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Third night using CPAP = giant nose sore
    Had my third night using my first ever CPAP machine, a Philips Respironics DreamStation Auto CPAP with humidifier and heated hose. When I did my Titration study the sleep center gave me two masks. A PR Wisp Nasal mask, that I used for the study and a ResMed AirFit P10 pillow. I used the Wisp during the Titration and didn't think I liked it, maybe it was all the other things going on that made me feel that it was not comfortable. So when I got my machine, I started using the nasal pillow for my first two nights of CPAP at home. It was less head gear and felt comfy on my face, but after two nights I got this monster sore on my nose.

Last night I used the Wisp Nasal Mask and while the head gear was more substantial, it didn't bother my new nose sore. I also felt like I got more air with it. I want to use the nasal pillows, but I think I am going to have to stick with the nasal mask for now.

I would like to try that new DreamWear mask that looks like it goes with my machine. I may ask the DME to take back the third mask I have, that the DME actually gave me with the machine, a ResMed Swift FX. This was another "sample" from the sleep center's closet and it was marked not for sale. My DME rep is based in the sleep center where I had my studies done, although she doesn't work for them, per se.

She wasn't even going to give me a mask, even though it was on my paperwork to be billed, until I asked for one and then she just grabbed whatever sample she wanted from the closet without asking me a preference. Let's just say I am not happy with her or my first experience with this DME, but that's another story.

So are these sores common and should I try the nasal pillow again once my sore heals, or do you think it will keep coming back.

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Hi pwgphoto,
It’s probably a good idea to wear the Wisp ‘till your nose heals.
Then, if you want to go back to the pillows, get some HPA Lanolin cream (found in the baby isle of most stores,) and dab a “little” into your nostrils with a cotton swav. A little gose a long ways.
Hang in there for more suggestions.
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+1 to above

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I agree with the above; however, be careful with lanolin - it is extremely thick and can clog pores. Have you ever had a monster pimple on the INSIDE of your nose - OUCH!

Also, I suspect your nasal pillow might not be the right size, or be too tight. Unfortunately the P10 headgear is not adjustable, but you can use a larger pillow. I got nasal sores with the medium pillows and suspected that it was because they were too small and went too far up my nose. So I switched to the large pillow and haven't had a problem since. I can breathe a LOT easier too!
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Another +1 to the above. And looking at your photo made me wonder if you had the nasal pillow mask a little too tight so that the pillow base was actually pushing on and irritating the outside of your nose like that. You shouldn't have "piggy nose" when using a NP mask (meaning the mask is so tight it's pushing your nose up).

You should be able to use a NP mask again once your nose heals. And FWIW, there are many styles of nasal pillow mask so if NP is your preference, don't give up. I got some irritation from the Swift FX NP mask but no problem with the Aloha NP mask -- according to a sleep tech I know not all silicone is created equal, so maybe different grades of silicone can make a difference to sensitive skin.

But really I have a feeling if you let the irritation heal, and don't adjust the mask too tight, you'll be fine.
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Thanks all, keep the tips coming. Anyone using that DreamWear mask? Looks like a neat idea.
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I spent my first two nights with a CPAP using a Dreamwear and I really like it. Which is why I hated to take it back to my (sucky) DME to replace it with a full-face mask because I developed a bruise and lesion under my nose. But . . .

I just ordered another DreamWear mask because I really did like it. I just needed something right away to allow the lesion to heal, and then I'm going to keep trying with the DreamWear. I truly do recommend it.

(I hope that's not all too confusing. To summarize, I had a small problem with the Dreamwear, needed an alternative, wanted a full-face mask for when I have sinus congestion, decided to let insurance foot the bill for the more expensive mask, bought a second DreamWear, let my nose heal, then learn to tolerate the DreamWear mask because it really is comfortable and easy to sleep with.)

I, too, tried nasal pillows during my titration study, and ended up with bruising and discomfort that lasted several days.

On the DreamWear, my first two nights I had zero leaks at 8-9 cm, 1.2 and .8 events per hour, and slept very well. With the full face mask (Resmed Airfit F10), my auto machine went to slightly higher pressure, I 3.8 events, and I had 1 L/hr leak (I don't know how that compares to anyone else, but I'm comparing it to my ZERO leak with the DreamWear).

I suspect that there is going to be irritation with ANY mask--at least that's been the case with the few I've tried.

Another mask my sleep therapist recommended as being associated with good compliance is the F&P Pillairo. I haven't tried it, but it looks to be a very soft mask that, like the DreamWear, uses inflation of the mask bladder to create a seal. It's on my list to try, as I expect I may end up with a mask rotation rather than picking one and sticking with it (experience may prove me wrong, however).

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Try the Respironics Nuance, once that sore heals. I am thinking it is going to become my new favorite. With nasal pillows, it's all about the fit and the Nuance has more sizes and the most adjustable headgear while still being minimalistic. I'm not a huge fan of the Nuance Pro with all the gel, but the fabric Nuance I use, I do like quite a bit.

From the location of your sore, I think the mask you used is probably just to tight for you; the Nuance is significantly more adjustable.

Having said that if the WISP is working for you, don't be in too much of a hurry to change. These masks all take getting used to, you are fairly new at it. Give it some time.

I LOVE my WISP on nights when I'm not congested. It is light comfortable, and easy to adjust to eliminate leaks.

The Pilario Q is also nice, but only if you are not an active sleeper. For me, it ended up on the floor a lot. I kept hitting and dislodging the hard plastic sides of the cushion frame. For me, it was quite comfortable, just not very effective since I couldn't keep it on.

Good luck!
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(10-30-2015, 04:41 PM)pwgphoto Wrote: Last night I used the Wisp Nasal Mask and while the head gear was more substantial, it didn't bother my new nose sore. I also felt like I got more air with it. I want to use the nasal pillows, but I think I am going to have to stick with the nasal mask for now.

Why? If the Wisp is comfortable, doesn't leak and give good results, why do you want to give it up and use pillows? There's some kind of cult around the P10, but there's no law that says the P10 or any other pillows type is superior.

There are only three things to consider: a) Comfort; b) Leakage; c) AHI. If the Wisp ticks these boxes, then stay with it.

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On my first night using the P-10 nasal pillows I found them pretty uncomfortable and woke up with pain in the base of the septum. Later that day I determined that I had worn the P-10 upside down the first night. They are definitely angled in such a way as to be very comfortable when properly placed, and they can be very uncomfortable if worn upside down. My pain was not on the side as your picture indicates, but perhaps the straps rub if worn incorrectly.

BTW, you can adjust the strap tension on the P-10... the part of the strap that goes on the back of your head is split. The more you separate the strap the less the tension. It's not a huge difference but definitely noticeable.

Saldus Miegas
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