I had a nasal mask before that I had gotten used to. Few leaks and good therapy but it made my nose bridge sore so I wanted to try a nasal pillow and went for the Aloha based on all the positive reviews. I thought the transition would be easy but I was wrong; I have been able to get to a point now where I really enjoy the aloha but the process was not out of the box; it took me a lot of time and many ninja skills to get there. Here is my process if it can save some time to someone else.
Problem 1 Solved: Sore nostrils
On the first few nights, it was hurting my nostrils. I realized quickly from many posts it was because my pillow size was too small. My advice is to buy the kit with the 3 pillow sizes, try them on quickly and whichever seems to fit better, take the size above that.
Problem 2 Solved: Frequent leaks and discomfort
After that, I realized that these nasal pillows are much more sensitive to hose management than for a nasal mask. My main hose was supported upwards but the weight of the small hose and the tugging would be sufficient to cause either discomfort or frequent leaks. I tried to alleviate this by fastening the small hose to the top of the headgear with the velcro ring but tugging on the main hose would still transfer forces to the small hose and the pillows. I finally solved this by changing the velcro ring location on the small hose; basically you have to set it tight on the portion of the small hose that is flat (no ridges), right next to the connector. that way it cannot slide either way and any tugging on the main hose is transferred to the headgear rather than the pillows.
Problem 3 Solved: Bad airflow
At this point I thought I would be out of the woods but something still didn't feel right with my breathing: I always seemed to have one blocked nostril. I realized the small hose is a bit too long for fixing it on the headgear and because of the swivel, it basically falls either to the right or left of your face. This makes the connecting tube point directly to just one nostril and because it is so close to that nostril, there is basically no turbulence and all the air flows into one nostril while the other doesn't get any. I could "unblock" my bad nostril simply by moving around the small hose! So I had to find a way to keep the small hose from falling on the side and keep it aligned with my nose. At first, I put a rubber band around the base of the pillows one one side and above the small hose exhaust on the other. This kept the hose in place but was creating easy leaks by squeezing the pillows closer together. Finally, I modified the mask to add a velcro strap across my forehead and attached a rubber band in its center that holds the hose in place. This worked
So basically I give 3 stars because:
pros: no sore nose bridge, no leaks, comfortable.
cons: had to modify the product to get the pros
