Nasal Pillow Question...

Hello,

I have mixed apnea and I'm using a Resmed VpapIII machine with pressure settings of 18/12. I use a Mirage Activa mask and now that I'm past the adjustment period, I find it comfortable and easy to use.

I've only been using my equipment since August 1, and it was definitely hard to get used to. But for the last week, I've been sleeping well and waking up with so much energy and such a clear head that I now realize that I spent the last 5-10 years sleepwalking through life!

Unfortunately, I also have seborrheic dermatitis, which has decided to flare up---big time. The skin along the sides of my nose is red and irritated. The Activa mask only makes it worse--as soon as I put the mask on, my skin starts to burn and itch. (I tried loosening the straps, but they're already loose. As soon as I adjusted them, I got major leaks around my eyes.)

I'm not willing to go back to the old sleepwalking days and I definitely don't want to give up my Activa. I'm going to contact my DME on Monday to see if I can get a nasal pillow system for the days when my dermatitis is acting up. (My insurance sucks, so there's a pretty good chance I'll end up paying for it out of my own pocket.)

My question is this: I remember reading "somwhere" that nasal pillow systems don't work well with higher pressure settings. Is this true? Does anyone out there use nasal pillows with a higher pressure?

Thanks,
Mithosa

Mithosa:

Yes the nasal pillows handle high pressure very well! i have had all types of interfaces over 11 years at a fixed pressure of 18cm H2O. the BEST of the nasal pillows for me is the SWIFT. handles high pressures vey well and leaks are almost non-exisent! also the most comfortable mask i have ever had. i now have a remstar auto and this mask continues to be the BEST at a range of 14 to 19 cm H2O. also the mask does not have a lot of bells and whistles etc, just a simple excellent deseign which works great for many of us on cpap. It also comes with 3 pillow sizes included which makes fitting very easy. i am also a back and side sleeper and have had no problems with this interface either with leaks or marks on my face. i use a bed pillow thicker at the back than on the front (anti- ache) type which also helps with any type of mask on cpap therapy!
i hope the above info helps YOU with your decision to try the nasal pillows.
from your post i beleive it will help you overcome the sebborrheic dermatitis problem etc.- having trouble loging in so i will probably get "GUESTED".
Welcome to the board!!!!
steve,
ufo13

Mithosa:

sorry i forgot to mention if you have to PAY for the mask yourself, i would check the price they want to charge you! i would advise you to go to: CPAP.COM and check the price for what you want! i have been doing business with them for a few years and they will help you greatly not only with the items and prices etc. but also with the helpful advice they provide. all of us also are on this form to help anyone we can so don't be afraid to ask ANYTHING!

best wishes to you,

steve,
ufo13

A nasal pillow interface will work great at most any pressure. They will also minimize the contact with your nose/face. This sounds like just what you need. i use the AEIOMed aura, but if you have a smaller head you may do better with th ResMed Swift or Puritan Bennett Breeze.

Steve had it right - if you have to purchase a mask "out of pocket" then our hosts here at CPAP.COM have the best prices I've found!

My only comment on the pillows is that you get a unit that has a couple of sets of pillows included (medium and large size). The DME told me that mediums were what I needed. After much pain and discomfort with the medium pillows I switched to the large pillows with great success!

My question is this: I remember reading "somwhere" that nasal pillow systems don't work well with higher pressure settings. Is this true? Does anyone out there use nasal pillows with a higher pressure?

It's not true. Nasal pillows interfaces probably work even better than traditional nasal masks (the miraculous Activa being a unique exception in nasal masks) for people who have to use high pressures.

I don't actually use a high pressure myself. My range on autopap is set for 9 - 15, rarely ever hitting 13 or 14. But I have experimented using quite a few straight high pressures, including 19 and 20 cm H20 just to see if two of my favorite masks could hold a seal up in the stratosphere.

Granted, I couldn't take it long enough to try an all-nighter experiment at 20! LOL!! But I did use both for at least 10 or 15 minutes each, and did a lot of toss'n'turn sleeping positions to see if high pressure + moving a lot would break the seal. Both my nasal pillows interfaces - Breeze and Aura - handled the pressure great up there. Sealed perfectly.

I should hasten to say my high pressure experiments with the Aura were with the addition of a soft homemade strap down near the nasal pillows part...an arrangement I use with that mask anyway even at my much lower pressure range.

I'm sure the Swift would do equally well and probably wouldn't even need anything added to stabilize it.

DME's seem to be most apt to say "pillows interfaces don't work at high pressures". Given the mistake so many DMEs make by usually fitting people with "too small" pillows, I can understand how they probably get that kind of feedback from their customers on high pressures. Add to that the cluelessness of most DMEs about how to manage the hose so it doesn't pull on a mask when people turn over... no wonder the high-pressure people they fit have problems...with ANY interface.

I tried a Breeze pillows mask for 1st time last night. In terms of lightness & sealing it seemed great & I was very enthused but my mouth let me down.

Just couldn't keep it closed & kept getting air blasting out (was at 15cms) and that then began to cause nasal pain. If I can solve the mouth sealing in a permanent way, I believe the nose pillows might prove my best mask.

I usually have to grapple with nasal congestion, the pillows seemed to eliminate this while I was doing ok.

Good luck

Cheers

DSM

Thanks for all the wonderful information! I have an appointment with my DME tomorrow morning. Even if my insurance won't pay for another mask, I'm hoping they'll let me "test run" one before I buy it online. Maybe I'll fall in love with nasal pillows and willingly give up the activa mask. I'm sure stranger things have happened!

In the meantime, I slept without my machine for two nights--so I was able to use my prescription ointment on my face. The redness is almost completely gone. It only flares up every couple of months and goes away within a couple of days, providing I can use the medication at night.

I've also woke up in the middle of the night to find air blasting out of my mouth. Such a weird feeling! So far, a chin strap has done the trick for me. It took some getting used to, but I finally figured out that if I fastened the straps over my ears and towards the back of my head, my mouth would stay shut without tightening the straps to the point that I had marks on my face the next morning.

Again--Thanks so much for your help.
Mithosa

rested gal wrote:

But I have experimented using quite a few straight high pressures, including 19 and 20 cm H20 just to see if two of my favorite masks could hold a seal up in the stratosphere.

Yes, and thanks to RestedGal for using herself as a guinea pig! I ordered an Activa based on your results (and on the helpful remarks of others who have used it at higher pressures).

To all the experienced hose-heads on this forum, THANK YOU! You have made these last few weeks MUCH easier for me!

Moogy