Review of Phillips Respironics DreamWear under the nose nasal mask
The following will describe some of my past recollections, current experiences with a particular emphasis on the Phillips Respironics DreamWear under the nose nasal mask
I was first diagnosed with one of the Sleep Apnea (SA) disorders in 1998 following emergency surgery that landed me within the confines of the ICU ward for several days. The nursing staff observed, documented and reported to my physicians their observations I was cyanotic and I would cease breathing for extensive periods of time and then wake up gasping for air, Not particularly good for someone with a staple line extending literally from my pubic bone to my Xiphoid in my chest.
I was sent for follow up sleep studies where it was confirmed I had SA related disorder and was placed on xPAP therapy.
I’ve been on and off various xPAP therapies, xPAP machines and masks for about 20 years.
I need to preface my entire review with I only sleep on my side. I’ve never slept on my back or stomach. So if you sleep on your back of stomach, your experiences may be significantly different and I would encourage you to document your experiences in this thread so others can benefit from your experiences specifically as they pertain to the Phillips Respironics DreamWear under the nose nasal mask.
I’ve tried numerous masks over the years for my xPAP therapy. I found when I was fitted with a full face mask; I quickly rolled onto my back and would get both hands and feet onto the mask and pry the mask loose getting it off my face in no time flat.
Then, I was fitted with an over the nose nasal mask.
It was kind of training bra if you will. The nasal mask trained me sleep with my mouth shut otherwise the xPAP air pressure would enter my nasal cavity and just exit my mouth quickly causing my mouth to dry out. It took about a week to get this figured out after being a mouth breather all my life. I continue to be a mouth breather during the day, but at night when I sleep, I’m strictly a nasal breather managing to, for the most part, keep my big trap shut ( a real novelty for me!).
While the over the nose nasal mask worked, the interaction with the seal surrounding my nose would frequently dislodge and leak severely. Most frequently, the leak would occur on the bridge of my nose and the escaping air would blow directly into my eyes awakening me numerous times every night.
The other significant issue of the nasal mask (or full face mask) was at the various points where the seal would touch my face or the support arms would come in contact with my forehead or other parts of my face, various forms of dermatological issues would occur requiring prescription medication to address. Grrrr…
At this point in time of my xPAP therapy, the only SA masks were either full face or nasal masks.
Nothing of the pillow type masks existed. My poor face always looked like that of a leper and it was this way for years on end.
Enter the new under the nose masks
My xPAP pressure is significantly high (Initially a fixed CPAP at 18 cmH2
O and now I've been moved onto a bi-level machine with IPAP = 20 cmH2
O and EPAP = 12 cmH2
O )and the new xPAP records leak rates for the first time, my physician had me migrate from a nasal mask to ResMed’s AirFit P-10’s in an effort to try and reduce my excessive leakage.
These were a wonderful change, and my face no longer presented with the creeping crud either around my nose or my forehead.
Hooray, finally I could return to looking more like a human able to fit within society without being the leper.
While the P-10’s were a wonderful change, at a pressure of between 18 – 20 cmH2
O , it worked out to be just too much pressure for even the largest of the P-10 pillows.
I had an appointment with my sleep Dr. and he told me to immediately cease using the P-10’s and switch to the “Phillips Respironiscs DreamWear under the nose nasal mask
.” The sleep technician had a “Sample” that I was fitted with and sent along my way. I’ll talk about sizes in a bit.
I scampered out of the Dr’s office with my new mask and went home looking forward to using the new mask that evening.
The P-10’s have two mushroom like flanges that insert into each of the nostrils. This entire component is refereed to as a "pillow".
In contrast, the Phillips Respironics DreamWear under the nose nasal mask has a component of the mask they refer to as a “Cushion.”
The "Cushion", is a few inches wide depending in size. On each end of the cushion is a snap like connector that clicks into the arms of the head gear. This allows the cushion to be cleaned separate from the actual head gear. The cushion has an elliptical “slit” that fits under the nostrils and unlike the "pillows" that fit the nostils, the slit in the cushion expands and opens allowing the pressurized air to enter the nostrils.
On the cushion is a small slit (facing outward, away from the face) for the purpose of allowing the expiration air as well normal over pressure to escape. When fitted properly, there is very little if any leakage.
Like the P-10 pillows, over time, the soft malleable material of the cushion distorts and gradually loses its ability for its memory to be restored at which time a new cushion for the mask needs to be acquired and used.
The ResMed AirFit P-10’s have their air supply at the base of the mask near the nostrils and the air supply of the Phillips Respironics DreamWear under the nose nasal mask is affixed to the top of the head gear that sits atop the crown of the head. At the connection air supply junction of the Phillips Respironics DreamWear under the nose nasal mask there is also a pressure relief mechanism.
The Phillips Respironics DreamWear under the nose nasal mask head gear itself is comprised of a soft, malleable silicone like material starting at the crown of the head having arms extending down each side of the head and across the the upper face where a replaceable cushion be replaced without needing to replace the actual head gear, similar to replacing just the nasal pillows of the P-10.
Similar to the P-10’s there’s a head strap that wraps around the back of the head securing the Phillips Respironics DreamWear under the nose nasal mask to your head.
The only complaint I have is trying to initially figure out how to put the mask on is like trying to differentiate between an octopus and a bagpipe.
Diving into the Phillips Respironics DreamWear under the nose nasal mask is not as visually intuitive as putting on the P-10 head gear assembly. Once you get accustomed to “diving” into the Phillips Respironics DreamWear under the nose nasal mask becomes easier but trying to put it on in the dark or while inebriated could prove to be a bit of a challenge.
My experience is that while I prefer the design of the P-10’s, at my pressure requirements, the P-10’s are ineffective.
My sleep technician shared with me he was a “beta” tester for the Phillips Respironics DreamWear under the nose nasal mask and it was intended to handle up to 30 cmH2
0 pressure although I can't find this documented anywhere, so it's at best speculative.
I can only attest the Phillips Respironics DreamWear under the nose nasal mask seem to address and satisfy my needs substantially better than the P-10’s.
The full head gear package, comes with the head gear (small, medium or large), two soft felt pads that can be wrapped around each of the arms so they don’t actually come in contact with the face and 4 under the nose cushions. One each small, medium, large and medium wide cushion is provided in the full head set package.
According to the Phillips Respironics DreamWear website
(note the above site has all the part numbers for the full mask set’s and the individual replacement parts)
It’s not quite as easy as saying I want….. but I suspect that’s a common occurrence without regard to replaceable parts for xPAP therapy.
According to the DME where I received my Phillips Respironics DreamWear under the nose nasal mask, the cost of the full head gear is something like $171 USD.
My copay was some $28 and change. How much replacement “cushions” are I’ve not a clue.
I have searched the web and have found full packs for everywhere from about $99 USD to $120 USD.
I’ve not been able to locate on the web anywhere to get just the replacement cushions, but then, perhaps I’m not formulating my search very well. Additionally, many insurance companies (and I think Medicare) will replace the cushions (like pillows) at the rate of 2 cushions per month.
While my xPAP reports the Phillips Respironics DreamWear under the nose nasal mask continues to have a substantial leak, I don’t seem to feel as “starved” for air like I did with the P-10’s at my pressure after my sleep sessions regardless of how fragmented my sleep.
I’m more than certain had my pressure been significantly lower the P-10’s would have worked fine, but, that’s just not in the cards for me right now.
Hope this helps someone
NOTE: I'm just an average bloke, suffering like all the rest of us here with one or more forms of SA disorder. Notice I did not make any recommendations for or against the use of any mask or device so there's no endorsement intended.
It's nothing more than a report of my personal experiences with these masks.