Nasal Pillow Pain

I've spent 3 nights with the Swift FX (for her) I'm waking up in the morning feeling like I've been punched in the nose. I ended up ripping the mask off at 5 a.m. because I couldn't take the pain, and then laid there for another hour fuming about it, I really want this to work.

Pros : I'm waking up less
I can scratch my nose freely
my AHI has been consistently low (under .9)
Leaks are good, the first night it was 19 but since then it's been under 6

Cons : I'm having more trouble laying on my side than I thought I would, laying on my side changes the alignment of the pillows and it's hard to get my head at the right angle
There is now a sore inside my nose
I'm waking up in pain with the soft cartilage in my nose throbbing, presumably from the pressure/movement of the pillows/hose


There is the natural temptation to say 'the heck with this' and go back to my nasal mask. But I have the feeling that I just don't have things adjusted right, and I'm hoping I can get past this. I want to give this a fair shot (or, I want to be stubborn, always a possibility) I know that the straps shouldn't be too tight, i can slide them easily around on the back of my head so I don't feel like they are tight. I am wearing small pillows, which the DME deemed "a perfect fit" They cover the outside area of my nose, leaks are small, I have run my finger all the way around them and it feels like proper coverage. I don't have a terribly small nose, and although I can try extra small, i think those would go inside my nose. I'm spending several minutes taking the mask on/off and experimenting with angles and strap positions before I go to sleep. I've watched the ResMed product video on this mask several times so I know what is supposed to go where. But in the end, I feel like I've been punched in the nose, and I wake up in pain. I'm not sure what I'm doing wrong. Sleeping better is nice, but waking up in pain is certainly not an option.

Any ideas what I'm getting wrong? Will my nose get used to the abuse? Or is this just not the right mask for me?

Too tight and probably you need the next size UP, not down. See the fitting tips in my signature below.

Use some lanolin cream to soothe your sore nose. Some people use it at night to help the seal and reduce the friction ( this never works for me).

Try to rig up some system to hang the hose over your head. The pillows are unstable because the weight of the hose pulls them away from your nose.

If these suggestions don't work, consider the swift LT as it's a little more stable.

Loosen the top strap a notch or two. As Janknitz said.. if it hurts...it too tight. I also second the thought to go up a size. It will be easier to seal with less tension.

I can only echo Janknitz's remarks as I think she is spot-on. If your straps are where you left them the night before it's a good indication they're staying put (or reasonably so). Please try the medium pillows as what you're using is apparently making (some) shin contact inside your nose and causing the sore. You can use a lanolin product called Lansinoh and you can find it with the baby bottles in Wal-Mart. It is a healing gel nursing mothers use. It can be applied inside your nose and I use an ultra thin app to the outside rims of my nostrils to 1) eliminate tenderness and 2) it helps my pillows seal (got a big nose) and if they get sore it's a giant hurt! Incidentally, it looks as though my tube of Lansinoh might last about a year so that fact softens the window shock of buying the Lansinoh at about $11 (don't hold me to that as it's been a while since I bought mine). Had I used it from the outset of using nasal pillows I honestly believe my nares would have never gotten sore.

If the Lansinoh doesn't take the hurt out of that sore in two days, I'd personally use my nasal mask until that healed completely and then go back to your pillows. You're lucky to get those leak numbers going from side to side. Lastly, put your pillows on in front of a mirror to ensure you have equal pressure from both sides - seems odd only one side of your nose was bothered if your nostrils are the same size. They can get crooked from movement. I used those pillows but found more stability with the Swift LT because of being an active sleeper. The LT also comes in a ladies size.

Funny, I typed all that just to just about quote janknitz. Good luck to you. You can overcome that sore situation.

Thanks for the input.

I will try the medium pillows - I remember that they are supposed to 'inflate' to seal, so that may work better. I forgot about hanging the hose, that makes a lot more sense now that i see/feel what having your nose pulled on all night feels like. I was a nursing mother and do remember Lansinoh quite well, I think that will be the perfect solution. I don't want to give up on the nasal pillows just yet.

I use the Swift FX pillows and, yes, laying on my side will disturb my "ideal" mask adjustments unless I make compensations. I've also just developed an annoying sore in one nostril. Don't know if that's related to mask slip while side sleeping. Using Ary nasal gel and that is beginning to help a bit.

EO,

I lie exclusively on one side and I don't move around much in bed, so I've found that I can actually adjust my Swift to accomodate this position--a little looser on the pillow side of my head and a little tighter on the ceiling side of my head (hope that makes sense). I also use one of those "orthopedic" tempurpedic pillows with a "ditch" in the center--that's where the side of my face goes, and my forehead and chin are supported by the neck supports, so there's not a lot of pressure on the mask on the side I lie on.

I'd like to report that last night went much better with the Swift FX. It's easy to get that mask too tight without realizing it. I put it on in the mirror and realized that my nose was being "smushed" Even though it felt like the same amount of pressure on my face I felt with a nasal mask, it was too much pressure for the end of my nose. I followed Jan's instructions, inflated the mask, then adjusted the straps. It really does "float" on your face. I also hung the hose over the headboard. I slept soundly and can't remember any problems, most importantly, my nose didn't hurt when I woke up! My AHI was low and the leak was 6, that's certainly reasonable.

Thanks!!

Whoo Hoo!!! Good news

That's good news.

I had the same problem when I started with the Swift LT.

I finally realized that the headgear can be really loose and the pillows will stay put.

I went from a Medium to a Small and viola! Better nights sleep with no crushed nose pain.

They DME's should tell you that the headgear does not have to be TIGHT TIGHT.

I went through 3 weeks of pain.

I have tried Nasal Mask, several sizes of Full Face Masks and now moved on to the Nasal Pillows. I have to say they are more comfortable overall, except I woke up with horrible nervy pain around my nostrils. I took the mask off, then my spouse woke me telling me I was snoring. I tried it again and shortly after had the same pain. Any suggestions?

I also started with the Swift FX nasal pillow, but found that the connecting ring was putting too much pressure on my upper lip and would end up hurting in the middle of the night. Bottom line, I switched to Airfit P10 and love them.

Four steps to nasal comfort:
--headgear adjustment; too tight will always hurt.
--try a different size pillow; the nose should ride on the curve, without anything wedged inside.
--Lansinoh, just a little bit, also makes silicone cling to skin.
--nasal pillow liners; our sponsor has them.
https://www.cpap.com/productpage/remzzz ... iners.html

Thanks for the suggestions!

I used some lotion and changed from small to medium pillow last night. I was able to tolerate it for 2 hours longer before it became too painful.
I supposed it wasn't bad for the second night.

tried all of the different masks last month but nothing went well then, so at least this feels promising.