finding nasal pillows hard to use

[boosmum]

Hi all. i'm new here and have been on CPAP for 9 days and so for LOVING the results.

I started with the Zest nasal mask but had some very minor issues with puffy eyes and little annoying leaks so the clinic gave me some nasal pillows to use.

I can't use them because no matter what size pillows I put on it feels like I can't breathe out properly and it's REALLY noisy!

I've gone back to the Zest but still not really happy with the puffy eyes thing but it seems like I need an even smaller mask but i'm already using the Petite size and the clinic says unless I get a childs mask they don't think they have anything smaller.

Any suggestions?

[robysue]

I can't use them because no matter what size pillows I put on it feels like I can't breathe out properly and it's REALLY noisy!

Do you know what nasal pillows mask you're trying to make work?

For the breathing out issue, you might want to see if the DME can turn on the C-Flex feature of your APAP machine. If it's already on, you might want to see if the setting can be increased to give you a slightly lower pressure to exhale out against.

The noise issue from the pillows mask makes it sound like you might be using a Swift FX. If the exhaust flow doesn't hit anything, the mask is pretty quiet. But the force of that exhaust flow is pretty significant and if it hits the covers or a pillow, you'll get noise. Also if the hose from the mask is on your pillow, you'll likely feel like the sound of your own breathing is really loud. Some of what you're hearing is noise that is being conducted from the hose, through the pillow, and into your head. Try moving the hose off the pillow to see if that helps.

[boosmum]

I just went to look at it's a Respironics OptiLife it seems. I feel like it's my breathing out that is really noisy not so much the machine and the hose is on my shoulder not the pillow.

I don't think my machine has c-flex, I just chose from the list of what seemed closest to what I have. The manual says it's a REMstar Auto A-Flex and I didn't see that on the list. I might edit my profile to show that. sorry to confuse.

I don't have any trouble breathing out with the nasal mask, only with the pillows. Very annoying because I really hoped they would work for me!

[cflame1]

an AFLEX has both CFLEX and AFLEX... your machine may also have CFLEX plus

[robysue]

To boosmum:

Is either the C-Flex or the A-Flex set on your REMStar? If not, you really should have the DME explain the difference between the two and set up the appropriate one to an appropriate level. Bring the machine, hose, and your nasal pillows mask with you and have them set the C-Flex/A-Flex while you are breathing through the mask at your full pressure to make sure that you're getting some relief on the exhale pressure.

If the hose is on your shoulder, then the excess exhale noise is probably stuff that's being conducted physically from the hose to your shoulder and then to your middle ear from inside your body---kind of like the noise you might hear if you ever "pop"/"crack" your jaw joints. Try moving the hose to see if it helps.

I beileve that you have a full data machine---can anybody confirm that? If so, you might want to get the software (EncoreViewer, if I recall; somebody correct me if I'm wrong) and check out your leak rates.

To cflame1 and anybody else who knows: Can someone explain the difference between the PR REMStar C-Flex and A-Flex options? I'm don't know this since I've got a ResMed with EPR, but I am curious about what the difference between C-Flex and A-Flex is and it might help the OP with his/her problem.

[nanwilson]

Are you breathing out of your mouth?? If so, the noise will be LOUD when you exhale. You will need to either tape, chinstrap, polygrip or whatever method you can think of the keep your mouth closed. Take a read on the subject, just type in the word "tape" and you will see all kinds of solutions.
Nan

[Janknitz]

Can someone explain the difference between the PR REMStar C-Flex and A-Flex options? I'm don't know this since I've got a ResMed with EPR, but I am curious about what the difference between C-Flex and A-Flex is and it might help the OP with his/her problem.

I'm not positive, but it seems to me that if you are operating an Auto machine in CPAP mode (fixed pressure) then you use C-Flex for exhalation pressure relief, and if you are operating in APAP mode (auto-adjusting pressure) then you use A-Flex for exhalation pressure relief. As to any difference between how they work and feel, I have no idea.

Most of the noise in nasal pillow masks is conducted noise in the short hose that connects from the nasal pillows to the large hose. The noise is conducted in your head, so if you try ear plugs it gets LOUDER. It can also be magnified if the hose is on your pillow or touching your shoulders, neck, or head.

You get used to it in time--it used to really bug me but I can barely hear it now. Some things help--using a hose cover dampens the noise a bit. You can also mask it with white noise like a fan, a sound machine, or listening to quiet, calm music through earbuds.

[Jersey Girl]

I had a lot of trouble learning to EXHALE with nasal pillows when I was using a Swift LT for her. Then I tried the Swift FX and I found that it was much EASIER with these particular nasal pillows. So, just because you find it difficult with one mask, doesn't mean that you won't be able to use nasal pillows; you just need to find the most comfortable one for you. Perhaps try another mask?

They now have a SWIFT FX for HER that comes with a small, extra small and medium size nasal pillow.

I went through 4 masks before I found my most favorite. When I get a bad cold (hopefully I will have less of them now that I have a humidifier and am on cpap), I made sure that I have a full face mask on stand by just in case I have to breathe through my mouth.

So, keep on trying!

Best regards,

Jersey Girl

[Muse-Inc]

Ah, my beloved OptiLife pillow mask...pause for a few moments of pleasant memories . While the RT suggested I start with the Medium pillows, I felt like I couldn't get enough air in so I used the Large to the maximum amt of air in and out of my nose. The angle of the pillows is critical on that mask for controlling leaks (noise) and getting comfortable.

Good luck!

[Duane Lord]

Boosmum, I feel as though I could have written your post to the letter. I, too, was using the Zest mask until my eyes suffered so badly that I figured something better had to exist. I bought the Optilife nasal pillows and was so thrilled when they arrived yesterday. I thought they would change my life. Unfortunately, I could not get any one of the four sizes to fit properly and finally gave up. I'll try again tonight, but for now, let me just thank you for posting as you did. I guess misery really does love company, though I am sorry for your problems! Let's hope we both find some improvement soon.

[masketeer]

I use the cradle cushion with my optilife. I find that it supplies much more air into my nose as well as feeling much better than a pillow interface. But the main benefit of the optilife for me is the built in chin strap which keeps my mouth closed.

[cflame1]

closest I can give to an explanation...

CFLEX is for CPAP or APAP... AFLEX is only for APAP (if I remember reading it correctly).

viewtopic.php?f=1&t=44344&p=395623&hili ... on#p395623

or
http://aflex.respironics.com/

[skylark40]

I'm relatively new to cpap, too, not quite two months. I started out with the Swift LT for Her and so far it works just great (if I can keep my mouth taped shut). I'm not familiar with the OptiLife, but I know if I have the nasal pillows slightly askew in my nose that it can seem harder to breathe out. That's easy enough to adjust, though.

I'd go back to your DME as someone above advised. Take your machine and nasal mask, and if they can't get you comfortable with it, see if you can swap the mask for another nasal pillow mask. I was able to swap out a ffm within a 30-day window.

Don't give up. It seems this cpap thing is very much trial and error.

[boosmum]

Thank you everyone for the advice and encouragement.

Last night/this morning I woke up at 3.45am and was WIDE awake. I got up and got a drink etc and then wet back to bed. I thought Hmm.... might try those things one more time. Surprise surprise I actually slept for about an hour or two with them on!!!!!

I think the problem is that my machine starts at pressure 4 but my average pressure is more like 15 or 16 so at 4 I think the pressure is just so very wrong i struggle with it. When I wake up and the machine is on 15 I don't even NOTICE it and have to wave my hand infront of the vent port to make sure it's blowing LOL

I'm going to ring my supplier tomorrow and ask if I can increase the starting pressure somehow.

As a side note i'm in Australia and have rented my machine and mask for 2 months to prove to the doctors I am going to use it before they can "give" me a machine through a government program. It only cost me $90 for the two months!!! I can change my mask as often as I want to during that time for no extra costs

I'm going to try tonight starting with the Zest and swapping over to the nasal pillows just before I actually go to sleep and see if I can manage that.

Oh and someone mentioned they love the chin strap thing.... well I hate it. I have no real "chin" as the underside of my neck is very swollen/fat so that strap kind of just sits there doing not much really. Once I actually OWN my own mask etc... i'll improvise and sew extra bits on if needed to make it feel more secure but for now just gotta live with it I guess.

[skylark40]

Thank you everyone for the advice and encouragement.

Last night/this morning I woke up at 3.45am and was WIDE awake. I got up and got a drink etc and then wet back to bed. I thought Hmm.... might try those things one more time. Surprise surprise I actually slept for about an hour or two with them on!!!!!

I think the problem is that my machine starts at pressure 4 but my average pressure is more like 15 or 16 so at 4 I think the pressure is just so very wrong i struggle with it. When I wake up and the machine is on 15 I don't even NOTICE it and have to wave my hand infront of the vent port to make sure it's blowing LOL

I'm going to ring my supplier tomorrow and ask if I can increase the starting pressure somehow.

As a side note i'm in Australia and have rented my machine and mask for 2 months to prove to the doctors I am going to use it before they can "give" me a machine through a government program. It only cost me $90 for the two months!!! I can change my mask as often as I want to during that time for no extra costs

I'm going to try tonight starting with the Zest and swapping over to the nasal pillows just before I actually go to sleep and see if I can manage that.

Oh and someone mentioned they love the chin strap thing.... well I hate it. I have no real "chin" as the underside of my neck is very swollen/fat so that strap kind of just sits there doing not much really. Once I actually OWN my own mask etc... i'll improvise and sew extra bits on if needed to make it feel more secure but for now just gotta live with it I guess.

Do you know if your machine has a ramp feature - meaning set to start off at a lower pressure and gradually increasing to the full pressure? If so, try not using the ramp feature and just starting off on full pressure. I had trouble with this, too, and finally just turned it off.