Nasal Aire II questions on fitting

[Ted_S]

I bought the sizing star for the Nasal Aire II and it arrived without instructions. I watched all of the movies... no instructions. I did a search and didn’t find any instructions. Perhaps I just missed them.

I finally decided to use ‘fits in my nose with a little effort and passes no air when I try to breathe in through my nose but doesn’t feel too tight’ as criteria. I now have a NAII with Medium Plus prongs and I basically can’t get them up into my nose with the air on or off, with or without Ayr gel. I managed once. I cleverly have discerned hat the darned things are too freaking big. Duh.

OK, two questions for the assembled wisdom:

1) What ARE the fitting criteria for the NAII (sizing star)?

And

2) Is there some secret to getting the prongs into your nostrils that I’m just missing?

Actually, there’s a third question. When I call InnoMed, do I beg for a size smaller or two sizes smaller? Is it better to be a trifle too large or small? Hmm, that’s four questions. I mean well...

Thanks, ya’ll!

Ted
(is it a sin to crosspost on cpaptalk and tas?)

[another_guest]

beware -

don't just accept the middle piece -

there seem to be two different sizes of the long tubes - one for small and extra small - other for medium, large, extra large -
when I went and got the nasal aire (not II but I was what the DME had but who knows what I really got) a few weeks ago the dme person had to swap out a extra small set of long tubes for my small prong piece because that was the size I needed and they didn't have a whole small set - they tried to put the small prong piece on a medium set of tubs and that didn't work - they gave me the prong piece out of a set of replacements they had

[judyb]

I used a Nasal Aire during my sleep study and just sort of squished and stuffed the prongs up my nose (they were extra small). They didn't just slide in. It was super comfortable. I understand you should use as large a prong as you can.

Now a question for you -- are you keeping it on by such hooking it behind your ears. I don't know how the tech did mine but it was wonderfully comfortable and stayed all night with no leaks. When I picked up one from the supplier though the gal says this thing doesn't stay on anyone, and sure enough there was no way it did on me. She said that my ears were too close to my head, etc. etc. but I know it worked at the sleep study. I also recognize that the sleep study tech must have done it in a different way than the pictures.

I ended up with an FP Infinity and it is not nearly as comfortable and I worry that it is leaking though am not sure.

Judy

[Gil]

I am no expert but I though my experience with the Nasal Aire II and other masks might be of help.
To give you an idea as to were I am coming from, I have use such mask as FP405, breeze, which I would not recommend at all. I have also tried the Ultra Mirage FULL FACE Mask which was recomened to have in case you get colds and a stopped up head. It may be good we will see. I certainly is not the best for everyday use.
Then I moved up to the Swift and after making a piece to keep the exhaust air from my bed partner it was far superior to any mask I have used. But after time I though it would be nice to have a mask to switch off to from time to time. So I got a Comfort Curve this took a little get used to but was not bad still think the swift was a little better. I also had to replace the cheek pads which left deep imprints in my face that lasted for about 20 hours. My wife was afraid it was going to deform my face.
Then I got the Nasal Aire II. I checked around and called the InnoMed Techn Customer Service: (800) 200-9842 or via email at customerservice@innomedinc.com They sent me the sizing gauge with instructions. I determine that the med plus seems to be the best fit. But was a afraid what if it does not work at about $100.00. I called Cpap.com and after taking to them I felt it was a little risky to get the Nasal Aire II. But then after checking around I found that InnoMed also makes a kit with the Nasal Aire II and three nose pieces for people just starting out like I was. It was a bout $10.00 more but worth the extra price. I called Cpap.com and asked about it and they said they were not aware there was a Kit with three nose pieces. I found a kit with three nose pieces a http://cpapsupplyusa.com And it was on my door step in a couple of days.
In using the Nasal Aire II and I have found it FAR SUPERIOR to any mask I have used. It is the most comfortable all around. I have compared my AHI reading and leak reading by keeping a daily log. With the Nasal Aire II ,I get lower AHI reading and lower leak reading then I did with the Swift or the Comfort Curve. I use the large nose piece . I also have used the med large nose piece and it does Ok to but do get some leakage but still no worst then the Swift or the Comfort Curve. I have had a little problem with the nose piece making my nose sore but at this point it is no bigger problem then I had with the Swift or the Comfort Curve and I can drop back to the smaller size nose piece if I can not correct it. I did find that the nose gauge said I should use a med large and it worked fair but I ended up using one size large then the nose gauge said.
I did have some problem using the head gear. I called InnoMed and she sent me a new style of head gear. But I still did not care for it. I ended up using it as showed at the bottom of the page at the link showing the different way to wear the mask. http://www.innomedinc.com/content/files ... adgear.pdf They call it the figure 8 method and I use a chin strap also that does help to hold it in place.
Again I think the Nasal Aire II is so superior to any mask I have used that I can not say enough about it.
Ther web site is at http://www.innomedinc.com/content/nasal-aire2 and the nane if the kit with three nose pieces are SKU K2X The Innomed Nasal Aire II New patient Setup Kit with 3 Sizes per package is designed for individuals who have never before used or sized a Nasal Aire II nasal interface system. Each package contains 3 sizes of nasal prongs to help the patient find the best fit. These packages include 4 different options 1)Extra Small, Small, and Medium, 2) Small, Medium, and Medium Plus, 3) Medium, Medium Plus, and Large, 4) Medium Plus, Large, and Extra Large.

Hope this helps
Gil
******************************************************

Below is a copy of the instructions I received with the nose gauge; I scanned it in using OCR so they may be a word or two not right.

Instructions for using the Nasal-Aire@ II sizing gauge
There are six sizes available for the Nasal-Aire II. Use the sizing gauge to determine the best fit for your patient. The sizing gauge is star-shaped with three-dimensional prongs. The prong should comfortably fill the nasal passage and should visibly conform to the natural shape of the nare. NOTE: If the patient is not sized properly, leaking and/or irritation may occur.
Helpful hints;
Apply a non-petroleum, water-based emollient (such as RoEzit7JI) to the external
portion of the nostril. This will allow the sizing gauge prong to easily insert into the nostril .!
~ Insert the sizing gauge into the nostril. The proper size should be determined by viewing at all angles around the nostnl to see if the prong has a seal without being uncomfortable for the patient.
~ With the selected size prong positioned inside of the nostril, close the opposite side of the nose by pushing down with one finger. Have the patient exhale slowly out of the prong-occluded side. If a large amount of air escapes, the size is too small. Try the one size higher and follow the same technique. The next size higher should seal; however, you want to make sure it is comfortable. If the rigid port on the sizing gauge is difficult to apply into the nostril then the size is too big. Keep in mind that the walls on the silicone prong of the Nasal-Aire /I is going to be reinforced with positive pressure.
Apply the Nasal-Alre II and confirm the size
~ Place the Nasal-Alre II's nosepiece section (disconnected from the tubing) into the patient's nose. Occlude the tubing holes and vent holes, and have the patient inhale and exhale to check for a proper seal.

~ Connect the Nasal-Alre II to a positive pressure device and apply flow. Occlude the exhalation ports and have patient inhale and exhale; listen for a flow leak .
· If you apply a Nasal-Aire II that is-too Iarge, the walls of the prong will fold in inside the nostril and create a leak. If this occurs, use the next smaller size.
~ Use all headgear components. This method will accurately stabilize the Nasal-Aire II.
Cleaning/Disinfecting the sizing gauge
1. The sizing gauge may be cleaned with mild soap and warm water.
2. InnoMed has validated disinfection of the sizing gauge with Cidex OPA, 20% bleach solution, and pasteurization.
To disinfect with Cidex OPA:
a. Prepare a solution of Cidex OPA (ortho-Phthaladehyde solution) per manufacturer's
instructions. Verify strength of Cidex OPA solution using Cidex OPA test strips.
b. Submerge sizing gauge into the prepared Cidex OPA solution for twelve (12) minutes.
c. Remove sizing gauge and shake excess solution.
d. Rinse three (3) times with clear water. e. Shake excess water from sizing gauge. f. Set aside to air dry.
3. To disinfect with a 20% bleach solution:
a. Prepare solution of 4 parts tap water to 1 part plain, unscented household bleach.
b. Immerse all components in solution and soak for 15 minutes.
c. Rinse with tap water until bleach smell is gone (approximately 2 minutes). d. Shake off excess water and set aside to air dry.
4. The sizing gauge may be disinfected by pasteurization at 63"G for a cycle of 30 minutes.

[another_guest]

hmm

In my whole two nights I have tried the figure 8 style basically since it is the closest to using an oxygen canula which I am used to. I have used the velcro to group the tubing together behind my head to be "tight".

But what about the different sizes of the connectors on the prongs- tubing - being able to try out 3 different ones here at home would have been great - I like the idea of several sizes - I ordered a swift for that reason (which I didn't get from the DME)

I got small nasal aire prong and maybe medium would have been right but I saw at the DME problems with fastening the pieces together of a medium tubing and the small prong piece. I looked again at cpap.com replacement parts and they seem to agree with the idea of two different sizes. I know the tubing I have is from a nasal aire I

[MartiniLover]

I use the NA II, and also find it a great mask. Of the six masks that I have, I rank it in the top two. I just went back to it again, a couple of days ago. I have a fairly new Full Face Mask that I also like.

I was fitted with the mask, as my first mask by the DME, at my request to have a mask that wasn't an over the nose mask. I had done a little homework and knew there were many different types of masks. It just seemed to me that a nasal type mask would be less intrusive.

Fit wise, the NA II should be snug, up inside the nares. At first I used KY to help it slide in and also seal it to the skin. There were times that it seemed difficult to insert in my nose, but now after much use, it just slides in, and no KY needed to seal. It takes the shape of your nose.

I am going to order a new prong (center piece) soon, and I am sure it will be like starting over to get it to mould to my nose shape. I have slotted nares and can see by looking at the prong piece that it has assumed the same shape as my nose.

I wore all the headgear when I first started out, but after reading others posts here about not wearing the headband I decided to try it out and have to say it is a lot easier to wear it with out the headband. As Gil said, the figure 8 in the link http://www.innomedinc.com/content/files ... adgear.pdf shows it very well and it works for me. It is very easy to put on, use, and comfortable, which makes it a mask that works for me. I do have to admit, I do have a large nose, small nares, and big ears to tuck the hoses behind. I am also a side sleeper, who likes to roll over in circles.

All in all, this as I said, it works for me. I am a believer, if the mask works for you, CPAP will also work. When a mask is uncomfortable, it ends up on the floor. I have hundreds of dollars laying on the floor, but offered the miracle of not having OSA, I would spend thousands.

Good Luck in your quest

[Hoover]

I just wanted to add my 2cents...
I used some water based gel to insert the prongs on the Nasalaire II and only did that for a day or two.
I tried the Aura and swift and of the two, the Aura is better, but still not good enough to replace my Nasalaire II. I like the newest headstrap, but I was useing the breathband with just an elastic band on each side to slip the tubes in. The new headstrap does the same thing as the loop is higher and it's all one peice. Hope it helps.
I have a large nose so that may be why I need Nasalaire rather than the pillow puffs.

[wildangel718]

I just recieved my Nasal-Aire II yesterday. I have had one full face mask that I started off with and for the past 6 months I've been using the Breeze. I think this one might actually be better and that's saying alot since I do love the Breeze.
Since it was time to order a new mask I decided on this one. It worked fine last night without much nasal irritation so I'm looking forward to another night. I did have some trouble with inserting it into my nose though. I had wondered about the sizing guide since it came with no directions, but found out how to use it on InnoMeds site on one of the videos. I too was still concerned about whether the size I chose would be the best one. I figured the medium plus was the best. I don't think there was any leakage last night but it was hard for me to tell because it is much more noisy than the Breeze.
Thank you all for the posts about the headgear, I have ordered a breathe band but it's not arrived yet. The instructions with the headgear did not mention anything about the other velcro piece...I was wondering what it was used for!! Now I know!! Anyway, thanks for the post...it helped greatly. And wish me good luck with my 2nd night!