C-PAP mask (sleep apnea): Which type do you use/recommend/pros&cons

In My Humble Opinion
1

When first diagnosed, of the three CPAP masks shown to me, I chose the one that appeared to be the least intrusive, most comfortable, and easiest to deal with – the ResMed Swift FX (nasal pillows system).

Well, it’s a pain in the arse. Every time I move, I have to readjust the “pillows” under my nostrils. It has an adjustable strap that goes over the top of my head, and an adjustable strap that goes on the back of my head, which won’t stay put. Positioned properly, it works fine, but any movement I make affects the position of the pillows and straps, and awakens me so I have to readjust it. As a result, I feel like I’m not getting a good night’s sleep. I’ve included a link to a site showing several types of masks. Mine is third from the left (nasal pillow).

I’d like to know about your experiences with any CPAP masks – pros and cons and whether you’d recommend any particular type. Thanks.

2

I currently use the ResMed Mirage Activa. It’s a nasal mask, rather than the pillows, and it’s really helped cut down on the leak that I used to get.

I also liked the Respironics ComfortGel Blue. Initially it was better (more comfortable) than the Activa, but the shape of my face actually caused it to shift down and really irritate my upper lip.

3

Sycorax, it’s a matter of trial-and-error and personal preferences. I’ve tried a few and am happiest with the exact type that you don’t like.

4

Lots of threads here about various types. I currently have the same one you do but am in the process of switching because I haven’t felt like it was working that well for me. Sizing was an issue - I seem to need between a medium and a large (large is significantly too large for me, medium is a titch too small).

A hose clip may be helpful. CPAP.com sells them for 2 for 10 dollars, but here’s a hint: if you have an old plastic badge clip (the kind with the metal clip, and a strip of clear plastic that goes through the badge and then snaps onto itself), use that, plus a Velcro cord wrap. This is quite literally exactly what they sent me. I don’t use it every night, but when I remember toi, it seems to take enough weight off the hose that the headgear doesn’t get dislodged as easily.

Make sure you’re replacing the pillows etc. as often as you should; after 3ish months, mine definitely don’t do as good a job and I’ve heard you’re actually supposed to replace that part monthly.

You may want to see if you can schedule a session, either with your DME provider or your sleep lab, to try on different styles. I just did so, and in fact wound up with a different nasal pillow system. Below is a copy of an email I wrote detailing the different ones I tried:

Pilairo - 4 stars
Looking for an alternative to the Mirage Swift FX nasal pillow system, I tried this one on at a fitting at a sleep clinic. My understanding is that this one is very popular among their clients. I had my doubts, after looking at it online, as the single thin strap seemed like it wouldn’t hold the thing in place very well. Turns out, it is easily the most secure nasal pillow system I’ve tried. Lying on my back or my side, that thing was not going anywhere. Of all the mask systems I tried, this one required the absolute least jiggling and shifting to get it to feel like it was “seated” properly - as in, none whatsoever. The sleep clinic checked the leak results while on the CPAP machine and there were no leaks at all.

However, coming from the Swift FX system, I actually found the nosepiece surprisingly obtrusive. It really wraps around the tip of the nose, which provides the great secure seal, but I found that distracting enough that I opted to try a different model. I may give it a try again in the future: it wasn’t intolerable by any means, but it is a very different feel if you’re used to a more traditional nasal pillow design.

Aloha Nasal Pillow: 3 stars
Looking for an alternative to the Mirage Swift FX nasal pillow system, I tried this one on at a fitting at a sleep clinic. The headgear is probably the most comfortable I’ve tried - easy on/off, and the plush covering felt genuinely good against my cheeks. Where this one failed was the pillow itself: I had a lot of trouble getting that to feel like it was securely sealed, without being irritating - especially when lying on my side. While I’m sure I could have learned to tolerate it, I decided to try other models.

Mirage FX Nasal Mask: 4 stars.
Looking for an alternative to the Mirage Swift FX nasal pillow system, I tried this one on at a fitting at a sleep clinic. The Mirage Swift FX is an ultra-minimalistic pillow system, so I think they were surprised that I wanted to try a nasal mask. I found this mask surprisingly comfortable once I learned to adjust it correctly (hint: the top strap of the headgear must be a little snugger than you’d do with a nasal pillow). I tried two cushion sizes: large and standard. I’m female, but have a large enough head that we tried the large size first - and found that it leaked like a sieve around the eyes. Switching to the standard size solved that problem.

The one thing I disliked about it was the air vents. They’re arranged in a circle around the hose connection, which means they blow in all directions. I kept checking because of the air blowing toward my eyes - it felt like the mask might have been leaking (as the large size cushion did), but the air was definitely coming from the vents, not from a cushion leak. This was borne out by the readings from the CPAP machine I was hooked to: all leak readings were well within acceptable parameters. It felt quite secure when lying on my side or my back, requiring only minimal shifting to get it seated properly.

Note that unlike a nasal pillow system, which often comes with multiple pillow sizes included, this one (as far as I can tell) comes with just the cushion size you select. It’s not clear whether the same frame system can handle both cushion sizes (standard vs large), or whether you’d need to get an entirely different frame. So be careful with sizing when ordering this product.

Ultimately I chose a different system, but have made a note of this and will almost certainly try it in the future, so I have several different types to rotate among.

Opus 360 nasal pillow: 4 stars
Looking for an alternative to the Mirage Swift FX nasal pillow system, I tried this one on at a fitting at a sleep clinic. I tried both the medium and large nasal pillows, and was surprised that the large one felt better (with the Swift FX system, the large is much too large for me). Of all the pillow systems I tried that same session, this one turned out to be the most comfortable. Lying on my side, I did have to jiggle / shift it a bit to get it to feel like it was seated properly, but lying on my back it was a complete non-issue. Leak readings from the CPAP machine were well within normal limits in both positions, though very slightly higher on my side.

This is the mask I ultimately chose, after trying on numerous others.

Mirage Swift FX nasal pillow: 4 stars
This system must be the lightest, most minimalistic one on the market. I wound up with this system after a truly awful titration session in the sleep lab, where they simply handed me a nasal mask and told me to practice breathing through it. No effort whatsoever to try to adjust it correctly or find one that actually fit my face.

So when the actual CPAP unit was ordered for me, I made sure the prescription said “any mask I choose”. The Swift FX was actually the only one I even tried - the respiratory therapist said she had several on hand, but that this one was so popular that she recommended I try it first - and it worked quite well.

The good: Extremely lightweight. Only one elastic strap (the top-of-the-head strap is translucent silicone and connects directly to the pillow unit itself). Comes with a useful velour bag for travelling (used to, anyway, my last replacement no longer had that). If you’re at all claustrophobic about having equipment strapped to your face, you can’t make a better choice than this unit.

The bad: Because it’s so lightweight, the hose portion has enough weight to actually dislodge the pillows unless you do something to manage the hose. I’ve taken to pulling a bit extra of the hose onto the bed with me, to reduce the weight pulling on the mask system. When I sleep on my side facing away from the CPAP machine, I tend to actually tuck the hose under my “upper” arm. It also requires me to jiggle / shift the unit a bit whenever I turn over, to make sure it’s seated properly.

5

I use the ResMed Swift LT nasal pillow mask. I like it quite a bit and especially like the top strap with hose-clip for keeping the hose up and out of my way at night. The mask supports small, medium, and large pillows from ResMed. I find the large to be too big and the medium to be just the teensiest bit to small. That said, it is still very comfortable and I move a lot at night while sleeping and do not have an issue with losing the seal. The hose-clip on the top strap really, really helps a lot with this.

As others have said tho’, it really is a trial and error process. Sometimes the mask you have isn’t the right one for you and you need to switch. It sucks, it is expensive, and it is frustrating. Be aggressive tho’ with your DME to get the right equipment you need for your health!

6

ResMed Mirage Quatro full face here. Pressure is too high for the little ones. My biggest preference is that the hose should depart your face over your forehead so you can roll over. In the ads they always show the hose going down over the chest, like you’re a fighter pilot. How can that work?

7

I’ve actually always wondered the exact opposite. Rolling over is no big deal with the hose hanging, except that if you turn away from the machine you need to make sure to bring enough of the hose with you.

With an over-the-head hose arrangement, it’s going up the middle of your face and toward the back of your head (the holder is on the top of the head). Lying on your back - how would that work??Wouldn’t the hose be forced to make a sharp turn when it gets to the pillow?

Of course, people also use a hose management system of one sort or another, which would seem to lift it more straight up (or up, and back a little).

8

I use it too but it took a little getting used to. One trick I’ve learned to keep the back strap steady is to tuck it under my hair. I’m a guy and my hair might be a little longer than average right now but I’ve found that it doesn’t take much hair friction to get it to stay in place.

Good luck, **Sycorax, **CPAP can be a pain but the health benefits, even if you don’t feel like your getting better sleep, are probably still worth it.

9

Thanks everyone! I will explore these options. As for the tube(hose) getting in the way, I have found online a c-pap holder which will hold the tube up and out of the way for those of you who have trouble with the tubes. Dealing with the tubing is another inconvenience that I’d rather not have to deal with when awakened at 2 a.m. Not sure if it’ll work for me – the tubing is ribbed and I don’t know if it will pull through the holder smoothly. Must followup on that. Anyhoo, thanks for the info. I knew I could get results if I came to the SDMB!

10

That may actually be a good thing: you want it to pull through the hook enough to give you the right amount of play, but not move through so easily that you wind up with too much on one side of the hook or the other.

I’ve seen other people mention, in other threads, things like rigging up something with a spring clamp on the headboard.

11

Good point! Thanks.

12

Another prior user for the Mirage Quattro full face mask (pressure was too high for nostril pillows).

Comfortable to wear, but needed to use extra padding at the top of the mask to prevent chafing on the bridge of my nose. (Augmented the padding with wearing silicone scar strips on my nose-- found those worked best vice using a small bandage, you can cut the scar strips to the right size and they’re reusable for a day or two).

As for a hose holder, I used one of these:

You just slip the base underneath your mattress and it keeps the hose away, I never had trouble rolling over at night while using it.

13

I’ve been using the Puritan-Bennett Breeze with nasal pillows for years. It definitely took some getting used to, but it seems to give me the best experience.

I tried the ResMed Mirage, and it was more comfortable, but I could never keep a good seal for more than a couple minutes, and it was just too big a PITA to deal with constantly readjusting the thing.

14

Oooh - important tip. Whatever you get… make sure it comes with the headgear and hose.

You see, when you speak to the DME provider choosing a new mask, and mention the pillow size, sometimes they don’t quite get the idea that you actually mean the WHOLE THING… not just a replacement pillow.

Yeah, not making that up. I spoke with the DME person late last week. Took me a few minutes to convince her that no, I was not having problems with my machine, and NO, I did not need to come in for a fitting session, as I’d already had one and that was why they had a message from the doctor.

A huge padded mailer envelope came Tuesday. I thought it was a bit small, but those things really don’t take up much room. So I opened it up to use it that night, expecting this, but instead found this.

Not terribly useful, huh?

So I called the next morning and the person was the same person I spoke with last week. Utterly clueless. “Yes, we can send you out a new one when the doctor sends in their order, but since we just sent you one, your insurance might not cover it”. I enunciated very carefully, repeating myself numerous times, and told her that in fact they HAD received the new order. “Well, since you just had one sent, insurance blah blah blah”. I repeated again “No. You did not send me a new mask system. You sent me the replacement pillow only. For a mask which I DO NOT YET OWN. It is not usable without the headgear. I have not had a new mask in over 4 months and I need one NOW.”.

::Oh. Um.:: clickety clickety click. ::OK, I’ll send one right out. “”

“Can you make sure it’s the right one, please? You see, I’m changing masks, and I want to make sure you don’t send me the old one by mistake”.

::Oh. Um. :: clickety clickety click. ::The Fisher and Paykel one? ::

“Yes. Thank you.”.

Egad.

And this is one of the biggest DME providers in the country. My insurance changed this year, same costs etc. but different servicers, and half the major places no longer are in-network.

The new mask should be there tonight or tomorrow. I’d say “I won’t hold my breath”… but I probably will :stuck_out_tongue: (at least when I’m asleep).