Nose-pinching masks?

[JaxDeepSleep]

I'm trying to sort out a mask as a first time user of CPAP. I started with an N30 which seemed to work pretty well but had the hose coming straight off the nosepiece making it challenging for an active sleeper like me (sides and back). I was actually able to sleep a full night with it though. After that I swapped it for an N30i which has the hose mounted above the head. I immediately had troubles making this mask work for me and have ended up pulling it off after only an hour or two. At first I thought it just wasn't generating the pressure that the N30 delivered, but in more carful consideration of what's going on, it seems that the properly sized nose pieces is slightly pinching my nose closed making it much more difficult to breath and leaving me struggling to get in air which in time drives me crazy. Then I went to a Resperonics DreamWisp which is an over-the-nose mask, also with a top mounted hose. I have the same nose-pinching issue with this mask, even with the larger sized nose piece. Do I need to go to a full-face mask, or back to the N30 and endure the hose wrangling all night? Is this a common issue?

[Julie]

Have you looked at the variety of masks listed on Cpap.com to compare? There are graphics of front, sides and back to look at for each mask and if any look interesting, come back to this thread to ask about them.

[Pugsy]

Help me clarify your complaint....are you saying that the under the nose cushion is causing the nostril opening to compress and close off?
If so...you have the straps way too tight.
I can understand the Wisp compressing things but not the cradle cushion kind of mask unless it is so tight it is squishing the nostrils together.

Have you looked at hose management systems for help with the hose trying to strangle you? Do you know about them?
You can make one or there are many you can buy.

One example here but if you look online there are tons available.
https://www.cpap.com/productpage/HoseBu ... ion-System

[JaxDeepSleep]

Thanks you guys for the prompt replies. To clarify, both the N30i and the DreamWisp seem to squeeze the sides of my nose so it's partially closing my nasal passages (mostly the left in both cases). I keep re-adjusting the mask to give what initially seems like more air access to the left nostril but it quickly goes back in the case of both masks to squeezing it closed. In the case of the N30i it makes me want to bend the hard plastic holder at the nose open a bit. With the DreamWisp even the large doesn't seem large enough to avoid squeezing the sides. I did try loosening the mask's straps (both) to no avail - even just holding one of the DreamWisp large mask insert gently over my nose to just the point of seal I can feel my passageway squeezed at the sides. I do not have a wide nose, but it's on the larger size in the other dimension...kind of a roman nose I guess. It is not squeezing at the nostril closed as far as I can tell, but instead it seems to be pinching the side of my nose. It makes me want to insert a straw up each nostril to hold them open (sorry, that's the best metaphor I could come up with). As far as I recall, the N30 did not have this problem as it only did that smile surround thing that the pads do, a short way up and did not seem to squeeze as the N30i does.

Pugsy - thanks again - I was not aware of the hose management systems. It would be great to put the machine on the floor instead of on my night stand so I don't have to listen to it. It seemed to whistle a bit at the machine end last night on each exhale.

[Pugsy]

Okay...I think I have a better idea...the pressure of the mask touching the side of the nose seems to cause the congestion.
I have the same thing happen to me if anything touches the side of my nose on the nasal bridge area...that area where eyeglasses would rest. For that reason I avoid all masks that touch the sides of the nose anywhere...and that eliminates pretty much all those over the nose cushion kind of masks.

I lasted only 90 minutes with the Wisp...longest 90 minutes of my life.

EXCEPT....for one. I did try the Swift FX Nano nasal cushion mask and it didn't happen with it. I could sleep decently and breathe just fine with the Nano cushion

Now I am a small woman and with not a particularly large nose and I used the Small Nano but the large Nano cushion isn't all that much larger so I don't known just what might happen if you tried the Nano. While it is a similar type of mask...it does fit a little differently overall and it might work better for you.

To be honest ...I would suggest that you target masks that don't touch the sides of your nose at all...so the under the nose cushion/cradle kind of mask or even the nasal pillow version. Just eliminate any chance of anything touching the sides of the nose anywhere.

Perhaps with adding the hose management system you would fare better with a mask that has the hose coming off the front.

Take a look at the mask in my profile that I now use...the Bleep. If it looks interesting let me know and I will provide more information about it.

You might also take a look at the ResMed AirFit P10 nasal pillow mask...diffused silent venting and the hose is super flexible and light weight and while it comes off the front I have never really needed a hose management system with it. I am a very active sleeper...toss and turn a lot to relieve back pain.

both the N30i and the DreamWisp seem to squeeze the sides of my nose

I am having trouble understanding how the N30i touches the sides of your nose though...there's nothing there to touch the side of the nose that I can see. I do have a P30i and it is the same mask except for it's a nasal pillow interface...it simply doesn't touch anything to compress anything that I can feel unless it is wrapping around the nostrils themselves and compressing the nostrils. If it is wrapping around...that's a wrong size or too tight issue. It might simply be too wide overall for the end of your nose. It is a fairly wide piece of equipment even in the small size.

[JaxDeepSleep]

Thanks, Pugsly. Yes, you're quite right, the N30i does not touch the sides of the nose, but I'm guessing it is squeezing the base at the side of the nostril just enough to cause some closure up above it. Regardless, both the masks I mentioned to the same thing and leave me wanting for air pretty much right away, in spite of any adjustments I've attempted...they both just slip back into the same restriction for me.

I was thinking that something like the BLEEP you use may work better, or any mask with nostril inserts like that (is that what is called "nose pillows"?). I'll take a look at the NANO. Or perhaps just go back to the N30 and call it good.

[Pugsy]

IMHO the mask journey is the most difficult part of cpap therapy. We all have to be comfortable to sleep and lets face it...sleeping with all this stuff isn't exactly the most comfortable thing in the world to be doing to promote sleep. Without sleep none of it matters.
Then we all have different facial structures along with different preferences, wants and needs to complicate things.
One man's treasure is another man's trash is never any truer than when we are talking masks.
I know people who just love a mask that I absolutely hated and didn't last 30 seconds with.

Since I have the congestion issue thing with anything really touching the sides of my nose I learned pretty quickly to eliminate those sort of masks. Sounds like you probably need to do that as well. Fortunately there are many more choices available now than when I first started therapy 11 years ago. It is a journey that is all about trial and error though and while we can ask other people to share their experiences it doesn't mean our experience will equal theirs.

Over the past years I have tried well over 40 masks...some I slept with and some just put on my face and said "no way in hell".
I do like to experiment so my mask experiments have been mostly out of curiosity than anything else. Also after a while this stuff does get boring and trying something new makes it a little more interesting.
I always went back to some sort of nasal pillow mask though...as new models got released I changed to the "new and improved" version...because it better fit my own needs and preferences.

From the very beginning though I always said I wished I could figure out some way to just tape the pillows to my nose and ditch the headgear. Then the Bleep came along and I found someone actually did what I had been saying all these years I wanted to do.

I recently got my hands on the P30i nasal pillow mask...someone donated it for me to pass along to someone in need. Donated masks is how I got to try to many different masks. I haven't even tried to sleep with it yet and I don't know that I will. It is extremely annoying with the Darth Vadar breathing noises for me. Other people say they don't hear a thing...go figure.

Using insurance limits experiments to mask allowance time frames....but cpap.com offers free return insurance on their masks.
If you hate it you return it within the 30 day window and get your money back and you get to try something else.
At least you don't have to keep robbing a bank to buy new masks to try. Unfortunately now that the return insurance is free my donations box is pretty bare. Unwanted masks were how I had donated/free masks to give to people to try...now people return them and get their money back instead of donating them.

[JaxDeepSleep]

Yes, I got the DreamWisp from CPAP.com and will send it back. All of this being brand new I appreciate knowing that I'm not alone or being overly picky about mask selection. I did realize that straight away with the N30i in that every time I tried to endure it I'd end up lasting an hour or two and then wanting to tear it off my face. I have yet to try any nose pillow solutions - so thank you for those suggestions. The Bleep looks intriguing except for $60/month in the fastening adhesive. I may try one of the pillow masks next. Again, I appreciate you're taking the time to share your experience. Thank you.

[Pugsy]

The Bleep port monthly cost is a downer for sure but it is covered by insurance if someone has insurance and their DME will actually supply it. It's covered just like any nasal cushion or nasal pillow mask...insurance usually allows 2 replacement cushions per month...each box of Bleep ports has the same billing code as those replacement cushions...2 boxes a month allowed. Even Medicare will pay for them.
If you get to the point and want to try it and have insurance..let me know as I know an online cpap supplier who will ship the Bleep and file your insurance for you and you don't have to pay up front.

We can get the monthly out of pocket port costs down a little from that $60 dollar figure though.
There are places where we can find a 2 week supply for around $24 and sometimes even less when people use some promo codes.
I think one of the members has got them for $17 for a 2 week supply of 32 ports which makes it $34 a month.

So if you get to the point you want to try it...we can chat more.

[JaxDeepSleep]

I may take you up on that. I'm already through my out of pocket and deductible for this year so it's all insurance at this point. Of course they insisted that I rent to own the machine itself. Thanks...I'll keep you posted as to how it works out and may come back around to get that contact from you. Thank you.

[JXG]

What size cushion did you try for the DreamWisp? I would just try a bigger cushion for that mask (depending on what size you tried). The XL cushion in particular is very wide and it might alleviate the pressure on the sides of your nose that is bothering you.

[JaxDeepSleep]

@jxg I tried both a Medium and a Large cushion. Even just holding the large up against my nose I could feel restriction. There was no XL available in the package - I'm guessing that's an additional order. I did get my RT to send on the nasal pillow inserts for the N30i. I figure I'll give that a try again, and perhaps also go back and try the N30 which did seem to work other than having the tube come out the mask. Thanks for the input.

[fmj13]

I discovered I have been using my Airfit N30 on backwards. I put it on the correct way, and it hurt my nose badly. So I went back to putting it on backwards.

[OldLincoln]

Just fyi on my experience of pinching. I use a full face mask (Simplex) and liked using it with my red chin strap as I'm a mouth breather. I have a narrow nose bridge that allows air leakage so I usually have to tuck a little bit of seal at the bridge to tighten it up. One night I woke up gasping and my nose was pinched totally closed. The chin strap had my mouth clamped and no air through the nose taught me no more chin strap. Tucking the mask seal for a better fit may work as long as you have access through the mouth. That's why I never tried the lip taping that was popular a few years ago. Just my input.