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Nasal Pillow users
I have been given a Nuance nasal pillow and I have to say, I was very excited. However, I am really struggling with it and I was wondering if you could give me any pointers / hints and tips.

When I use the pillows, should they be whisper quiet?

How 'tight' should they be on your nose?

Mine seem to rotate down with the weight of the hose, is this normal?

How do you stop them from leaking air?

I woke this morning with a nose bleed, it was only 3.30 and I am so unhappy. I really thought that pillows were the way forward, but I think I am going to change back to a nasal mask tonight.
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I use a P10 nasal pillow mask, but same principle.

They are normally quiet, unless you are experiencing leaks, then you may need to use a chin strap

They should not be tight, should just sit at the bottom of your nose, not shoved inside.

If too tight, you will have irritation. Also, you can try a different size pillow. One size larger is often better. If you have the correct size, they won't leak.

I see that your profile says you are not using humidifier. That may be why you have nose bleeds.

Also, be sure to use either a nasal gel or lansinoh cream.

As far as the hose pulling the mask down, try a hose lift system, where the hose is routed up over your head.

Nasal pillows aren't for everyone, but if you can make it work, it is the most comfortable to wear.
My 2 cents. Smile
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(12-30-2015, 07:30 AM)OpalRose Wrote: but if you can make it work, it is the most comfortable to wear.

Yes I believe you as well.

I seem able to start the night off okay, but things go pear shaped in the early hours.

I will look into a nasal gel to help.

Life could be so simple if it things just worked the same for everyone eh?!

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(12-30-2015, 07:45 AM)DumfriesDik Wrote: Life could be so simple if it things just worked the same for everyone eh?!


Yep, that's why there's many different mask styles available, to acccomadate the many different noses and face shapes. Wink

When you find a mask that works for you, everything else will fall into place.
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The Nuance suffers from having a large 22 mm connector and swivel right on the mask. Compare to the Resmed Airfit P10 which uses a lighter 15 mm hose section fixed with a lightweight connection. In addition, Nuance vents a lot of air off that connector which is noisy and disruptive. Some people like the mask, but I'm not one of them. I encourage you to give an alternative nasal pillows mask a try before writing them off.
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A technique that works well with all masks is to immediately route the hose from the mask to an area at the top of the head band and securing it there. If that isn't possible, then attach the hose to some point on the front center of your sleep wear. That is especially useful with nasal masks since they are easily disturbed by lateral hose forces when changing sleep positions. Velcro straps or tie-wraps work well so use what's readily available. I use a Resperonics OptiLife mask and it comes with a velcro strap that has an alligator clip attached. A great idea! Also a great mask I will add and much lower priced than most.

Another tip is to try the large size pillows since pillows too small will irritate the nose. Everyone want to think that the medium is best but that's not the way to think. Try the large size once you get the hose tugging problem under control.

Then experiment with the humidifier setting to see what works best for you. It's important to supply the proper humidity to keep the nasal area moist but short of being too wet and slippery.

Mouth leakage is another major problem, especially for those who need therapy pressures exceeding 12 cm H2O. Chin straps are often needed but generally it just takes time to master the tongue seal method.

Edit: I notice you are running APAP at 4 ~20 cm H2O. You should try to narrow that down by checking your data using the available software.
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Thanks for the replies everyone. I found the pillows much more comfortable, but I have got back to the nasal mask for now. I will revisit the pillows with a view of controlling the hose better. I think this may be the culprit for many of the problems.

Yes surferdude2, I think I will change the minimum setting.
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Edit: I notice you are running APAP at 4 ~20 cm H2O. You should try to narrow that down by checking your data using the available software.

What is the advantage of narrowing the range? I just always figured that 4-20 covers everything. Just curious to know why you suggest that. Thanks!
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There are some good reasons for not leaving the machine set at factory default. Some will apply to you, some not.

1. The 4 cmH2O as a bottom pressure will feel like it's smothering you.

2. The 20 cmH2O as a top setting can make it very difficult to have success when using the "Mask Fit" test feature. That test is conducted at the highest pressure you have set. Generally most (MOST) people will not need that high pressure.

3. Some people are bothered by large pressure changes. You can set the machine to a much narrower range and it will be less bothersome in that regard. You would have to use the software to determine the correct pressures, both min. and max.

4. Setting the minimum pressure up to just below your median pressure will give the machine a head start on increasing the pressure when a restriction occurs. If you leave it at 4 cmH2o, it may not have enough time to get to the required pressure to prevent an event from being flagged.

5. If you leave the top pressure set at the max. 20 cmH2o, there can be situations where the pressure will rise higher than needed and cause sleep disturbance. The generally agreed max. pressure to set is 1 cm H2O above the 95% reading the software gives. That caps the pressure at a reasonable setting and serves the dual purpose of providing a reasonable pressure for the "Mask Fit" test and protect you from sleep disturbance from unnecessarily high pressure excursions.

Short answer ...It has often been said that 4 and 20 is only good for blackbird pie.

ps. The reasons you may get a machine set at the "wide open" 4/20 setting; your Doctor or therapist may be ignorant, they may not have time to spend on you and lastly, some of them just don't care beyond getting their money. You would be wise to tailor your therapy using the software available. Nobody cares about you as much as you.
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Use a very small amount of lanolin on your nose.
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