If Dreamwear Under the Nose mask is too noisy, what might be better?

[willo]

I started off with the Nuance Pro Gel Pillows Mask (size small.) It stayed in place well, but every night that I wear it, I develop more pain on the inner part of my left nostril. (I think there is a bump developing in that spot.) When positioned well, this mask gave me better breathing for sleep than I ever remember having in my life, directing air right into my sometimes congested nasal cavity. (FYI: I've got an appointment to see an ENT doctor as follow up to apnea diagnosis, but couldn't get in for another month.)
   
My DME failed to give me all the parts from the package, so I'm waiting to get the Med & Large cushions to try, just in case there's a fit issue. Basically, though, I tore the mask off and slept without it after my most recent attempt to use it. Turning over resulted in a terrible stabbing pain to that sore spot from pillow pressure. Ouch!

Before I knew anything from you guys, I went back to the DME complaining of the pain, and I got a Dreamwear Under the Nose mask next, also size Small.
   
I'm wearing the Under the Nose mask almost exclusively now, but it leaks more than the other mask. I find myself waking up to shift it to keep air from oozing into my eyes, etc., especially when I change position.

I also tried, one night, switching off in the middle of the night when the first mask was hurting. That's when I realized how much louder and more annoying the non-painful mask was!

I can sleep with the Under the Nose mask in place, but I think I could sleep better if I had an option more like my first mask that didn't hurt my nostrils.

The one other noticeable comfort improvement with the newer mask, though -- beyond "no stabbing pains!" -- is that is pushes less on my upper lip, which I dislike. From photos, I think maybe all nasal cushion masks must push on the upper lip to sit there, though? (Thoughts?)

With several days of straight wearing, my upper lip was being irritated by the original nasal cavity pillow mask. (Little red bumps developed with daily use.)

Given that noise is an issue for me, and that I've read here that the Dreamwear mask is noisy (I believe people are referring to the Under the Nose model?), would anyone like to suggest a next mask to consider?

Other mask issues:
* I wear glasses
* I have very fine, straight, slippery hair (my mask popped right off within a couple of hours the one night I didn't cover it with a silk nightcap I wear to protect my hair)
* My nose is beaky, i.e., narrow in width but perhaps deeper in length/protrusion than an otherwise "small" nose (based upon sizing card in Respironics packaging)
* I have arthritis in my hands, so doing fiddly fasteners could be an issue (if there are any masks with headgearthat go on very differently than my neoprene/velcro models?)

Is there anything else I could tell you to get better recommendations?

I have followed fit suggestions I've found here. I don't think I overtighten my masks, for example. I'm keeping the parts that touch my skin clean and I go to bed with a clean face.

I can certainly continue with what I've got, but I feel like there is room for improvement, at least for upcoming purchases, and I want a backup setup to leave at my parents' house when I visit them anyway (to avoid TSA agents touching any of my breathing stuff if possible, because changing gloves is really not enough to make me less disgusted by unwashed hands on my medical equipment...)

Thank you!
--willo

[Fats Drywaller]

Brevida. It's great. I haven't been able to understand why so many people are so crazy about the P10, when the Brevida is obviously better. Maybe it's the marketing power of the Resmed brand name? We know that F&P's machines are lame, but at least one of their masks happens to be ab fab.

BTW, the fact that a mask doesn't work well with one size of cushion or nas-pil nosepiece doesn't mean that it doesn't work well in general! I understand about wanting to ditch the Dreamwear because it's noisy (I did the same thing with it, after trying both cushion and nas-pils), but with any mask of any type it's essential to get all of the cushion or pillow sizes and try 'em all, at home, over some number of hours or nights, not just during a brief visit to the DME. The right size for an individual is often counter-intuitive: someone who seems like she supposedly "must" take a size S ends up being much happier with size L. And then with a different make & model of the same general type, it turns out that L is not right and M is better. It's not predictable, and there are no convenient ISO standards for nostril sizes, etc.

I don't know why DMEs do that stuff, keeping random parts of the mask packages from the patients, unless it's just more control-freak nonsense, which would figure.

Brevida product page: https://www.fphcare.com/homecare/sleep-a...ks/brevida

[Sleeprider]

Resmed Airfit P10 For Her, with a medium cushion.

[Fats Drywaller]

The P10 doesn't include a supply of lanolin cream for sore nostrils, and it should. I have a P10 that I've tried, but I've stopped using it. I'll get back to it eventually to give it another try just to be fair, but I have serious doubts. (And yes, I was using the size L pillows; I know that a common mistake is to use ones that are too small.)

[willo]

Follow up question: If suggesting a mask, and if you know which supplier on the list might have it for the best price, please share that information, too.


I will check with my DME as I pay only 20% coinsurance through them, but 30 odd suppliers is a lot of comparison shopping.

[willo]

And a fitting question. Given that sometimes Amazon will have just the cushion part of a mask at a discounted price (sometimes <$10 instead of $20 or $30 retail), does anyone suppose I could just order a cushion and see if it felt like it fit in my nostrils before ordering a mask for $100 or more?

Is that nuts, or clever? Because, if I liked the mask, eventually I'd need another cushion anyway, right?

[Fats Drywaller]

Most of us have had our fave masks for a while and don't know current prices. In any case, the browsing goes pretty quickly; just now I zipped through about ten or twelve of the U.S. suppliers in the list (at each site, click "Masks", then click "Nasal Pillows", etc.) and found that the Brevida is $89 almost everywhere, but priced higher at a few places. When I bought mine earlier this year it was $76 plus shipping from Supplier #14, but I can't remember whether a sale was going on.

In the U.S., the only one I know of that can bill insurance is Supplier #30.

[OpalRose]

Follow up question: If suggesting a mask, and if you know which supplier on the list might have it for the best price, please share that information, too.


I will check with my DME as I pay only 20% coinsurance through them, but 30 odd suppliers is a lot of comparison shopping.

I assume you would only be looking at US suppliers.
There are:
4 Australian suppliers
2 Canadian suppliers
1 German supplier
1 UK supplier
1 New Zealand Supplier
2 suppliers that offer repair work.
1 that only sells Oximeters

That whittles down your comparison shopping list quite a bit.  

Now with some seriousness, my feeling is that finding the right mask is the most difficult part of therapy.  

After trying a few different masks, I prefer the P10 mask. Most love it, and probably the same hate it.
We are all different...face shape, nose size, head size, etc.  then there is a consideration of what a person can tolerate, like straps that cover too much of the face, bulky headgear, noise level...you get the picture.

All I can say is take the recommendations with a grain of salt.  What’s right for me may not be for you.

If you are only paying 20% copay through your DME, you will not likely get the same coverage buying on line, and most online suppliers will not bill your insurance, but will supply you will an invoice to submit on your own.

Online suppliers also offer a 30 trial on masks. You normally have to pay to ship back if it doesn’t work out for you.

[mesenteria]

... I develop more pain on the inner part of my left nostril. (I think there is a bump developing in that spot.) When positioned well, this mask gave me better breathing for sleep than I ever remember having in my life, directing air right into my sometimes congested nasal cavity...

...Turning over resulted in a terrible stabbing pain to that sore spot from pillow pressure. Ouch!...


Thank you!
--willo

Many report initial trouble with those nostril cushions.  Often a larger size results in a much better experience, and that's the advice given by the resident experts here when asked.

You say you slept exceedingly well, except for the sore lump.  That's a sign you have the right mask, but another problem.  I think it's a cyst, probably akin to folliculitis that we sometimes get in sweaty conditions late in the spring when working out in the garden (am I giving away too much?)  Those who pluck nose hairs and get the same condition can fill you in if you'd care to know.  It may be that your too-small cushion slipped too far into your nostril, and after a night of rest, or by the time you tore it off out of frustration, it had migrated upward and pinched one of your nose hairs. If my brother can get sores from plucking a nose hair, perhaps you can as well?

The other mask sounds like it is unsuitable for you because it severely limits your range of repose....which you obviously need and cannot find while wearing this other mask.

You may find some relief by judiciously applying a tiny bead of 'barriere cream' just inside your nostril(s).  It won't damage anything, least of all the silicone cushion.  I wore such a cream, with that spelling on the tube, for two nights shortly after commencing PAP with my nose cushion and developed a sore nostril.  Worked like a charm.

[Walla Walla]

I haven't been able to understand why so many people are so crazy about the P10, when the Brevida is obviously better. 

Aside from the fact that the Brevida felt like a clam that was sucking on my nose? I felt the P10 headgear was more comfortable. Also the Brevida leaked at the bottom of the mask. I assumed it was because I have facial hair. Also the Brevida protrudes further into the nares than the P10 does. If the P10 Pillows are worn correctly with the correct size they hardly enter the nares.

Also another option is a full face mask like the Resmed Air Touch F20.