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Nasal Pillows and Nasal Congestion
#11
Resistance is futile.
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#12
Heated hose was a game changer for me. Even with just the heated humidifier and regular hose, the air would cool off to a point of being uncomfortable.

I keep the hose at a low setting, and the air is just a little warm. I believe the warm, humid air is what keeps the congestion clear.
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#13
(03-17-2017, 06:44 PM)Sleeprider Wrote: Resistance is futile.
Perhaps Smile

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#14
I have never used the heated hose, but have found a humidity setting above two congestive and that higher ones seem to clog the P10 venting with water and make exhalation difficult. Mouth breathing and sealing posts here are my related focus.

Unless you are desperate for mouth breathing solutions, like I was, you will want to skip this long story, which I hope is not too long for posting. I apologize for not taking time to edit, shorten and clarify it as I usually try to do. I can't sit still, here, about the solution I found that, yes, WORKS FOR (let's hope not only) ME.

A long envying and very recent convert I, too, join praises of the P10--that as a side sleeping, mouth breathing person, that is, as an "SSMB" who is working on and expecting to wean himself of the chin strap. A simple and serendipitous breakthrough in sealing came after trying but not yet being ready for or comfortable with resorting to taping as THE solution to chinstrap-helped but still-too-leaky-for-pillows lips.

Vanity played a role: weight loss having added to my wrinkling with age, I felt pulling off of either of the two tight adhering and medically accepted tapes as further stretching of my already Shar pei-like loose skin--never mind taping's interferences with coughing (I have irregular swallowing with frequent choking) and sneezing or, as some report, any thoughts about vomiting or my one-time reflux episode.

My first Rx set me up with the Airfit F10, Medium (still my fall back or alternative mask and cushion that did get my RDIs down) I struggled, not satisfied with a "treated" AHI of (mostly) no more than 5, with the F10 and other FFMs for nearly a year and a half--including the Amara View (having successes with it punctuated by LL messes), the F10 Large cushion, and the F&P Forma.

The F&P: a disaster for me (forehead-post discomfort, leaks, slide wire balancing act). The F10 (M): it rode up during sleep, leaking at the bridge, the bottom getting up onto my lower lip quite often--still the favored FFM. The F10 (L): no way to get it to seal, though it rode lower at the bottom. The Amara: erratic successes with that vision improving, and overall more wearable configuration, but I was never able to consistently seal the leak at the re-entrant crease/groove between the flare out of the nostril and adjoining cheek. I tried Amara View Medium, but only with the Large and many Forum helps did I get some success (and a "cauliflowered nose" tip when I did, yeah--guilty, eventually tighten it up to stop leaks).

Over time, I had tried or practiced, with all FFMs, many times, all the many helpful and very often effective helps here on the Forum: "lie down and 'pressurize to feel the needed tightness without straps', re-balance/equalize/micro-adjust strap tensions, let it inflate and let it float techniques", etc. All that and the tongue forward and up with suction technique too.

Though I got great RDI reductions with a FFM (with Forum help and reading, and Sleepy Head--no thanks to sleep MD), it took a lot of fussing to control leaks, which I saw as detracting from effectiveness of PAP as leaks moved near and into the 20s. Leaks disrupted sleep too often; results were erratic. Eventually I reverted to the same (and often-adopted) attitude as Cranberry Ray's: "I'm going to make pillows [the P10] work NO MATTER WHAT." Success came almost immediately because I decided I'd somehow stop the MB by trying different methods of sealing the leaky lips.

Clearly, the pillows approach, with only a pair of nostrils and one lip-slit to seal, each being dealt with independently (rather than with just one "goldilocks" mask), presents a reduced and easier perimeter to defend against leaks (body oils, etc.) than one FFM's longer sealing edge along diverse facial contours and creases. Further, the mask is lighter and, er, less cantilevered when hanging off the bed pillow on a side sleeper. More yet, I think others have written as I had thought, too, that the close coupled pillows, having less mask volume with less dead air space to compress than in FFMs helps the air pump and its sensors be more responsive to OSA disturbances (think about the air chambers used to mitigate and cushion water hammer from the sudden pressure change in water pipes when valves are suddenly closed to stop flow).

Evolution of a breakthrough solution (an advance to the point of my thinking I may soon be free of the chin strap if any ideas for extension of my breakthrough application work).

First, think about 2 x 4 inch tape without an adhesive, mostly non permeable to air. The "tape". Held to face over lips how? Think grandma's old apron tied around and extending down from her waist, but sized to cover only the lower face and just below the nose from just under one ear lobe to the other and held there by a tied cord (or velcro) going around the back of the neck. The upper edge of the "waist band" passes just below the nose about 1/4 inch. If worn with chin strap and there is a problem with the apron dropping, then velcro it upward with the chin strap (with velcro hooks outward on the strap and loops, if necessary, on the apron unless you put strap over apron).

My apron was made from cutting a band off from the top an old elastic compression stocking so it with its velcro-loop strap going around the back of my neck could be stretched to the desired tightness and be fastened with the hook velcro affixed to the other end of the apron span. I tried the apron-with-chin strap scheme using Saran wrap as the sealing membrane over my lips and inside the apron; I either awoke or dreamed the most bizarre experience of confusion in my life that night. Next I tried something natural, remembered fondly, and compatible with delicate skin: an opened up tubular section from a lamb-membrane condom, 3 for $15, but no ecstasy now. It was hard to flatten and smooth when soaked and would dry out, shrink and wrinkle unless a wet backing (I fashioned) covered it through the night. All that: far too touchy and complicated.

All the while, lots of googling and asking local PAP and med appliance people for appropriate membrane material. But the local store where I was buying new compression stockings had a silicon gel material bonded to fabric, 3mm by 4 x 4 inch pieces. I tried that but it was too thick and difficult to position and lock in place. Going back to exchange stocking compression strengths I noticed in the display case the boxed Silipos "Gel-E-Roll", 4 x 48 inch strips with a mineral gel. (Read about this kind of scar healing product at http://www.silipos.com).

The Roll is like the elastic Ace bandaging strip with a gel coating on one side, elastic along its length, but inelastic transversely though flexible across its width. It adheres comfortably on its own while mounting its apron retainer and all through the night without slipping. If you cough (with the apron tightness I use anyway) it allows that, though it might shift it and require adjustment. It is thin enough, with the apron top edge just below the gel strip's upper edge, to avoid lifting of the pillows outward. I place the chin strap over it. All can be lifted in a flash to cough, etc.

I believe I'll soon be able to simply use the Roll material with only the holding apron and, possibly, by itself. Like the Ace bandage it comes with small metal hooking clips for use in securing the end of a wrapping. Those clips will likely chew the fabric up much as velcro destroys itself and nappy fabric (like that of my newest and most favored strap, the 3 inch wide Deluxe II with forehead and back of head short, velcro attaching straps--all Velcro hooks too aggressive on the native material for long life so I sewed on some velcro loop material at attachment points above the ears).

If more detail is desired, PM me. I post this only because of how hard I know it is for some of us to make peace with xPAP and I know friends who have given it up out of frustration--to their detriment.

Many thanks to all in this Forum, particularly to those who have responded without thanks to my posts, with and without psychoanalyzing me and my OCD, if that is what it is. Collection of back to back stents in the LAD, a new aortic valve and a pacemaker and doing rehabbing and conditioning along that Dec 2015 through August 2016 path until this time, I learned snoring and pokes in the ribs from my wife, when she realized I was not breathing through the years, were signs and opportunities to stop damages, all ignored or laughed off and lost. I got the message and hope others hang in there. It takes determination to keep on keeping on for many of us.
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#15
Thanks 2Sleep, that was an interesting read. I admire your perseverance!
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