Struggling with Transition from Nasal to Pillows

[thistle]

I started with an N20 and it worked well but the leaks wake me up quite often due to sound and feeling the air.  I've tried adjusting the mask to no end and have it working as well as I feel I can now, but it's still enough for me to feel like I need to try something different.  A good night with the N20 is just under 1 AHI.

I got a P30i after trying on several pillows masks at the DME.  I'm having a lot of issues.  I feel like it's really hard to get a good seal.  I've tried the headgear loose, tight, and in the middle.  If it's tight past a certain point the pillows themselves make a lot of noise.  Looser than that and they're silent but they won't stay put when I move.  My last night on the pillows was 2.5 AHI and the night before that was 5.9.  It also feels like the pillows fit better if they were angled more towards the top of my head.  If I pull them out and down and angle them up it gets quieter and a better seal but it eventually moves back to having an issue.  

They also created sores in my nostrils, especially the right one.  I took a 5 day break for them to heal and callous up but my nostrils still start hurting about 10 minutes into the night.  I've tried the small, medium and large pillows and settled on medium.  I run the N20 at 10 with EPR at 3.  I've tried the P30i at the same pressure and at lower and it doesn't seem to make a difference.

The N20 causes a lot of disruptions and I feel like I could get better sleep if I could get the pillows to work effectively.  But if not the N20 is a decent fallback option.  I've attached my charts from the last 2 nights.  The 2.54 night is the P30i and the other is the N20.  I can provide closeups if it helps.  

I'm hoping maybe I'm doing something wrong that someone can point out or have some tips to get the pillows working with a fair trial.  

   

   

[CaptPat]

I've no experience with the P30, however, I have years of success with the P10 after trying several nasal and FFM. The P10 has a definite up/down orientation that tilts the pillows upwards in my nostrils. The headgear is not adjustable, it looks a bit inadequate but it works just fine. Never had sores from using it.

[djont57]

I use the P30i; it took a few weeks to get used to it but now it's the only mask that I am comfortable with. I use the Dreamwear headgear with arms, seems to be more stable.

[sunsaffron]

I have a P30i with Philips dreamwear headgear and a P10 with a few extra holes poked for extra venting (or leaking depending on how you look at it). both work well, I like the P30i for its top tube placement but sometimes it gets uncomfortable.

[thistle]

I tried the P30i again last night and I just really fight leaks with it.  If I could hold the pillows in the orientation I want it would be great.  I'm going to try the small and large and see if they're any better.  But it's pretty frustrating right now.

   

[readingteacher]

All pillow masks are not created equal. I started my CPAP journey with a ResMed P30i nasal pillow mask, and got sores and pimples under my nostrils. Ouchie -- not fun!

I then tried the Nuance Pro nasal pillow mask.The Nuance Pro was much softer and "squishier", much better for me. I also added RemZzz's liners for nasal pillows. They are thin cotton knit, like T-shirt material. They make a soft barrier between the mask and your skin. They are GREAT! No more sores or even red skin! And most nights I have zero leaks!

Pad-a-Cheek also makes liners for nasal pillow masks.

For many of us, the hardest CPAP struggle is finding a mask that works. Everyone's face is different, so you may need to try a different nasal pillow mask to find one that works for you. There are many brands and models to try. You might also want to try mask liners for both the nasal pillows and for your N20 nasal mask, as they can increase comfort and decrease leaks.

[YipeekiOH]

I went through the P10 and P30i. Between leaks and nostril discomfort I bought the F&P Brevida. The Brevida pillows are soft, comfortable and seal nicely. I now use Bleep and the F&P Evora (nasal cushion).

[Ockrocket]

A common problem with nose and full face masks is people tend to overtighten them in an effort to reduce leaks.

The masks are meant to "puff out" to match the contours of the face.
In order to achieve this they often need to be what feels on the loose side before the machine starts to blow air into the mask.

It may be worth trying the nose mask again and experimenting to see if you can get it to seat better with a little less tension on it.

[thistle]

A common problem with nose and full face masks is people tend to overtighten them in an effort to reduce leaks.

The masks are meant to "puff out" to match the contours of the face.
In order to achieve this they often need to be what feels on the loose side before the machine starts to blow air into the mask.

It may be worth trying the nose mask again and experimenting to see if you can get it to seat better with a little less tension on it.

I've certainly been guilty of trying this.  But recently I've been starting with them fully loose and only tightening enough to get the leaking to stop.  The result is a pretty loose mask.  If I wake up to leaks I'll snug them up a bit further.  It really does feel like if I could get it to stop leaking it would handle movement quite well when left quite loose.  I don't know why my leaks seem to be ok for the first half of the night and really bad the second half.

[thistle]

I had to take the CPAP off about 5 hours in last night.  The leaking sound and feeling wouldn't stop no matter what I tried.  It was just annoying and distracting.  I also had more flow limitations than normal early in the evening and I'm not sure why.  I'm starting to think nose pillows just aren't the right fit for me.

Is it worth trying a cushion to change my P30i to an N30i?  I think that would be a pretty easy trial to do.  Otherwise I'll look at going back to my N20.