You just received the results of your sleep apnea test - the diagnosis? Obstructive sleep apnea. You're committed to taking the next steps to feel better and you know that you've got to get a CPAP machine, but what to do about the mask? You've seen something small that nestles just under the nose and seems appealing. This style of CPAP mask is called "nasal pillows" and it is extremely popular. But if you don't know the facts about whether this is the right option for you, your nose could end up seriously out of joint.
Here's a quick review of all the essentials that you need to know about nasal pillows masks, including the latest models available from five major players in the CPAP equipment industry.
Why Would Someone Choose Nasal Pillows?
Nasal pillows can be a great option for certain groups.
- Claustrophobic sleep apnea patients tend to gravitate towards nasal pillows masks as this type of interface allows the least amount of material on the face and doesn't cover the nose or mouth.
- CPAP users who have experienced lines on their faces from nasal or full face masks often switch to nasal pillows CPAP masks for this reason. These lines can persist during much of the morning and become a source of self-consciousness and embarrassment at work.
What are the Downsides?
1. A Shady Seal
It may be harder to maintain a good seal with a nasal pillows mask than with a standard nasal mask as there is less surface area in contact with the skin of the face. The nasal pillows may be more susceptible to leaking from jostling during body movements (a "CPAP pillow" can help this problem). Higher CPAP machine pressure settings may also make it harder to maintain a perfect seal with a nasal pillows mask.
2. Keeping Your Mouth Shut
We also encounter numerous patients who will only consider a nasal pillows mask due to claustrophobia but are also strong mouth-breathers. If you open your mouth during sleep, the air will follow the path of least resistance and go right out of your mouth. This may lead to dry mouth and throat, insufficient treatment efficacy, and waking up periodically during the night due to "mouth leak." CPAP chin straps can be an effective workaround for this issue.
3. A Busted Nose
Depending on your nasal anatomy, the design of some nasal pillows masks may put undue pressure on the end of your nasal septum (the cartilage between your nostrils), causing pain after prolonged use. The pillows themselves may also cause irritation of your nares (nostrils). This can sometimes be alleviated with a lubricating gel. I recommend Ayr's nasal gel as it's saline-based and won't promote the breakdown of the mask.
In Review: Latest Nasal Pillows CPAP Mask Options
If you've decided that a nasal pillows CPAP mask is definitely the right choice for you, the next step is to figure out which nasal pillows mask to order. Here are the most recent offerings from several major CPAP equipment companies:
Aloha - InnoMed
The aptly named Aloha (Hawaiian for "breath of life") features InnoMed's proprietary ArcedTrack pillow adjustment system for an individualized fit. The Aloha nasal pillows comes standard with all pillows sizes so there's no possibility of not getting a good seal.
"The Aloha nasal pillows mask gets rave reviews from our patients, "Jacqueline Rubio, Singular Sleep's office manager says. "It's definitely our most popular nasal pillows mask. Patients comment on the ease of fit and comfortable design."
DreamWear - Philips Respironics
This new offering from Philips won the 2016 Gold Award for Product Design from the International Forum (iF). According to a Philips survey, patients found the new DreamWear Nasal Pillows to be more comfortable and appealing than their existing masks. There is also an "under-the-nose-nasal" version of this mask, that doesn't actually involve anything going into your nostrils; the mask simply nestles underneath the nose. This mask has been extraordinarily popular with our patients:
AirFit P10 - ResMed
The latest ResMed nasal pillows mask has been found in internal studies to deliver "more than 40 additional minutes of sleep per night....when compared with the earlier version of the mask." The AirFit P10 is billed as 50% quieter and 50% lighter than its predecessor.
Brevida - Fisher and Paykel (F&P)
Winner of the 2017 iF Gold Award for Product Design. Katherine Duarte, Fisher & Paykel product manager, says “F&P Brevida™ is a nasal pillows mask designed for confidence and built for comfort. F&P Brevida features adjustable headgear to deliver an individual fit and the innovative AirPillow™ seal which inflates to form a ‘pillow’ of air in and around the nose for a gentle, effective seal.”
Rio - 3B
The tagline for the Rio nasal pillows is, "Designed with one goal in mind: simplicity." To that end, 3B touts the freedom of movement that the Rio's "unique rotating ball in socket swivel" provides. The Rio mask also claims the trophy for lightest nasal pillows mask, weighing in at just 2.6 oz.
The Nose Knows
There are many great options out there for those who prefer a nasal pillows cpap masks. Just follow your nose...but armed with the information above, it won't lead you astray.
Joseph Krainin, M.D., FAASM is the founder of Singular Sleep, the world's first online sleep center. He is a Fellow of the American Academy of Sleep Medicine and board-certified in both sleep medicine and neurology. He has been practicing medicine for over 10 years.
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