Help Finding a Nasal Pillow Mask

Hello everyone. I need a bit of help due to a recent medical change. I’m on a medicine that causes nasal congestion on top of my existing allergies. I have been on a Cpap for 5+ years and use it “religiously”. My favorite mask has always been a P10 and it has worked well up to now. I have tried full face masks and just can do it. I also have a N30 that I can wear but I don’t like the mask. I have trouble with the N30 maintaining a good seal no matter how well I adjust it (but I do like the head top hose).

So here is the problem. The P10 is hailed as quiet due to the tight mesh exhale vent. With my newfound congestion I simply cannot get enough air to exhale. At that point I start breathing through my mouth and close off my nose to catch my breath. That makes my ASV flip out no matter how easy the RT sets up the machine for exhale. I need a nasal pillow mask that is not as “quiet” and is more exhale friendly. The N30 is more exhale friendly and that’s why I think I can stay on a pillow.

Does anyone have a recommendation on an alternate mask for me? My RT is a bit clueless on this one.

BTW - I have also worn a swift FX, but I’m having problems sourcing that mask lately. Basically I am looking for a better “mousetrap” now. My specs are wrong (I will fix them). I’m on an Aircurve 10 ASV now.

thompsdw wrote: ↑

Sat Jan 11, 2025 11:25 pm

So here is the problem. The P10 is hailed as quiet due to the tight mesh exhale vent. With my newfound congestion I simply cannot get enough air to exhale. At that point I start breathing through my mouth and close off my nose to catch my breath. T

may I recommend a nasal decongestant? Flonase works very well.

try it and if it works for you AND you're a Costco member, there is a generic equivalent. If I were you, I'd try the Flonase first. the generic equivalent is sold in a multiple pack.

good luck!

I have been on Flonase for years and tried many other treatments. Just not enough to overcome congestion.

thompsdw wrote: ↑

Sun Jan 12, 2025 9:20 am

I have been on Flonase for years and tried many other treatments. Just not enough to overcome congestion.

ah, okay.

good luck with the mask search!

What are your pressure settings?
Are you using any exhale relief (EPR on a ResMed machine) and if you are...at what setting?

Take a look at the F & P Nova Micro nasal pillow mask.

Pressure: 5-10
EPR Maxed at 3

Is your problem exhaling happening at the beginning of the night while you are still awake or later in the middle of the night after you have been asleep for a while?

I assume you aren't using the ramp????

I can actually feel it when I am going to sleep. That is when I will start breathing through my mouth to catch my breath. I am using a 40 minute ramp. I know the problem here is my body and not the machine. I do think that there are masks that are easier to exhale through (like a valve, small diameter holes versus mesh, etc). So I am not saying that the P10 is a bad mask if you don't have issues with congestion. I think it's both the physical issue and that the P10 mask is just harder to push air out of it. Thats why I am just looking for a pillow that has something other than that mesh.

Your current settings could be playing a part in your issues.

Using ramp means you start at 4 cm and stay there and it take 40 minutes to ramp up to 5 cm minimum pressure.
EPR is essentially not doing anything to help you exhale because even when set to 3 cm it can only drop to 4 cm (1 cm drop which most people find is rather stifling) until your pressure goes up to 7 cm and THEN it can help with 3 cm drop during exhale.

I am quite familiar with the P10 mask. Used it for years and years. Your fears of rebreathing CO2 are unfounded but I know you aren't comfortable so lets see if you can get comfortable.

Try this experiment while awake and under no pressure to go to sleep.
Change your machine settings..
Turn ramp off.
Set the minimum pressure from 5 cm to 7 cm
Leave EPR set to 3
See if you are comfortable or not with those settings.

As far as you original question about a different nasal pillow mask.
Look at the F & P Solo nasal pillow mask and/or the F & P Nova Micro nasal pillow mask.
The venting system in both those masks is a bit more aggressive than the P10.

I will second the F&P micro. It has replaced the P10 for me. Have used P10 for aprox five years. Tried the micro and found it to be superior...for me. Smaller profile with nostril cones that go deeper into the nose make for much better leak results...for me. Headgear is superior also...for me.

Good luck with Pugsy's recommendations, She knows her stuff.

JPB

Makes sense. I have seen this suggestion before but never tried it. One quick question - with my top pressure being a 10, is a 7-10 range of pressure too small. In other words do I need to open the top end or leave it alone? I had a loner machine for a while that had a top pressure of 15, but they reduced it because the script was 5-10.

thompsdw wrote: ↑

Sun Jan 12, 2025 6:23 pm

is a 7-10 range of pressure too small. In other words do I need to open the top end or leave it alone?

Having a higher maximum setting really isn't that critical unless you look at the software reports and see that you are consistently hitting that max setting of 10.
Just because a machine can go higher doesn't necessarily mean that it will go higher.
It won't hurt to use a higher max but I would rather see how you do with 7 - 10 and get you comfortable first and then worry about changing the max setting....if needed. It may not be needed at all if you never ever hit 10.

But if it never ever hits 10 then it won't matter what that max setting is...15, or 20 or heck even 100 if it could go that high.

Pugsy - thank you so much for your help!

Just updated the settings and tried it with the n30i and then the p10. I alternated several times to see if I could get a feel for not only the difference from the ramp but also the mask difference. I think the changes made a difference on both, but the p10 still seems slightly harder to exhale to me. Might be fine if I can get the nose to clear up.

I just don’t like the pillows on the n30i. They seem overly tight but the slightest shift in body position I hear them leaking. I might try the new n30i that has a whole different design in the pillow area. That might work really well for me.