Tough adjustment to nasal pillows

I've been having good success with CPAP treatment overall but the masks have been problematic. I get skin rashes when using nasal masks. Remzzzs liners help but don't solve the problem completely. So I thought I'd try nasal pillows. Got a ResMed Swift FX set. I'm using the small pillow size. First night went OK. woke up a few times due to the unusual mask. Had some leak issues at 4am, solved them. went back to sleep. AHI was 2.1, pretty good. Second night started out OK but at 3am I had to switch back to the nasal mask because my nasal passages were getting very sore. Pressure range was 9-14cm all night, at the 3am mark I was at 14cm. Third night (tonight) I tried the nasal pillows briefly but my nose is still too sore to use them. I do use a humidifier every night.

Any suggestions? Is this typical at the pressure levels I am using? I'd much rather use the pillows if I can get rid of the soreness and get the fit dialed in properly. Thanks!

Get some Lansinoh cream and put around the nare openings. I had read about this before I bought my nasal pillow mask, and I used it from the first time.....not a single problem with irritation. This cream is found on the baby aisle of stores since it is usually used by nursing moms. Purple box/tube. You might want to use it for a couple of nights with the nasal mask so your nares can heal. It will soothe them and then go back to the pillows. It is a bit tacky to the touch so it also helps get a good seal with the pillows.

I'm wondering if you need to go up a size in the nasal pillows, too. When people complain of irritation, usually the headgear is too tight and the pillows go too deeply in your nose, then cause friction as they inflate and deflate with EPR/Flex.

Use the Lanisoh for a few days, and when you're ready to try again, loosen the headgear and fit the pillows like this:

1. Hold the pillows up to your nose (try the next size up).
2. Turn the machine on so the pillows fully inflated.
3. Put the headgear on, and adjust just enough to stop the leaking.

You can use Lanisoh on your nares to help seal the nasal pillows--others have good results with this (but it never worked for me).

for some people, Nasal pillow requires high degree humidifier to prevent dryness in nasal passages

The first week of using nasal pillows for me was somewhat painfull. I wouldn't call it irritation persay since the skin was fine, no redness or anything but the tip of my nose just downright hurt days 3-5.
Day 6 it stopped and hasn't been a problem since. I did add a extra strap that i read about somwhere on this forum to the headgear, so that might have been what fixed it.

Mine is the Swift LT For her and I use the medium pillows even though my RT says they are to big. But I like em that way and only get leaks if I lay on my side and dislodge them. But I am a back sleeper most of the time anyhow.

Hi---I also use and like the Lansinoh cream --works great on the dryness that can happen on the nares when using the nasal pillows. Just don't use too much. A little dab goes along way! I also use the Swift LT for her---love the freedom that the nasal pillows can give you. The Swfit FX is great too --I have that mask as well. I can't see to find a sweet spot with that mask and keep going back to the LT. Follow the tips that the other posters gave you--it is great advise.

Keep trying--hang in there --it will work for you --don't worry, we all had issues like this when we first started out, it will get better,

Carrie

Dan, you say "passages", people here are assuming just inside the opening - if not please advise.

Two things I'd note:
- if the tip is going deep into your nostril that is a more sensitive area and also the end is more likely to abrade due small surface area.
- leaks cause me some trouble (one corner of one nostril is a sharp corner, if I have soreness or dried gunk it will be there).

People using the P-B pillows system, IMJ the best by far if you have good headgear like CONJO, have the option of two different tips in most sizes - the "dilator" version has a thicknened end.

Also beware the odd nasal interfaces that are designed to seal up in the nostril - I think that is simply not possible and has high risk of irritation.

As for rash from a mask, I hope all makers are using basic medical grade silicone or at least platinum-cure silicone, cheaper materials are far more likely to cause a reaction (avoid tin-cure silicone). Perhaps different finishes make a difference - some are silky for example.

Try a very slight loosening of the headgear. The pillows do not need to be crammed into your nose.