New CPAP user - sent home with Not For Sale nose pillow mask

So I’m about two and half weeks into my CPAP - and I got this nasal pillow mask from my sleep center (I’ve got a full beard and mustache)
I’m getting some sore spots on the inside of my septum and when I went to look up how to deal with it, I mostly saw things about right sizing the pillows and loosening the straps.

I’m a little concerned about what I was sent home with having paid for all of these parts...my pillow mask is labeled as “not for sale” and the straps have no adjustment at all - is this normal? I feel like I got sent home with something that I should not have? I’ve worn it everyday save one night a coupe days ago to give my sores a rest. I know there’s some ointments out there to help - but I feel like they passed off a cheap nose pillow mask on me that wasn’t supposed to be “sold” to me to begin with - and that’s the root of my problem?

Is this normal practice? It’s been working for me so I wanna keep it up.

Welcome to the forum.

That mask is actually the ResMed AirFit P10 nasal pillow mask. Not a "cheap" mask at all. It's the one I have used for several years now.

Sleep labs will often get mask packages given to them from the mask manufacturers. They aren't supposed to be sold but instead used during the titration sleep study for patients to try on and decide if that's the one that they want to use or not.

Did you have an in lab sleep study where you used this mask? If so it's quite common for the patient to be sent home with what they slept with during the titration part of the sleep study. It's part of the sleep study costs.
Now if you got your machine and this mask from the sleep center and paid a separate fee for the mask and you didn't use it during the titration study...they aren't supposed to do that. The masks are given to them so they shouldn't be selling them.

It's the same mask package as I might buy though...the manufacturers don't donate/give cheaper versions of any mask when they donate to sleep centers. Same product just a different package. Mask manufacturers want you to be happy with their mask so that you will request it often and they sell more of them. They give the sleep centers the same quality masks as they sell to anyone else.
Everyone gets the same product at the same quality....just some are given away and aren't supposed to be sold.

The question is, did you get charged for a new mask and did your insurance pay for a new mask? Or did they just give you this one to keep since they would have to throw it out anyway?

My guess is they just gave you this mask, and a new mask has not been ordered for you because in most states the "Sleep Lab" cannot also act as your DME. So that means that you should still be able to order a brand new mask covered by insurance--if you don't like the one you are using you can explore other masks (talk to the DME).

Even if your insurance did pay for that mask, chances are the pillows are wearing out. A fresh set of pillows may do the trick, if they were doing well in the beginning. Most insurers follow Medicare replacement guidelines which permit up to two sets of nasal pillows per month. You should check with your insurer to find out if they paid for a new mask and what their replacement schedule is.

Pugsy wrote: ↑

Mon Jun 25, 2018 3:43 pm

Did you have an in lab sleep study where you used this mask? If so it's quite common for the patient to be sent home with what they slept with during the titration part of the sleep study. It's part of the sleep study costs.

So great info Pugsy - thanks - So yes - it’s the same mask I used during the sleep study. I’ve been told I’ve got 30 days to change it for a new one, but the only option for pillows was this one. I guess my concern is more about the head strap and lack of adjustability? It feels like if I could just give it another inch it would be better but there’s no way to adjust it. It feels just a bit too tight.

Janknitz wrote: ↑

Mon Jun 25, 2018 6:11 pm

The question is, did you get charged for a new mask and did your insurance pay for a new mask? Or did they just give you this one to keep since they would have to throw it out anyway?

My guess is they just gave you this mask, and a new mask has not been ordered for you because in most states the "Sleep Lab" cannot also act as your DME. So that means that you should still be able to order a brand new mask covered by insurance--if you don't like the one you are using you can explore other masks (talk to the DME).

Even if your insurance did pay for that mask, chances are the pillows are wearing out. A fresh set of pillows may do the trick, if they were doing well in the beginning. Most insurers follow Medicare replacement guidelines which permit up to two sets of nasal pillows per month. You should check with your insurer to find out if they paid for a new mask and what their replacement schedule is.

Hey Janknitz...so I’m fresh into this - week three of the CPAP and honestly started out thinking this was expensive witchcraft and only went through all of this because my wife insisted - but damn it seems to be helping! Very surprising - and so I’m going all in even though my sleep center dr is crappy...I’m on my own.

- So what’s DME?

- I’ve only had the mask for about 3 weeks - I think it’s more about the head straps? There’s no way to adjust them to lossen them up. But I’m interested in understanding more about the two sets of pillows per month? My sleep center told me I could get a new mask once every three months?

LincolnCowhuntet wrote: ↑

Mon Jun 25, 2018 11:32 pm

I guess my concern is more about the head strap and lack of adjustability? It feels like if I could just give it another inch it would be better but there’s no way to adjust it. It feels just a bit too tight.

Have a look: https://www.youtube.com/watch?v=MylY6a6KXMY

LincolnCowhuntet wrote: ↑

Mon Jun 25, 2018 11:32 pm

I guess my concern is more about the head strap and lack of adjustability? It feels like if I could just give it another inch it would be better but there’s no way to adjust it. It feels just a bit too tight.

There is adjustment but it's with the separation or closeness of the 2 straps and sometimes for some people with larger heads it simply isn't quite enough.
The good news is the headgear will stretch over time. The bad news is the headgear will stretch over time. Which it is depends on if you have a small head or a big head and how much it stretches.

You can force faster stretching...place the headgear over something rather large like a basketball when not on your head.
You can even modify the headgear if you are handy by cutting the headgear and sewing additional elastic strip (small strip) to add a bit of length.

Alternately you could switch to the ResMed Swift FX nasal pillow which has headgear that is much more adjustable and the pillows themselves are very similar to the P10 pillows. The down side is the venting...the Swift FX venting isn't so silent nor is it diffused like the P10. With the P10 you can't really feel the air being vented unless your hand is about an inch away from the holes....with the Swift FX your bed partner may get a not so nice blast of cold air.

I have been on this cpap therapy for over 9 years now. Always a nasal pillow user and I have tried pretty much all the various pillow masks out there. The P10 isn't perfect but for me it checks off almost all my preferences boxes.

You might also look at the F & P Brevida...it has diffused venting as optional and the headgear is more adjustable.
It's a nasal pillow mask but the cushion part that goes on the nostril area is a bit more billowy. It's a nice mask but I personally found that the billowiness (made up word because I can't think of a better term) of the overall pillow a bit annoying but others don't mind it.
The nasal pillow material is super soft and comfy and as with any mask there can be good and bad. The good is how soft it is...the bad is that the softness can cause the pillow cushion to inflate and deflate for some people to the point of it being annoying. Doesn't happen to everyone though but it did annoy me a bit. It annoyed me more than the headgear on the P10 annoyed me. Sometimes we have to choose the lessor of the annoying.

I have yet to find a perfect mask...always something but then I have really high standards as to the boxes that a mask needs to check off. Masks all come with a huge YMMV sticker. Your personal preferences, wants, needs might be different from mine so what you might love I might hate and what I might love you might hate. It's just the way of life for any mask out there. The only way for you to know is by trying something. Expensive experiments though unless insurance pays.

DME stands for Durable Medical Equipment and it's the term we use for whomever is supplying you the cpap equipment.

Insurance usually has a replacement allowance schedule for this equipment. Often the insurance company will mimic Medicare's replacement schedule and I will insert a picture of the Medicare replacement allowance schedule below. You will need to check to see if your insurance uses the Medicare schedule and adjust accordingly if it doesn't.
Medicare allows a 2 pillow replacement per month...and a new mask ever 3 months but without headgear (but sometimes the DME just will go ahead and include the headgear in the package) and every 6 months with headgear. So Medicare only pays for the headgear every 6 months. Some DMEs will do the 3 month thing and not expect to be paid for the headgear portion. Some won't (mine won't..I get a new mask every 6 months). Sounds like yours might if they told you a new mask in 3 months.
You and use the 3 month allowance to try new masks if you wish.

Nasal pillow life...Medicare (and most insurance) allow 2 per month. Most people find that they will last a lot longer than 2 weeks.
I have always got months and months and months of life out of any nasal pillow mask I have ever used. Your mileage may vary though.
Again something that you will need to sort out for yourself.

The replacement schedule will have to wait until I can go find it. My image hosting site is down at the moment.
Will get it for you later when I can find it again.

Here's that replacement schedule. Your insurance may or may not have the same schedule and you need to check with your insurance to confirm.

They gave you a great mask, and for free! You can make adjustments by widening or pulling closer together, the two straps. Eventually they get stretchy and loose, so you can wash them in hot soapy water and it will come back to life somewhat.

A DME tried to SELL me a mask with that label--for full price!
I said, "No, thanks", and never returned to that wretched hive of scum and villiany..

What Pugsy said!

The way I see it, your insurance could not have yet provided you with a mask (Samples are NOT for sale) So you should still be eligible for an entire new one. So if you want to try out a new mask, now's the time.

I also highly recommend the Dreamware mask. It has a choice of nasal pillows or a unique soft silicone tube that runs across the bottom of your nose with a slit to push air into the nostrils. The headgear is adjustable.