Nasal mask vets, I could use a little help.

Hello all!

I'm new here. Just got a CPAP last night and I have the ComfortGel Blue Nasal CPAP Mask with Headgear from respronics.

Anyway. If some of you other Nasal Mask vets out there could give a rookie some advice, I'd appreciate it.

This morning when I woke up, my septum nasi (the bone that seperates my nostrils) really hurt. It felt like someone punched me right where the septum nasi and maxilla meet. Very uncomfortable, and I'm 6 hrs post sleep and its still tender. Is this normal? Is the mask to small? Is there something I'm doing wrong?

I don't have any marks or bruising, just uncomfort and a lingering pain.

Any suggestions?


Thanks in advance for the help!

p.s. This post originated with "Nasal Pillow" but I didn't know the difference until one of the people below started to explain. Very sorry.

I think you may have it strapped on too tight. Try loosening it up a bit and see if that helps.

rosie

Sometimes there is a little tenderness with nasal pillows at first, but what you're describing suggests that the headgear was too tight. It does not need to be tight with nasal pillows.

First, we aren't sure what system you are using. "Blue one from Respironics" is kind of vague. Can you look on the packaging and see--you should have gotten a little instruction book. If not, take a look at the nasal pillow masks on CPAP.com (our hosts) and see if you can find the one that looks most like it.

Now, about the fitting. First, forgive me if you already know this, but a lot of DME's do not and tell their customers the wrong thing--the nasal "pillows" (the little cone shaped tips), rest AGAINST the nose, not IN it (although a very small portion of the cone will go inside the nose). So if you were told to cram the nasal pillow IN your nose, that is wrong!

Nasal pillows inflate with the CPAP air pressure. So you want to fit the fully inflated pillow against your nose. If there is leakage, when in doubt, go UP a size. The second biggest mistake people make is using a nasal pillow that is too small.

Now, as for fitting.

1. Loosen your headgear.

2. Hold the nasal pillows up to your nose without putting the headgear on your head.

3. Turn on the machine and let the pillows inflate.

4. Now put the headgear over your head, and adjust the headgear just “tight enough” to keep the pillows from leaking air. This fit should be fairly loose, but not so loose that they leak if you turn your head or move around in your bed.

You can use some Lanisoh cream (medical grade lanolin, available in the “baby” aisle for nursing mothers) both to soothe your sore nose, and some people find it helps seal the pillows to the nostrils (that didn’t work for me).

Janknitz wrote:Sometimes there is a little tenderness with nasal pillows at first, but what you're describing suggests that the headgear was too tight. It does not need to be tight with nasal pillows.

First, we aren't sure what system you are using. "Blue one from Respironics" is kind of vague. Can you look on the packaging and see--you should have gotten a little instruction book. If not, take a look at the nasal pillow masks on CPAP.com (our hosts) and see if you can find the one that looks most like it.

Now, about the fitting. First, forgive me if you already know this, but a lot of DME's do not and tell their customers the wrong thing--the nasal "pillows" (the little cone shaped tips), rest AGAINST the nose, not IN it (although a very small portion of the cone will go inside the nose). So if you were told to cram the nasal pillow IN your nose, that is wrong!

Nasal pillows inflate with the CPAP air pressure. So you want to fit the fully inflated pillow against your nose. If there is leakage, when in doubt, go UP a size. The second biggest mistake people make is using a nasal pillow that is too small.

Now, as for fitting.

1. Loosen your headgear.

2. Hold the nasal pillows up to your nose without putting the headgear on your head.

3. Turn on the machine and let the pillows inflate.

4. Now put the headgear over your head, and adjust the headgear just “tight enough” to keep the pillows from leaking air. This fit should be fairly loose, but not so loose that they leak if you turn your head or move around in your bed.

You can use some Lanisoh cream (medical grade lanolin, available in the “baby” aisle for nursing mothers) both to soothe your sore nose, and some people find it helps seal the pillows to the nostrils (that didn’t work for me).

Thank you... Your reply was very helpful. I'm sorry that I did not get the mask correct and I do have the ComfortGel Blue Nasal CPAP Mask with Headgear. I just realized that there is a major difference. Very sorry... rookie mistake!

Any suggestions?

Straps are too tight. Loosen until pillows leak, then tighten it a tad. Keep an eye on your leak rate each night until you have a handle on how tight the straps need to be. Getting the tension in the headgear just right takes some time, but once you get it right, you'll know how it should feel.

Re: tenderness, ranch hands used to soak their hands in a bucket of lye to harden their skin. I suppose you could do the same with your nose, but unless you have a schnoz like the late Jimmy Durante or Jacques Cousteau, that might be more trouble that it's worth.

(The foregoing was an attempt at humor om my part. I don't seriously condone immersing your nose in lye for any reason).

You're going to go through a period of adjustment. Your external nares aren't accustomed to anything touching them for long. Expect some redness, even some inflammation and pustules if skin bacteria find you appetizing. Applying a little Neosporin or similar topical antibiotic will knock that down until your nares harden up. Once they do, symptoms will go away and you'll be fine.

You can apply a little Vick's (my preference) or lanolin "nipple cream" to your nares which will help seal the pillows to your skin and reduce friction and resulting irritation.

Dunno which mask you're using. Mine has a ball joint where the hose attaches and a velcro tie up top of my head where the hose is supposed to be secured. I can't stand the hose going up the front of my face, so I removed the velcro and just let the hose flop around wherever it wants to during the night. It always seems to end up exiting the mask and going across my neck toward the machine when I sleep on my side. I don't even know it's there.

Oh yeah, a hose "snuggle" thingy is nice to have. The snuggy has the same feel as a blanket, so you won't even know it's there. The bare hose tends to stick to your skin and will exert tension, torque, or compression on your mask which you'll definitely feel if you don't have one.

Finally, I sluice out my nose thoroughly with saline nasal spray immediatly before putting my mask on. Four vigorous squirts in each nostril, alternating left, right, left right . . . inhaling will loosen anything in there and allow you to breathe better. My doc' said he could not overemphasize the importance of saline before putting on a nasal mask. He was right.

Hope this helps.

Ooops! My mistake! You do not have a nasal PILLOW mask, you have a nasal mask.

That's a whole different thing when it comes to fitting!

But it was too tight, it sounds like and may perhaps be the wrong size if you are so sore. I'll let vets of your mask tell you the proper fitting--please ignore my previous post.

You have a adjustable "T" bar at the top of the mask to help relieve pressure from the bridge of the nose. Hold the mask on you face so it sits square with your face, adjust the "T" bar to provide needed forehead support. Tighten straps to maintain that position of the mask, without over tightening to the point of pain, just enough that the mask holds position.

You may find that the mask moves up badly at night, sometimes rolling the lower webbing in the back a couple of turns, and securing it in that position helps, I guess the shape of Chinese heads are different from mine. PAD-A-CHEEKs here makes a great product to help with the comfort of the mask webbing, if that bothers you. It makes my neck sore and itchy.

As always, you need to monitor your leak rate to see that you are NOT mouthbreathing, and keep the leak rate low so the data will be correct. I have found that mask and the Comfort Full to work best for me, both adjust the same way. Jim

Thank you all! This is all very helpful!

Starybartfast - HILARIOUS!

I have never had a nasal mask (not pillows) cause any soreness on the septum.

I am wondering about your humidity level or do you use a humidifier?

Is the front of the maks pressing on the tip of your nose? it may be pushing into your septum and causing soreness.

Just possible suggestions on my part. I have used nasal masks and nasal pillows.

If your mask is the nasal cushion mask, (I don't know of any pillow masks that are blue), it sounds like maybe your mask is either too small or too tight against your face along the bottom edge.
It might help to adjust your mask while lying down--start loose-ish; and with the air on.
--then just gently adjust it a little at a time until the air just stops leaking. Maybe a tad more if it leaks again when you move.
If you do all the adjustment while sitting up, it may be tighter when you lie down--due to gravity adjusting your facial tissue.
(My fat just moves around)

I use the nasal mask also, and have a little discomfort in the same place. (I had to look up maxilla.) I went to the DME and showed the RT how I adjust the straps at home and discovered I had been wearing them improperly. That helped a bit, having it adjusted properly. I find that the straps tighten up as I lay down. Adjusting them in your natural sleep position can be very helpful. I lay down, get comfy and then lift the mask up a little and wiggle it around until I get a good, comfortable seal. If loosening or re-adjusting the straps does not relieve the pain, you may want to look into a different mask... another nasal mask, or perhaps even a different type of mask, pillows or full face. My current mask is the third I brought home with me, and I tried on about 10 at the DME in addition. And I didn't even try pillows. There are lots of masks out there, so if you can't make this mask work, it's ok.

Good luck on this wild and crazy adventure!