Two Aura Thoughts

I had one not-so-great time on Friday with the Aura being leaky. So last night, instead of using the pantyhose leg over the nosepiece and tied down behind the base of the skull, I used one of RG's OTHER suggested fixes and used the pantyhose leg as a cradle, so to speak, under a bit and up the front of the nosepiece, bringing the two sides to be tied above the ears, behind the head. Worked like a platinum diamond-encrusted charm! The pillows COULDN'T move since the were being forced to stay just where they were.

I would suggest anyone who is having a problem keeping the pillows in place and getting movement try this method. I truly feel it's far better than perhaps causing the nosepiece to be pulled down and out of the nares possibly by securing the straps in a downward position behind by the base of the skull. This worked perfectly. Thanks again, RG.

I am editing this part of my post since I have done some investigation since and have found out I was incorrect, but my theory may be right. As far as what size pillows to use, I think if you have large nares, the large pillows dimensions might be right for you, but they have a very large hole for the air to enter. Why they do that, I don't know. One size hole should be enough, although a different diameter in overall pillow shape might be needed. I think if your nares are on the larger side and you use a pillow whose hole is large, too, it creates more of a possibility of leakage. The hole should be further away from the edge of the nare so as to make a better seal. I don't know why they made the hole larger, too. You would think a standard sized hole should deliver the correct amount of pressure regardless of how large or small your nares are. But the difference in size of the pillow is what should be altered according to nare size.

That is why I think I do better with a medium. It is still large enough to seal off the nare without putting the hole of the pillow so close to the edge of the nare as to cause leaks when you move. I hope I am explaining this correctly so that others can follow my rationale. Does this make sense?

Lori, I have moved away from wrapping the cannula as well. Now I use about a 3 inch wide piece of stretchy material that covers from about mid-nose to the bottom of the cannula, basically a stretchy material mask over everything. Since the cannula material is rather sticky it doesn't slide around at all. I am still fixing at the back of my head under the ears. But I don't bother with trying to tie the knot, I just use one small piece of Velcro, which gives me full adjustability as to tightness. This gives me a great seal all night long. I think above and behind the ears would work great as well, this has the added benefit of pulling the pillows up into the nares, hence increasing the seal.

I have also abandoned the large pillows. I just compared both sizes again, and the large pillows on mine are definitely larger in every way than the medium pillows. Anyway, I think the medium pillows, because the material is so squishy and conforming, tend to seal better in the nare. As a comparison to the breeze, the breeze pillows tend to compress a lot more, and use pressure to achieve this seal, so a larger size works better for me with the breeze. But with the aura, I think the medium works better because it conforms and squeezes into the nare, rather than using brute pressure to achieve the seal. I think this is also the reason why we need extra support with the aura. Even with the wire, the cannula is not rigid enough for many people to achieve a good seal.

I think we're pretty much saying the same thing, although I'm not sure the size of the hole has that much to do with it. But maybe it does. At this point, I really don't care as long as I keep getting a good seal.

-BP

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CPAPopedia Keywords Contained In This Post (Click For Definition): breeze, Aura, seal

I agree with the fact that no matter what you do, as long as it helps seal the nares, that's what counts. And I think the mediums do a better job than the larges. You're right that with the Aura, it's okay to almost stuff them into your nose as they are just plain soft and comfortable and wouldn't hurt like if you did that with the Breeze, or even the Swift. I just feel the holes in the larges are too big and don't give you any room for movement without letting air out. I think they could have made the size of the pillow itself larger, but kept the size of the hole the same as with the mediums, thereby reducing the risk of air escaping through such a large opening.

I can't believe how much more secure the cannula was last night with just the change in direction of the strap under it, rather than across and pulled down. You don't need to cover it, as you said, but rather just a gentle cradling effect so you can lock it into place. Worked great for me. Glad you found your solution, too.

So, it looks like if you use pillows there IS a chance of it moving around. I'm calling the DME today, and hope to try pillows. We'll see what they have. Thanks everyone for all the experiences with this. Thanks to you all, I have knowledge enough to know what to ask for....

Barb, I use the Swift not the Aura, but these general comments apply.

I move all over, rolling from my left side to my back to my right side to my stomach (always from my right side with my head turned to the left). Then I start rolling back the other way.

I couldn't do this with a traditional nasal mask, but with a good nasal pillow system properly adjusted (note emphasis) the mask follows my twists and turns, usually without signicant leaks.

I won't say it is perfect, but I'm amazed at how well it works. Definitely falls in the category of "good enough", with room to spare.

"The amazing thing about the dancing bear isn't how well it dances, but that it dances at all!"

Barb,

I don't know what one you're going to choose, but I know the higher the pressure with the Aura, SOMETIMES the harder people are finding to keep a seal. However, the comfort you get from the Aura is usually worth the extra tweaking necessary once you find a solution. Not saying you won't be one that can't use it right out of the box, but you should keep this in mind. I think the Swift can take higher pressures without breaking the seal the way the Aura might-but there's always pantyhose...

Thank you for your thoughts Bill, I appreciate it!

that's another slant on it, too..the sleep center set my pressure at 12, although I'm having a really hard time with that pressure. Seems like the pillow interface would just blow off my face at that pressure *grin* I won't be able to use ANYTHING out of the box, my life with CPAP hasn't been smooth for 8 years, and I don't expect that to change...sigh...I sound depressed...I am. I am tired of messing with this...back to the drawing board again! Thank lori for your help too!!!!!

Barb,

I'm sorry you're depressed, but we wouldn't be human if we didn't get that way from time to time. Especially being on therapy eight years and still looking for the right mask...gees, I'd be shocked if you didn't get frustrated.

I'm not saying the Aura won't work for you. It might be the best mask you've ever used. Maybe you'll need a little extra help from a panythose leg to keep the pillows in place, maybe not. We all know by now it's a crap shoot when we order a new interface. I don't think the 12 cms. of pressure is going to blow the mask off your face, though. Many people feel what seems to be like an increase in their pressure when they start on the nasal pillows, even though it isn't, just for the mere fact of that air being injected directly into your nose. But you do get used to it very quickly.

Try not to let this get to you. You are no different than most of us in that it's a day-to-day struggle to get it as close to perfect as possible. We just have to remember we can probably never reach utopia when it comes to this condition, at least not with what they've given us to work with thus far.

Thank you

I woke at 3am and got stuck thinking about the Aura trying to determine if there were any factors rather than sheer random luck that it works so well for me. Like Wader, I sleep on my side and switch sides through the night. I also just slap the mask on each time with no adjustments, just breathing for the machine to start. Here are my middle of the night thoughts:

1) I have very thick hair and thought from the start that it was probably an advantage, giving me some extra padding after tightening up those huge straps. The headgear seems to nestle into my hair and never move. I pull my loose hair through the back, such that the back strap is anchored under my back hair line.

2) Once I initially adjusted the nose piece I secured the tubes with a twisty tie from a bread bag. Has anyone else tried this? I am convinced that this is a key to my success. I never have to fiddle to adjust as the tie keeps my original adjustment in place, despite rolling around.

3) I sleep on latex pillows. My seal is never dislodged by the pillows which I've seen frequently mentioned. When I turn, the soft latex contours around and absorbs the little of the mask that touches the pillow. There is no bumping, disturbing or dislodging. Many probably already sleep on latex; you might consider a switch if you don't.

That's my middle of the night analysis which seems far less compelling now in the daylight, but offered in hopes it might help.

Seamaiden,

I am having a leak, albeit small, from time to time now, too. When you talk about using the twister tie like from a loaf of bread, doesn't that pull the pillows too close, causing them to pinch the skin between the nares? Ouch, unless I'm picturing it wrong. And the wire from the tie doesn't hurt or dig into the bridge of the nose when you sleep?

Would you kindly be like RG and give us photo illustration??? Only kidding. Wouldn't expect you to .

Lori if I had any idea how to do photo illustrations I certainly would.

To effect and maintain a perfect seal, I needed to bring the nose tubes closer together. When I just bent the wires, I would lose that form during the night. So I pulled the tubes exactly where I needed for perfect fit, and secured it with the twisty tie. No pinching, it brings and keeps the pillows to just where I need them to be and stay. On my fit, that plastic cross bar falls roughly an inch or so below where the tubes come down. I have my tubes tied (talking cpap not gynecology) above that plastic cross bar. That tiny twisty wire is encased in paper. I have the paper flat in the back (and twisted in the front) and can't begin to feel it.

seamaiden,

I'll take a wild stab that that last guest post was you?

Thanks for the clarification. And LOL about having your tubes tied.

Oops, guested, yes that was me. Hopefully the panty hose reluctant guys won't notice the gynecology reference. It's wire. It's a very manly thing to use.