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Need help with Nasal Pillows

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Kathie +0 points · almost 9 years ago Original Poster

I started with my CPAP 30 days ago. I am using a ResMed AirSense 10 Autoset for Her. My first nasal pillows was an AirFit P 10 for Her. After I developed sores in my nose, I was switched to a Phillips Nuance Gel System. The Nuance stopped the nose sores but it is so much louder and the air exhaust is very loud and wakes me up blowing air on the pillow, my arm etc. So I went back to the AirSense which the exhaust is silent and much easier to sleep with.. When I started with the CPAP, I was sleeping 6 to 7 hours with the machine. Now I am shutting the machine off in my sleep. I wake up in the morning with the mask around my neck and the chin strap somewhere in the bed. The Air report shows that I used the machine for 1.5 hours but I slept for 6 to 7 hours. I moved to the guest room and tried the Nuance again, but this time I woke up with the machine shut off and the mask still on my face, the Air Report showed I used the machine for 3 hours but I slept for 7 hours. Additional, my husband says I make loud "honking noises" when I open my mouth while sleeping.

With both machines, I wake up with my mouth so dry I am getting sores in my throat and roof of my mouth. I am using Biotene and have the humidity set at 5.

I am at a loss and am hopeful that someone will have solutions for me so I can return to my bed without causing my spouse sleepless nights because of the noise. I do not to give up but I am so disappointed that I seem to be doing worse every night.

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Ruby +0 points · almost 9 years ago Sleep Commentator

Are you set on using the nasal pillows? I started out with them but because my mouth opened so much during the night, I switched to a mask that covers my nose and mouth. That also eliminated the dry mouth and throat when I use the humidifier. My suggestion would be to try a different kind of mask. I do hope you find relief soon!

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Kathie +0 points · almost 9 years ago Original Poster

The nasal pillows is what the RTherapy gave me to use. I will check with them about a mask on Monday. I think that if I didn't get so dry I would stop turning the machine off. What I need is an alarm that would sound when I turn it off.

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Ruby +0 points · almost 9 years ago Sleep Commentator

You know, that's a great idea!

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pepemayo +0 points · almost 9 years ago

I started with mouth and nose mask I couldn't sleep because the filling of the straps didn't let me sleep I changed to the nasal pillows they sore my nose I woke up tired like I didn't sleep well like I sleeped only a couple of hours now Im using a nose mask It help me to sleep a little better but the straps still don't let me sleep even that I have the straps coming down. From the top

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Supersonic +0 points · almost 9 years ago

There are different sizes of nose pillows - small, medium, and large. Have you tried a different nose pillow size. Also, if you are a mouth opener it has been suggested to me that dental cream on your upper lip sometimes help along with the chin strap. Hope that helps.

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Kathie +0 points · almost 9 years ago Original Poster

I tried all three sizes that came with the Nuance nasal pillows. I found the small one worked best. I don't like the Nuance as much as it blows air everywhere. The Air Fit have a mesh over the exhale so the air doesn't blow everywhere.

I have solved some of my problems by making my own headgear for the AirFit. I made it with two bands and I also added a loop for the hose so that it goes up over my head. Without the downward drag on the hose, the AirFit stays on so much better. the AifFit only had the one pillow and it is a small. I did download a measure from the ResMed sight and according to that the small is the right size.

I will try the dental cream but I don't understand what kind. Is it the stuff that is the adhesive that keeps the denture in place?

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Supersonic +0 points · almost 9 years ago

Very clever with the self made headgear. Yes, it would appear to be the denture cream (as gleaned from other CPAP bloggers on other sites). I'm merely passing on their advice. I haven't had the need to try it.

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TheresaS +0 points · almost 9 years ago

Care should always be taken when taking steps to keep the mouth closed. Should the person need to cough up secretions or vomit, sealing the mouth in a heavy way (as using dental fixative on the lips) could cause a person to aspirate (material goes into the lungs). Best measure is to speak to your physician about making any closure of the mouth when in a sleepy state.

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Kathie +0 points · almost 9 years ago Original Poster

Great Warning Theresa. I was afraid of skin break down but I hadn't thought about the aspiration side of it.

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StraightforwardPurpleWolverine1614 +0 points · almost 9 years ago

It sounds like you are mouth breathing. If you don't want a full face mask, try a chin strap. Also, the AirFit has different size pillows, if you hose is making it leak, you probably have the wrong size.

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snuzyQ +0 points · almost 9 years ago Sleep Commentator

Hmmm...here's a few tips. Try using a Q-tip to dab a little AYR into your nasal passages before you put your mask on. Mask up and settle into bed with lots of positive thoughts like: "I'm going to love my CPAP now", "CPAP is a very good thing", "this is my new way of sleeping and I will always do this", etc. Next, after you're all settled in and comfortable, gently close your mouth, (lips), and let your teeth fall into your natural bite. Gently place your tongue against the back of your from teeth and leave it there, all relaxed. Do you feel good? Great! Now give yourself more positive thoughts: "I must keep my mouth closed all night long...Is everything where it is supposed to be?" Check carefully and take your time. OK? Affirm what you have just done by thinking; "Good...everything is right where it is supposed to...I'm very comfortable now...I'm going to keep everything right where it is all night long and my mouth will stay closed the whole time...It's safe for me to go to sleep now!". Quietly reach over or up if you have a Hose Buddy and hook up, then just breathe naturally and assume your usual sleeping position. Repeat your affirmations and take your time if you like..."everything is right where it is supposed to be. When I wake up in the morning everything will be right where I left it and my mouth will be closed...it will stay closed all night long...etc."...until you just can't stay awake any longer. It's amazing, but this comforting technique, with tongue placed against the backs of your upper front teeth actually works! You can take it from me...a lifelong mouth breather until a generous soul from ASAA shared this tip in answer to someone else's post. Try it! All that positive affirmation is great stuff. Good pappin' to you.

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UnassumingHarlequinGrouse9616 +0 points · over 7 years ago

What is AYR?

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DanM +0 points · over 7 years ago Sleep Enthusiast Support Team

Ayr is a saline-based nasal gel or mist that is used to help keep the nasal passages moist.

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TheresaS +0 points · almost 9 years ago

Dear snuzyQ,

What a positive, useful message anyone can try! The use of affirmations is a "free" and non-invasive method to drive the success needed. Hats off and congratulations on your great experience.

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Kathie +0 points · almost 9 years ago Original Poster

Thank for the reminder to use positive affirmations. So simple and yet something that I forget to use. On that same note, I attended a mindful based stress reduction course and it was very useful.

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BrainsNeedSleep +0 points · almost 9 years ago Sleep Commentator

First and foremost, get your DME to be helpful about getting a properly-fit mask. IME, many are unhelpful and the good ones are worth their weight it...good sleep!

Second, your PAP most likely DOES have an alert that goes off -- your DME probably did not set up your machine properly. I have similar machine but not gender-specific and have it set to alert me. When you get hold next of your doc or DME, be sure to ASK them to tell you what all the possible settings are and have they been maximized for you! For example, there are mysterious settings for specific mask types. Is yours set properly for you?

Third, ResMed has very responsive folks on Twitter so if ALL else fails, you can tweet a question directly to Mick Farrell, the CEO, at @ResMedMick or just @ResMed.

I have learned we must ask the questions we don't know to ask -- almost an impossibility -- but unless you are one of the very lucky ones, you will need to be your own best advocate. Persist and don't be discouraged.

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Kathie +0 points · almost 9 years ago Original Poster

Thank you so much for your help. I have gotten no help from the company that my insurance sent me to when I got the machine. Is that a DME They didn't even tell me that I was able to get a read sent to my computer. When I contacted ResMed they referred me back to the dispensing company. When I got the AirFit 10 I only received the small pillows so I have no way of knowing if they are the wrong size.
On a positive note: My Primary Doc has referred me to a sleep Doc and I have an appointment the 1st of June. I am so hopeful that he doesn't try to get me to go to the sleep lab again but I have a list of questions for him.

This has been a long two months. I am leaving for a two week trip later this week. I had planned to take the machine but now I am having second thoughts. After flying to Kansas, I will be a guest staying in a motor home. What will happen if I don't take it? Suggestions anyone?

By the way, I have done better with the headgear the I made for the AirFit. Two nights ago I didn't take it off at all and had no leaks -- then last night I used it less than 2 hours and showed a poor mask seal. I did the same thing both nights. I haven't used the Nuance for several weeks. I have been taking Benadryl at bedtime trying to keep my allergies under control. The sedation part doesn't hurt either, instead of being awake for an hour after going to bed, I am asleep in 15 min.

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DanM +1 point · almost 9 years ago Sleep Enthusiast Support Team

Hi Kathie. I'm happy to see that you are seeing a sleep physician and that you have a list of questions prepared. Have you considered taking your machine and mask to the appointment? You might consider contacting your DME and asking them for the medium size pillows to try if you are feeling air leaking around your nostrils. I would encourage you to take your machine with you on your trip, as persistence is key! Even some use is better than no use, and going without treatment for 2 weeks means that you might have to start adjusting to treatment all over again. Enjoy your travels, and sleep well!

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BrainsNeedSleep +0 points · almost 9 years ago Sleep Commentator

Kathie, Your own headgear sounds pretty darn clever -- you may have the prototype for a saleable item, there!

Sorry, DME= Durable Medical Equipment provider, shorthand for the various companies that sell oxygen, wheelchairs, and your PAP machine. Again, some are absolutely fabulous while others are nightmares and should have complaints made so as to help the next poor guy/girl who comes along and knows nothing, trusting to the "experts."

Your mask absolutely comes in a sealed bag with the three sizes of pillows. Your DME should properly fit you with one but KEEP the others because you never know...i am having surgery to prop open nostrils whose cartilage is damaged, and i may need the larger pillows when we're all done. Keep everything.

It is your decision whether or not to take your PAP on vacation. Without a WORKING machine/mask, you may not be receiving any therapeutic effects and so are continuing to have damage done to various parts of your one-and-only body. On the other hand, if it isn't working for you yet AND you have a doc appt soon, perhaps you may as well enjoy your vacation as best you can. Me? I'd take it along and persist in figuring out how to make it work.

The benadryl sleepiness effects will wear off before a week is out for most people. Someone told me it changes your sleep but I can't breathe without some kind of antihistamine. Buying an air filter machine next...ENT insists...as I am 'lergic to just about everything now!

By the way, be sure to get and keep copies of every test and report that is done on and about you. I keep mine in a binder just for sleep. And not all labs do good sleep tests. Mine wants me to take (and pay for) a third one but I am losing faith in it since we've been doing this about 1.5 years and we still don't have my AHIs anywhere near under 5.

Having a sense of humor (of any sort) really helps this process along. Good luck!

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Kathie +0 points · almost 9 years ago Original Poster

Thanks for t he insight. No - My DME already had the small pillows hooked to the tubing when they called to go over the machine. I did not get the other two. I can't recall them even turning the machine on and they sure didn't check for mask fit or leaks. This is the DME that my insurance uses but I do know that I will insist on better information - they were going to MAIL me a full face mask this coming month but I called them today and told them not to do anything until after I see the Dr. Then I am going to go into their office and try on the mask - and lay down on the floor if necessary to make sure it is a fit. I am suppose to take my equipment with me when I see the Doctor so maybe he will fit something that works better.

I haven't made up my mind about my trip yet. Tomorrow is another day but I will need to make up my mind then.

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BrainsNeedSleep +1 point · almost 9 years ago Sleep Commentator

Alas, too much in current health care is about neither patient health nor care. There are some really good DMEs out there and I hope you are able to convince yours to do the right thing by you. If they look at you like you have 2 heads when you gently insist on fitting, etc, may you be heartened by the thought you are not alone in this. Until we have our masks 3-D printed for our own faces, it's a trial. 😄. Good luck.

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