Leaks with Swift FX Nasal Pillows

hi all,

after a first horrible try at CPAP with a brick and a full face mask, I got a Resmed S9 AutoSet with Swift FX Nasal Pillows and a chin strap (my wife confirmed I open my mouth otherwise). I slept awesome for 2-3 weeks as I was probably catching up and I can definitely feel some energy coming back. However this past week, I have been more and more bothered by leaks on my nasal pillows and I am trying to figure out why I am having more leaks now. It is possible that I had the leaks earlier but that I was too tired to notice but I doubt it. It seems that something has changed and I can't put my finger on it. My mask is fine when I first adjust it and go to sleep but later on, the headgear seems to move around my head way more than it used to. I usually can't adjust it, I have to take the whole thing of (strap and headgear) and start from scratch in order to make things better.... The tightness setting is the same as it always was. Anyway I had a few questions for Swift FX users:
- Does the headgear become loser over time?
- Do the pillows themselves become less airtight?
- How often should I change the headgear and pillows?
- Any recommendation to make them last longer?
- I only shave once or twice a week meaning that I have some short facial hair present every now and then. Can that cause issues with the nasal pillows?

Much appreciated!

Franck-

I'm curious to see the more experienced user's responses to your questions.

I had two for you though:

1) What is your cleaning schedule for the pillows? From what I read in Resmed's website facial oils can affect the seal. Also, by other's experiences I recently started using lanolin on my nostrils to help with the seal.

2) How do you situate your line/hose when you sleep? Is it laying in the bed with you? I at first had the hose in bed with me and it would inevitably get stuck under me or a pillow and would actually "pull" the mask away from me and cause leaks. This would cause leaks which caused me to wake up, and also I have heard others call this "hose pull". Since that time I started to hang my hose on top of me when I sleep from the headboard so there is no part of the line from the machine to the mask that touches me or the bed. I allow a little slack for movement. This has worked well for me and others.

FYI- I have a full face beard.

The elastic back strap can stretch out some, but there is quite a bit of adjustment range, should be able to tighten it enough. If not, you may need to replace that strap. Don't get things too tight, it should be comfortable.

The pillows can wear out. Some people only get two to four weeks. I got six months when I used the Swift FX. Very individual. Same with the life of the entire mask, very individual.

Note--there are an inner and outer cone structure right where the air exits the pillow, on each nostril. One thing that I found on the FX, those inner cones can be popped kind of into the body of the nasal cushion, leaving only the outer piece to make the seal, which cause leaks. Check each nostril opening for this. If you don't see the double wall structure, squeeze them and they should pop back in place. I found this happens sometimes when you wash the nasal pillow.

I don't think facial hair will have much impact.

ZZzseekerREM wrote:I'm curious to see the more experienced user's responses to your questions.

I had two for you though:

1) What is your cleaning schedule for the pillows? From what I read in Resmed's website facial oils can affect the seal. Also, by other's experiences I recently started using lanolin on my nostrils to help with the seal.

I believe you're mistaken, lanolin is recommended to help the sore nose that sometimes (often?) accompanies starting to use a nasal pillow mask. I used it when i first started with a pillow mask, after a week or two, I didn't need it anymore.

if you think about it, lanolin is going to do the same thing as facial oils do, it makes the mask slip around and makes leaks more likely.

my only problem with it is that I only used about 1% of the tube during my 'getting used to it' phase.

SleepDisturbed wrote:The elastic back strap can stretch out some, but there is quite a bit of adjustment range, should be able to tighten it enough. If not, you may need to replace that strap. Don't get things too tight, it should be comfortable.

The pillows can wear out. Some people only get two to four weeks. I got six months when I used the Swift FX. Very individual. Same with the life of the entire mask, very individual.

my partner's had his p10 for almost a year now... he's still happy with the first set of pillows. they seem to last a lot longer than some folks think.

pugsy replaced hers after 10 months or so, then discovered it wasn't the pillows, it was the headgear had stretched too much.

in my experience, with other masks, the headgear losing it's stretch is the first thing to go, but that can still last a long time.

I believe you're mistaken, lanolin is recommended to help the sore nose that sometimes (often?) accompanies starting to use a nasal pillow mask. I used it when i first started with a pillow mask, after a week or two, I didn't need it anymore.

if you think about it, lanolin is going to do the same thing as facial oils do, it makes the mask slip around and makes leaks more likely.

my only problem with it is that I only used about 1% of the tube during my 'getting used to it' phase.

If you google "lanolin mask seal" you will see several posts on how it helps with mask seal. Maybe the conclusion in the end is that it does nothing to help with the seal, and if that is the case I will just give to my wife when she starts breastfeeding!

ZZzseekerREM wrote:If you google "lanolin mask seal" you will see several posts on how it helps with mask seal.

and several others stating that it makes the mask too greasy and it slips off.

so, I suppose, as with most things cpappy... ymmv. if it works, great, if not, try something else.

I've used several masks. Until I got my Airfit P10, the Swift FX was my favorite. But I didn't like the tightly focused jet of air exhausting from it. It makes noise where the exhaust air impinges on sheets/blankets/pillowcases. The Airfit P10 has a very quiet, diffused exhaust and I think it fits better than the Swift FX, which is an older design. Just thought I'd mention it.

It's true, lanolin has a paste-like consistency (it's sticky), and can help to make a seal between your skin and the nasal pillows. When I started out and had some nose irritation, I found that K-Y (a very thin layer) eliminated the irritation and also made a better seal once it began to dry a little. Lanolin is greasy; K-Y is water soluble and wipes/rinses off your nose easily.

However, consider your nose hairs. The Swift FX (I found) is particularly susceptible to leaks if I don't keep nose hairs trimmed.

Keep the headgear loose. Most of us have found that nasal pillows leak more when we tighten the mask.

I'm on my original headgear and pillows. After 5 years, I've never had to replace any of my masks because they began leaking or stopped working, or got loose.
My masks last a long time possibly because I don't clean them very often. And when I do, I either wipe them with a damp washcloth or wash them in warm water with hand soap. Silicone rubber is pretty durable stuff, but by using harsh detergents, or washing in hot water, even boiling them (some have recommended that), you probably shorten the components' life. Since I'm paying for everything out of pocket, I am very gentle with my masks.

Thanks for all the answers. I do need to trim my nose hair! I think that indeed the headgear has been loosening up and that maybe I have tried to tighten it too much. Also, I never tried the large nasal pillows because the medium seem to fit pretty well but it seems that the large fits as well and I read somewhere that you should use the largest you can use so I will try that too! Finally, I think the tube being pulled while I turn around has something to do with my mask moving indeed. I have noticed it a couple of times. I will get one of these hangers and try to make it work that way!

Thanks!

Yes, use the largest nasal pillow that fits, since part of what helps with leaks is a good fit helping to hold them in place after they inflate with air pressure from the cpap. If they're smaller than that, you'll indeed be fighting leaks more than you need to.

FranckDG wrote:Thanks for all the answers. I do need to trim my nose hair!

if I don't keep 'em trimmed, I find that I'm waked by itches on and around my nose... it never itches INSIDE, even though it's clear that it's the air tickling them that's causing the itching, cuz when they're trimmed... the itches don't happen.

Yeah, I've been having similar questions about the Swift FX Nasal Pillows. Been on CPAP now for about a month, and this was the first mask I've tried.

At the beginning I definitely noticed improved sleep, and overall that's still true. However, I've frequently found the fit of the nasal pillows irritating. The fact that the straps aren't really adjustable other than moving them around, is discouraging. I'm a side sleeper as well that moves around a lot in my sleep. When I lean my head against a pillow touching my nose, I either feel like the nasal pillow is restricted making airflow reduced, or it starts leaking. Sometimes I don't notice it as much, but sometimes it happens so frequently, going to bed can be annoying.

I haven't tried different pillow sizes yet, but will soon. I'm regular shaped, and feel like the medium fits well enough, not sure what a different size will do for the pressure against the sidewall aspect.

From what I've read, that's a common catch-22 with air-pillows, and that's why Jason over at FreeCPAPadvise talks about preferring nasal masks. I've been particularly interested in trying the FX Nano, but my health provider (Kaiser) didn't have one in stock at the moment, so I've recently been lent a Mirage FX nasal mask.

An extremely adjustable mask, with a comfortable over the nose pillow, it doesn't leak or feel constricted no matter what side position I'm in, and furthermore the swivel joint connecting to the hose (absent on the Swift FX) allows for a lot more movement without that *tug* feeling you normally get. Oddly enough despite how much better it feels, my sleep quality has been reduced since I switched, and I think it might have something to do with my machine needing to have a different setting turned on or adjusted to compensate for different air pressure or something. I can't imagine why I would be getting less effective sleep with a mask that feels so comfortable, doesn't leak, and seems to work well.

Planning to talk to my provider about that and have him review my SD card data to see what happened.

I definitely recommend you try a nasal mask though.

Darkshader wrote: At the beginning I definitely noticed improved sleep, and overall that's still true. However, I've frequently found the fit of the nasal pillows irritating. The fact that the straps aren't really adjustable other than moving them around, is discouraging. I'm a side sleeper as well that moves around a lot in my sleep. When I lean my head against a pillow touching my nose, I either feel like the nasal pillow is restricted making airflow reduced, or it starts leaking. Sometimes I don't notice it as much, but sometimes it happens so frequently, going to bed can be annoying.

I think that you have them switched around...the Swift FX has the adjustable straps and swivel hose joint, the AirFit P10 has nothing adjustable, and a fixed hose joint.

Just thought I'd mention that, in case anyone else reading was confused *smile*.

This is very interesting news about the size of the nasal pillow. At my tritration study, they said I needed a size small nasal pillow. It worked fine, I thought. When I met with the medical equipment rep, she said I needed a small and that's what she gave me, but she also included an extra size medium. I think I'll try it, just to be sure. They both told me to use the smallest I could tolerate. Hmmm....

No one ever told me about putting any ointment on the nose. Mine is a little sore on day 6 of treatment. I was scared any lotion might interfere with the pillow, even if I rinse it off before bedtime. How would KY gel provided any moisturizer?

Also, the rep said to turn the humidifier up if my nose was sore. I turned it from 4 to 5 and soon I felt a drop of moisture in my nose, so I turned it back down to 4. Any suggestions?

SunnyBeBe wrote:No one ever told me about putting any ointment on the nose. Mine is a little sore on day 6 of treatment. I was scared any lotion might interfere with the pillow, even if I rinse it off before bedtime. How would KY gel provided any moisturizer?

Also, the rep said to turn the humidifier up if my nose was sore. I turned it from 4 to 5 and soon I felt a drop of moisture in my nose, so I turned it back down to 4. Any suggestions?

um... did you read through the above thread?