Nose cushions are for low pressures

[profoundapena]

I just wanted to post for all newbies that those like me with pressures over 16 probably can't use nose cushions or the other nasal masks. My technican told me this; it has to do with the size of your nasal passages I think. The pressure seems like your head is going to burst, so don't even try the "pillows." Nor that expensive liberty mask. I tried it and it was quite uncomfy. Quattro is the deal; just tighten the bands down, even if they feel very tight.

[Amigo]

I disagree completely.

You're trying to limit people's options prematurely.

Everyone's nasal anatomy and tolerance levels differ, and for those with any claustrophobia problems, nasal pillows are a godsend.

People should be encouraged to try ALL options...including nasal pillows at higher pressures.

[akcpapguy]

Your technician gave you bad information. Nasal pillows CAN and DO work for people who have pressures over 16 cmH2O.

[GumbyCT]

I use Aeiomed Headrest nasal pillows successfully at 18cm and wouldn't trade for a full face or nasal mask.

The nose will do just what it is designed to - regulate air flow.

It may be time to find another RT or DME.

[Patrick A]

I use the Opti-Life Nasal Pillow set up. Before that I was using the Mirage Swift II Nasal Pillow, I forget what the other two nasl pillow setup's I used but I didn't like them....not the pillows but the way they came over my forehead. When I started using the Mirage Swift II I was using a Remstar Pro 2 machine with a 20cm setting.
Since I have been on BiPap my setting is 25/10cm so I would say that you can use them I have been on C-Pap since 2005. The clowns at Apria Ripoff told me the same thing and they stuck me with a cheap mask. While they billed my insurance full bore for the piece of junk mask and piece of junk machine (a Remstar Plus, but they charged the same price as if it was a Remstar Pro2 Auto) So by all means tell them (your DME) to pound salt. You are the customer if they won't give you what you want go to Cpap.com and buy what you want. For that matter buy your supplies from Cpap.Com any way!

[roster]

just tighten the bands down, even if they feel very tight.

Also very bad advice. The masks are designed to be adjusted lightly. Overtightening can cause more leaks, bad irritation of the face and nose bridge, and interruption of sleep.

Thinking the mask needs to be tight is a major reason for failure and walking away from CPAP.

[DaveMunson]

My reaction is that the tech is right. Just my experience. Blew the little suckers right off the nose when I tried years ago. I'm suprised that so many can make a go of it but I do not know the brands mentioned. When it was me, the DME admitted that she never seen anyone have success with high pressure and the nose cushions.

[cobra4x4]

My reaction is that the tech is right. Just my experience. Blew the little suckers right off the nose when I tried years ago. I'm suprised that so many can make a go of it but I do not know the brands mentioned. When it was me, the DME admitted that she never seen anyone have success with high pressure and the nose cushions.

I'm sure technology advancements in the past year or two have made a huge difference in the ability for nasal pillows to withstand the higher pressures.

I also think his technician has given him incorrect advise.

[robink]

I also crank the straps down tight on a Quattro full face mask. I often hear the idea that the mask should float lightly on the face but for me, that is a bit of fantastic wishful thinking.

[sleepmba]

I just wanted to post for all newbies that those like me with pressures over 16 probably can't use nose cushions or the other nasal masks. My technican told me this; it has to do with the size of your nasal passages I think. The pressure seems like your head is going to burst, so don't even try the "pillows." Nor that expensive liberty mask. I tried it and it was quite uncomfy. Quattro is the deal; just tighten the bands down, even if they feel very tight.

I also disagree. I have performed many a titration at higher pressures with nasal pillows and nasal/ triangle masks with success. I would say I have used these style masks more often than full face masks in the higher pressures. However, for some people, full face is the way to go. To each his own when it comes to masks...no matter what the pressure.

[WearyOne]

My husband received the same from his DME, that with his pressure of 19 he wouldn't be able to use a mask like mine or any pillow-type mask, only FF. (I had asked her about a mask like mine, the Hybrid.) He still did try mine for about a minute and couldn't stand it. He took to the high pressure quite well with the Quattro, but does have to tighten it down or it leaks every time he moves. Even though floating the mask is what is supposed to work, from some posts I've read on here in the past, it doesn't work for everybody.

[profoundapena]

Just remember the old proverb, "Opinions are like backsides; everybody's got one." My experience is unique; your experience may vary.

Thanks to the nay sayers, but I point out their tone, that they do not mention their own pressures (probably because they are low), or they use face masks. My intention was to help newbies and I think I angered some of the nose cushion manufacturers. I thoroughly researched this online and tried all the latest and most expensive masks. I experienced first hand the pressure difference of 21cm in my nose, which, by the way, is not designed as a pressure regulator. Its purpose is to filter and warm air and smell, and perhaps if you are an Eskimo, to kiss.

My technician, whom some here have maligned, not only patiently let me try on 7 masks over the course of a month, but also gave me a set of Pad-a-Cheeks for free! He also gave me a free quattro, which is worth about $170. He spends all day working for a DME that sells nothing but sleep apnea products, has done it for years, and seemed very competent. Plus my trial period is over and I have no intention of buying a new mask with my own cash. That's what my health plan is for.

Masks I tried:

ResMed
Fit Life Total Face Mask, Mirage Quattro, Ultra Mirage, Mirage Libery
Phillips
Mirage Liberty, Comfort Full 2
Fischer Paykell
Flexi-Fit

[Tielman]

Thanks to the nay sayers, but I point out their tone, that they do not mention their own pressures (probably because they are low), or they use face masks.

Interesting, I read at least 3 people with pressures at or above 16, including one at 18, and one at 19 that personally use either Nasal Masks, or Pillows.

I don't find them "nay sayers", I find them to be "informed" opinions because they actually use the products at higher pressures than what you suggest. I would also mention that both of the ResMed pillow masks clearly state that they are good up to 20 cm.

I believe that this again boils down to a personal comfort issue, and should not be broadly brushed as "nobody should use them", nor "everyone should use them". Find what works for you, and use it, at least that's my opinion.

[deerhound]

I use the Swift FX with my BiPAP set at 10 - 18. I don't have any problems with the pressure with nasal pillows. I didn't have pressure problems with my Swift II either. I sleep much better now than I did with my FF masks of various brands.

Dale

[DreamStalker]

Yep.

Everyone is different. I think the main issue with nasal interfaces and high pressure is that some may have issues with mouth leaks. Some are able to tolerate the higher pressure by mitigating mouth leaks in some way. On the other hand, FF masks have more surface are to seal on a convoluted facial surface and thus seal leaks can become a problem at higher pressures.

It really is what works best for each individual so try as many different masks and headgear adjustment variations as possible.