Swift LT Pillows

I know that this has been addressed before, but I seemed to have lost the stream on this question. When using the Swift LT mask, I find that the best fit for my nose is the "small" size of the pillows. However, I also find that the holes that the air passes through are TOO SMALL and create some rather dramatic noises (whistling and air rush) on both inhalation and exhalation. I find that I have to expend more energy to exhale even with the AFlex engaged. When I switch to the "medium" size pillows, those noises seem to abate. But, the "medium" pillows then seem to have issues with leaking during the evening as I turn left and right in my sleep. This then wakes me up and I then have trouble getting back to sleep, thereby mitigating the benefits of the CPAP therapy.

Since I am about ready to obtain some new pillows, I thought that I would experiment a bit. I took a fingernail clipper and clipped the "small" pillows to enlarge the opening. I will assume that this will compromise the integrity of the pillows , and I think that I am out ahead of curve since I have not tried to sleep with this "altered" pillow yet so I do not have the proper report to let you know if this worked or not.

My question is: Has anyone else had this sort of trouble? Is there some sort of replacement pillow that has the smaller size pillow but still have a good size air hole? Any ideas on a different tack that I could take for this issue?

Racurl wrote:I know that this has been addressed before, but I seemed to have lost the stream on this question. When using the Swift LT mask, I find that the best fit for my nose is the "small" size of the pillows. However, I also find that the holes that the air passes through are TOO SMALL and create some rather dramatic noises (whistling and air rush) on both inhalation and exhalation. I find that I have to expend more energy to exhale even with the AFlex engaged. When I switch to the "medium" size pillows, those noises seem to abate. But, the "medium" pillows then seem to have issues with leaking during the evening as I turn left and right in my sleep. This then wakes me up and I then have trouble getting back to sleep, thereby mitigating the benefits of the CPAP therapy.

Since I am about ready to obtain some new pillows, I thought that I would experiment a bit. I took a fingernail clipper and clipped the "small" pillows to enlarge the opening. I will assume that this will compromise the integrity of the pillows , and I think that I am out ahead of curve since I have not tried to sleep with this "altered" pillow yet so I do not have the proper report to let you know if this worked or not.

My question is: Has anyone else had this sort of trouble? Is there some sort of replacement pillow that has the smaller size pillow but still have a good size air hole? Any ideas on a different tack that I could take for this issue?

Some of us here have experimented with cutting the openings of the nasal pillows to make the larger (including myself). Usually, people notice a definite easing of the amount of effort it takes to inhale and exhale.

Actually, I'm thinking of totally removing the 'outer' nasal pillow. This appears that it should make it like the nasal pillows that are on the regular Swift design. I seemed to have less problems breathing with the nasal pillows on the regular Swift design.

Any ideas or suggestions on removing the 'outer' pillows of the Swift LT nasal pillows?

Thanks.

Allen

I think ResMed should be made aware of this problem regarding exhaling with the Swift LT small pillows. Does anyone know if ResMed knows about this? If not, any ideas on who to contact?

Gail

gailandartie wrote:I think ResMed should be made aware of this problem regarding exhaling with the Swift LT small pillows. Does anyone know if ResMed knows about this? If not, any ideas on who to contact?

Gail

I totally agree. The bizarre thing is, I have more trouble inhaling through them that exhaling.

Go figure.

Allen

I had trouble exhaling with my Swift LT. I tried trimming the pillows. I read on this forum to be VERY CAREFUL when trimming them, because it's easy to slip and over-do it--which I did. I tinkered with each set of pillows, and every time I quickly went from, "This is almost enough" to "Oh, no, the pillow ripped down!" That being said, the trimming did seem to help.

However, I felt the main problem for me was the fact that the exhalation holes seemed too small to allow the exhaled air to escape before I needed to inhale again. Before checking with the forum, I lab ratted a little. I took a sewing needle that was just a little larger than the exhalation holes, and ran it through the holes to expand them. I increased the needle size several times to stretch out the holes. I eventually even took the tip of my embroidery scissors and used that the expand the exhalation holes. When I was done, I wiped it out to remove any residual plastic dust, and then blew it out with the hair dryer.

Result: WONDERFUL!! My air can enter and exit quickly. I do not feel claustrophobic! My mask surgery did increase the air noise level a little bit, but not too much!!

WARNING: This obviously "damages" the mask. I was also warned by others on the board that messing with the air ports can cause leaks. I have the ResMed Auto Set S8--my leak rate is about .20. That is higher than what I'd like it to be, but I think it's still within the acceptable range. Plus, I am sleeping and breathing much better! My mask surgery rendered an unusable mask (for me) into my favorite mask!

hth,
All in Knots

Well......I tried the "altered" pillows last night, and they made more racket than ever! Lots of air rushing noise that was virtually impossible to ignore. I think that the cutting edge of a fingernail clipper is too curved to make a proper snip. To be blunt, I sort of wiped them out in the surgery process! I think that the semi-ragged edges that I ended up with caused a lot of the air rush noise. I saw no difference in the exhalation effort needed as I had to change the pillows out quickly due to the noise generated.

When poking around yesterday waiting for some of you to respond, I came across a post that mentiond that they tried to cut down BOTH of the pillows (inside and out). I did not do this and, when I think about it, it would make sense that only enlarging one of the pillows (the outside) would not fully do the trick.

There is, however, not much material on the "small" size pillow and I will assume that my next venture into the cutting down will more than likely annihilate the pillow. I don't see the problem as being the exhaust ports on the mask itself. As I mentioned, the medium sized pillows do not have this same issue for me. I would be reluctant to tinker with the mask itself, but I guess if it works, it works and that is what matters.

It just seems unbelievable that we have to fool around with our equipment to make it work. It seems to me that pillow sizes would be better served to be more like hat sizes instead of only S, M, and L. Every person's nares are different and even a small difference in size will make a large difference in fit. Maybe that is too much nitpicking on my part.

If I need to operate on my nasal pillows again, this is what I plan to do: I plan to put a dowel rod (or something similar) into a nare, so the nare will tightly fit over the dowel rod. Then I plan to take a pocket knife or other very sharp knife, and carefully cut around the outside nare, going in a circle. Then I would remove the nare and separate the inside from the outside nare as best as possible, and slip a slightly smaller dowel rod into the nares, so it is a tight fit to the inner nare, and trim in a similar manner. Please no flames about this, it took me a long time to think of this plan, LOL! But I'm hoping that my exhalation ventilation hole surgery will not necessitate this.

I agree, it would be great to have different types of nares to choose from. Perhaps RESMED could come up with differently shaped nares and then photos of nostril shapes with corresponding best nare choice. I'm sure this would be difficult to do. OR, it would be great to be able to somehow form a set of nares to the shape of an individual's nostril, and be able to heat-set them somehow for a totally custom fit! Or maybe make a nostril mold the way orthodontists do when fitting a person with an orthodontic retainer!

All in Knots

The idea of using a dowel for "back support" as the surgery is conducted is BRILLIANT! As my father used to say, "Too soon old and too late smart."

Since I have wiped out the "small" sized pillows, I will use those to experiment with. If anyone hears of any other way to adjust the hole-size on the pillows, I would be all ears.

Well, my bragging rights are overshadowed by the fact that I operated on all three nare sets--extra small, medium and large--before thinking of the dowel rod idea. The most useable post-op pair was the size small, but the edges are jagged at best on that one. I just rec'd my new pair of size smalls, and I'm hoping that I won't need to trim them, but we'll see... So I destroyed about $60 worth of nares in the process!

All in Knots

Well, I just used a "Sharpie" permanent pen for the dowel and it worked very well! It was kind of difficult to get at the inner pillow, but I did it and now the holes are approximately the size of the holes on the "large" set. I just hope that there is enough of the pillow left to hold a seal. I tried them just now and they seem to work just fine, but the proof will be in the sleeping.

Hang in there "Allin" and if you come up with any further ideas, be sure to share them with us!

Just wondering: Do the ends of the inner nares still sit up higher than the ends of the outer nares? I'm guessing that that is important for correct air flow, but I could be wrong. In other words, did you cut off the exact amount (or almost) for each set of nares? (For instance, 2mm off the bottom of the inner nares and outer nares?)

All in Knots

The "inner" pillows are shorter than the "outer" pillows. I sort of snipped the same amount from both inner and outer. Like I mentioned, there seems to be very little left of the outer pillows, so I am not sure how it will seal in a full-blown sleep situation, but I am going to find out tonight!

I'm sure they'll seal better than mine did with my original trim attempt. The side of the outer part of the nares has a vertically angled gash in it that sort of makes a number 7. If I bump my head on the pillow the wrong way I hear a hiss noise, and I know that I need to re-seat them.

But I'm still standing by my ventilation-hole size expansion project. VHSEP for short. Really made the difference for me. Life altering mask altering.

All in Knots

I tried to clip a small 1/8 moon shape from only the inside of a pillow tubes so the outside nasal tube section wasn't changed on a small pillows since the air passes through are TOO SMALL . Now I got a screwed up small pillow and moved to the medium pillow. Wish they were a little longer.

Shilohcane wrote:I tried to clip a small 1/8 moon shape from only the inside of a pillow tubes so the outside nasal tube section wasn't changed on a small pillows since the air passes through are TOO SMALL . Now I got a screwed up small pillow and moved to the medium pillow. Wish they were a little longer.

Hi, Shilohcane. Please explain a bit more. I don't understand how your clipping ruined the pillows.

All in Knots