Pilaro Nasal Pillow - Nose Irritation

[AICPlanner]

Newbie here. I've poked around the board and found some answers to my question, but the posts didn't focus on the F&P Pilairo specifically so I thought I would throw out a line.

I am new to the CPAP world (2/1/13). I am 38 and went to a sleep study because my wife could not handle the snoring any longer (Neither could my roommates in college 20 years ago). My doc was skeptical but the sleep lab proved my suspicions.

Anyhow, I went with the Pilaro nasal pillow. I am at a 6 and was using pass-through or "1" on the humidity. I used it the first week with success and by the 5th night I was sleeping 8 hours staight with no issues. During the end of the second week, I started to notice an irritation on the inside of my nostrils. I treated with some Neosporin, took a night off from the CPAP, bumped my humidity up to "2" and all seemed well. Then last night (2/17) I felt the irritation coming back/feeling a lot of pain. Took off the pillows/powered down and went back to sleep. Woke up to dried blood on the inside of my nose (both sides) and dried blood on the 'air pillow'. Nose is quite painfull to the touch.

I'm 99% positive I have been wearing the device correctly. Any theories here? Why now, after 2 weeks I am getting this bad irritation and didn't get it after the first few days? Does the silicone pillow maybe just need to be replaced? Thoughts/Comments appreciated.

[HoseCrusher]

One thing to consider is that there may be some residue on the pillows. Do you wash them and if so what soap do you use?

You may be able to boil them and remove any residue.

Another thought is that you may have impregnated the pillows with some mucous and that may be causing some irritation.

[bucksbeek]

I use the Pilairo nasal pillows as well. I had the same issue when I first started it and someone told me to use Lansinoh (lanolin ointment) on/in my nose every night before putting on the mask. You don't need a lot..just a dot will do the trick. You can find it in the baby care aisle with the nursing stuff. Its a bit pricey but the tube will last you forever. Anyway, it worked wonders! I never have any irritation from the mask. I also wear the band just above my ears and straight around my head (not like they show you in the user instructions). I find the mask fits more comfortable for me this way. Try not to use vasoline or any pertroleum based ointment as it can weaken the silicone of the mask. I wash the pillow part of my mask every day with Dawn dish soap and warm water. It will help get the old ointment residue off.

P.S. To answer your other question: I find that because the mask is so light, sometimes when I move during the night my tubing can pull upward on the mask causing a piggy nose type effect. My hose is hung over the headboard. When this happens my nostrils are very sore the next day. Not sure if that's what might be happening with you, but something you could look at.

P.S.S. You could also try a simple saline spray in your nose just in case the air itself is drying out your nose, until you can figure out the humidity issues. I'm also fairly new to this whole process so I'm learning right along with you. But, these are things that have helped me! Good luck!

[AICPlanner]

Thanks Bucks. I adjusted the headband lower and bumped up my humidity to 3 and woke up just fine. My only drawback this morning was the water in the nasal pillow. Felt it leaking onto my face at about 4 am and took it off. So might have to reduce it again and see what happens.

[Pugsy]

Moisture in the nasal pillow is most often caused by a combination of the extra humidity from the machine and the moisture in our own exhaled breath. It simply condenses right in the nasal pillow and we get a cold shower if it comes out the vent or we get to snort some water in the middle of the night. Not conducive to good sleep for sure.
Often this is limited to the winter months when bedroom temps are often cooler because we turn the heat down.
Turning the humidity down is not an option for me...my nasal mucosa get really mad at me when they dry out.
I like a cold bedroom...sleep better with cold bedroom...so I battled rain out (condensation in the nasal pillows) every winter.
I use the Swift FX nasal pillow and Padacheek makes a nice barrel cozy that I use as extra insulation around the nasal pillow. It works wonderfully.
The Pilairo's nasal pillow is made in such a manner it is difficult to create a barrel cozy for it because it needs to inflate.
You might add just a bit of fleece around the short hose in an effort to keep the incoming air, going to the nasal pillow, a little warmer to reduce the chance of condensation.
Increase room temp is an option.
Adding a hose cozy (for the long hose) is an option since it can help keep the incoming moisture laden air a little warmer.
Remember...warm air holds more water than cold air...keep the air a little warmer and we reduce the chance of condensation.

So anything you can do to keep that nasal pillow warmer is going to help reduce the chance of condensation.
Finally...our exhaled breath actually contains more water than a person might think. I have heard from people who don't even use a humidifier and they are getting rain out in the nasal pillows.

You might consider a mask like mine where a barrel cozy is available if your nasal mucosa don't like a reduction in humidity and increasing room temp isn't an option and/or adding some sort of hose cozy doesn't help.
http://www.padacheek.com/PACSwiftII_Barrel_cozy.html

[AICPlanner]

Will do. I'll keep experimenting. I'll take the little bit of water over the nose irrtation any day.

[Pugsy]

I'll take the little bit of water over the nose irrtation any day.

That's where my thoughts are. Snorting a little water is annoying briefly...nose irritation from dryness for me can last several days and make me totally miserable (have run out of water a few times or forgot to fill the humidifier) so I take briefly annoying over miserable days anytime. Though I do try to limit the snorting of water because it disrupts my sleep and that is of course unwanted. That's why I use hose cozies or heated hose and the barrel cozy.

[jencat824]

I have used the Piliaro & loved it. I have some other issues going on, so I'm trying some different masks. My experience with the Piliaro is that irritation does develop over time, not initially, such as it did with you. Follow bucksbeek's advice, since my advice would be the same, except to be careful what you clean the pillow with, it is quite fragile. I would recommed Ivory dish soap, or baby shampoo. These are mild and should not damage the pillow. Although most nasal pillows can be boiled to extend their lifespan, I would not boil the Piliaro, it is so very delicate, I would be afraid that would cause it to tear faster. In my experience, the pillow does eventually tear, I remedied this with superglue, just don't glue any of the part that goes directly into your nostril.

The Piliaro can be a very comfortable mask. I was having mouthbreathing, that's why I've been experimenting, I think part of my leaking was coming from that mask. I have found I get less leaks with some other masks, while I get more leaking with others too. If your numbers are good, I'd stick with the Piliaro if you can get the sores resolved.

If you are not able to use the Piliaro, my next choice would be the SleepWeaver Elan - its a great nasal mask & loved by many forum members, it is nasal mask. The Swift FX is a nasal pillow mask, similar to the Piliaro, but a more traditional nasal pillow design. The Piliaro is the only mask on the market that I know of with the design that 'blows up' to keep the cushion softly on the face. That said, remember all our faces are different, so we each have different needs. If you need to look for another mask, assuming you can't get past the 'sore' stage, I recommend you go to cpap.com, they have the best selection on the web & they host this site. I've bought several masks from them & highly recommend them if you are purchasing out of pocket. Most DME's will take a mask back in under 30 days, & switch it out for another to try. Ask your DME, some have different policies.

Good luck & keep us posted about your progress.
Jen

[cosmo]

How were your sinuses before cpap?

[AICPlanner]

My insurance allows me to get 2 'pillows' per month. Going to exercise that option soon to keep one as a back up in the event of a tear.

Been washing it with Dawn 'clear' dish soap. No fragrance, et al. Seems to be working good so far. The pillows look pretty delicate so I don't see myself boiling them anytime soon. Hope this nose thing clears up as I am noticing a huge difference in my sleep and am not snoring. I am curious about the software discussed on this board. Going to check it out and maybe get a better view of how I am doing with the machine. Thus far, no complaints from my wife or kids on my snoring.

[Pugsy]

I am curious about the software discussed on this board. Going to check it out and maybe get a better view of how I am doing with the machine.

Your profile shows a PR System One Plus CPAP with CFlex + machine.
You probably want to confirm exactly which model machine you have....hopefully you just chose the wrong one in the choices.

Turn the machine over and look on the bottom for a sticker with a 3 digit number on it.
The PR S1 Plus CPAP machine will be either 150, 250 or 260 and unfortunately those models don't gather any useful data on that SD card..all they gather is how many hours you use it each night.
Software won't show anything but hours of use.

To get the full data that you are seeing on the reports we post...you need at least a model 450 machine.
Hopefully you have just chosen the wrong machine in your profile..but if you do indeed have the Plus machine..
you might want to read this...especially the part down at the bottom
http://maskarrayed.wordpress.com/

[AICPlanner]

Thanks. I see I have a "Brick" machine. Bummer. I guess I am not all that concerned about the data, just curious. I have to mail the SD card in to my insurance carrier at some point and can read the hours on the machine. Reviewing my paperwork, I was shocked to see that it is 'rented'.

Had a good night again last night- 8 hours. Must be getting used to the pillow because I woke up twice thinking I had took it off- but it was still there. Hopefully the nose sores don't resurface as it was at the end of the week when I started getting them before. Adjusting the headband level with my ears may have been the solution (Thanks Jencat!) Keeping my fingers crossed.

[Pugsy]

Reviewing my paperwork, I was shocked to see that it is 'rented'.

Depends on your insurance but it is common to "rent" for a period of time (varies between insurance companies) and once they are satisfied that you are going to be using the machine and not toss it in the closet then it normally converts over to a purchase where you own it and there are no more "rent" payments. Normally the "rent" applies to the purchase price.
Don't know what insurance you have but Medicare normally rents for 13 months and then you own it.
You can call your insurance company to find out exactly what it is they do...some rent for 3 months and then the machine is yours.

[AICPlanner]

Not quite at the Medicare age yet. I checked into my insurance before my study and noted they cover DME 100% so no worries here.

[Fr Greg Romanski]

I am new to the Pilaro nasal pillow and two days after changing from the full mask, I, too, had a small but noticeable irritation in my left nostril. It was hard to get rid of (possibly due to Texas high pollen season). A few days of polysporin creme, with better absorption than ointment, took care of it. I clean the thing now every day with Purell and my skin with Neutrogena astringent. Aside from the risk of airborne alcoholism (kidding), does anyone know if these alcohol-based products will degrade any parts of the pillow? Thanks . Greg R.