Swift LT and pain throughout the night

[MichaelWalker]

Hi all.

I've only been on CPAP for four days but I'm having a problem I can't seem to fix. I fit my Swift LT perfectly the first night I wore it... had absolutely no problems with leaks, comfort or keeping it on all night. It seems that was just luck, however. On nights 2, 3 and now 4, I've woken up just a few hours in to sleep with the inside of my nose and the upper part of my lip hurting like hell. Not fully conscious, I've slipped the mask off each night and am getting little restful sleep.

Again, the first night I adjusted and wore the mask perfectly, somehow. The second night I didn't modify the "tightness" of the straps at all but had the pain problem. The third and fourth I've tried to re-adjust the tightness of the mask but with the same problems.

Any idea's on what I could do differently? How do you all fit the pillows just inside your nose without them rubbing against the inside and causing pain? How can I keep the fit tight enough not to leak but not hurt the upper part of my lip after a couple hours use? Any ideas would be greatly appreciated.

Here are the last two nights reports if it's of any use to you:





Thank you and have a great day.
Michael

[twokatmew]

I had a lot of pain from the XS pillows, but when I switched to the S pillows, I had none of that. At first I thought the S pillows would be too large, but I found that I have fewer leaks and am more comfortable with the larger pillow. When my upper lip was hurting, I found that I had the back strap too tight. I loosened it and let the short hose track downward. When I hooked the short hose into the hose clip at the top of the headgear, it tended to pull the pillows up, and I get a better seal without the hose pulling on the headgear. Once I unclipped the short hose from the headgear, I was able to loosen the top strap, too.

[Marietjie]

inside of my nose

Michael, I use Lansinoh (Nipple cream) inside my nose.
It also helps for a better seal.

I replaced the tube retainer with a piece of double
sided velcro. Slide it through the buckle with the
soft part of the velcro facing the straps.
This holds the short tube still. With the retainer
it tends to pull the nasal pillows up and can hurt
your nose.

GoodLuck for tonight!

[Hawthorne]

I was wondering, as some of the previous posters have said, if you are using the right size nasal pillow for you. If it's too big, it can cause that soreness in the upper part of your lip.

I was also going to suggest the lanolin (Lansinoh) cream or Ayr Nasal Gel for the soreness inside your nose. That could also be related to the nasal pillow size you are using as well.

Good luck!

[timbalionguy]

I don't know if this applies to the Swift LT pillows, but if the opening in the top of the pillow is oval, the angle that oval is at can affect comfort. I am also finding that after a couple of months of using nasla pillows (on a hybrid mask), problems wit discomfort from the nasal pillows is diminishing.

Nice cheetah, Marietjie! Hawthorne's cats are cool, too.

[MichaelWalker]

Thank you for the replies.

Tonight and tomorrow I'll try both the smaller and larger pillows and adjusting the back strap to loosen it a bit more. It also happens my wife just finished breast feeding our 1 yr old so I happen to have some Lansinoh as well! I'll try that tonight too. I'll also try the velcro tip with the hose instead of the clip. It also seems from your post, timbalionguy, that the pillows "break in" a bit after use for a while. I wonder if any of you help speed that process along by "softening" it in boiled water or any other method?

I was hoping to avoid snaking the hose over my head and strapping it on to the headgear, but it sounds like thats how you all wear yours for the most comfort. I assume some of you have tried having the hose hanging freely from the pillows but it tugged too much on the apparatus? Was this mainly a comfort problem or did it cause too many leaks as well? I'm wondering how I can best snake the hose behind my pillow but still having enough hose play for me to turn my head during the night without strapping it to my head. Maybe its just not doable and be comfortable/non-leaking?

When I hooked the short hose into the hose clip at the top of the headgear, it tended to pull the pillows up, and I get a better seal without the hose pulling on the headgear. Once I unclipped the short hose from the headgear, I was able to loosen the top strap, too.

I'm not quite visualizing what you mean, twokatmew. You hook the short hose into the clip at the top of the headgear and that seemed to give you a better seal without any pulling from the hose. But you also unclipped the short hose from the headgear so you could loosen the top strap as well. I'm sure I'm being dense but could you clarify if you wear the short hose clipped at the headgear or in some other fashion?

Thank you all for your help... I very much appreciate the tips and experience you share here.

Michael

[twokatmew]

When I hooked the short hose into the hose clip at the top of the headgear, it tended to pull the pillows up, and I get a better seal without the hose pulling on the headgear. Once I unclipped the short hose from the headgear, I was able to loosen the top strap, too.

I'm not quite visualizing what you mean, twokatmew. You hook the short hose into the clip at the top of the headgear and that seemed to give you a better seal without any pulling from the hose. But you also unclipped the short hose from the headgear so you could loosen the top strap as well. I'm sure I'm being dense but could you clarify if you wear the short hose clipped at the headgear or in some other fashion?

Thank you all for your help... I very much appreciate the tips and experience you share here.

Michael

Oh sorry, I wasn't clear. At first I clipped the short hose into the plastic tube retainer on the top strap of the headgear. I found that the weight of the hose in the retainer pulled up on the pillows and away from my face, which actually broke the seal and caused me some pain under my nose. Once I let the short tube "roam free," so to speak, I found that my nose was more comfortable, and the seal was better. It took me several days for my nose to get used to the pillows, and now I use a little Lansinoh in my nares. I just put a tiny bit on a Q-tip and apply it that way.

As far as trying to soften the pillows, I wouldn't. There's another thread on Swift LT pillow quality, and it seems there are softer and firmer pillows. Many of us in the thread have noticed that the slightly firmer pillows seal better.

When I do get leaks using the Swift LT, it seems it's mostly around my right nostril on the side close to my lip. I wake up with that telltale hissing sound and sometimes a cold spot. On the nights I manage to keep a good seal through the night, it's great!

I hope this helps. Lemme know if I'm still not clear.

[plr66]

Michael, I’ve been a vocal proponent of the Swift LT here for the past 10+ months, and have been easily able to keep my leak rate absolutely steady at 24 (using pressure of 10 or 10.5), and AHI below 1.0 for most of that time. Quite remarkable, IMO.

Do NOT boil your nasal pillow!!! Your nose is the part that needs to get broken in--not the pillow! The life of this expensive equipment is short enough for the cost, that you should not take such risks of destroying the stuff.

I remember that I had pretty raw pain of my nairs for the first 2 weeks, and so used a FFM for a few days in the middle of that, to give them a rest. I also used Aloe hand lotion liberally on the whole sore area of my nose, both inner & outer edges, many times per day. Ayr saline gel was what I used up into the inside of each nostril—and these routines greatly reduced the pain to nearly zero after the first 2 weeks. Really. I think lanolin may be even more helpful, but never tried it at the time.

I am one who completely hated the hose routed over my head. Tried it for just one night and it resulted in horrible rainout, and created additional pressure on my nose that I did not like at all. Everybody’s different. I have always allowed my hose to hang freely, and quickly developed a habit of always rolling over from one side to the other on my back and gently holding the hose down in front of me as I turn, so the mask is not dislodged.

For these reasons, I have always recommended that folks keep the top strap loose (not quite snugged against the top of your head), and the back strap just tight enough to take up all slack without stretching the straps.

One other critical adjustment to play with (well before bedtime), is the tilt of the nasal apparatus on its hinges. Tilt it in each direction until you lessen the feeling of pressure by the bulb part against your upper lip. But also find the sweet spot where there is no feeling of the air being constricted as you breathe in. You’ll see what I mean as you do this. Edit: Of course, find the place where there is also no air whatever escaping from the nasal pieces.

Hope all this is clear, but if not, keep asking. Despite some quality problems with the pillows which ResMed may eventually clear up—this is a great mask. (See viewtopic.php?f=1&t=41729&st=0&sk=t&sd=a). I’ll defer to others to comment on your data reports.

[Hawthorne]

I think, with the right size nasal pillows, and the Lansinoh, you are going to adapt to this mask. Strap adjustment, as others have said is important as well. I had trouble with the top strap slipping so I put pieces of Velcro each side (as in the picture) once I got it right.

The light blue is a strap guard that comes with the "SwiftLT for Her". I have both and use the strap guard on both.