Nasal Pillows - Does anyone get a really good seal

[Rogocop]

As much as I love the freedom of nasal pillows, I struggle to keep my L/min below 20. In fact, it has been downright impossible. Have tries a couple of different headgears and pillow sizes, but the result is always the same.  Suggestions, other than going to a mask?

[Sleeprider]

If that is a leak rate from your mouth, then a full face mask that equalizes the oral and nasal pressure may be the best answer. I assume that is not merely a seal-leak.

[Rogocop]

I think I have trained myself pretty well to sleep with my mouth closed, but not really certain of the answer. How do you determine this? Ask your bed partner to observe?

[Crimson Nape]

If you used #SleepyHead, you could look at any large leaks and/or the exhale portion of the Flow graph a diminished magnitude as opposed to when your mouth is closed.  Usually both a large leak and the diminished exhale will coincide.  The reason for the "and/or" in my first sentence is because you can possibly leak just below the Large Leak threshold of 24L/min..

[Gideon]

One way is to look at Sleepyhead charts and look for the tell-tale signs. See my sig for the how to and pay attention to the organization. It is usually the leak chart provides the primary hints and others like the Flow rate may give hints.

[Rogocop]

Thank you. Have been adapting to life with CPAP and now looking to advance beyond “MyAir” which was great to learn with and on to something more sophisticated.

[Sleeprider]

Rogocop, what mask and cushion size are you using. Have you tried a larger size nasal pillow? Many people make the mistake of using too small of a size.

[PaulaO2]

When looking at leak rate in SleepyHead, open mouth breathing is kinda flat topped vs a sharp spike of a mask leak or hose disconnect.

Other signs it is a mouth leak is the nasty fuzz and/or dryness in your mouth when you wake.

I've used nasal pillows nearly my entire time on CPAP. If I start getting leaks, it means the pillow is ready to be replaced. Or the headgear is stretched. First I take the mask apart, reassemble, then make sure I am putting it on right. If that doesn't stop the leak, then I replace the pillows, which is the cause 75% of the time for me.

[herbm]

The orignal question: I get a near perfect seal with a nasal pillow, almost every night.

My leaks are near optimal and my AHI is usually about 1.0 +-1

How? Get the right fit. Position the mask and pillows, THEN turn on the air, the don't move it. Really. Practice not moving it. If you must reposition, turn the air off, fix, air on.

The pillows will 'sitck' or 'fix' to the moisture in your nose if you leave it still.

Don't allow ANY "sound" or any "flutter" (vibration you sense in your noise.)

If it makes noise it is leaking. If it is fluttering it is PROBABLY leaking.

If you can't get a seal try a different size pillow or us LANOLIN paste.

Get the lanolin that is a bit thicker than grease for your car, not the liquid or easily spread stuff but the stuff that is like gum nearly.

Spread a small amount around your nostril (I guess you could put it on the pillows but I was never smart enough to try that).

STICK that sucker in your nose and LEAVE IT ALONE.

I seldom need to go this far.

Also, if using a mask like a P-10 don't OVERTIGHTEN. You really want the mask to feel a bit loose, almost too loose and just float on your face.

Think more like glasses than a watchband. Just enough to keep it from falling off until you can relax, let it stick, and go to sleep quietly.

PS: You also have to train yourself not to "bump" it either with your hand or your pillow, or stress the hose enough to move it.

I run the whip hose of the mask down my sternum the over my ribs when facing inward, and UNDER a body pillow when facing outward so there is NO TENSION or stress on the hose pulling OR pushing the mask.

No complicated hose management devices just learning how to route the hose and protect the area near your face from contact.

It only sounds complicated because I am giving much more detail than anyone would typically spend on such a simple idea -- but I worked very diligently to find perfect a method that was both simple and effective.

*MY METHOD* may not work for you but start with these ideas and think about everything you can do to keep the pillows MOTIONLESS.

After a while you can scratch your entire nose -- carefully -- without ever moving the mask or breaking the 'seal' of the pillows, but that requires professional level dedication to detail.

[PaulaO2]

Herb, I actually get a better seal starting the machine and then putting on the mask. If I put it on first, then it gets blown off. But I have higher pressure than you do so maybe that's the difference? Just shows to go you how different users are!