure begins at 5 for 20 minutes. I initially had it set for 4 at 40 minutes, but with the nasal mask with a pressure of 4, I felt like there wasn't enough air and I couldn't breath well, so I turned it up to 5. That seems to work with the nasal mask. I can somewhat handle the pillows at 5 but for some reason, breathing is just not as easy. I definitely can not handle the nasal pillows at the higher pressure through the pillows because the force of air is too hard to breath against.

My exact pressure from the sleep study is 10. My doctor has my CPAP set at a range from 8 - 12.
When I review my nightly stats, the pressure usually says 11.2 or 11.6. I don't know if that number is the average pressure rate or the maximum pressure rate from the night before.
The doctor said that she doesn't want the pressure too high because it could cause more problems.

Nasal Pillow size
I'm glad you mentioned going up in size. I didn't think to do that. Have you tried the Bella ear loops with your pillows? I have both the ear loops and the headgear, but have only used the loops. I've only tried the pillows three times in about 3 1/2 weeks.

I haven't uploaded the software yet. I'm trying to decide if I want to partition my Mac or not. Or if I would rather risk using an open source download with the other software.
Once I get it running, do I just copy and paste part of my report to a new post and ask for help reading it? What is the best way to handle that?
Thank you!

[ughwhatname]

Hi Pugsy! Thank you for your help.

My machine says my EPR Full Time, EPR level 2

My Ramp pressure begins at 5 for 20 minutes. I initially had it set for 4 at 40 minutes, but with the nasal mask with a pressure of 4, I felt like there wasn't enough air and I couldn't breath well, so I turned it up to 5. That seems to work with the nasal mask. I can somewhat handle the pillows at 5 but for some reason, breathing is just not as easy. I definitely can not handle the nasal pillows at the higher pressure through the pillows because the force of air is too hard to breath against.

My exact pressure from the sleep study is 10. My doctor has my CPAP set at a range from 8 - 12.
When I review my nightly stats, the pressure usually says 11.2 or 11.6. I don't know if that number is the average pressure rate or the maximum pressure rate from the night before.
The doctor said that she doesn't want the pressure too high because it could cause more problems.

Nasal Pillow size
I'm glad you mentioned going up in size. I didn't think to do that. Have you tried the Bella ear loops with your pillows? I have both the ear loops and the headgear, but have only used the loops. I've only tried the pillows three times in about 3 1/2 weeks.

I haven't uploaded the software yet. I'm trying to decide if I want to partition my Mac or not. Or if I would rather risk using an open source download with the other software.
Once I get it running, do I just copy and paste part of my report to a new post and ask for help reading it? What is the best way to handle that?
Thank you!

I had the exact same trouble as you did. I changed my start pressure to 5, my EPR to 3 and moved up in size on the pillows. Prior to that, I was freaking out with feeling as if I were suffocating because I couldnt exhale against the pressure. Now, the pressure doesn't bother me at all.

[SmilingSharon]

Wow Ughwhatname... thank you so much! When you bought your pillows, did you get a couple of sizes in the bag? I didn't and thought that I was supposed to.

[Pugsy]

The Swift FX comes with 3 sizes of pillows. In the For Her package you should have received the XSmall, Small and Medium.
In the regular package (dark blue back strap) it should come with Small, Medium and Large.
If you didn't get the additional sizes then the DME ripped you off. Tell them you want the additional sizes you were supposed to get to try. We have a thread where people post stuff like the nasal pillows they get and can't use and we swap them with people who can use them and they give us the size we use.

With your starting pressure on ramp of 5 you really aren't getting the benefit of EPR at 2 because the lowest the machine will go is 4. Would you be willing to do an experiment while awake just to see if an idea I have might help with the exhale issue?
I know it is going to sound weird but it is actually easier to exhale when there is a larger difference between inhale and exhale.
Right now 5 cm seems like a LOT of pressure but in 3 months you will think it is a gentle breeze instead of a hurricane.
Set your starting pressure at 7 but with EPR of 3. That will give you an inhale of 7 cm and exhale of 4cm. It's weird but it is the difference that offers the comfort. If you don't have much of a difference then EPR doesn't get to work its magic.
Try it while awake and watching TV or reading...not right at bedtime.
You could also try minimum of 6 but again it won't go below 4 and trust me...it is the difference that makes it easier. When you use 3 EPR you are sort of creating a bilevel pressure situation and bilevel is what is prescribed when people have trouble exhaling against any pressure.

Regarding your pressure numbers. That would be off the machine's LCD screen wouldn't it? That number is a 95% number which means that for 95% of the night your pressure was at OR below that number. Leak number is the same thing. At or below. People tend to forget the OR BELOW part of the definition and panic sometimes when it seems kinda high. Gotta look at the whole report and graphs before we decide to panic.

Go ahead and install the Mac SleepyHead version. Just slide the little plastic thing on the SD card to the locked position to prevent the computer from adding that little file that the S9 doesn't like.

This thread talks about how to post images of the reports and has some examples. I don't know how Mac users get a screen shot so disregard the parts about getting screen shot using Windows OS.
viewtopic.php?f=1&t=81072&p=737779#p737779
Once we get a chance to look at your reports we will have a better idea what might be going on that might be responsible for the wake ups.
It may just be the brain still adjusting to having an alien stuck on its face and being sort of hypersensitive.
It also might be leaks or events or even pressure changes that are disturbing sleep.

This will get easier and it won't be long before that hurricane you think you are exhaling against becomes a non issue.
I remember when I thought 6 cm was horrible and now I can start with 12 or 13 and it barely seems to be blowing. The body does adjust but it takes some time.

[Pugsy]

Forgot to answer your question about the Bella Loops. Yes, I have tried them. Bought it the first day they were released for sale last spring to online sellers. I really like them. I go back and forth between the traditional headgear and the loops.
I also like the ALoha and the Pilairo but the Swift FX is my main mask. I like to try new stuff when it comes out. It helps with the boredom and gives me a little change to occupy me for a while.
Been using the Swift FX coming on 3 years I guess. They just added the loops last spring.
I like the loops a lot. It's a toss up as to which I prefer...