[Equipment] Nasal Pillows - how to make them work?

[storywizard]

I have used the Swift FX nasal Pillows mask right from the start. Why? Because I absolutely cannot stand having something on top of my nose. During my first titration study I kept sneezing when the tech held the nasal mask about three inches or so away from my face. And the during five minutes or so she had it on my nose the itching was intense. I'm not claustrophobic, but I've got really sensitive skin and not being able to scratch the top of my nose was (and still is) a huge issue.

How do you make the pillows style masks work?
First, you don't over tighten the straps. I keep the straps on my FX ridiculously loose---so loose in fact that without the machine turned on, my mask is likely to fall off my face. But once my machine is turned on, the pillows fully inflate and rest against my nostrils very firmly but gently.

Other tips: Read and reread the fitting guide carefully. The bulk of the nasal pillow cones stays OUTSIDE the nostril. (A very common mistake is for people, including RTs, to jam way too much of the cone into the nostrils.) On a typical nasal pillows mask, only the very tippy-tip of the cone goes into the nostril. You also have to pay careful attention to the angle you have the cones at. Too steep or too shallow will lead to leaks OR will lead to the inner surfaces of your nose being assaulted with a jet stream of air from the nasal pillows. If there's any leaking at all, you gently pull the pillows slightly away from the nostrils while the machine is still running and then allow them to settle back against your nose. It's also important to use a nasal pillow that is BIG enough. If the pillow is too small, then too much of the cone is likely to slip into the nostril. Ideally, the diameter of the base of the cone should be a bit bigger than the outside edge of the nostril it rests against.

For sore nostrils, use Lansinoh lanolin nipple cream. It's sold to nursing mothers to soothe dry, cracked, sore nipples. So you find it in the baby aisle of drug stores and grocery stores. It comes in a purple tube; it's a bit expensive, but a tiny bit goes a long, long way. (I am still using my original tube, but then I no longer need it on a nightly basis.) Lansinoh is made out of 100% lanolin (not petroleum) and it's safe both to insert into your nose and for the silicone in the nasal pillows. Lansinoh has the same texture as vasoline (which is NOT safe for your mask) and for many people the fact that it is a tiny bit tacky helps keep those nasal pillows stuck to the nostrils just a little bit better.

Final tip: If you feel like your nose is being pushed into a "piggy nose", you've got the straps too tight OR you've put too much of the nasal pillow cones inside the nostrils OR both.

Thank you RobySue for this post, It may have solved my mask problems. Even my sleep teck was doing it wrong...I have had a 3 hour nap, yesterday and great sleep last night using these instructions, takes a level of trust to let the mask float, but that seems to be the trick, thanks so much for that...

Stephen