What new mask to get.

I have an appointment (DME) tomorrow to check out new masks and don't know what to try. I'm able to try one for a couple days no charge but are unsure which would be best suited for me.

Problem:

I can't seem to get comfortable with the present mask
Keeps sliding and I constantly get leaks with setting at 14.
Leaks are waking up my wife or if I fall asleep first she doesn't like the "leak" noise.
I adjust the mask tighter to prevent as many leaks as possible and my nose likes like rudolf in the moring as well as being sore.

have you tried viewtopic/t58377/I-velcroed-up-last-night.html

I assume you're suggesting using some Velcro to modify my present mask. If so I'm not having problems with the back strap moving up during the night, my problem is with a high pressure of 14 which I'll assume is not standard. I find it doesn't take much for leaks to occur and with only a slight movement of the mask against the pillow level 14 will easily allow leaks. I also want to have a mask that allows the hose to run along the top so I can easily turn my head from one side to another.

If I missread the info in the link please ask me to reread.

Thanks for the reply cflame1

if the leaks are coming from the pillows... have you tried lanisoh (lanolin)?

if not where are your leaks coming from?

I have a higher pressure than you and the Swift nasal pillows (LT and FX) work great. My guess is that they are not fit properly. I'm not sure how they are "sliding" if it's not the back strap, because the little tabs on the headgear do a pretty good job of keeping this mask stable. I've had issues with the back strap sliding around when I move my head on the pillow, hence the velcro fix.

But my guess is that the mask is not fit correctly. First, make sure that you are wearing the pillows AGAINST your nose, not IN it. Some stupid DME's are telling patients to cram the pillows up into the nose, and that's not how they are to be worn. Only a very small portion of the cone-shaped pillow tip should be in the nose--the wide base of the cone-shaped pillow is what seals against the outside of your nostril.

If you cinch the straps tightly, the pillows cannot inflate, and they need to be fully inflated in order not to leak. Try the following fitting instructions--ideally with the pressure on your machine all the way up to 15 while you are doing the fitting:

First, loosen all the straps on your mask and start with it off your face. Now:
1. Hold the pillows up to your nose.
2. Turn the machine on.
3. Now pull the headgear over your head, and adjust the straps just enough to stop any leaking. Lie down in your normal sleeping position and re-adjust the straps. They should NOT be tight. If you are having trouble getting a good seal against your nose, go UP a size in nasal pillows.

Some people find a non-petroleum cream like Lanisoh, Ayr gel, or KY jelly help make a seal (I find the opposite). If you go to ResMed's website you will find a slide show that shows fitting. Pay special attention to the angle of the headgear.

Using the clip on the top of the head to hold the short hose will reduce the drag that tends to pull the pillows away from your nose.

Also, note that there are little gears on the sides of the base that holds the pillows. This allows you to change the angle of the pillows against your nose.

Finally, the biggest mistake we all make sometimes is putting the pillows in backwards. The raised "ResMed" logo should be facing forward, away from your face.

A couple of other thoughts:

Are you perceiving leaks from the pillows or could your wife be complaining about either the vent air bouncing off bedding and making noise or mouth breathing???

cflame1 wrote:if the leaks are coming from the pillows... have you tried lanisoh (lanolin)?

Yes I believe the leaks are happening based on my mask being moved by means of my pillow. The pillow I use it the obus form (hard). I've had to go with a harder type pillow since using cpap. I should have also mentioned that I sleep on my stomach and I use size medium cushions/pillow. I still can't sleep on my back since for some reason I still have nightmares when I sleep on my back. Just a bit of history, before using cpap, whenever I slept on my back I would stop breathing and I always knew that when I was having a nightmare that meant I stopped breathing and I had to wake up. Results of sleep study stated that I stopped breathing 85 times per hour, which I still find hard to believe. I will pick up some lonolin on my way home from the DME.

Janknitz wrote:I have a higher pressure than you and the Swift nasal pillows (LT and FX) work great. My guess is that the mask is not fit correctly. If you go to ResMed's website you will find a slide show that shows fitting. Pay special attention to the angle of the headgear.

Using the clip on the top of the head to hold the short hose will reduce the drag that tends to pull the pillows away from your nose.

Also, note that there are little gears on the sides of the base that holds the pillows.

Wow it's not often I find someone that has a setting above 14. Do you find much difference between the LT and FX, other then the position of hose? I did notice that the gearing on the pillows have work a bit and that maybe whey it wouldn't stay in place. I should pick up another medium pillow. Thanks for the link Janknitz.

Janknitz wrote:Are you perceiving leaks from the pillows or could your wife be complaining about either the vent air bouncing off bedding and making noise or mouth breathing???

They are leaks for the pillow and yes my wife also complains about the hurricane that occasionally blows in her face, but that's an issue for another day.

Thanks for the responses.

Just a suggestion: nasal pillows need to be fit while pressure is on.
I, too have 14 cm pressure, and my FX pillows are held in place with the air pressure as much as the gear holding them up to the nose. Also, some technicians do fit pillows incorrectly (go figure), cramming them up into your nose, rather than letting them rest just barely over the nasal opening, allowing inflation to finish the seal.
You might actually need the next larger size pillow. You never know until you try. Good luck!

Do you find much difference between the LT and FX, other then the position of hose? I did notice that the gearing on the pillows have work a bit and that maybe whey it wouldn't stay in place. I should pick up another medium pillow.

I love the FX even more BUT it is harder to stablize because 1) it is very soft, 2) it has no adjustment mechanism for the angle of the pillows, 3) the weight of the slinky hose pulls the pillows away from the nose, and there's not a satisfactory way to attach the slinky hose to the headgear (some people have found workarounds using a headband, but I don't want more stuff on my head). With tweaking, however, the FX is far superior.

If the gears on the sides of the LT pillow cradle move easily, they are worn down. Which brings me to another question: How long have you been using the same mask, and most importantly, the same pillows? There is a manufacturers defect which causes the pillows to wear out quickly--some in just a few weeks, others after about 3 to 4 weeks. They get soft and "mushy" and the inner pillow layer collapses easily rather than standing up like it's supposed to. When that happens, the pillows WILL leak. So, it may be as simple as replacing the nasal pillows--Medicare covers 2 nasal pillow replacements per month, a whole new mask every 3 months, and many private insurers follow Medicare guidelines. Or you can take advantage of "The great pillow exchange" thread here. Also try going up one size of nasal pillows, just to see if it works.

chunkyfrog wrote:You might actually need the next larger size pillow. You never know until you try. Good luck!

I’ve got nothing to loose by trying to use the large size tonight, other then maybe a poor nights sleep.

Janknitz wrote:I With tweaking, however, the FX is far superior.
How long have you been using the same mask, and most importantly, the same pillows? So, it may be as simple as replacing the nasal pillows--Medicare covers 2 nasal pillow replacements per month, a whole new mask every 3 months, and many private insurers follow Medicare guidelines. Or you can take advantage of "The great pillow exchange" thread here. Also try going up one size of nasal pillows, just to see if it works.

First off, when I read my quote I realize I was typing to fast and my spelling..........well sucked.

No adjustment for the angle of the pillow is a con.
I find the weight of the LT pulls the pillows down also so that's neutral.
Not a satisfactory way to attach the hose to the headgear is definitely a con.

Yet you still feel the FX is far superior? Since you've used both, I should ask the DME if they have one I could borrow for a couple days.

I just cleaned the pillow and gearing in very hot water and they are a bit more stiff again so I may have solved one problem. I've been using the Swift LT and pillow for one year. Are you suggesting I get a new pillow or another whole LT?

Not familiar with the pillow exchange, I've only used the medium since that's what the DME fitted me for before I even bought the LT. I did contact Sun life Insurance and they told me I was covered for a new mask since I was overdue. I never realized about the coverage. Keep in mind I'm from Canada, don't know if that makes a difference.

Thanks again for the replies.

Bingo, there's your problem. If you've been using the same set of nasal pillows for over a year and that inner pillow no longer stands up well, they are worn out! My guess is that the headgear is stretched out too by this time.

Yes, I still like the FX better. I use the velcro trick, AND I hang my hose to negate the weight of the slinky hose. With those two tweaks, the FX is stable enough (I still have to fiddle when I turn on the other side) and SO lightweight and comfortable compared to the LT.

I don't know a thing about reimbursement in Canada, so you'll have to figure that out.

New masks come with three sizes of pillows (S,M, & L) for the standard LT, XS, S & M for the LT for Her. What a lot of people do here is trade the two sizes they don't use for the ones they do on The Great Pillow Exchange Thread. I use that, since my insurance won't cover the FX. You can also buy the nasal pillow replacements online, and E-Bay has some good deals as well.

There is also a temporary fix on the lab rat pages--you can use a rubber O-ring to prop up the pillow, but this is a short term solution because the rubber in the O-ring reacts to the latex in the pillow and breaks it down over time.

Ok, sounds like a plan then, I'm going to:

Ask if I can borrow the FX for a couple days to try out and if I like it purchase it. If they don't have one.........well, I'll go with what they recommend.
Get another set of medium pillows to work with the LT.

I'm wondering if, the insurance will cover both a new mask and replacement pillows for the old but I'll deal with that. And....if the FX doesn't suit my needs than I'll get a replacement LT since I believe as you do, mine has gone past it's life expectancy.

I'm glad I came back for a visit after being away for some time. I should have never left. Got good answers in a matter of a couple hours.

I like the lab rat trick but I think it's time for a new pillow.

Glad we could help.

BTW, it would have helped us help you faster if you had told us you used the LT successfully for a year before the problem occurred--we could have figured it out immediately with that info.

Not such a minor detail!

I use the Mirage Activa if I am going to sleep on my side as when watching TV. Perfect seal at 14+ cmH2O. When I hit the sack and intend to smoosh my face into the pillow I use the Mirage Quattro FFM and at 14+ it gives me a perfect fit. If, for some reason, it is not sealing 100% and I am getting the infamous "face farts" from around the mask I put a loop of velcro around the nose and back of my head, as if a gently finger push on the nost of the mask. Problem solved (rare).

I have tried dozens of masks at great cost and have not yet found another mask that works as well as the above for me. Sizing is very important; you want the mask sitting on the fleshy parts next to your nose so that it is a relatively even surface. It takes time to get used to and I have found that as time goes on, I am more and more inclined to go with a FFM (the Quattro) as my nose tends to stuff at times due to allergies, etc. and I will mouth breath come hell or high water, which, of course, messes up a nasal mask or pillows.

I find that I am virtually unable to get nasal pillows to sit still on my face while sleeping and lose seal all the time which wakes me up by blowing air in my face. I have tried a dozen different makes and models and none work for me. Back to the Mirage Quattro. You should be able to pick one up online for about $50 give or take. Highly recommened.

[quote="My_Dream"]Ok, sounds like a plan then, I'm going to:


I'm glad I came back for a visit after being away for some time. I should have never left. Got good answers in a matter of a couple hours.

[quote]

I hope you've now made a New Year's resolution to become an active member of this forum! . Good luck and keep us posted!