Fitting the AirFit P10 pillows

I am trying to optimize the fit of the pillows because the nasal pillows are the best mask in terms of comfort, noise and ability to fall asleep with something on your face for me. I've watched the ResMed fitting video, read the user guide, and also watched some other videos on YouTube.

From reading in this forum what has been repeatedly said is that the nasal pillow is not supposed to go into your nose, only to brush up against the nares of your nostrils.

I am trying all the different pillow sizes and the only one that makes it too big for the pillows to go into my nostrils is the large size. I have been having inconsistent problems with leaks though. I have been taping my mouth shut but the leaks still aren't going away some nights, so I wasn't sure if the pillows are not being fitted correctly. Without mouth taping, some mornings I wake up and my mouth is caked dry. I believe the tape does help though, with the same settings I can see that more CO2 is getting exhaled (minute ventilation goes up when I mouth tape).

While sitting or laying down while awake, I can have no leaks with the large pillows even at really high bi-level pressures to test. My machine set up is on the left on my bed, and sometimes I like to turn onto my left side away from everything so facing the right or sleep on my stomach with my head turned to the right. When I do this I usually drape the hose onto my headboard so it's not getting snagged. I am not sure the fact that I'm turned away from the machine, if the hose being curved around me would cause leaks if I move around a bit in my sleep.

When putting the pillow mask on, the tip of the pillows tends to go into my nostril no matter what, and then the bulk of the pillow seems to widen a bit and scrunch up against my nostril. I've tried loosening the straps as well, but I run pretty high pressures so they have to be somewhat snug. I've seen a lot of people giving reviews on YouTube and they seem to be putting the pillows into their nostrils. Obviously they aren't the ones using the mask every night like us.

What I did was use the largest size possible that allowed me to breath properly without leaks.
I found myself between the Med and Large pillow. The Med did extend into my nostril and caused some irritation and discomfort.
The large pillow did not extend inside my nostril and caused no problem. If I turn my a head a certain way with the large I can develop a leak and have to adjust the mask.
for me the large pillow Is my preferred as I suffer no irritation.
I thinks it's great that p10 mask includes 3 different pillow sizes so you can find the one that works best for you personally .

You should be able to feel a leak esp. if leaking at the nares. Try a dab of Lansinoh on the pillow sealing surface and the nares. Make sure you adjust your straps at your highest pressure.

The tip of the inner cone does go barely into the nostril but it shouldn't touch anything inside the nostril.

I used the medium sized pillows for the first half of the night, and when I woke up I noticed my nostrils felt sore and the airflow a bit restricted. I noticed the pillows had crawled further into my nostrils. Swapped out for the large pillows and that sensation went away. I guess I just have to be careful with the fitting and also adjusting the headgear, making sure the leaks are low/non-existent during the higher pressure portions of the night.

My ResMed S9 reported the leak at 4L/Min with my mouth taped shut, and I think ResMed reports the 95% value on the machine so that is very good! I have noticed that with the bi-level, when I use a higher EPAP it tends to leak more, as opposed to when I raise the IPAP.

I'd sure like to see Resmed come up with an intermediate pillow between the medium and large for the P10. Or perhaps snap on interface for the p10 that is more like the Dreamwear.

Redonthehead wrote:I'd sure like to see Resmed come up with an intermediate pillow between the medium and large for the P10. Or perhaps snap on interface for the p10 that is more like the Dreamwear.

I like the dreamwear more overall personally, as it seems to allow for more freedom of movement, but I've found that it doesn't handle IPAP pressures above 20CMH2O very well. Sometimes my pressures go up to 22-23CMH2O and when it does I get noisy leaks. I will have to play with that mask some more though, and try different sized nasal pieces.

I have determined that the best fit is a nasal opening of the pillow that best matches the opening of the user's nostril with the pillow opening no larger than the nostril opening.