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Pillow mask discomfort
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herbm Offline

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Posts: 852
Joined: Jan 2014

Machine: ResMed AutoSet S9
Mask Type: Oral
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: ResMed H5i
CPAP Pressure: 11-16
CPAP Software: ResScan SleepyHead

Other Comments: Backup Mask: Innomed Hybrid FFM -- Oral+Nasal Pillows

Sex: Male
Location: Austin, TX

Post: #11
RE: Pillow mask discomfort
Nose soreness fixes with the P10:

1) Retired_Guy mentioned Lanolin -- buy and use it

2) NEVER take the pillows off by just pulling it down opposite the way it went in -- instead, find a GOOD way to first wiggle it loose and then slide it out from a different position than the one where you wear it for sleeping -- usually I tip the BOTTOM of mine way away from my upper lip, then perhaps move the mask to the left or right, and finally pull the opposite side down and out. The idea is to get it OFF the sleeping position before pulling and to UNSTICK any adhesion first as well.

2b) [EDIT] Remove the pillows BEFORE removing the headgear as the opposite order leads to abrasions since the pillows MOVE BEFORE you are ready to carefully remove them fully.

(Generally, I also put on the headgear first, insert pillows second but that is not an important point.)

3) Do NOT mess with the mask when wearing it -- put in in place and learn to LEAVE IT ALONE. All movement adds to abrasion (a little.)

4) Put the mask on BEFORE turning on the air (preferably in front of a mirror the first weeks or months

5) NEVER take the mask off until AFTER the air is off (it deflates the pillows and helps get them out without pressure or abrasion) -- in fact, turn it off, disconnect the pigtail hose to even stop any cool down pressure.

6) When suffering any abrasion that is uncomfortable, switch pillow sizes (up or down) -- usually UP is softer but probably causes more leaks -- but switching even DOWN in size will put the pressure inside your nose in different spots.

7) LOOSEN the headgear by stretching it -- even if the headgear SEEMS PERFECT it probably (YMMV) should be a tad looser than you would predict. Extra strap pressure translates to more friction when the mask moves.

8) Along with #4 if the mask is dislodged, force yourself to sit up, turn off the machine, reposition and turn it back on.


#2 is likely the most important NON-obvious item -- much of your abrasion actually happens when removing the pillows on purpose.

Getting the air pressure down before removing it (or donning it) helps a LOT more than you might think.

#7 is just HARD to convince people to take seriously but it is AMAZING how much abrasion I had to endure when my SECOND mask showed up and was just a "perfect fit" compared to the old lose piece of junk that remained of my first P10.

Despite having worn a P10 for 8.5 hours (avg.) for 6 months every single night AND that the new mask felt like a PERFECT FIT, I had to run through pretty much all of the steps above to stop the irritation.

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
(This post was last modified: 09-18-2014 09:42 AM by herbm.)
09-17-2014 10:01 PM
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PollCat Offline
Apnea Board Polling Administrator
Monitors

Posts: 1,576
Joined: Feb 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: H5i Cleanable with ClimateLine
CPAP Pressure: 10 - 18
CPAP Software: SleepyHead

Other Comments: CPAP-ing since 1995; Type 2 Diabetes; Chronic Asthma; Gout

Sex: Male
Location: Westfield, IN

Post: #12
RE: Pillow mask discomfort
I pretty much agree with what herbm said; except that my ENT doc recommended coating the inside of my nose with bacitracin instead of the petroleum jelly that I had been using. Whistle
09-17-2014 10:16 PM
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Galactus Offline

Advisory Members

Posts: 1,384
Joined: Jan 2014

Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #13
RE: Pillow mask discomfort
I never tried #2. Will have to test that. Right now I usually put the pillows in my nose then slide the headgear over my melon. Then turn the machine on. Then in the morning I shut the machine slide the headgear off my melon and remove the pillows. I do now and again get some nowe annoyance and soreness, I wonder if that will help me.

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
09-17-2014 10:20 PM
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surferdude2 Online

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Posts: 1,077
Joined: Jul 2014

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro & Optilife
Humidifier: ResMed H5i @ #3 if nose breathing & #5 if mouth breathing
CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #14
RE: Pillow mask discomfort
You guys have made this P10 thing sound like such a grand adventure that I broke down and ordered one today for a test run. I have a moderate problem with nose breathing and have avoided nasal mask so far. No harm in trying since it's returnable. Nervous
09-17-2014 10:44 PM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #15
RE: Pillow mask discomfort
You'll like it Surfie. Especially if you can keep your mouth shut without using a chinstrap. But even if not, it's still much more liberating than a ffm. ..and I kind of liked my ffm.
09-17-2014 10:50 PM
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Doc J Offline

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Posts: 199
Joined: Dec 2013

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: resMed H5i Dumped and dry daily
CPAP Pressure: 10-15
CPAP Software: ResScan SleepyHead

Other Comments: Knowledge is King and this is the place to find it! Thanks everyone.

Sex: Male
Location: Central Nebraska

Post: #16
RE: Pillow mask discomfort
P10 works great, but the straps were too tight for my big head. No choice but start stretching it out. Still is springing back and have to stretch more. I have not gone so far as try to adapt the old swift fx headgear for this pillow as some had suggested. Some adjustment would help but they were making a very small amount of gear on your head which I understand.

Anytime I had any mask too tight I could feel it pushing back on jaw or teeth or nose in this case. So loosen it up so it inflates back into you to make the seal and it's the lowest impact possible.

Good Luck!

Doc J (despite my nickname I am not a doctor)

Remember to donate to the board if you can, it has helped a lot of people including myself.
09-17-2014 11:09 PM
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Galactus Offline

Advisory Members

Posts: 1,384
Joined: Jan 2014

Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #17
RE: Pillow mask discomfort
(09-17-2014 10:44 PM)surferdude2 Wrote:  You guys have made this P10 thing sound like such a grand adventure that I broke down and ordered one today for a test run. I have a moderate problem with nose breathing and have avoided nasal mask so far. No harm in trying since it's returnable. Nervous

You're gonna love it, and if you don't we'll force you too. It's just how we do things.

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
09-18-2014 02:59 AM
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surferdude2 Online

Advisory Members

Posts: 1,077
Joined: Jul 2014

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro & Optilife
Humidifier: ResMed H5i @ #3 if nose breathing & #5 if mouth breathing
CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #18
RE: Pillow mask discomfort
Okay

I'm printing out this thread. If this P10 doesn't work, you all will be hearing from my attourney..errr..atturny..err...lawyer.

Thanks I think...
09-18-2014 08:24 AM
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herbm Offline

Preferred Members-2

Posts: 852
Joined: Jan 2014

Machine: ResMed AutoSet S9
Mask Type: Oral
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: ResMed H5i
CPAP Pressure: 11-16
CPAP Software: ResScan SleepyHead

Other Comments: Backup Mask: Innomed Hybrid FFM -- Oral+Nasal Pillows

Sex: Male
Location: Austin, TX

Post: #19
RE: Pillow mask discomfort
Couple of points:

1) It is generally recommended to avoid anything PETROLEUM based INSIDE your nose or mouth. There is some weird petroleum induced pneumonia (IIRC).

This must be pretty rare because we grew up getting Vicks Vaporub (petroleum based) in our mouth or nose whenever we had colds or flue as kids, but it is not recommended.

Check the bacitracin ingredients to ensure they don't also use a petroleum base.

This is one of the main reasons for the lanolin creams/ointments, etc.

2) I find that removing the headgear BEFORE the pillows also leads to abrasions since the pillows MOVE BEFORE you are ready to carefully remove them fully.

Generally, I also put on the headgear first, insert pillows second but that is not an important point.

This should be added to my list above.

3) Applies to #3, especially as it relates to #2 above and #2 in the list:

The idea of "leaving the pillows alone" to avoid both unseating them yourself AND to avoid abrasion leads to an interesting effect, where the pillow is practically GLUED to the inside of my nose by morning.

This may SOUND BAD, but is a VERY GOOD THING. With the pillows STUCK you get NO movement to cause abrasion and a GREAT SEAL to cut down on leaks.

However, this means we need to CAREFULLY break this adhesion before pulling the pillows out. That is a big part of the goal in finding a way to "wiggle" the pillow lose and to a different spot before pulling it out.

Also why we want to keep the headgear holding the pillows motionless UNTIL we deal with this issue.

[I know this is a LOT of analysis for something so simple, but those who have been reading my posts know that I am a troubleshooter and problem solver and spend a lot of time figuring this type of thing out.]

4) The P10 is fantastic for ALMOST everyone who can meet 2 requirements: Breath through the nose, and Keep the mouth shut (naturally or with chin strap etc.)

Also, some people just don't FIT the "one size fits all headgear" but people have modified it to insert a velcro or other adjustment fastener.

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
(This post was last modified: 09-18-2014 09:48 AM by herbm.)
09-18-2014 09:40 AM
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surferdude2 Online

Advisory Members

Posts: 1,077
Joined: Jul 2014

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro & Optilife
Humidifier: ResMed H5i @ #3 if nose breathing & #5 if mouth breathing
CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #20
RE: Pillow mask discomfort
Thanks herbm!

Pulling it all together we now get:

Nose soreness fixes with the P10:

1) Retired_Guy mentioned Lanolin -- buy and use it

2) NEVER take the pillows off by just pulling it down opposite the way it went in -- instead, find a GOOD way to first wiggle it loose and then slide it out from a different position than the one where you wear it for sleeping -- usually I tip the BOTTOM of mine way away from my upper lip, the perhaps move the mask to the left or right, and finally pull the opposite side down and out. The idea is to get it OFF the sleeping position before pulling and to UNSTICK any adhesion first as well.

3) Do NOT mess with the mask when wearing it -- put in in place and learn to LEAVE IT ALONE. All movement adds to abrasion (a little.)

4) Put the mask on BEFORE turning on the air (preferably in front of a mirror the first weeks or months

5) NEVER take the mask off until AFTER the air is off (it deflates the pillows and helps get them out without pressure or abrasion) -- in fact, turn it off, disconnect the pigtail hose to even stop any cool down pressure.

6) When suffering any abrasion that is uncomfortable, switch pillow sizes (up or down) -- usually UP is softer but probably causes more leaks -- but switching even DOWN in size will put the pressure inside your nose in different spots.

7) LOOSEN the headgear by stretching it -- even if the headgear SEEMS PERFECT it probably (YMMV) should be a tad looser than you would predict. Extra strap pressure translates to more friction when the mask moves.

8) Along with #4 if the mask is dislodged, force yourself to sit up, turn off the machine, reposition and turn it back on.


#2 is likely the most important NON-obvious item -- much of your abrasion actually happens when removing the pillows on purpose.

Getting the air pressure down before removing it (or donning it) helps a LOT more than you might think.

#7 is just HARD to convince people to take seriously but it is AMAZING how much abrasion I had to endure when my SECOND mask showed up and was just a "perfect fit" compared to the old lose piece of junk that remained of my first P10.

ADDENDUM:

1) It is generally recommended to avoid anything PETROLEUM based INSIDE your nose or mouth. There is some weird petroleum induced pneumonia (IIRC).

This must be pretty rare because we grew up getting Vicks Vaporub (petroleum based) in our mouth or nose whenever we had colds or flue as kids, but it is not recommended.

Check the bacitracin ingredients to ensure they don't also use a petroleum base.

This is one of the main reasons for the lanolin creams/ointments, etc.

2) I find that removing the headgear BEFORE the pillows also leads to abrasions since the pillows MOVE BEFORE you are ready to carefully remove them fully.

Generally, I also put on the headgear first, insert pillows second but that is not an important point.

This should be added to my list above.

3) The P10 is fantastic for ALMOST everyone who can meet 2 requirements: Breath through the nose, and Keep the mouth shut (naturally or with chin strap etc.)

Also, some people just don't FIT the "one size fits all headgear" but people have modified it to insert a velcro or other adjustment fastener.

Despite having worn a P10 for 8.5 hours (avg.) for 6 months every single night AND that the new mask felt like a PERFECT FIT, I had to run through pretty much all of the steps above to stop the irritation.
09-18-2014 09:50 AM
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