I'm so close, but still can't find the right nasal cradle

I'm about six weeks into using CPAP (AirSense 11). I was initially given the P30i Nasal Pillow mask. It worked okay at first, but a couple weeks in I started fighting with it. The medium cushion would slip out of place and blow me in the eye; the small cushion made me feel like I was suffocating, an effect only heightened by the fact that if I lay on one side, it blocks the airflow in the frame on that side. Plus, the pillows made my nose sore, the hard plastic filter digs into my nose, and the silicone headgear is uncomfortable and pulls at my hair. It was a bust for me.

My sleep tech threw a bunch of different masks at me, and the two that I am happiest with are the ResMed AirFit N30 size medium (they were out of small) and the F&P Evora Nasal size small. Any kind of hard plastic mask is a no-go, and all the nasal pillows make my nose burn.

The N30 was so, so comfortable. The headband itself is kind of a joke--too stretchy, doesn't stay put if your hair is over an inch long, fussy to disassemble. But the cushion was perfect. That is, until I started waking up to find the whole cushion sitting on the bridge of my nose, having slipped right off the end. Over and over, no matter how many times I tried to seat it, and tighten the straps.

The Evora came the closest to perfect--not quite as comfy as the N30, but the headgear and overall cushion design make the whole thing stay put. I thought I had found the one. And then...I started waking up suffocating, with the mask suctioned to the end of my nose. That hole is just a little too big, and I'm back to square one.

I ordered myself a Small cushion for the N30 but my hopes are low. Does anyone have any advice, maybe hacks, for keeping these cushions in place? I saw one person suggested lanolin cream for extra tackiness, but I'm allergic to lanolin. I can't help but think if there was a strip in the middle of the Evora mask, like on the N30, if that would prevent the suckage. Help!

warriortwo wrote: ↑

Fri May 19, 2023 1:54 pm

The Evora came the closest to perfect--not quite as comfy as the N30, but the headgear and overall cushion design make the whole thing stay put. I thought I had found the one. And then...I started waking up suffocating, with the mask suctioned to the end of my nose. That hole is just a little too big, and I'm back to square one.

The only way the mask can be "suctioned to the end of your nose" and giving you a suffocated feeling is if your machine is off.

My guess is you have auto off on your machine, and it large leaks make it turn off.
Without pressurized running from your machine to the mask, you wake up.

OSCAR is a tool that will show what happened to your machine / mask / breathing during the night.

See: viewtopic/t172378/Sticky--Newbies-PLEAS ... STING.html
And viewtopic/t183806/Attachment-storage-is ... MENTS.html

Do you need help in getting OSCAR and uploading images to an external site?

This is the last night I wore the Evora.



I was using a loaner AirCurve 10 on this night, which was not set to auto off. Perhaps "suctioned" is not the right word, but the mask kept slipping so that the end of my nose ended up in the hole, which blocked any air in or out.

warriortwo wrote: ↑

Fri May 19, 2023 1:54 pm

My sleep tech threw a bunch of different masks at me, and the two that I am happiest with are the ResMed AirFit N30 size medium (they were out of small) and the F&P Evora Nasal size small. Any kind of hard plastic mask is a no-go, and all the nasal pillows make my nose burn.

The N30 was so, so comfortable. The headband itself is kind of a joke--too stretchy, doesn't stay put if your hair is over an inch long, fussy to disassemble. But the cushion was perfect. That is, until I started waking up to find the whole cushion sitting on the bridge of my nose, having slipped right off the end. Over and over, no matter how many times I tried to seat it, and tighten the straps.

I ordered myself a Small cushion for the N30 but my hopes are low. Does anyone have any advice, maybe hacks, for keeping these cushions in place? I saw one person suggested lanolin cream for extra tackiness, but I'm allergic to lanolin. I can't help but think if there was a strip in the middle of the Evora mask, like on the N30, if that would prevent the suckage. Help!

I'd give the Small size cushion on the N30 a fair shot. I tried both the Small and Medium cushions on the N30, and found that the Medium is most comfortable for me. It has more leakage for me than the Dreamwear nasal mask, my second choice. But the N30 is much quieter, lighter, and doesn't have the stream of air coming straight out from the cushion vent. Parenthetically, if the Dreamwear had a vent diffuser, I might still be using it. I've worked with the N30 to get the leakage down on it, and have gotten it low enough that I'm fine with it. About 10L/min more or less for the 95% leak number. As you said, the N30 is comfortable. However, I can see how the nasal cradle cushion could slide off it it was too big. I have had the back strap slide up and off, but now make sure that strap is pulled down low enough in the back that I don't experience that anymore. I agree that the N30 headgear is pretty rinky-dink, but again, it's lightweight and low impact.

One other thing that happened with the N30 was that the headgear on mine had a "buckle" adjustment clasp that adjusted itself. It was fine when I went to bed, but by morning it had re-adjusted itself to be too loose. That was a disaster for leakage, of course, so I simply replaced the headgear with a new one, and fixed that. I could see how, if that was happening to you, that the nasal cradle could slide off. Or if the nasal cradle cushion was simply too big. Or a combination of the two, of course *smile*.

I also tried the Evora, and that didn't work for me, either. I had high hopes for it after seeing videos about it on youtube, don't remember what the problem was with it. I'm a side sleeper, which is why the N30 has more leakage than I'd like, but not too much *smile*. The comfort of the nasal cradle cushion and vent diffuser make up for a lot for me. Being a side sleeper, masks that work for others often have unacceptable leakage for me, since my mask is pushed from the side.

Anyways, the N30 is my current choice for comfort, hope that you can make it work for you.

Nowadays, you can find mask fitting video instructions on either youtube or the company site.
And I know ResMed even has leak troubleshooting instrcutions for masks.

Keep in mind that you have to do the mask fitting when lying down - its easiet to start on your back - and the check to see what happens to the fit when you turn to your favorite sleep position.

Type of pillow and hose handling can also affect mask fit.

Babies learn to grope for their pacifier and insert in in their mouth if it drops out, we can learn to handle our hose in a way that keeps leaks to a minimum when turning over in bed.

Thank you for the comments. I went back to the N30 and sent the Evora to my "mask graveyard". The place I ordered the small cushion from takes ages to ship (at least it feels that way when you are desperate!) so in the meantime, I've started putting a flex-fabric bandage on the end of my nose to block the mask from moving, and to add a little more resistance. That seems to work. I've slept several nights now with only one incident of slippage. The added bonus is that it really is comfortable, like a little cloud under my nose, and I am barely aware of it once I drift off. Fingers crossed this ends up being the one.

warriortwo wrote: ↑

Sun May 21, 2023 11:55 pm

Thank you for the comments. I went back to the N30 and sent the Evora to my "mask graveyard". The place I ordered the small cushion from takes ages to ship (at least it feels that way when you are desperate!) so in the meantime, I've started putting a flex-fabric bandage on the end of my nose to block the mask from moving, and to add a little more resistance. That seems to work. I've slept several nights now with only one incident of slippage. The added bonus is that it really is comfortable, like a little cloud under my nose, and I am barely aware of it once I drift off. Fingers crossed this ends up being the one.

Creative solution for the mask slippage. Congratulations for figuring out a stopgap until you get to try the Small size cushion. That's the kind of "make do" spirit that typifies us rugged pioneer CPAP'pers *smile*. Really, good thinking!