Improving Nasal Comfort with Air Nasal Pillows for PAP Therapy

Proper Mask Selection and Fitting

The American Academy of Sleep Medicine recommends ensuring proper mask fit by testing the seal under treatment pressure before beginning therapy, as poor fit is a primary cause of discomfort 1, 3
Mask refit or adjustment should be performed whenever significant unintentional leak is observed or when experiencing discomfort, as suggested by the American Academy of Sleep Medicine 4, 5

The American Academy of Sleep Medicine suggests adding heated humidification to your PAP device if not already using it, as this significantly reduces nasal dryness, congestion, and discomfort 2, 6
Higher PAP pressures reduce relative humidity of delivered air, requiring higher humidification settings, according to the American Academy of Sleep Medicine 1, 7
Cleaning the humidifier chamber regularly is recommended to prevent mineral buildup that can affect performance, as stated by the American Academy of Sleep Medicine 2

Unintentional mask leaks, particularly mouth leaks when using nasal pillows, are a major cause of nasal discomfort, and using a chin strap to keep the mouth closed can help, as suggested by the American Academy of Sleep Medicine 4, 3
If mouth breathing persists despite using a chin strap, considering switching to a full-face mask may be necessary, according to the American Academy of Sleep Medicine 4, 5

The American Academy of Sleep Medicine recommends considering using pressure relief features (flexible PAP) that lower pressure during exhalation if experiencing discomfort during exhalation 4, 8
Adjusting rise time (duration for pressure change from EPAP to IPAP) for comfort, with shorter rise times (100-400ms) often working better for obstructive airway disease, is suggested by the American Academy of Sleep Medicine 4

Elevating the head of the bed can help if experiencing difficulty tolerating prescribed pressure, as recommended by the American Academy of Sleep Medicine 4
If persistent nasal symptoms occur despite other measures, consulting a healthcare provider about prescription nasal sprays is suggested by the American Academy of Sleep Medicine 2

The American Academy of Sleep Medicine advises against assuming dry mouth or nasal discomfort is normal with PAP therapy, as these often indicate correctable issues 5
Focusing only on mask type while ignoring humidification and pressure settings should be avoided, as stated by the American Academy of Sleep Medicine 5