[Product Review] Phillips-Respironics DreamWear

[thecpapguy!]

Dreamwear Review

Hello! I have been using the Respironics Dreamwear nasal mask, with a size medium nasal cushion, for a little over thirty consecutive days. This mask has been on the market for a few months, and there are a considerable number of reviews available to you! I hope that my personal experience can offer you some insight into the mask itself and what it has to offer, along with the problems that I encountered! So, let’s get to it!


The Respironics Dreamwear: What’s included?

• Medium Frame (The frame of this mask is not solid plastic. It is the tubing that connects to the nasal cushion and sits along the cheeks to the top of the head.)
o You can also get this piece in a small or large frame if needed.
• Small, medium, large and medium nasal cushions (This is the piece that touches your face sitting directly underneath your nose.)
• One size fits most headgear.
• Fabric wraps (These are velcro wraps that offer extra padding along the mask frame.)
• Quick connect at the exhalation port elbow


The Respironics Dreamwear: Specifications

• Weight: 0.81 lbs (I cannot find this information anywhere online, so I weighed it myself)
• Small frame length: 19 in
• Medium frame length: 20 in
• Large frame length: 22 in
• Not made with natural rubber latex
• Category: Nasal Mask
• HCPCS Reimbursement Code: A7034. A7035, A7032


The Pros
• It is lightweight and able to maneuver in lots of different positions.
• There is no pressure at the bridge of the nose.
• I can finally wear a mask similar to pillows.
The Cons
• Tubing at the top of head is somewhat awkward throughout the night.
• Exhalation port noise.
• Discomfort directly underneath the nose and above lip.
• The frame stretches over time causing the mask to be over tightened to assure leak control.

My Personal Experience

As I wrote above, I’ve worn this mask for thirty days. And this frame of time is crucial into what I’ve experienced. When I first started using this mask, I found it was very comfortable and relaxing. The range of movement I had with the tubing connected at the top of head was comforting as I moved from side to side. Even so when somewhat pushing the mask into my pillow throughout the night. I did not have to wear the headgear tightly, just snug.

The comfort began to change after thirteen to sixteen-days. I noticed that leaking was starting to become a factor. Now, I want to be clear; this was not according to any clinically downloaded data through any external software. My leak was within normal limits. The leak I experienced was based entirely on comfort. I noticed that the silicone frame had stretched, and needed tightened; this has become worse over time, but at the one month mark, it seems to have reached the limit (so far).

The comfort of the mask was now starting to decline. Not greatly by any means, but considerably after how well it fit in the beginning. The seal was solid throughout the night, due to having to tighten the mask. However, this created a pressure point underneath my nose pushing on my mustache, upper lip, and nostril. I was waking throughout the night with discomfort. It did not cause any sore or irritation. After a hot face rinse, I never had a continuing problem throughout the work day.

My review of this mask may be somewhat biased because I was very much hoping for a mask that I could use that was similar to the nasal pillow style. I have never been able to tolerate a nasal pillow due to the structure of my nostrils and to hold a seal, so I was very much determined to make this particular style work. I have to say that I am very much impressed with the range of movement you have, even if the headgear must be tightened over time. You still have the exhalation port noise that comes with covering them slightly with a pillow or sheet. However, it adds a great strength to the mask.

The Dreamwear is stated by Phillips Respironics to be a nasal cushion style when billed through insurance. However, the way it interacts with your nasal passage and fit, it resembles much more a nasal pillow (in my opinion). So it truly is somewhere in between a nasal pillow and a nasal cushion not only in the build but also in the way it interacts with you! So, I took the same precautions most patients receive when using nasal pillows. Acclimating to the pressure intensity, humidifier utilization and furthermore as this helped greatly with my comfort.

In ending of my small review; I like this mask very much! I believe there are some users out there that could benefit from the mask and also, a number that likely won’t. That doesn’t make it an unsatisfactory mask by any means. If you are looking for a comparable mask to nasal pillow but want something that is not as obtrusive, then give the Dreamwear a test drive! I think you will find it comfortable, and you may not even have the issues that I experienced!

I hope my little bit of information helps someone along the way! Have a great night of sleep!

[wolson]

I too am starting to notice a bit of frame stretching such that I need to tighten it a bit more. Still like the mask though.

[PollCat]

I've found that the mask works best if I sleep on my back (the position my cats prefer I sleep in). Sleeping on my side causes the mask to move off center, resulting in the need to half-awaken to reposition it; plus my cats have been known to pad on me and talk to me in order to get me to roll back over on my back.

[ISnoreBadly]

The comfort of the mask was now starting to decline. Not greatly by any means, but considerably after how well it fit in the beginning.

I've found that the nasal cushion/pillow doesn't last very long. After 2-3 weeks it starts to get a little stretchy (I think) and starts to leak. I'm pretty sure that the recommended replacement schedule is every 2 weeks so that's what I've been doing, as long as I'm able to get the cushion in my size. Otherwise I had to tighten up the headgear and/or mess with the placement of the cushion to get it to seal properly.

[PollCat]

The SleepyHead program shows that my leakage rate sky-rocketed when I started using the DreamWear mask! Thus, my search for a new mask continues.....

[macbob]

I have never been able to tolerate a nasal pillow due to the structure of my nostrils and to hold a seal, so I was very much determined to make this particular style work.

tcg-you might try a Respironics Nuance mask. I too cannot use the vast majority of nasal pillows (seal). The Nuance has a gel ring that provides the seal on the outside of the nostril (similar to the seal on the DreamWear, but for each nostril). It protrudes a very little bit into the nostril to keep the gel ring in place.

If you try it, I would recommend trying the Nuance vs the Nuance Pro--the gel cheek inserts have popped out after ~ 2 months for every Nuance Pro I've tried.

[icyura10]

Review of Phillips Respironics DreamWear under the nose nasal mask

Objective

The following will describe some of my past recollections, current experiences with a particular emphasis on the Phillips Respironics DreamWear under the nose nasal mask.

Hisory

I was first diagnosed with one of the Sleep Apnea (SA) disorders in 1998 following emergency surgery that landed me within the confines of the ICU ward for several days. The nursing staff observed, documented and reported to my physicians their observations I was cyanotic and I would cease breathing for extensive periods of time and then wake up gasping for air, Not particularly good for someone with a staple line extending literally from my pubic bone to my Xiphoid in my chest.

I was sent for follow up sleep studies where it was confirmed I had SA related disorder and was placed on xPAP therapy.

I’ve been on and off various xPAP therapies, xPAP machines and masks for about 20 years.

I need to preface my entire review with I only sleep on my side. I’ve never slept on my back or stomach. So if you sleep on your back of stomach, your experiences may be significantly different and I would encourage you to document your experiences in this thread so others can benefit from your experiences specifically as they pertain to the Phillips Respironics DreamWear under the nose nasal mask.

Prior Experience

I’ve tried numerous masks over the years for my xPAP therapy. I found when I was fitted with a full face mask; I quickly rolled onto my back and would get both hands and feet onto the mask and pry the mask loose getting it off my face in no time flat.

Then, I was fitted with an over the nose nasal mask.

It was kind of training bra if you will. The nasal mask trained me sleep with my mouth shut otherwise the xPAP air pressure would enter my nasal cavity and just exit my mouth quickly causing my mouth to dry out. It took about a week to get this figured out after being a mouth breather all my life. I continue to be a mouth breather during the day, but at night when I sleep, I’m strictly a nasal breather managing to, for the most part, keep my big trap shut ( a real novelty for me!).

While the over the nose nasal mask worked, the interaction with the seal surrounding my nose would frequently dislodge and leak severely. Most frequently, the leak would occur on the bridge of my nose and the escaping air would blow directly into my eyes awakening me numerous times every night.

The other significant issue of the nasal mask (or full face mask) was at the various points where the seal would touch my face or the support arms would come in contact with my forehead or other parts of my face, various forms of dermatological issues would occur requiring prescription medication to address. Grrrr…

At this point in time of my xPAP therapy, the only SA masks were either full face or nasal masks.

Nothing of the pillow type masks existed. My poor face always looked like that of a leper and it was this way for years on end.

Enter the new under the nose masks

My xPAP pressure is significantly high (Initially a fixed CPAP at 18 cmH2O and now I've been moved onto a bi-level machine with IPAP = 20 cmH2O and EPAP = 12 cmH2O )and the new xPAP records leak rates for the first time, my physician had me migrate from a nasal mask to ResMed’s AirFit P-10’s in an effort to try and reduce my excessive leakage.

These were a wonderful change, and my face no longer presented with the creeping crud either around my nose or my forehead.

Hooray, finally I could return to looking more like a human able to fit within society without being the leper.

While the P-10’s were a wonderful change, at a pressure of between 18 – 20 cmH2O , it worked out to be just too much pressure for even the largest of the P-10 pillows.

I had an appointment with my sleep Dr. and he told me to immediately cease using the P-10’s and switch to the “Phillips Respironiscs DreamWear under the nose nasal mask.” The sleep technician had a “Sample” that I was fitted with and sent along my way. I’ll talk about sizes in a bit.

I scampered out of the Dr’s office with my new mask and went home looking forward to using the new mask that evening.

The P-10’s have two mushroom like flanges that insert into each of the nostrils. This entire component is refereed to as a "pillow".

In contrast, the Phillips Respironics DreamWear under the nose nasal mask has a component of the mask they refer to as a “Cushion.”

The "Cushion", is a few inches wide depending in size. On each end of the cushion is a snap like connector that clicks into the arms of the head gear. This allows the cushion to be cleaned separate from the actual head gear. The cushion has an elliptical “slit” that fits under the nostrils and unlike the "pillows" that fit the nostils, the slit in the cushion expands and opens allowing the pressurized air to enter the nostrils.

On the cushion is a small slit (facing outward, away from the face) for the purpose of allowing the expiration air as well normal over pressure to escape. When fitted properly, there is very little if any leakage.

Like the P-10 pillows, over time, the soft malleable material of the cushion distorts and gradually loses its ability for its memory to be restored at which time a new cushion for the mask needs to be acquired and used.

The ResMed AirFit P-10’s have their air supply at the base of the mask near the nostrils and the air supply of the Phillips Respironics DreamWear under the nose nasal mask is affixed to the top of the head gear that sits atop the crown of the head. At the connection air supply junction of the Phillips Respironics DreamWear under the nose nasal mask there is also a pressure relief mechanism.

The Phillips Respironics DreamWear under the nose nasal mask head gear itself is comprised of a soft, malleable silicone like material starting at the crown of the head having arms extending down each side of the head and across the the upper face where a replaceable cushion be replaced without needing to replace the actual head gear, similar to replacing just the nasal pillows of the P-10.

Similar to the P-10’s there’s a head strap that wraps around the back of the head securing the Phillips Respironics DreamWear under the nose nasal mask to your head.

The only complaint I have is trying to initially figure out how to put the mask on is like trying to differentiate between an octopus and a bagpipe.

Diving into the Phillips Respironics DreamWear under the nose nasal mask is not as visually intuitive as putting on the P-10 head gear assembly. Once you get accustomed to “diving” into the Phillips Respironics DreamWear under the nose nasal mask becomes easier but trying to put it on in the dark or while inebriated could prove to be a bit of a challenge.

My experience is that while I prefer the design of the P-10’s, at my pressure requirements, the P-10’s are ineffective.

My sleep technician shared with me he was a “beta” tester for the Phillips Respironics DreamWear under the nose nasal mask and it was intended to handle up to 30 cmH20 pressure although I can't find this documented anywhere, so it's at best speculative.

I can only attest the Phillips Respironics DreamWear under the nose nasal mask seem to address and satisfy my needs substantially better than the P-10’s.

The full head gear package, comes with the head gear (small, medium or large), two soft felt pads that can be wrapped around each of the arms so they don’t actually come in contact with the face and 4 under the nose cushions. One each small, medium, large and medium wide cushion is provided in the full head set package.

According to the Phillips Respironics DreamWear website

http://www.usa.philips.com/healthcare/pr...nasal-mask

(note the above site has all the part numbers for the full mask set’s and the individual replacement parts)

It’s not quite as easy as saying I want….. but I suspect that’s a common occurrence without regard to replaceable parts for xPAP therapy.

According to the DME where I received my Phillips Respironics DreamWear under the nose nasal mask, the cost of the full head gear is something like $171 USD.

My copay was some $28 and change. How much replacement “cushions” are I’ve not a clue.

I have searched the web and have found full packs for everywhere from about $99 USD to $120 USD.

I’ve not been able to locate on the web anywhere to get just the replacement cushions, but then, perhaps I’m not formulating my search very well. Additionally, many insurance companies (and I think Medicare) will replace the cushions (like pillows) at the rate of 2 cushions per month.

While my xPAP reports the Phillips Respironics DreamWear under the nose nasal mask continues to have a substantial leak, I don’t seem to feel as “starved” for air like I did with the P-10’s at my pressure after my sleep sessions regardless of how fragmented my sleep.

I’m more than certain had my pressure been significantly lower the P-10’s would have worked fine, but, that’s just not in the cards for me right now.

Hope this helps someone

NOTE: I'm just an average bloke, suffering like all the rest of us here with one or more forms of SA disorder. Notice I did not make any recommendations for or against the use of any mask or device so there's no endorsement intended.

It's nothing more than a report of my personal experiences with these masks.

[PaulaO2]

Somnia16, I moved your post to the Main Forum since it seemed to be more about asking about a product rather than reviewing one. You can find it here:

http://www.apneaboard.com/forums/Thread-...-questions

[Dramagal27]

Love this Product!

Pros:
Soft material
Hose on top of head
Velcro cloths that attach to the sides of the mask unit
Flexibility of the silicone
No facial pressure

Cons:
I have absolutely no issues with it. I am new to a CPAP machine, but I have tried the hybrid mask, the Amara View, before this to see if I could tolerate a bigger mask. Honestly, once I put on the DreamWear mask, I was sold.

[beet]

Noise ameliorated by Sleeves

I sense there is bone conduction of noise from the side tubing to the ear. This source of noise was eliminated by covering the side tubing with the fleece sleeves included with the mask.

I mention this because I've never bothered using sleeves with other mask frames because they never irritated my cheek. With the Dreamwear, I recommend trying the sleeves for noise reduction.