Nasal Pillows for Pressure of 18?

[thegregster]

I've been using Respironics Comfortlite 2 mask with Direct Seal nasal pillows for several years and have found it comfortable and had no major leak problems, but I was only at Bipap pressure of 10/8, which hasn't been controlling my apneas. A new sleep study just titrated me to 18/14. I've been increasing the pressure gradually (while awaiting my referral to the DME) and at 15/12 I'm unable to get the leak rate down to an acceptable level. It's a pretty consistant leak, not just when repositioning, and I'm not mouth breathing. They put a Mirage Swift II on me for the study, which was OK, but I tend to sleep on BOTH sides so I was not sold on the side hose position. As I'll be heading to the DME shortly, any suggestions of other masks to try? I went through 4 or 5 nasal masks without any luck before I landed on the nasal pillows, so I'm partial to them if I can find something that stays sealed at the higher presser.

Thanks.

[rested gal]

There are much newer models of the ResMed Mirage Swift nasal pillows than the old ResMed Mirage Swift II.

See if you can try a ResMed Swift LT or a ResMed Swift FX. Both of those nasal pillows masks have the hose connection in the center of the piece that holds the nasal pillows, instead of at either end like the old Swift II.

Some of sleepnationtv's excellent videos, and their free mask try-out program might be helpful:

Features and step-by-step menus of many machines and their humidifiers:
http://www.cpaplibrary.com/machines.html

Some popular masks and how to fit them:
http://www.cpaplibrary.com/masks.html

Free (except cost of shipping) mask try-out program:
http://www.cpaplibrary.com/mask-trials.html

[rested gal]

Since your ComfortLite II with nasal seal suited you well at lower pressures, you might want to try adding a homemade soft stretchy strap around the front to steady the nasal seal better at your nose for the higher pressures. If that works, you can keep on using the mask you're already accustomed to. I wouldn't be able to use my favorite mask (Headrest nasal pillows) at any pressure, if I didn't add a homemade strap to cradle the pillows better at my nose. Without the strap, it would be too leaky when I turn over frequently. With the extra strap, it's perfect for me.


Using homemade straps -- useful for stablilizing masks other than just the one shown.

http://www.tnlc.com/Lara/laura/osa/aura-strap6ways.jpg

Cutting legs off Pantyhose tights to use as a homemade strap
Score another one for Rested Gal's Pantyhose!
viewtopic.php?p=232922#p232922

DoubleStart Knot How to tie a flat knot behind head when using a homemade strap.
http://www.fieggen.com/shoelace/doublestartknot.htm

My edit: fixing a URL

[TedVPAP]

I've been using Respironics Comfortlite 2 mask with Direct Seal nasal pillows for several years and have found it comfortable and had no major leak problems, but I was only at Bipap pressure of 10/8, which hasn't been controlling my apneas. A new sleep study just titrated me to 18/14. I've been increasing the pressure gradually (while awaiting my referral to the DME) and at 15/12 I'm unable to get the leak rate down to an acceptable level. It's a pretty consistant leak, not just when repositioning, and I'm not mouth breathing. They put a Mirage Swift II on me for the study, which was OK, but I tend to sleep on BOTH sides so I was not sold on the side hose position. As I'll be heading to the DME shortly, any suggestions of other masks to try? I went through 4 or 5 nasal masks without any luck before I landed on the nasal pillows, so I'm partial to them if I can find something that stays sealed at the higher presser.
Thanks.

I am at 19/15 and use Swift LT and like it. I leak out my mouth so I use Ultimate Chin Strap which is the only chin strap that works for me. Why do you think that you are not leaking out of your mouth???

[thegregster]

Thank you rested gal. Even before I read your reply I had added a rubber band and twist tie to the mask which seems to help reduce the leak a bit. I'll have to try the pantyhose trick - maybe add some duct tape for good measure, too. Funnny, the things we do.

And thanks for the mask recommendation, TedVPAP. The doctor told me I should switch to a nasal mask but finally agreed to leave it up to the DME and myself to find something that works. I can actually hear the mask leaking around my nostrils sometimes, especially when I shift and I have to re-adjust it - I think the part that holds the pillows against the nose is just way too "springy" and the higher pressure along with any movement at all just doesn't work well. The leak is relatively consistent and not big peaks and valleys. That along with the fact that my mouth isn't dry and I don't have crusty bits in the corners of my mouth in the morning makes me think it's not mouth breathing. But thanks for questioning it - if other measures don't work I'll definately try some tape or a ching strap.

[Physician]

I could not tolerate nasal pillows when my pressure titrated >12. The air flow was just too noisy. Also found that they didn't feel secure, pushed up on my nose, or the straps pulled up on my cheeks. My doc tells me to avoid pillows if pressure is above 12.

A nasal mask feels more comforting.

[gulfpearl]

My bipap pressure is 21/13 I use the s Swift LT nasal pillows. I have made 2 tweaks to it & I have very few leaks, The first tweak I put a small rubber band around the pillows so they are closer together & secondly I use a strap (like the panty hose fix) to hold them in place. I rarely have any leaks. it's possible to use nasal pillows at high pressures.