CPAPtalk.com

Yes I love the "no pillow present" feel as well, best one I've found for me. It's all in personal preference, what I love others hate, what others love I hate.

After a night with the Nuance frame and headgear, I decided to give the Pro another shot because I like the gel pads on the cheeks better.

So, I started over completely and threw the fitting instructions and everything the RT told me about fitting it out the window. I didn't look in a mirror and went by feel alone. When I was finished the top strap was way further forward than the crown of my head (and much looser rather than being pulled tight to try to keep it at my crown). It sits almost where a woman's 'bang line' would be, not on the forehead but where the bangs start. Now the whole thing fits great, I have plenty of room left to tighten the side straps as they stretch and the back strap stays in place. Last night my AHI was .2 and my leaks were minimal and I didn't even feel the durned thing.

Looser is definitely better here! I guess my head is just shaped funny, but I learned a lesson. If I ever switch masks, I'll fit it my own way.

I always try the "textbook" fit then end up tweaking to my liking it seems.

I seem to have the opposite problem from most people here. I have a big ol' noggin (XXL hats big, about 62+ cm/24+ inches). The Nuance fits OK, except that it feels like the headgear should be closer to my ears. I've got the top strap loosened as far as it will go, though, and I need another 1/2" to 3/4" of strap. I'd have to craft some sort of extension. It stays on, but I think I'm having to over-tighten the straps.

I'm very new to CPAP (4 nights, not counting the awful sleep study), but I'm high strung about stuff that has to touch me for long periods of time. I can't imagine any non-gel nasal pillows being this comfortable. I feel some mild pain after a few hours, which is from a combination of not being used to these things and a sore septum due to the nasal mask digging into it during the sleep study. That will subside, especially if I give my schnoz a few days off after the initial 2 weeks. Aside from that, when I wake up I barely know I've got them on aside from the straps being so close to my eyes.

Oh, and nasal pillows are probably my best option, as I'm a Van Dyke guy. My facial hair is a part of my identity, so I'm not shaving it on a permanent basis. I'll pop Nuvigil for the rest of my life -- and anti-anxiety meds to counter the jitters -- before I part with the fur.

Any suggestions or experience someone can share with me here?

(Side note: I'm new here, so please forgive me if this is considered thread necromancy. It's on-topic, so I had to guess whether it was worse to start a new one or resurrect one that hasn't been active for a few weeks. I figured this was better for new folks searching the board.)

Don't worry about the thread's age--it's only a month old, the mask is relatively new,
and many of us are trying to figure this puppy out. Our comments are available to not only help each other,
but are accessible to the manufacturer--in case they care to solve problems with their product.
I believe the headgear has some basic design flaws--ignoring different size and shapes of human heads.

Thanks, chunkyfrog.

Now that I have some more time with it, I can make a few more comments:

The headgear stretches out over the first couple of weeks. I still need a little slack, but it stays where I put it better now. I imagine when it's a few months old, it will have lost some elasticity and fit perfectly. I still need to make myself an extension, I think, or I'll be back in the same boat when I replace the headgear or buy a spare for travel and cleaning rotation. Sliding the crown strap forward a bit lets me lower the strap closer to my ears, but it isn't the best solution.

I can definitely see why so many folks think it's way too big. The cheek straps really don't offer a lot of room for adjustment. Even I have them adjusted up a bit, with my giant head, and I purposefully keep it loose (the flex in the nasal pillows ensures a little movement won't break the seal). I would definitely suggest that those with smaller heads get the standard/non-gel headgear, since it sounds like it's got more adjustment range. I'm not convinced the gel pads do much aside from offer some grip, anyway, and that's not really necessary with such a flexible nasal pillow.

Even wearing it loose, it stays in place surprisingly well, though I have to fiddle with it quite a bit before and after I lay down to pull the headgear and cheek pads down. The gel cushions "stick" a bit to my nose, which can feel a little odd in the morning, but it keeps the seal without having the mask tight. They stuck a little too well a couple of mornings, and increasing the humidifier level seems to have helped. I do adjust the pillows a bit on my nose, but I imagine anything not custom-fit would require a little manual adjustment.

The hose loop is an obvious afterthought. It sits too far to one side due to the adjustment strap, and it doesn't have much holding power. Plus, you have to loop it through before you hook up and unhook to un-loop it. I'm concocting an alternative that uses velcro, but I'm not sure how I'll attach it yet.

I do hope Philips gets feedback and makes some improvements to the headgear for this great mask. I think I found the best one for me on my first try, short of having something custom-molded for my head and nose. Worst case scenario, I might make some custom headgear -- or rather, design it and hire out the work to someone with better sewing skills.

I have the lowest leak rate by far with the Nuance Pro pillows. I've been trying to figure out how to alter a set of Bella Loops to work with them so I can avoid the headgear. No luck so far!

I tried the regular Nuance (not the pro) and the headgear fit so well and was so comfortable, it was amazing. But I could not get a seal on the nasal pillow. I was so disappointed.