Any presure limits for pillows (Swift)

[LarryPer123]

My bipap pressure is 12/9
I heard this may be too much pressure for the swift or other pillows
I can't do full face any more

Many Thanks Larry

[rested gal]

Although DMEs often seem to tell people this pressure or that pressure is "too high" for nasal pillows, or they say "nasal pillows can't be used at pressures over ___" (usually they pick "15" as the cutoff pressure for pillows) I don't think they are right.

If anything, I think nasal pillows are likely to hold a seal better than regular nasal masks or FF masks at high pressure. Pillows have less "perimeter" to have to maintain a seal against high pressures.

Possibly the DMEs think the nasal passages will be bothered by higher pressures blowing the air more directly into the nostrils, but I believe that's an individual thing.

There are people on this forum who use nasal pillows comfortably and effectively at pressures of 18, 19, 20, etc.

[Pugsy]

I use the Swift FX nasal pillows (before that the Swift LT) my pressures are 10 minimum and 20 maximum. While I don't hit 20 often any more I do hit 16 to 18 couple times a week. Never had a problem with seal. I still have a nice straight line almost entirely on zero line. Sleep right through it. No leaks, no hissing, no repositioning needed.

[Janknitz]

15 here with NO problems. The higher the Pressure the better they fill with air and seal against the outside of your nose. I've heard of people using them up to 25 cm on bipap.

[dae3dae3]

Currently at 15.5 with Swift FX. No problems at all with leaks.

[Marietjie]

(This story seems to be a great summary of why we help one another ... because it makes a difference. It makes a difference for other folks on their CPAP journey.
- JohnBFisher) - John, I agree - For two nights I used KY jelly as recommended by undermentioned members and it works 100% for me - thanks for helping me on my CPAP journey!

The brochure that comes with it says it is tested to pressure 20. My BiPAP pressures are currently 18/14 and I have no
problem with Swift FX pillows. I use a dab of K-Y Jelly to make a good seal.

I also use Swift FX and it works great with the Jelly. Thank You Lars4Life!

[JustWannaGo2Sleep]

My machine came with a 4/20 setting. I strongly suspect that the attitude was to leave the thing at the extremes and let the machine make adjustments as necessary. I have no issues with high pressure (much to my astonishment!); in fact I really like high pressure. I find that I'm gasping for air at lower pressures. I have been gradually raising the lower pressure and am now at 8. It's almost bearable on my Comfort Classic but it still feels too low when I use my Swift.

I notice that the hose attached to the Swift is significantly narrower than the one attached to the Comfort Classic. I know that my machine (Remstar Auto AFlex, the one with the big twisty knob) has a 15mm vs 22mm diameter setting, but it takes care to lock it down unless you are really supposed to use it. I wonder if I should make the adjustment.

If I do switch to 15mm setting, will I have issues when I swap out the Swift for the Comfort Classic in the middle of the night?

[Kilgore Trout]

This thread rocks, I'm buying a Swift FX mask!

[chunkyfrog]

Swift is good. Still my most comfortable mask.
I hate when my nose is too stuffy to use it.
Gotta break out the Neti Pot. (Havent done it yet; I'm chicken--cluck!)

[LinkC]

Nipple grease...a little dab'll do ya!

[Shellie_p]

started the swift lt for her pillows with settings of 15/20 bumped them up to 17/22 on my bipap and the pillows are doing just fine. I WISH I had started using pillows years ago. But i was told the same thing that you cant use them with pressures over 12 is what i was told.

the BS RT's and DME's tell us..

[Breathe Jimbo]

No problem whatsoever at 14 & EPR 2.

[rested gal]

I've got a theory about why it's so common for DMEs to tell people "can't use nasal pillows at pressures higher than blah-blah." It's been pretty much standard for the past several years for people to receive a heated humidifier with their CPAP. But there was a time, not that many years ago, when insurance would not pay for a humidifier at all, much less a heated humidifier, until a person had used CPAP without a humidifier and had serious problems.

You had to "prove" (think nose bleeds, stinging burning pain inside nostrils) that CPAP was intolerable without heated humidification before insurance would pony up for one. Maybe the direct delivery of nonhumidified air into the nostrils was more of a problem for people back then. Although, now that I think about it, the only nasal pillows around back then were the Breeze and the Adams Circuit masks.

Ok, another theory then... Maybe it's just something that one non-CPAP using DME or RT or doctor intuitively thought would be so, said it to a colleague, and it got passed around as people changed jobs until it became an urban bricks/mortar DME legend, and DME employees were trained that way. Trained to the tune of an old wives tale.

Or... some hapless, helpless cpap users were given the good old DME "mask fitting", sent home with nasal pillows too small and had all kinds of trouble keeping them sealed. DME jumped to the conclusion that ___ pressure was blowing them out of the person's nose, instead of realizing the fit was wrong. Many DMEs do seem to think nasal pillows are supposed to be small enough to insert up into the nostrils. For most people though, a bigger size than the DME (or even the new CPAP user) would think they needed, is usually better. Nasal pillows should fit against the outside of the nares (the rim of the nostril openings) with barely the tip of the pillows inside.

And then there's the hose tugging on masks, moving pillows out of place. And the need for some toss 'n turn sleepers to add a cradling homemade strap to keep pillows steadily in place. All kinds of reasons why nasal pillows work/don't work, that have nothing to do with the amount of CPAP pressure being delivered.

[Shellie_p]

I've got a theory about why it's so common for DMEs to tell people "can't use nasal pillows at pressures higher than blah-blah." It's been pretty much standard for the past several years for people to receive a heated humidifier with their CPAP. But there was a time, not that many years ago, when insurance would not pay for a humidifier at all, much less a heated humidifier, until a person had used CPAP without a humidifier and had serious problems.

You had to "prove" (think nose bleeds, stinging burning pain inside nostrils) that CPAP was intolerable without heated humidification before insurance would pony up for one. Maybe the direct delivery of nonhumidified air into the nostrils was more of a problem for people back then. Although, now that I think about it, the only nasal pillows around back then were the Breeze and the Adams Circuit masks.

Ok, another theory then... Maybe it's just something that one non-CPAP using DME or RT or doctor intuitively thought would be so, said it to a colleague, and it got passed around as people changed jobs until it became an urban bricks/mortar DME legend, and DME employees were trained that way. Trained to the tune of an old wives tale.

Or... some hapless, helpless cpap users were given the good old DME "mask fitting", sent home with nasal pillows too small and had all kinds of trouble keeping them sealed. DME jumped to the conclusion that ___ pressure was blowing them out of the person's nose, instead of realizing the fit was wrong. Many DMEs do seem to think nasal pillows are supposed to be small enough to insert up into the nostrils. For most people though, a bigger size than the DME (or even the new CPAP user) would think they needed, is usually better. Nasal pillows should fit against the outside of the nares (the rim of the nostril openings) with barely the tip of the pillows inside.

And then there's the hose tugging on masks, moving pillows out of place. And the need for some toss 'n turn sleepers to add a cradling homemade strap to keep pillows steadily in place. All kinds of reasons why nasal pillows work/don't work, that have nothing to do with the amount of CPAP pressure being delivered.

But it makes you wonder.. Don't the DME's have some kind of training program for the people who have to fit us with this stuff. I mean there are a handfull of basics even a non hose head can pick up with half an ounce of common sense. A few hours of time in a place like this makes most of us who come here more knowledgeable then the people who perscribe and dispense our equipment.
Theres something seriously FLAWED with this system.

I'm lucky since the 2 RT's i deal with at my local apria are ALSO CPAP users.. however past ones werent and i've heard all the older *Myths* that way.

[HoseCrusher]

"half an ounce of common sense..." You know how rare that is and how much that would be worth?