need advice on mask options

1speechpick · Post by **1speechpick** » Sun Jun 27, 2021 6:42 pm

I'm so thankful for this forum and the experience you all are willing to share. It is so helpful. I'm a newbie.

I'm using the Resmed Airsense 10 For Her and the Resmed Airfit P10 nasal pillow mask, and have the AHI under control on a pressure of 5. Problem is...I'm having terrible sores underneath the nose on both sides. I've tried xsmall, small, and medium adapters. I rest the nasal pillow against my nose gently after it is fully inflated, so it doesn't seem like it should be too tight unless I'm not placing it correctly . The straps on the P10 nasal mask really don't adjust much. Still no luck with the sores getting better. I tried to go to a full face mask (Resmed Airfit F20) but my AHI increases significantly when using the Airfit F20.

Questions:

1. It's the only mask I have to use tonight. Can I place surgical tape under my nose to shelter the skin a bit?

2. Will the skin eventually toughen up and heal? If not, what other nasal masks might be more comfortable?

Thanks in advance for any input!

Pugsy · Post by **Pugsy** » Sun Jun 27, 2021 6:59 pm

Yes to both questions.

Though I don't know how the tape on the skin might affect leaks but it should at least protect the skin from further debridement.
Plus I don't know what the tape on the wound might do in terms of affecting healing process. Especially the removal part of all that.
Now maybe a bandaid where the cushion part covers the wound part....might be an option.

Go to WalMart or similar store and in the baby aisle look for a product called Lansinoh lanolin cream/ointment. Nursing mom's use it on their nipples when breast feeding. It will help promote healing and help prevent future abrasion.
Use it liberally during the day and sparingly at night.

But for any nasal pillow to cause skin breakage, abrasion, sores, extreme pain....something is wrong with the fit or size.
I have used nasal pillow masks of some sort for over 12 years and the absolute worst I have ever had is very, very minor tenderness...like a small bruise and that was from the mask being slightly too tight.

Other alternate...let the nose heal up and just use the full face mask until the nose heals up and quit worrying about the AHI.
If you keep screwing with the wound it just delays healing...like pulling tape off or having the pillows move around on the open sore.

There are other mask alternatives that are maybe more easily adjusted but that won't help you tonight.

I don't think that the skin toughens up so much as a person learns how to best adjust the pillows and fit the size.
We don't get tough skin or calluses or stuff like that on our nostrils...or shouldn't.

Make sure the pillow isn't too small and trying to crawl up inside the nose. I had the XSmall in the P10 do that to me and it did hurt.
I stopped it before it made a sore spot though. Size up to small and it doesn't move.

1speechpick · Post by **1speechpick** » Sun Jun 27, 2021 7:12 pm

Pugsy wrote: ↑
Sun Jun 27, 2021 6:59 pm
Yes to both questions.

Though I don't know how the tape on the skin might affect leaks but it should at least protect the skin from further debridement.
Plus I don't know what the tape on the wound might do in terms of affecting healing process. Especially the removal part of all that.
Now maybe a bandaid where the cushion part covers the wound part....might be an option.

Go to WalMart or similar store and in the baby aisle look for a product called Lansinoh lanolin cream/ointment. Nursing mom's use it on their nipples when breast feeding. It will help promote healing and help prevent future abrasion.
Use it liberally during the day and sparingly at night.

But for any nasal pillow to cause skin breakage, abrasion, sores, extreme pain....something is wrong with the fit or size.
I have used nasal pillow masks of some sort for over 12 years and the absolute worst I have ever had is very, very minor tenderness...like a small bruise and that was from the mask being slightly too tight.

Other alternate...let the nose heal up and just use the full face mask until the nose heals up and quit worrying about the AHI.
If you keep screwing with the wound it just delays healing...like pulling tape off or having the pillows move around on the open sore.

There are other mask alternatives that are maybe more easily adjusted but that won't help you tonight.

I don't think that the skin toughens up so much as a person learns how to best adjust the pillows and fit the size.
We don't get tough skin or calluses or stuff like that on our nostrils...or shouldn't.

Make sure the pillow isn't too small and trying to crawl up inside the nose. I had the XSmall in the P10 do that to me and it did hurt.
I stopped it before it made a sore spot though. Size up to small and it doesn't move.

Thanks again, Pugsy! For the benefit of a newbie, would you be willing to explain to me the proper way to place the nasal pillow? Thanks !

Pugsy · Post by **Pugsy** » Sun Jun 27, 2021 7:58 pm

1speechpick wrote: ↑
Sun Jun 27, 2021 7:12 pm
would you be willing to explain to me the proper way to place the nasal pillow? Thanks !

I could show you really easy if you were sitting here with me but I can't put it into words. I am not good at composing.

What I usually tell people is they need to take one of the nasal pillows (off the frame totally) and place it very gently against the nose and press gently....that's as tight as it needs to be to seal as long as it is the correct size.
Absolutely nothing goes inside the nostril that you can feel. The pillow rim (big cushy part) rests gently against the nostril opening.
It actually has to be able to inflate to seal. Most people make things so tight it can't inflate.

There are tons of videos out there...watch several to see if maybe one has an idea you haven't seen or thought of.

The P10 tension adjustment is how close or far apart the straps are. When I used the P10 I put my lower strap down below the base of my skull almost on my upper neck and then the top strap went over my crown area at the very top of my head.

The headgear is/was a little snug initially but it does stretch out after about a week's worth of use so it's a little looser.

There are other nasal pillow masks with more traditional tension adjustments on the headgear that some people like better.
The ResMed Swift FX is very similar to the P10 but has headgear that has easier adjustments but it isn't nearly as silent as the P10.

The F & P Brevida is a nice mask and has an optional vent diffuser to make it more silent and it has more traditional adjusting headgear.
There is also the F & P Pilairo Q.

readingteacher · Post by **readingteacher** » Sun Jun 27, 2021 8:07 pm

1. It's the only mask I have to use tonight. Can I place surgical tape under my nose to shelter the skin a bit?

2. Will the skin eventually toughen up and heal? If not, what other nasal masks might be more comfortable?

I have had trouble with the Resmed nasal pillows causing sores under my nose, both sides. This has happened for me with both the Airfit P30i and the SwiftFX. I think the edge of the Resmed pillows that rests under your nose is rather hard and puts pressure on the area.

I used a Bandaid under my nose to protect the area. I cut the Bandaid lengthwise in half, so the pad could rest right up against the bottom of my nostril and cover the sore. This helps protect the area. It did not significantly affect my leaks. I got by with this as a newbie CPAP user until my doctor suggested that I try a different mask.

I have found the gel pillows from Phillips Respironics to be much softer. I like the Nuance Pro mask.The gel nasal pillows do not give me sores or even red marks under my nose! Very little leakage. It's the one I'm sticking with!

I also tried the Dreamwear Gel nasal pillow mask. It was a comfortable mask, but I had a lot of leakage with that one. To me, it seemed like the small Dreamwear pillow was actually larger than the small Nuance pillow. But everyone's nose is different, and as they say here "Your Mileage May Vary"!

I think you will probably be happier and more comfortable with a different mask. Maybe try a gel pillow.

1speechpick · Post by **1speechpick** » Mon Jun 28, 2021 1:36 pm

Thank you both for your input! It is so greatly appreciated!! I guess there's just something with the P10 that doesn't fit my face well. I applied the bandaid. It got me through the night, but I'm exchanging for a couple different masks to try. Thankfully I'm still in my 30 day window. I'm going to try the Nuance Pro (nasal gel pillow), Resmed N30i (nasal cushion).

I also want to try a nasal mask. Would you Resmed N20 or the Mirage FX???

readingteacher · Post by **readingteacher** » Mon Jun 28, 2021 1:57 pm

I forgot to mention that I also am using RemZZZs nasal pillow liners with my Nuance Pro nasal pillow mask. They are very cleverly designed thin cotton cloth liners that go between the nasal pillow and the skin under your nose. They are like thin cotton T-shirt material, soft. https://www.remzzzs.com/hero They are available at Amazon, CPAP.com and lots of other cpap websites. They also make liners for nasal masks and full face masks.

I also tried a Pad A Cheek barrel cozy, which wraps around the nasal pillow. It is comfortable, but I found that it increased leaks for me. https://www.padacheek.com They also make liners and cheek pads for many masks, and are available at their website and lots of other cpap websites.

I have not tried any nasal masks, so I cannot make a recommendation for that.

Good luck in your quest for a comfortable mask!

clownbell · Post by **clownbell** » Mon Jun 28, 2021 2:29 pm

I heartily second Pugsy's mention of the Brevida pillow mask by Fisher & Paykel. It is a pillow mask but does not look or work like other brands' pillow masks. I wear the mask loose as instructed and don't get leaks. In fact, I've experimented and tried to get it to leak -- unsuccessfully, hooray. As I see it, other masks achieve the seal by having the headgear pull the pillow against the nose; the F&P "Air Pillow" seal design seems completely different, creating a pillow that goes around the nose rather than into the nostrils. There is a little piece that goes inside the nostril JUST A BIT, and I can't even feel it after airing up the mask. Hope I have described this adequately.

1speechpick · Post by **1speechpick** » Mon Jun 28, 2021 2:33 pm

readingteacher wrote: ↑
Mon Jun 28, 2021 1:57 pm
I forgot to mention that I also am using RemZZZs nasal pillow liners with my Nuance Pro nasal pillow mask. They are very cleverly designed thin cotton cloth liners that go between the nasal pillow and the skin under your nose. They are like thin cotton T-shirt material, soft. https://www.remzzzs.com/hero They are available at Amazon, CPAP.com and lots of other cpap websites. They also make liners for nasal masks and full face masks.

I also tried a Pad A Cheek barrel cozy, which wraps around the nasal pillow. It is comfortable, but I found that it increased leaks for me. https://www.padacheek.com They also make liners and cheek pads for many masks, and are available at their website and lots of other cpap websites.

I have not tried any nasal masks, so I cannot make a recommendation for that.

Good luck in your quest for a comfortable mask!

Thank you so much for your input! I have the RemZZZs arriving tomorrow! I doubt they will make the P10 more comfortable but I'm hoping they will make the Nuance Pro a comfortable option.

1speechpick · Post by **1speechpick** » Mon Jun 28, 2021 5:16 pm

1speechpick wrote: ↑
Mon Jun 28, 2021 2:33 pm

readingteacher wrote: ↑
Mon Jun 28, 2021 1:57 pm
I forgot to mention that I also am using RemZZZs nasal pillow liners with my Nuance Pro nasal pillow mask. They are very cleverly designed thin cotton cloth liners that go between the nasal pillow and the skin under your nose. They are like thin cotton T-shirt material, soft. https://www.remzzzs.com/hero They are available at Amazon, CPAP.com and lots of other cpap websites. They also make liners for nasal masks and full face masks.

I also tried a Pad A Cheek barrel cozy, which wraps around the nasal pillow. It is comfortable, but I found that it increased leaks for me. https://www.padacheek.com They also make liners and cheek pads for many masks, and are available at their website and lots of other cpap websites.

I have not tried any nasal masks, so I cannot make a recommendation for that.

Good luck in your quest for a comfortable mask!

Thank you so much for your input! I have the RemZZZs arriving tomorrow! I doubt they will make the P10 more comfortable but I'm hoping they will make the Nuance Pro a comfortable option.

Hi there! I now have the Nuance Mask and the RemZzz. I'm having difficulty with the small fabric holes to "stay put". They seem to shift and cover the holes of the nasal pillow. Any tricks or suggestions?

readingteacher · Post by **readingteacher** » Mon Jun 28, 2021 5:43 pm

Hi there! I now have the Nuance Mask and the RemZzz. I'm having difficulty with the small fabric holes to "stay put". They seem to shift and cover the holes of the nasal pillow. Any tricks or suggestions?

Yes, the RemZZZs are a little fiddly, especially until you get used to them!

Push the large holes over the nares (nose cones) and all the way down to the bottom over the widest part of the cones. Then grasp the liner by the sides beside the small holes and stretch it. Try the fit. If it's still too small, stretch it again. The directions do say to stretch it. I was too timid about stretching at first, but that is the key!

Then I hold the liner in place with one hand and push it up to my nose, holding it there while using the other hand to pull the mask headgear over my head.

Once it's on, you can adjust the liner a bit by pulling gently on the edges of the liner that stick out if you need to.

I hope this all makes sense! The liners are a bit fiddly, but for me the comfort they provide has been well worth figuring them out! If it's too frustrating, you might want to use bandaids and the Nuance without the liners for a while to get used to the Nuance. Then you can add in the liners.

Best,
Robin

booksfan · Post by **booksfan** » Mon Jun 28, 2021 6:48 pm

I had an awful time trying to find a mask that I could tolerate the first 14-15 months I was on CPAP! I went through at least that many masks, many on my own dime, after the first month. I was buying a new mask probably every month...it drove my husband crazy! Not the expense so much (he wanted me to find a mask I was comfortable using), but he just could not understand WHY it was so difficult, because he is so happy with the P10...best mask ever according to him (he made me try it several times but it was a dismal failure for me).

All that to say, the 2 I kept going back to were the Nuance Pro and the Brevida. They were the least objectionable. For the last 2+ years, though, I have been as happy with the Bleep as hubby is with the P10!

4betterO2 · Post by **4betterO2** » Mon Jun 28, 2021 8:05 pm

Every time I've tried nasal pillows masks, the part under the nostrils was hard, even when the pillow part that goes to the nostrils itself is soft. I found a solution in the Philips Respironics Wisp mask, it's a nasal mask but a cushion one, not a pillows one. Details here:
https://www.usa.philips.com/healthcare/ ... nasal-mask
It gives a lot of air, better than full-face masks, as much as good nasal pillows masks, and because it goes over the tip of the nose, it does not have to be too tight to stay in place and do well. Very cushiony and comfortable

1speechpick · Post by **1speechpick** » Tue Jun 29, 2021 6:10 am

readingteacher wrote: ↑
Mon Jun 28, 2021 5:43 pm

Hi there! I now have the Nuance Mask and the RemZzz. I'm having difficulty with the small fabric holes to "stay put". They seem to shift and cover the holes of the nasal pillow. Any tricks or suggestions?
Yes, the RemZZZs are a little fiddly, especially until you get used to them!

Push the large holes over the nares (nose cones) and all the way down to the bottom over the widest part of the cones. Then grasp the liner by the sides beside the small holes and stretch it. Try the fit. If it's still too small, stretch it again. The directions do say to stretch it. I was too timid about stretching at first, but that is the key!

Then I hold the liner in place with one hand and push it up to my nose, holding it there while using the other hand to pull the mask headgear over my head.

Once it's on, you can adjust the liner a bit by pulling gently on the edges of the liner that stick out if you need to.

I hope this all makes sense! The liners are a bit fiddly, but for me the comfort they provide has been well worth figuring them out! If it's too frustrating, you might want to use bandaids and the Nuance without the liners for a while to get used to the Nuance. Then you can add in the liners.

Best,
Robin

Thanks so much, Robin. I appreciate the information.

1speechpick · Post by **1speechpick** » Tue Jun 29, 2021 6:18 am

booksfan wrote: ↑
Mon Jun 28, 2021 6:48 pm
I had an awful time trying to find a mask that I could tolerate the first 14-15 months I was on CPAP! I went through at least that many masks, many on my own dime, after the first month. I was buying a new mask probably every month...it drove my husband crazy! Not the expense so much (he wanted me to find a mask I was comfortable using), but he just could not understand WHY it was so difficult, because he is so happy with the P10...best mask ever according to him (he made me try it several times but it was a dismal failure for me).

All that to say, the 2 I kept going back to were the Nuance Pro and the Brevida. They were the least objectionable. For the last 2+ years, though, I have been as happy with the Bleep as hubby is with the P10!

I have the same situation!! My husband has been on CPAP for 5 years. He acclimated very quickly and also wears the P10. Though he could see the sores below my nose, he just couldn't understand why they hurt so much. Lol his advice was to keep wearing the P10 and let the skin toughen up. My husband agrees with your husband, the P10 is the best ever! I think the Nuance Pro will work for me after my skin has healed. I may not be able to wear it every night but it could be in the rotation. I will look into the Brevida and the Bleep, as well. Thanks a bunch!!!

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