Severe Sleep Apnea

Let me qualify my previous remarks. Even though I said severity should not dictate mask choice, perhaps a middle or higher pressure setting does dictate against nasal pillows.

I tried nasal pillows once, but they didn't seem to work for me and I was not dissatisfied with my original mask type.

Over the course of treatment, by minimum (or fixed) setting has varied from 11 to 13.5. I've had an automatic for about one year; I have the max at 20, which is the capacity of the machine.

D.H. wrote: Even though I said severity should not dictate mask choice, perhaps a middle or higher pressure setting does dictate against nasal pillows.

Please don't perpetuate that old wives tale. Now some people might have issues with nasal pillows at higher pressures but there's a lot of people who do not and are quite successfully using nasal pillows with bilevel machines and with pressures in the 20s. When using my S9 Adapt I would see pressures up around 22 almost every night at some time or other during the night and I slept right through it and they didn't leak.

Just because you didn't do well with them doesn't mean the next person won't either.
Just like because I don't do well with a full face mask doesn't mean that the next person won't either.

Nasal pillow masks can be used with ANY pressure and heck, even some are rated up to 30 cm pressure.

ANY mask at higher pressures can present problems sealing...simple fact of life.

So please don't add to this old wives tale about nasal pillows and higher pressures. It simply bears no truth unless you want to add the YMMV thing but then everything about CPAP comes with that big sticker.