Phillips deficient in sizing of Dreamwear cushions

[BigNortherner]

Phillips should be providing an XL cushion.

They provide an MW which will help the roughly 10% of the US population who have wide nostrils.

I expect as many people have tall nostrils.

I have to fiddle every time I put the interface on to get good seal and airflow.

(Phillips provides only S, M, MW, L - not XS nor XL.)

[LSAT]

Why are you telling us? Tell Phillips.

[BigNortherner]

Phillips does make a small version of the original Wisp: https://www.cpapoutlet.ca/product/respi ... 04953/3224

[chunkyfrog]

OP needs a BIGGER interface--or a smaller beak.
If one needed rhinoplasty in order to use cpap, would it then be medically necessary?
And insurance would be forced to cover it?

Hmmmmm.

[BigNortherner]

froggy is not making sense.

Is s/he suggesting a complete nose job to reduce size of nostrils?

My point is I want a larger nostril interface, plain and simple.

As for Phillips' huge bureaucracy, with long effort I found an email address, hoping that person will pass my request on to decision makers. (If I were younger I'd consider a new career as a skip tracer.

It is good for readers to know of limitations of various designs.

[chunkyfrog]

Sadly, we already know.
Those companies have no desire to serve the patient--only the dealer.
Masks are designed to fit people who look good in them-
for ad copy-not people suffering from apnea.
It is what it is.
For your own survival, find a mask that works--whatever that takes.
Or deal with the masks that come close, and alternate.
(I did this for about a year--both masks hurt, but I alternated between them.)

[Dog Slobber]

Why are you telling us? Tell Phillips.

Because:

• Maybe he has tried contacting Philips
• Posting and follow-up responses can be helpful in determining how prevalent his issue is
• Philips doesn't have the best reputation for responding to customer feedback
• Posting about a size deficiency can be beneficial to others who are in the xl size range
• Others who may have had the same experience could offer alternative solutions
• Pointing out potential problems, with any manufacturer, should never be discouraged

@OP
If you are ever in a position to need a machine, LSAT sells them at a great price and has a solid reputation. But anything he posts, not related to selling machines, should be ignored.

[chunkyfrog]

And the esteemed sponsors of this forum, cpap.com
have free return insurance on masks.

[Stilltired01]

I use the Wisp and the XL cushion. My sizing chart lists P, S/M, L and XL. I get 3 cushions in my package, it does not include the P.

[BigNortherner]

I received a reply from one of the persons in Phillips that I emailed, promising to pass my request to the right department to be considered for future 'enhancement'.

You want tall nostrils, check https://www.msn.com/en-ca/money/topstor ... a854&ei=46. Janet Yellen.

(As for the post about XL size in Wisp interface, poster did not identify the version - original or Dream.... Earlier I pointed to a version of the _original_ Wisp as having quite small nose cup, for very young children.)

[BigNortherner]

Thankyou 'Dog Slobber'.

Information is valuable in the zoo of interfaces, which are a key reason for 40% of people who try CPAP abandoning it.

[BigNortherner]

'chunky frog' omits that some designs indeed are designed to work.

IMJ Swift nostril pillows, Phillips Wisp nose cup, Phillips Dream under nose cushion are.
But Phillips predecessor to that one was incompetently designed, clever looking but hopeless in use even when modified.
(Respironics ComfortCurve or such was good except would not stay in place vertically because it lacked vertical restraint - a penalty of keeping eyes clear. The Dream concept of using air tube as headgear keeps eyes clear and works well generally, some shortcomings such as backstrap, retention of cushion to air tube in some variants, and materials in general.)

A challenge is finding a provider who has a range of options, understands them, and learns from customer feedback.

[BigNortherner]

Nothing more from Phillips nor on vendor websites I checked.

I tried the pillows version of Dreamwear because I ended up with the wrong product from SleepEh, not good.

So I continue to buy spare L cushions, price of fitpacks way up.

With the L I have to fiddle a lot to ensure seal at each end of nostril.

And need to wear headgear tighter than desirable leads to:
- strap plastic end coming out of frame
- occassionally cushion comes off of frame and one of the hard sleeves is lost
-
Not an interface for people who cannot deal with interface coming apart during the night.
Especially if have to get up during night.
Must have spare cushion handy.

Retention of arm of frame in end of cushion may require two hard plastic sleeves, one you hold in place with finger inside cushion the other is on arm, then push them together until snap. (The material of this interface stretches with age/sweat.)
If desperate during night you can force end of cushion with missing sleeve over end of arm, and adjust straps.

Recently I had one cushion develop a tear in the opening, had to throw that cushion out.

[chunkyfrog]

I never had that problem with Resmed masks.
Most masks will work with most machines,
even though respironics may imply otherwise.

[BigNortherner]

'chunkyfrog'
The Question is what interface design suits an individual's face.

I have tried many.

The best for me is Respironics nostrils cushion, latest incarnation is in its Dreamwear design which has air passage tube forming the headgear, one leg down each side of face.

It is a derivative of the ComfortCurve, which was great except it compromised on vertical position stability to keep eyes clear. (Which the Dreamwear does too.)
In between was a different design that did not work well even when modified - do designers and marketing people every try to sleep with CPAP and their latest cutesy interface.)

Among interface types are:
- full face mask, I mean Full (on forehead and under chin)
- mask for all of face
- mask for nose, often people get one too small
- smaller cup for nose works better
- nostril interfaces, including cushions and pillows
Over the years there have been odd ones that did not work well, one had tubes sticking into your nostrils with bulbed section partway to seal against inside of nostril openings - did not work well at all.
Most pillows designs are not correctly sized/shaped/oriented. I made my own once and wore them out, may do it again.

Headgear is a problem with most interfaces, various strap configurations are used. Need four straps for full face, three for nose mask.
The original CPAPMan Joe in Yakima sold a bulky design that worked well in part because its rear strap went below the occipital lump most people have. But I wore out (I bought custom dimensioned one, adjustable would have been better though bulkier.)
Respironics hacked up the Dreamwear headgear to get strap below the lump, but does not work well.

Much to learn!