Pillows versus Cushion, thoughts?

Hi,

I’m on day 18, have used Dreamwear pillows up until today. Got a sore on the inside middle part of my nose. Used neosporin an Lasinoh and it healed, but still feels sensitive on both sides. My nose is very small and the cone part of the pillow only fits if I wiggle it in (using small size). Needless to say, it seems like they get blocked or fall out many times during the night so I am constantly waking up and adjusting.

So trying the cushion tonight.

I am also experiencing awakening to my mouth wide open and air blowing out. So tried a chin strap but seemed to cause my jaw to be sore and pop like it used to before I started using my plackers mouth guard. Yes, major teeth grinding and tongue biting a couple years before getting diagnosed. Clear symptom, but plackers solved the jaw pain and tongue biting. So chinstrap seems to push lower jaw back and aggravate the jaw pain.

Dreamwear full face mask is also on its way and I will also test it out.


Thoughts? Experiences?

Btw, love dreamwear with the pillows or cushion. Very non intrusive.

Thanks.

Airsense 19 for her
Dreamwear aheadgear (medium)
Dreamwear Nasal Pillows (small) days 1-17
Dreamwear Nasal Cushion (small) day 18

Titration set at 4-20

AHIs mostly less than 1

Try mouth taping? I use microporous surgical tape, works fairly well, and doesn't put your jaw in an unnatural position like a strap.

The other thing to ensure is you have correct tongue posture, and that your tongue is resting on the roof of your mouth. For myself, it's when my tongue drops my mouth is likely to drop and leak.

Some people here use a soft cervical collar to prevent mouth dropping.

I have always been a nasal pillow girl...started 9 years ago with them and that's what I have always used. Never had anything but minor tenderness at times which was rare and more related to poor fit than anything else.
You might be like me...really need an XSmall for better mask stability with the DreamWear because it's when things move around that we get the skin abrasions. Unfortunately they don't make an extra small.

Now you might also need a small DreamWear frame. I found that when I went to the small frame the mask instability (for both the DreamWear pillows and nasal cushion) at the nose greatly improved.
Also the fleece side wraps helped. Did you get those with your mask package? Some packages had them and some don't.
https://www.cpap.com/productpage/pr-dre ... wraps.html
Actually you could probably make some as a DIY project if you are handy.

In the end between the 2 models in the DreamWear...the nasal cushion or the pillows I prefer the pillows but remember that's what I have used for years and years. I could successfully use the cushion but the air blowing on my skin at my nostrils made me feel like it was leaking because I was having air touching skin that never had air touch it before unless there was a leak.
They weren't leaking but it sure felt like it at times which was annoying to me and would wake me up.
Now maybe since you are so new to therapy you won't have that annoying sensation because you don't have years of nasal pillow experience.
I preferred the pillows over the cushion myself with the DreamWear but I always felt like the small size wasn't quite small enough. Now maybe it was but I always wanted to try an XSmall to see but it's not available.

At any rate YMMV and obviously worth trying.
Consider frame size modification if the cushion wants to flop out too easily ....or the addition of the side wraps to help take up a little slack if you aren't already using them.
The frame comes in a small, medium and large and can be purchased separately. Ebay is usually a good quick cheap source.

For the mouth breathing...assuming it is more out of habit and not a physical need to mouth breath from nasal congestion..consider briefly taping the lips just a little to help retrain the brain to keep the mouth shut. That's what I did.
I taped for about 2 months (some 9 plus years ago) and the quit and I rarely had mouth opening issues after that and when I did it didn't wake me up and was so rare I don't care.
Yes..one of the disadvantages to chin straps is it can cause TMJ issues...don't want that.
I did try some chin straps but I found that they were more annoying than the mouth breathing and that's why I decided to tape.

Oh...I don't know where you are getting your DreamWear FFM but some of those packages include a small frame..so you might be having a small frame on the way and no need to buy one.

In the end while I can be successful with the DreamWear cushion or pillows...not quite as good for me as the P10 nasal pillows so they didn't replace my number one go to mask. The P10 venting is diffused and silent and a big factor in why I like it better...again one of those YMMV things.

macmermaid wrote: ↑

Tue Jul 24, 2018 11:10 pm

. . . pillow only fits if I wiggle it in . . .

Yikes! Are you cramming the whole thing inside the nostril?
The outside rim needs to rest just OUTSIDE your nostril.
Otherwise it will HURT.
Adjust headgear to hold the pillows LIGHTLY against your nose.
Air pressure will make the cones gently expand to make a seal.

chunkyfrog wrote: ↑

Wed Jul 25, 2018 8:07 am

macmermaid wrote: ↑

Tue Jul 24, 2018 11:10 pm

. . . pillow only fits if I wiggle it in . . .

Yikes! Are you cramming the whole thing inside the nostril?
The outside rim needs to rest just OUTSIDE your nostril.
Otherwise it will HURT.
Adjust headgear to hold the pillows LIGHTLY against your nose.
Air pressure will make the cones gently expand to make a seal.

Agreed, I do not "roto-root" my nose with the pillows.

That is a relief.
This has actually happened!
There would be no "bell curve" without somebody at the bottom.

Finally got my Dreamwear pillows and gave them a try to compare to the cushion.

The pillows stick up a lot more than the cushion does - this is a bit of a design compromise from Philips claim of the system being interchangeable. Ideally, changing from cushions to pillows shouldn't change the fit of the frame, but for me it does. And the fit kits with multiple cushions or pillows only come with a medium frame, so I had to buy a separate large frame to get the pillows to work.

As with most pillows, when these work, the seal is great. When they don't, I get leaks, septum pain and nasal irritation. The Dreamwear pillows are better than most in terms of not pressing too much on my septum, but the cushion is much better. Either works for me surprisingly well as a side and back sleeper - I like the top of the head hose mount and the soft frame. Adding a suspended hose management (an old microphone stand with a boom) really helped, even with the top of the head hose mount - I'm going to try to never sleep without a suspended hose again.

I like the Dreamwear version of nasal cushions better than the Philips Nuance version - which have a very poorly designed fabric frame with no stiffening to prevent the nasal assembly from torquing when you move. I wish they made a larger pillow, though, the large are just barely big enough for my nares. In the end, though, I think I'm going to stick with the cushion. The pillows woke me up at 4 am with discomfort (as as the P10 and the Nuance pillows do). I want pillows to work, but I've yet to find a way to make that happen. I may try again after my nose has recovered from the pillows.

Thanks everybody for sharing your thoughts.

Chunky Frog, I am not putting the pillows themselves in my nose. There is a cone part in the middle that goes in the nose (not sure what they call that part). It is a tad too big so it needs to be carefully set inside the nostril and it collapses and blocks the air flow or falls out and then leaks. It was causing a lot of soreness on the inside of the nose. So I think, like Pugsy, my nose is just too small for the Dreamwear pillows. I wish they would make an extra small.

I got the cushion, and so far, after three nights, it has been much better for me. I am not waking up multiple times to readjust it, like I was with the pillows. I wake up much less, only because my nose itches, but I am so sound asleep I don't wake up until I am pulling the cushion off to itch my nose. It is causing some soreness/redness on the outside of my nose, but I hope that skin is a bit more durable and can adjust better than the skin on the inside of the nose. It certainly doesn't hurt as much as the chafing on the inside from the pillow.

So I think the pillow are out for me, and cushion is in.

I am still waiting for the FFM to arrive...I want to have that ready to go for my next cold/sinus infection. It sounds like it it just like the cushion on top, plus the part that goes over the mask.

I think the frame is the right size, based on comparison to the pictures. It comes down the side of my head almost exactly in the middle of my ear and eye. I will try the fleece wraps that came with the mask. I ordered the FFM separate from the headgear, so I won't be getting a small to test.

I used the chin strap again the past two nights and it worked a little better to put it over the frame instead of under the frame. I think I will try taping my lips, but I fear it will cause a rash since my skin is so sensitive. But I will try.

ResMed Airsense 10 For Her
Dreamwear Pillows and Cushion

It may seem strange, but nose itching can be caused by long hairs in the nose getting disturbed by CPAP air flow.
It can even feel like the nose is itching on the outside when the problem is inside. I need to keep mine trimmed to avoid itchiness.

I bought the Dreamwear nasal pillows after the F20 I was provided with hurt my nose bridge and the Dreamwear Full Face just wasn't what I was after. These really allowed me to breath well, but I did get nostril irritation. I didn't know about Lanolin creme then, and I am sure that would solve that after using it on the Brevida. Since the pillows gave some irritation, I bought the nasal version that attaches to the same gear. WOW! Those are comfortable! They seal well. I did have some trouble getting airflow equal to both nostrils, but that is my problem not the mask. I simply didn't care for the headgear mashing my hair dead flat, so I am trying some other stuff.

But I will say I could use the Dreamwear nasal from now on if I had to.

Just starting my third week on APAP. Started out with a FFM and recently got the ResMed P10 nasal pillow mask. Took me a couple of *dang* painful nights to figure it out. First night I arranged it so the pillows were pressed as tight against my nose. Next morning, I felt like I had walked into someone's fist and my nostrils were on fire. I half expected to see a bruise, but there wasn't. Second night, I thought I had it loose enough, still woke up with the edges of my nostrils on fire, but at least my nose didn't feel bruised though. Third night, I finally figured out how to arrange the non-adjustable P10 headstraps so that it was as loose as I could make it while still acquiring a good seal. No more pain or burning after that.

Lessons last *longest* when learned *hardest* and I have a knack for learning the hard way.

Had I searched & read a bit more in the forums here, I likely could have avoided or reduced the pain I experience the first two nights. At least for me with the P10 mask, keep loosening the fit until you lose the seal, then adjust the fit juuuuuust snug enough to form a seal and absolutely *no* tighter. Even though it feels (in my newbie, inexperienced opinion) like the fit is too loose, it is clearly good enough to form a seal and not leak. Now to be clear, it is an easy seal to break if you toss and turn a lot, but it is also easy to gently tug the mask a bit to regain the seal. So while I have to be somewhat mindful of maintaining the seal when I roll or move, I would much rather have a seal that I have to be careful with that is comfortable, than a stronger seal that bloody hurts.

I generally need to put the mask on, move the head straps so the fit seems right - then once the mask gets up to pressure and air is flowing good, I pull the mask slightly away from my nose and then gently allow the pillows to settle onto my nostrils to get the best seal. Might have to do that two or three times until I get it aimed right and seals best. Hard to describe, but you will know it when it seals best and the holes are centered in your nostrils.

I decided to switch to pillows as my nose will get itchy from time to time and I couldn't easily scratch it with the FFM and I thought the Nasal mask would still be in the way. That's really the main reason as silly as it sounds.

Good luck with whatever you decide!
-JD

Make sure you try different size pillows.
For me the itching nose, even though is feels like it is on the outside, is due to hairs in the nose growing too long. Trim them and the itching goes away for a while.

Might try my mask. Pillows and covers mouth so no loss of therapy air. Comes with 3 sizes of pillows and oral cushions. Click on it in my signature to see it. Works with low and high pressures.

Hi Muse-inc.

Your mask looks similar to the Dreamwear FF, except the tube comes out of the mask instead of the top of the headgear.