Please help a new CPAP user!

[Denver80210]

Hi Folks... I've spent a lot of time reading the messages, but thought I would post asking for help...

Me: Male, 38 yrs, BMI 30, moderate sleep apnea (AHI 15), prescribed CPAP at 6 cm H20, just getting started with CPAP. I had signifiant symptoms prior to CPAP and the good news is that CPAP is noticeably improving my symptoms. The bad news for me is that I am having difficulty with my mask fit, which sounds like par for the course.

I got a philips respironics system one CPAP machine, which seems pretty good to me, no issues there. I was given a RESMED full face mask initially. Hated it... kept leaking when I slept on my side, felt like way too much on my face, itches I couldn't scratch, I was miserable.

Swapped out the full face mask for a Resmed swift FX nasal pillow mask. I was given a M and a S set of pillows. The M pillows were suggested by the DME tech. I tried the M pillows for two nights, but they felt too large. They hurt my nose a lot, very sore nose in the morning, and I got pimple like sores on the base of my nose. I tried the S pillows, and they felt better, but were still problematic. It seemed like they leaked unless I tightened the mask, but when I tightened the mask, it hurts my nose. Have sores developing on the tip of my nose and at the base of my nares where they meet my upper lip. I feel like goldilocks... M pillows feel too big, S pillows perhaps too small and don't fit my nose right. My nose is in a lot of pain and I wake up with lots of soreness. Ouch!

Part of the problem is that I sleep on my side. The nasal pillow mask (and full face) seems to leak when I roll on my side. I suspect part of the problem is that I have narrow elliptical nares that have 1/2 the width to length ratio that the pillows have. I feel like I have to tighten the mask down too tight to get the more rounded pillows to fit my narrow nares. I have not tried using jelly/cream to help with the seal yet, but will tonight.

My questions:
-How long do you suffer though sores, nose pain, discomfort before crying uncle and changing masks?
-Do you get used to the nose soreness and work through the sores to get used to the nasal pillow?
-Any tips on how to get a better leak free fit? Minimal info from the DME and the "instructions".
-Are there nasal pillow masks that are better suited for narrow nares?
-I am thinking about trying a nose mask. Maybe a compromise between full face and nasal pillow? Good idea?
-I sleep on my side and seem to have leak problems when doing so. Suggestions? Is a CPAP pillow a good solution or a waste of money?

Reaching out for help! CPAP is helping me sleep, but the mask issues are a struggle. I am fine with the breathing part of the CPAP, just not the mask fit on my face.

Any help would be appreciated!

P.S. I have tried to read through scores of previous posts and have spent hours on the internet trying to get info. I have got a lot of good info thus far! Thanks. Apologies if the questions I asked have already been covered. Its a lot of material to read through!

[Starlette]

Hi Denver.

We just started a North Denver Forum:
viewtopic.php?f=1&t=69041&p=642866&hilit=denver#p642866

This time we're doing "show & tell" of our equipment. You're more than welcome to come.

Starlette

[Emilia]

Get some Lansinoh pure lanolin and put a dab on each nostril opening around edges and just inside each opening to prevent chafing and soreness. I was lucky to read that before I started using my nasal pillows and have used it since night one.... never had so much as an irritation. You find it on the baby aisle of any pharmacy or big store like WalMart/Target.... it is used, normally, by nursing moms to protect their nipples, but it is a godsend for us pillow users. You will find if you use it during the day while getting your current sores to heal and then a little dab each night, you will not only have less soreness, you will also get a much better seal on the pillows because Lansinoh has a tacky texture. Remember that nasal pillows don't go into the nose...only the narrow tips should enter the nostrils with the wider part snugly up against the nostril openings.

[Pugsy]

Here is a video on how to fit the Swift FX nasal pillow mask.
http://www.cpaplibrary.com/nasal-pillows.html

Some written instructions from one of our forum members on her blog.
http://maskarrayed.wordpress.com/swift- ... ing-guide/

When secured properly there should not be pain. Maybe minimal tenderness because the nostrils aren't used to having something stuck to them. The Lansinoh ointment will help some. The most common cause of pain with the nasal pillow mask is that people simply tighten the top strap too much. Pulls the end of the nose upwards a bit.
If not sized properly and they want to slide around all over the nostrils one can have some abrasion like tenderness or pain.

I have used nothing but the nasal pillow mask type for well over 2 years now. I often sleep on my side and end up on my stomach. Other than very minimal tenderness when I first started due to tightening the straps too much, I have zero pain with them.. no redness..no sores.

If your skin is reacting to the silicone and facial oils creating the break outs, you might consider a barrel cozy to cover all but the inner cones which slip inside the nostrils.
http://www.padacheek.com/PACSwiftII_Barrel_cozy.html

[Cpapman11]

Hi Denver.

I am very sorry you are having trouble with your CPAP mask, You are not alone, I have been under CPAP therapy now for 1 month and 3 days, and my BIGGEST problem is that my FF mask leaks way too much during my sleep, I don't notice it, but I know my mask is leaking, and I end up with some pain above my eyes when I wake up.

What has been working for me somewhat are looking at videos that have people demonstrating how to solve CPAP mask leak issues on Youtube. There are alot of useful content there, I recommend you try watching them. I've used some of the tips that he show and Ive had good results, my problems are not eliminated completely, but I still press on and try other ways to help my problem, washing the inside of your mask with mild hand soap seems to help a great bit on stopping my mask leaks, but you have to wash your mask almost daily to get a good result. Also, you may try pulling your mask away from your face and let the air blow out the mask seal, then put your mask over your face again, the seal will act as a cushion and may seal around your face much better after you've done it.

Hope That helps!, Good luck, Happy CPAPing!

Jose

[Carl LaFong]

Seems like I get the "nasal zits" when I don't wash the pillows often enough. I try to do that every night now.

Be sure the mask isn't tight. Snug, but not tight. I keep the top strap rather loose, just enough to keep it on my head. I know it's right when I barely notice the mask is there. If you play golf, softball or racket sports, it's like that swing where you hit the ball a ton but don't feel the impact.

[JeffL]

The technique I've been using the last few nights, is to "unlatch" one side of the Velcro strap, then slowing pull the strap tight just until the hissing stops. That seems to give me a comfortable fit... at least until I reposition myself while sleeping.