Masking the pain!

Philips Respironics Wisp Nasal System Review

Drew you in, right? I never leave well enough alone. I currently use an F&P SIMPLUS full face with mask pads. I have figured out (after a year of fumbling) how to make the mask work where I don't get high leak rates every night. Wash face, use mask pads, wash mask, MMA mouthguard and properly adjusting the mask where it is a bit tighter under my lower lip. All is well. Oh yeah, have a full beard.

I got the bright idea to try a nasal mask. I decided to try out a Philips Respironics Wisp Nasal System - Clear - 1094050. Was under $60 on Amazon and comes with 3 different sized snouts. I was curious as to how it could be sold without a prescription but hey... why not try? I had read mostly positive reviews elsewhere.

Put the mask on and decided the middle sized one was the way to go. Adjusted the mask on the couch in front of the TV and all seemed well. It was more difficult to breathe with the mask in place... Time for the test... went to bed early and got the thing on my face.

First thing I noticed is that it was REALLY hard to breathe through the thing without the my Airsense 10 going. WITH the BIPAP going, it was still hard to breathe; felt like I wasn't getting enough airflow and new mask definitely doesn't supply as much as as my original mask; using the same tubing basically (they supply a short "whip line" that connects to the long hose normally used).

I have the ramp time set to 5 minutes on my machine and turned it off trying to get more air pressure. When you turn off the ramp, it doesn't actually turn off! Found that you CAN NOT turn off the ramp in BIPAP mode but it does go down to 3 minutes before it hits full pressure settings; mine are 25/21. I was uncomfortable with lack of air. Once the machine got up to full pressure settings, it seemed a lot of the exhalation went into my mouth. Never happened before and I had to crack my lips before my head inflated and blew up. A lot of unpleasant noises were the result of the air in my closed mouth. Perhaps not enough exhale relief through the mask and it may possibly be the high pressures prescribed for me.

Anyway I dozed off and awoke with my nose WET and STOPPED UP... I felt as if I had overfilled my water reservoir but I had not. Did I say my nose was very plugged and runny at the same time? This had NEVER happened with the Simplus mask which works great even with a stuffy nose. Perhaps there is not enough exhalation relief on this nasal mask and moisture accumulated? Well, I wanted the thing to work because it is comfortable so I turned down the humidity from 5 (where it had been) to 2. Felt like the excessive moisture issue actually got worse and that I was going to drown.

Took the mask off after an hour and I am convinced that it won't work for me. Probably due to pressure used and lack of exhale-ability. Not sure If there is anything I can do to make the thing work for me and suggestions are appreciated but the Simplus it back in the game unless I hear something that will cause me to try the nasal mask once again. Thanks for reading all my babble!

Hi wiredgeorge. Your story of attempting to switch from a full face mask to a nasal mask and the condition of difficulty exhaling is similar to others I have heard from patients. At pressures of 25/21, I suspect the volume of air going only into your nose may have contributed to both the feelings you were experiencing and to the nasal congestion. With the full face mask, you are able to open your mouth (even if only slightly) during sleep, allowing the air to enter and exit through both your mouth and nose. You have also mentioned using lozenges to help keep your mouth moist, which is likely very helpful with the full face mask. If you attempt a nasal mask again, you might look for a product called Cann-Ease or something similar that is designed for patients who use CPAP or oxygen. It helps keep nasal passages moist so they do not dry out and swell. Good luck!

The inside of the nasal mask wasn't dry at all Dan, it was like a rain forest. I have a bit of a theory that the smaller amount of exhaust perhaps caused moisture build up. When I put my Simplus mask on, I can breathe normally through my nose but with that Wisp nasal mask, can't breathe well at all. I really wish the mask had worked. Thanks

I see. So lots of condensation in the mask and a clogged nose, which is not comfortable. I'm sorry it didn't work well for you, but I'm glad you can go back to the Simplus. Keep us posted if you try new masks or find a solution! I often use a steroid nasal spray, or I have chronic congestion that makes it difficult to use CPAP.

DanM, I seldom get congestion and even if I do, the Simplus mask combined with the pressure allow me to breathe normally. When I first started therapy and was a little congested I worried that I wouldn't be able to breathe and took some Allegra D or the like. I found I did not need to take anything. To be honest, although I have been on therapy for a year or so, haven't gotten a cold or flu or the like and any allergies that are common in my area have not bothered me during the night due to the therapy I suspect. Anyway, the Wisp was a bust. The Simplus is working for me better than ever with very good leak rate; last night 6 L/min which is my all time record. I just thought that now that I have figured out where the leaks came from and have fixed the issue I could try another mask. Should have saved my money on the Wisp.

To follow up... examined the Wisp mask closely and there are no exhaust holes... How is this supposed to allow an exhale? Where is the exhaled air supposed to go?

Hi wiredgeorge. The exhalation for that mask should be on the elbow joint and not the mask itself. Check out part H of page 2 at this link: http://incenter.medical.philips.com/doclib/enc/10670288/Wisp_Nasal_Mask_-_Instructions_for_Use.pdf%3ffunc%3ddoc.Fetch%26nodeid%3d10670288

DanM, No wonder I didn't see the holes! They are miniscule and not nearly adequate for breathing. The volume of air through the holes on the Simplus mask is probably greater as a guess. Not sure if it would diminish the efficacy of the exhale holes on the Wisp to enlarge this opening some but I can breathe with the Simplus mask on and in place and hooked up with my Bipap not turned on and can't breathe almost at all with the Wisp also hooked up and the machine off. Unfortunately, they put the exhale holes in the same location as air comes in so it would likely create just an air leak to open the holes up. Perhaps making some holes elsewhere in the mask mark rather than the supply hose (imho a dumb location).

Hi wiredgeorge. I do not pretend to understand how some of the masks get designed :-). I know that there is a lot of testing performed to make sure the carbon dioxide that is exhaled is released from the mask at appropriate rates and to make sure the pressure the machine is supposed to deliver is delivered properly. Increasing the size of the holes might cause the pressure that should be delivered to the patient to escape, so your comment about diminishing efficacy if the holes were enlarged is valid. It is very interesting when working with patients to see the differences in what some patients tolerate and what they prefer.

I prefer to breathe and the exhaust holes are woefully inadequate for that purpose for me. They obviously work for someone and probably the majority. Supplemental exhaust holes would not be placed at the ingress point from the PAP machine to the mask but offset somewhere else on the mask. For instance, on the Simplus, they are above the air inlet. With a tolerable level of exhale exhaust capability on the Simplus mask and and inadequate amount on the Wisp, seems it wouldn't hurt to try augmenting the exhaust capability with a few holes. Heck, I have no use for the mask as it is now. BTW: I bought the Wisp on Amazon and no prescription was asked for or given. Will let all know if I go the modification route. I wish I had some way to gauge the amount of exhale relief so will start small and add until the mask either loses efficacy or works as it should for me.