Nose cushions are for low pressures

I have a fairly high top pressure (15). For me, the most important thing about how the mask fits (or doesn't fit) and how badly it leaks are the strap arrangements. I have a head like a bowling ball and very fine hair. Been through plenty of masks (nasal pillows, full face, nasal cup, etc) and because of the way the straps were arranged, I would end up with the straps moving towards the top of my head and the mask leaking like a sieve. I jokingly (and not so jokingly) told my doctor that I wanted to have a snap surgically embedded in the back of my skull so I could snap the sucker in place. On my Quattro, I had the straps so tight that it would take about a half-hour in the morning for the marks to go away and still had leaks. The nasal pillows ended up feeling like someone taller than I am had put two fingers in my nostrils and dragged me around all night. The *only* mask that has fit me correctly is the Hybrid, a combo of nasal pillows and mouth thingy with a chin rest. I believe that in my case, the chin rest was the critical part.

Cynthia

Adding a strip of Velcro (the hook, or rough side) to the inside of the straps helps to stop them from sliding. The hooks grab onto the hair to hold it in place.

That's what I think, Cynthia
The chin rest on the Hybrid is what makes Hybrid so great for pressures up to 18 or higher. I tried once to cut the chin flap off and I like it better with the support.

My problem with this thread is the blanket statement "Nose cushions [sic] are for low pressures". That is true for some people like the person who started the thread, but it is clearly not true for everyone who needs a high pressure, as other posters have stated (and as the studies conducted by the nasal pillow mask manufacturers confirm).

What a tragedy it would be if someone with a higher pressure is dissuaded from even trying nasal pillows becuase of this thread--someone who cannot get comfortable with any other mask. Maybe that is a person who would succeed with nasal pillows when he or she cannot succeed with other masks--that person will never know if he or she doesn't try. If that person gives up trying CPAP thinking that no mask is ever going to be comfortable enough to tolerate, then that person will not get the treatment he or she needs. Serious health issues are at stake here!

We all have a responsibility here to be supportive of people on xpap therapy. I don't think that such blanket statements fulfill that responsibility.

profoundapena wrote:I just wanted to post for all newbies that those like me with pressures over 16 probably can't use nose cushions or the other nasal masks. My technican told me this; it has to do with the size of your nasal passages I think. The pressure seems like your head is going to burst, so don't even try the "pillows." Nor that expensive liberty mask. I tried it and it was quite uncomfy. Quattro is the deal; just tighten the bands down, even if they feel very tight.

When I first started CPAP therapy, the RT told me about the same thing. I believed her and for about 3 years never even gave a thought about anything else except a FFM. Then as I was looking at my wife's old Opus 360, I decided to give it a try. What a difference. I'm glad I did. The pillows are a lot better than a FFM for me.

Today I am experimenting with a Swift LT and a recent re-titration has my pressure at 19. The straps on either the Opus or the Swift LT I can keep relatively loose and still have no leaks.

I think that you have been misinformed.

Allen

There was a recent thread here where someone with really high pressure (25 or higher, if I recall) was successfully using a nasal or nasal pillow mask.

I use a Hybrid mask with a pressure range of 14-18. I have some leak issues with it, but they are usually easily dealt with. I, too need to have the mask tighter than what is recommended. This may because I am a restless sleeper, and exude a lot of skin oil.

allen476 wrote:

profoundapena wrote:I just wanted to post for all newbies that those like me with pressures over 16 probably can't use nose cushions or the other nasal masks. My technican told me this; it has to do with the size of your nasal passages I think. The pressure seems like your head is going to burst, so don't even try the "pillows." Nor that expensive liberty mask. I tried it and it was quite uncomfy. Quattro is the deal; just tighten the bands down, even if they feel very tight.

When I first started CPAP therapy, the RT told me about the same thing. I believed her and for about 3 years never even gave a thought about anything else except a FFM. Then as I was looking at my wife's old Opus 360, I decided to give it a try. What a difference. I'm glad I did. The pillows are a lot better than a FFM for me.

Today I am experimenting with a Swift LT and a recent re-titration has my pressure at 19. The straps on either the Opus or the Swift LT I can keep relatively loose and still have no leaks.

I think that you have been misinformed.

Allen

My sentiments exactly. Making the statement, "so don't even try the pillow" is irresponsible, does NOT apply to everyone, is not in the least helpful, and may cause many people unnecessary distress. If you had worded your post a little differently, perhaps it would not have caused such an uproar of disapproval from people who are a great deal more knowledgeable about this than you or your DME provider are.

profoundapena wrote:I just wanted to post for all newbies that those like me with pressures over 16 probably can't use nose cushions or the other nasal masks. My technican told me this; it has to do with the size of your nasal passages I think. The pressure seems like your head is going to burst, so don't even try the "pillows." Nor that expensive liberty mask. I tried it and it was quite uncomfy. Quattro is the deal; just tighten the bands down, even if they feel very tight.

Not all sleep professionals know about how a mask will work for each person. It is easier for them to generalize and use the 1 size fits all but without actually using the product they have no clue how it will perform in the home. As a long time user with a pressure setting of 17 I have tried many different masks and can honestly say that until I tried the Opus 360 I was never comfortable sleeping and always had red marks on my face. With the Opus 360 I can sleep on my side or stomach with virtually no leaks and my face is free of mask marks when I awaken. MY AHI averages around 1, I have energy levels that would appear normal, and never require a nap. There are also ways to help secure the pillows for those who have trouble with them and as far as the pressure goes, if you would sit with the machine a couple of hours a night either watching TV or reading after a couple of nights your body would adapt and going back to a full face make would be very undesirable. Of course if you like the full face mask then by all means continue using it but I highly recommend that you keep working with it to loosen the straps because if you continue with them strapped tightly you will end up with sores and a aching mouth. It is great that you want to help newbies with advice, just do not use absolutes as what works for you may not be what others need to succeed, and maybe there are some here that can offer a better alternative to you that would enhance your experience. I have been doing this a lot longer than most on this forum and have used much from here to optimize my already successful therapy. If I had been close minded to others ideas I wouldn’t be doing quite as well as I am. Good luck and welcome to the forum.

wow last time I checked I was under the impression that 20 was a high pressure, especially since my poor machine wont go any higher lol. but yet I use nasal pillows successfully. And have for more then a year now. And I love them!! And yes my pressure is set to 20.
And when I first asked about pillows several years ago I got the " They wont work with the higher pressures" speech too, So last year when I went in to try on masks I was shocked when the technician pulled me out a Swift LT for HER. And I asked him about it.
His comment was "Some people like to live in the dinosaur age I guess" And he laughed.

After 15+ years and well over 30+ techs I have dealt with through my DME and hospitals its amazing how many of them actually know very little about the actual use and day to day handling of the machines and equipment, even my current guy has admitted on select masks he only knew what the manufacturers paperwork said about them.

And most likely a pillow type mask is not what the DME is currently getting the biggest kickback on which is usually what determines what product they push anyhow. granted they are there to supply our healthcare items but it all boils down to which one gets them the most $$$.