Last night was the first time since late October that I slept through the night without an air leak. It was glorious! I’m not saying it was a perfect night — thoughts of Thanksgiving to-dos swirled around for quite some time before I could doze off — but six hours of uninterrupted sleep felt like eight, and I awoke refreshed and ready to hit the kitchen.
The first mask my sleep doc fitted me with was a ResMed N20 nasal mask. While comfortable, I found it’s not well suited for my side-sleeping position. Pillow pressure frequently pushes it out of alignment, breaking the seal. A full month into my CPAP therapy, I’d yet to have a full night without interruption while using this mask.
A week ago, I order a ResMed AirFit N30i nasal cradle mask (check out this post on selecting a mask). As the name implies, cradle masks cradle the end of your nose and nostrils in a silicone, trough-shaped cushion with air ports cut into the bottom of the trough. Nothing protrudes into your nostrils, as does a nasal pillow. It “hugs” the bottom of your nose with slight upward tension applied by the frame and headgear.
I tested this mask setup the night before last, and it was comfortable but not without a few problems. It inched out of position a couple of times, causing the air ports to become misaligned with the center of my nostrils, which, in turn, made exhalation difficult. I tightened the headgear, and it stayed put for the rest of the night.
One of the reasons I ordered the N30i setup was because it was compatible with the P30i nasal pillows, so I ordered one of those as well. That turned out to be a wise purchase.
Last night, I installed the medium-sized P30i pillow, put on the headgear, turned on the CPAP machine, and tested it for comfort and seal before lying down for bed. One difference between the P30i and the N30i, besides the nasal tabs, is the N30i cradle cushion has a hard-plastic body that is over 2.5 inches wide. While this didn’t affect its comfort for me, when sleeping on my side, however, it could be pushed out of alignment by my pillow, potentially causing the cushion it to lose its seal. The P30i’s nasal pillow, on the other hand, has a soft silicone body between the connection points, which provides flexibility at the joints and cheek and reduces the potential for being pushed aside.
The P30i also incorporates a QuietAir exhalation filter into the body of the pillow cushion. The removable filter lessens and quiets the air released during pressure regulation and exhalation from the front of the cushion. The majority of the air is released from the appliance through the elbow, which is positioned on the top the head.
There are a number of reasons I like this new setup. The pliable hollow frame directs air from the connection port, through the frame and down both sides of your face and into the cushion. When side sleeping, the channel against the pillow may be pinched or compressed, but the airflow continues through the channel on the other side, delivering a consistent pressure. Because the connection port is on top of your head, the pillow isn’t weighed down by the hose, as is common in other models, and is less prone to be pulled away from your nostrils as you move during the night. Because there’s no downward resistance, the appliance doesn’t have to be as tight, increasing comfort.
Those are my impressions after one night with the ResMed AirFit P30i setup. I’ll update this post with additional thoughts after a few weeks of wearing the appliance with the P30i and the N30i cushions.
As an alternative to the AirFit 30 series, take a look at the Philips Respironics DreamWear mask. It appears to be a comparable design for about the same price. I don’t know which company first developed this frame design, and my purchase of the ResMed was purely because that was the brand of my first mask and machine. The DreamWear mask uses a universal hose connection, so it should be compatible with most machines.– by Matt Lindler (a.k.a. CPAP Matt)
STATUS UPDATES:
2 Dec. 2020 — Nearly a full week in with the ResMed AirFit P30i setup and all is still good. I had one night in six where I encountered a couple of leaks, but I attribute it to not cleaning my face well before going to bed late that night. Washing your face at night is an important step in ensuring a good mask seal. Wash with facial soap and water or use an astringent/alcohol on a cotton ball/pad to remove oils from around your nostrils. The oil can act as a lubricant, allowing the cushions to slide around and potentially lose their seal. Removing the oil and cleaning your cushions/masks daily provides a dry fit that should not slip from position as you move during the night.
Matt's CPAP Journey 