Pilairo nasal pillows by Fisher Paykel

[Ianscpap]

I have just recently started using CPAP and tried these nasal pillows first. They are very comfortable on my face and the first night I thought they were great, but the next few nights didn't work so well. I felt they either didn't allow enough flow or they provided too much resistance to exhalation. Last night I broke open the new nasal mask that came with my Fisher Paykel Icon + Auto Adjust and tried it. It worked great, but it's much bulkier that the pillows. I feel if only the nasal holes were a bit wider on the Pilairo it would work perfectly. Has anyone ever modified pillow holes before?

[Pugsy]

I feel if only the nasal holes were a bit wider on the Pilairo it would work perfectly. Has anyone ever modified pillow holes before?

You are talking about the opening on the inner cone that goes up to the nostril.....and not the vent holes???

In the other brands of nasal pillows that offer various sizes of nasal pillows the opening of the inner cones do vary so I would think enlarging that opening wouldn't be a problem.

We never mess with any vent holes though.

[HerbM]

The pillows on the Pilairo INFLATE though.

Wouldn't trying to enlarge them then ruin the integrity of the air bladder that inflates them?

That wouldn't be the case on most pillows since they don't use air pressure for inflation.

Maybe there is some wiggle room to enlarge a Pilairo though?

[Pugsy]

The pillows on the Pilairo INFLATE though.

They all inflate...the Pilairo has a larger base though.
Has nothing to do with the inner cones themselves...there is some wiggle room on all the nasal pillow inner cones for a small amount of "trimming" to open the opening just a little.
Very little wiggle room with any of them but there is room for tiny trimming...not something I would do myself and I shake too much.
I am talking millimeters here..width of a hair or two trimming.

[Ianscpap]

Thank you all for your responses. Yes I am referring to the holes in the pillows and not the vent hole. Other manufactures have different size pillows. Not sure if the nostril holes are different. Has anyone else here experienced what I am talking about? Its almost as if I get short of breath when using this device. I sort of have a mini panic attack and have to breath through my mouth.

[Pugsy]

Other manufactures have different size pillows. Not sure if the nostril holes are different. Has anyone else here experienced what I am talking about? Its almost as if I get short of breath when using this device. I sort of have a mini panic attack and have to breath through my mouth.

Other manufacturers do have different sizes of nasal pillows and the openings for those different sizes are indeed different.
The opening for a Large nasal pillow will be larger than for XSmall.

What you are experiencing is actually fairly common especially when someone is using a lower pressure...or the ramp feature which typically starts out with only 4 cm pressure.

The lower pressure sometimes just doesn't seem to move enough air to be comfortable.

The Pilairo seems to do better with a bit more pressure because it is larger and needs more air to keep it inflated....and thus more comfortable..less stifling feeling.

What pressure are you using? And are you using the ramp feature at all?

[jencat824]

I have tried to change the opening size of the pillow - very unsuccessful. I've also had my high pressure blow holes in the thinnest part of the cushion, I tried fixing with superglue, also unsuccessful. I would recommend trying another nasal pillow mask. There are a lot of models, most with cushions from sizes XS to L.

Jen

[Ianscpap]

Pugsy, I am using a "F & P Icon +" in auto-adjust mode with ramp off. I tend to agree with your assessment on this. So I think the solution may be to increase the minimum CPAP level (currently at 4 cm H2O) until the feeling goes away. Thanks for your help. I may try it today (I work at night). I will let you know the results when I do.

[HerbM]

The pillows on the Pilairo INFLATE though.

They all inflate...the Pilairo has a larger base though.
Has nothing to do with the inner cones themselves...there is some wiggle room on all the nasal pillow inner cones for a small amount of "trimming" to open the opening just a little.
Very little wiggle room with any of them but there is room for tiny trimming...not something I would do myself and I shake too much.
I am talking millimeters here..width of a hair or two trimming.

Looking at the Airfit P10 is doesn't have any type of "bladder" in the pillows themselves (it does have two separate pillow cones, one within the other but they are open at the front end.)

So yes, it might inflate or at least expand as a result of the mask pressure but there would be no loss of integrity if you cut that tip down or widen the whole as long as you remained within the cone of the tip and didn't remove so much that it wouldn't seal in your nose.

I was under the impression that the Pilair had a sort of "airbag" that inflates, and was thinking that if that airbag are was punctured or compromised the pillow would not work even close to the way it was intended.

It's pretty likely that you could but a little off (just chop at 90 degrees) the AirFit P10 if you were careful. You would lose some depth, and eventually you would reach the edges, but a clean cut would not compromise the integrity. (Haven't tried it so proceed at your own risk after careful examination.)

Wouldn't it be more likely to go bad on a Pilairo?

[Pugsy]

Wouldn't it be more likely to go bad on a Pilairo?

Not sure what "it" is that might go bad or what "go bad" means
The Pilairo pillow is very thin when compared to other nasal pillows and there have been reports of tears.

I have never had the need or desire to trim the cones. I look at things and decide if it "could be" done but that doesn't mean I would advise doing it or do it myself.
If I felt a bit stifled..I would increase the pressure just a little. I feel that is a better way to go.
I can't glue parts of a mask back on it if I screw up the cutting and at the price of nasal pillow replacements...I would rather play with the pressure but if someone else wants to mess with the cones...it's up to them.

[HerbM]

"It" means the integrity of the balloon like feature of the Pilairo where I believe it captures a little "bag" of air.

I absolutely agree about cutting on the mask -- unless it is an old one or a pillow I didn't really need then I would shy away from that too.

Upping the pressure sounds right to me, but we were discussing the possibility of modifications (not recommending them), in fact we were generally recommending against them and my point was that with the Pilairo the modification is far more likely to go wrong.

Even a perfect modification of the P10 "cones" of the pillow by cutting off the last millimeter or so MIGHT leave "rough" or "sharp" edges that would irritate the nose.

I looked at modifying the Oracle mouth piece insert to make it smaller as well, and that thought came immediately to mind. Even if I was careful to avoid RUINING the mask completely it was likely I would need to take special measures to buff or smooth any cut edge.


A man's got to know his limitations.
--Inspector Harry Callahan (Clint Eastwood) in Magnum Force

[longtimeinsleep]

You may want to look into the Aloha or Swift FX as alternatives

[Ianscpap]

Well today I increased the minimum pressure on my F&P Icon Auto from 4 to 5 as suggested by Pugsy and that seemed to work pretty well. I didn't get the same panic /suffocating effect i had got before. I still only used it for only half the day or sleep (a great sleep by the way) and switched to the nasal mask (Respironics Tru Blu). I looked at the pillows on the Pilairo as well to see if modifying them would be possible (although I consider the question irrelevant at this point). I don't see any sort of " contained pillow bladder" that fills with air that would be compromised if they were trimmed. I also think that rimming them would not be that difficult to do. I will reexamine them in light of what the last 3 post have indicated and let you know what I find however as it may be that it is extremely difficult to discern without airflow.

[HerbM]

If you don't see what I thought was the Pilairo design then just use your good judgement and ignore me as I was solely going on written descriptions of the product.

[cpierc01]

I use the Pilario and love it. It is the only mask I have used since I started my cpap adventure in June 2013. Sometimes I have to re position the air holes to blow up in the nose. If they get lower they will blow against the wall of your nose and feel like you are not getting enough air. Good Luck.