Nasal Pillows

[piperjoe68]

Newbie here - first post.

I got my Bipap machine about a month ago, and started out with a Wisp mask. I got excellent results: although I showed a moderate amount of leak every night (always <=1-3%), my AHI was well below my prescribed level (I was getting <=1-2 each night with a prescribed level of <5). On top of these good numbers, I immediately got excellent therapeutic results: whereas I had been involuntarily falling asleep at work, the dinner table, etc constantly, and had no energy, after the Bipap I was not falling asleep at all and had much better energy than I'd had in a few years.

About a week ago I went back to my med supplier to try a new mask. The problem was the Wisp would close off my nasal passages, making it hell to wear the mask. I was up and down several times a night, and was dreading wearing the mask and NOT looking forward to bedtime. Through all of that I was wearing the mask 100% of the time (knowing if I didn't, I'd quit on it). I got a nasal pillow mask and instantly fell in love with it. I can sleep through the night, and only wake up to go to the bathroom, and usually <2 times a night. My leak is constantly 0%, and my AHI has not gone over 1 since wearing the pillow. Sounds like heaven, right?

The problem now is that although I feel better than I did before the Bipap, I'm not feeling as wakeful as with the Wisp. I get between 6.5 and 7 hours a night of sleep - which may be low, but it was the same as I was doing with the Wisp. Has anyone else had this experience? Is it the nasal pillows? (hard to believe) Or, is it some kind of natural retrogression that is common at this time frame? I'm confused, and can't bear going back to the Wisp...

[Julie]

If your mouth ends up opening overnight and letting Cpap air out, instead of down your airway, you're not being treated well and should investigate a 'full face' mask (it just extends to cover your mouth as well as your nose), or a hybrid type like Liberty - you can look at them on Cpap.com. Sometimes if leaks are large enough (or too large), they don't register properly on data.

[Pugsy]

What is the model number of your machine? It's not showing up on the profile page and you may have selected the wrong machine.
The model number is on the bottom of the blower unit...a 3 digit number with DS or REF maybe in front or behind the 3 digits.

I too couldn't wear the Wisp because of it causing nasal congestion due to pressing on my nasal bridge
I am a long time nasal pillow user and for you to be more sleepy using them is not a common complaint if you aren't having problems with them like a lot of wake ups because you had a lot of wake ups with the Wisp...as did I.
So I don't know why the difference in how you feel if the therapy is the same and if a ton of large leaks aren't involved.

You might look at the Swift FX Nano nasal cushion mask...it's very similar in construction to the Wisp and I was able to use it successfully without it causing the congestion that the Wisp did. Though I still prefer nasal pillows as the primary mask at least I could use the Nano where I couldn't the Wisp.
Maybe you just sleep "better" with that type. I would be more apt to think that maybe something else is going on though.
Anything change otherwise in your life...meds, general health, bed comfort, humidity, stress????

If your machine is reporting 0% of time in large leak then if you are doing any mouth breathing it sure isn't very much so unless you just wanted to try a full face mask I don't think that you are losing much therapy with mouth opening.
So with 0% of the time spent in large leak...your low AHI is valid. You would need prolonged periods of time in large leak for it to give you false low AHI readings.

[piperjoe68]

What is the model number of your machine? It's not showing up on the profile page and you may have selected the wrong machine.
Anything change otherwise in your life...meds, general health, bed comfort, humidity, stress????

Pugsy - I think I have the same machine as you. I have it listed in my profile, but for some reason it is not showing it (grrr). Regarding changes, I have just moved into a new home (9/18), and am getting married (my second one) on 11/1. So, although I don't FEEL too stressed, I'm sure it's there.

I had no trouble with mouth-breathing during my titration (using a Wisp). I don't believe I was mouth-breathing for the month-or-so I used the Wisp - I can't see why I would start mouth-breathing with the nasal pillows...

[Pugsy]

I wouldn't worry about mouth breathing...you machine says 0% time in large leak and even if you were mouth breathing a little the machine can compensate for a little mouth breathing and mouth breathing will show up as a leak...it doesn't get ignored.

I think you just chose the wrong equipment...you saw PR System One and didn't look further...
Look for the PR System One grouping that has 60 Series in the name. The 60 series is important part of the choices.
What you have chosen is probably the 50 series counterpart (older and discontinued and those links for those machines are broken). If you choose what I show...those links work.

My machine is the 760 model...PR System One 60 Series BiPap Auto.
Then there's the 660 model...PR System One 60 Series BiPap Pro
then there's the 560 model...PR System One 60 Series Auto CPAP
and the 460...PR System One 60 Series Pro cpap.

All the above will use the same humidifier I have chosen in my profile
the PR System One 60 Series heated tube humidifier with heated tube.


With the prior 50 series machines the 50 wasn't part of the model name but there had to be some way in the equipment menu to separate the 2...so this ended up being our choice.

Look again in both machine and humidifier for the PR S1 grouping that has "60 series" in the name...they are there and all the links work and should show up.

[piperjoe68]

Thanks - it's showing up now.

So - if you're with me, and think it's not mouth-breathing... then, should I chalk it up to stress for now? I'm not falling asleep in meetings now - but it just definitely feels laggy compared to before. Jeez - I just wish I was getting Wisp results with nasal pillow comfort and clean seals...

[Pugsy]

You might be doing a little mouth breathing....but it isn't enough to kick you into large leak territory or the machine would flag it.
Now it might be enough to disturb sleep quality but if you are sleeping well ....I would doubt it.
People like to blame mouth breathing for not feeling so great and sub optimal therapy pressure but if the mouth breathing doesn't even make it into large leak territory I really doubt mouth breathing is to blame. The machine can handle/compensate for some leaks even mouth breathing leaks.
Mouth breathing leaks will show up as a leak...so it's not like the machine totally misses it. Leak is a leak no matter what the cause.

I would be more apt to think mainly the extra sleepiness is just related to the fact that with the upcoming move and marriage (congrats BTW...I finally got lucky with number 3 in 2002...sure had to kiss a lot of frogs though before I found my prince). Stress doesn't have to be "bad stress"...stress can be "good stress" too.
Heck, just moving or planning a move would wear me out just thinking about it.

Sometimes we just "sleep better" with one mask over another. It's hard to say exactly why but we just do.
If you get a chance to try the Swift FX Nano...you might really like it and there's the added bonus that the Swift FX nasal pillows will fit on the Nano headgear (or vice versa)...I know because I used it successfully that way.
Might find a good deal on replacement parts and build your own. Let me know if it interests you.

Finally....may have to just "give it time". We all can go through cycles where we don't feel as well rested or get a little drowsy and can't really put a finger as to why. Like yesterday I had a bad case of the drowsiness despite getting 8 hours of quite decent sleep the night before and really felt pretty good but just drowsy and lack of energy feeling.
Nothing really changed...didn't wake more often than usual but I was more draggy and drowsy yesterday than I am today.