Swift FX Fitting Guide

I love the ResMed Swift FX mask.  I think they should pay me for my slogan, “it’s the next best thing to sleeping naked!”.  This is a really comfortable and unobtrusive mask, but it is a little tricky to fit.  On top of that, there are some really stupid DME’s and even some ResMed reps who are telling people that this mask works by cramming the nasal pillows UP YOUR NOSE.  I wish they would cram it up their own noses (or someplace farther south!)—that is NOT how this mask works!

I end up posting this on CPAP forums quite often, so I wanted to have one place to direct people to (except that I cannot post the link on the OSAA boards :o(   ). 

First, take a close look at the nasal pillows of the mask.    Those are the cone-shaped parts of this mask that touch your nose, with a narrow neck at the bottom.  The wide part of each nasal pillow goes against the outside of your nostrils.  The narrow tip where the air opening goes just slightly into your nose, not very far at all.  A properly fit nasal pillow should not really touch the septum or walls of the inside of your nostrils.  The only part touching should be the wide base of the cone outside your nostrils. 

Before you start trying to fit your new Swift FX, try this experiment that will help you understand how this mask works.  Holding the mask in your hand, turn the machine on, and place the meaty part of your hand over the opening in the tips on the pillows.  What you will see is that the nasal pillows seem to suck right onto your hand and the air pressure in the pillows holds it against your skin.  The inflation of the nasal pillows provides the pressure that seals the mask.  That action is what makes these pillows work, and if you understand that, then fitting this mask will be easier.

Fitting the Mask

Preparation:

With the mask off your face, loosen all the headgear straps.

1.  Hold the nasal pillows up to your nose.  Don’t put the headgear on yet.

2.  Turn on the machine, allowing the nasal pillows to fully inflate.

3.  Now put the headgear over your head. 

4.  Tighten the headgear just enough to stop any leaking.  The headgear should be fairly loose.  If you can’t get the leaking to stop, trying going UP one size in the nasal pillows and start again.

5.  Once you’ve gotten the leaks to stop, lie down in your normal sleeping position and re-adjust the straps as necessary.  Remember, the nasal pillows must be fully inflated, and the only way to ensure that is to keep the fitting as loose as possible. 

Hint:  I sleep almost exclusively on my right side, and I find loosening the strap just a bit on the right while tightening it just a bit on the left compensates for any displacement of the nasal pillows by the bed pillow.

Because this mask fits so loosely, it’s easy to dislodge the nasal pillows.  Try these hints:

1.  Sew a bit of Velcro hook tape (the stiff side) inside the back strap of the mask.  This will keep the straps from sliding around when you move your head on the bed pillow. 

2.  I find that the weight of the slinky hose causes the nasal pillows to pull away from my nose.  I use a hose hanger (hose management system) to hang the hose overhead, and that eliminates this problem.  It also points the vents up and away from me and my bedding, an added bonus (I’d love to shoot the person that thought the angle of these vent holes was a good idea on this mask!).

3.  Some people (not me) find that using something on your nostrils helps get a better seal.  Use a non-petroluem product like Lanisoh cream, KY Jelly, or Ayr Gel.  I think this makes the pillows more slippery and contributes to the problems, but others disagree.

You might find your nose a little sore the first night or two, but it should not really hurt and there should be no pressure on your nose.  If so, it’s TOO TIGHT!  Loosen things up a little. 

Soapbox Time:

On CPAPTalk.com and the OSAA board there’s been an ongoing debate about whether or not a nasal pillow mask will enlarge your nostrils.  Personally, I think it’s a bunch of bunk.  The pressures the CPAP exerts against your nose are really not very high, and it’s for 1/3 or less of your day. 

There is no scientific evidence to support this crazy theory, though proponents try to extrapolate other studies to support their assertions.  Nostrils tend to enlarge slightly as we age anyway, so I don’t think there’s been any study to isolate CPAP nasal mask use from the normal aging process.  Furthermore, nasal pillow masks can mean the difference between CPAP success and failure.  I would hate to see somebody give up on CPAP because they are too afraid to try nasal pillows.    There’s enough to worry about with CPAP without stressing over whether or not your nostrils are going to get bigger!

Additional Resources:

Resmed has a slide show demonstrating fitting (slightly different technique than I recommend) here:  http://www.resmed.com/us/products/swift_fx/swift-fx.html?nc=patients

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Responses

  1. I am a newbie that just got a bipap on Tuesday, March 22, 2011. I wined and complained so much to my therapist at Apria about my apprehension about using every mask I had ever seen that she finally showed me the Swift FX. I can see why you are crowing about it. Its far better than that horrible nasal mask that I used at the Sleep Test Center. All the masks were horrible.

    I am nonetheless waking up every 3 hours and taking everything off to give myself a break….just sitting up and shaking my head trying to feel free and taking some deep breaths on my own. I realize how important it is that I learn to accept this new way of sleeping so I will stick with it. This Swift FX will help a lot. It goes off and on so easy and the Bipap has a “ramp” that eases me into it each time.

    I asked the therapist for information so that I could read my own chip on the machine but she was adamantly against it. She seemed shocked by the question.Who can give me that information?

  2. Kathleen,

    First, if you haven’t already, I suggest you go to http://www.cpaptalk.com as you will find a lot of your answers there.

    It may be the ramp feature that is causing you to wake up and feel you must remove the mask to breathe. The pressure on the ramp can be so low that you may feel like you are not getting enough air, or your pressures may need some adjusting to work better for you under your normal sleeping conditions rather than the artificial conditions in the sleep lab. The therapist CAN help you figure this out, but it sounds like you will have to make it HER idea or she will get snippety with you. That’s too bad!

    I have a particular bias that WE should have access to our own data. Imagine if you were a diabetic and you were given a blood glucose monitor with no patient readout. If your blood sugar was out of whack, you would not know until your next doctor’s appointment. If you were not feeling good and wanted to know why so you could work with your doctor on adjusting things, you would not be able to. You’d have to wait for an appointment to get the doctor or someone to read your data and then see what’s going on. Stupid, right?

    So why should it be different with XPAP? Suppose you are having leaks big enough to cause pressure problems with your biPAP, but not big enough to show up as “large leaks” on your machine’s screen. You aren’t feeling well either. I can’t tell you how many times we’ve seen this scenario on the forums. The person calls the sleep doctor who says “just keep using the machine”, only to find out months or even YEARS later that the leaks were a problem and the AHI was too high. Or suppose you are not feeling so great and the AHI is too high because the pressures aren’t correct. But you don’t see the sleep doctor for another three months (or more). Not feeling better, you give up on BiPAP–why bother if you’re feeling so badly? Or suppose the AHI is good, but you’re still feeling rotten. Numbers alone do not tell the story. Take a look at my post on data to see why (https://maskarrayed.wordpress.com/2010/06/19/the-importance-of-having-data/). My numbers looked great, I felt awful. The software revealed that the pressures were inadequate, so WITH MY THERAPIST we raised my pressures and all was well again. Having data does not supersede the professionals–it helps YOU be a member of your own health care team and work with them to acheive optimal results. Any therapist or doctor who does not understand that is either too full or his or her own cheese or afraid that you will know more than they do.

    The Encore Viewer 2.0 software is LEGAL and made specifically for CPAP users. It’s available from online suppliers for about $100. Using the software you CANNOT change the pressures or do anything to harm the settings on your machine (there are other ways to make the changes, but not through the Encore Viewer software). But you can get a good picture of what is going on with your therapy, and work with your health care providers to make changes when the software shows you what the problem is. See https://maskarrayed.wordpress.com/2010/08/07/respironics-data-tutorial/ to see what kind of data it reports.

    So what is your therapist afraid you’ll find out???? That your therapy isn’t optimal and needs tweaking? She should welcome that–the idea is to get the best treatment possible, not stroke her ego that she is the smartest and most wonderful person in the world. A good therapist will welcome your involvement in your own treatment, not expect you to be passive and accept whatever she deems is appropriate.

  3. Your comments above have been most helpful to me, as a new CPAP user. I have the ResMed Swift FX for her nasel pillows system. I prefer it over the 2 full face masks that I have tried. I am a mouth breather so have to use a chin strap which I put over my mouth instead of my chin. It works great to keep my mouth closed. I often wonder what I would do if I had a bad cold with sinus congestion. I don’t now how I would wear the mask. I am now trying to adjust to a full face mask for that reason, but sure don’t want to give up my Swift FX for her mask. I have also paid attention and think that I will get a hose hanger. Thank you much for your comments.

    iammrsbear

    • It’s a great idea to get used to a FF mask before you HAVE to. That was a miserable few nights until I learned to sleep in it–when I was already feeling terrible because I was sick. Now I’m having fun because I can wear any one of several masks and sleep well, so it just depends on what I feel like wearing at the time, or, if I’ve just washed one and it’s not dry yet, I have other options.

    • I’ve been a user for about three years, always using nasal masks – I started with a ResMed Mirage Activa mask (the one that goes over the whole nose and seals on the face), and am now using a Swift FX. In that time I’ve had four colds with stuffy/blocked nose, but strangely this has not caused me any trouble. After putting the mask on and relaxing into sleep, although it starts off a little less easy to breathe I have found that after a few minutes my nose actually seems to clear, then I get a normal night’s sleep. If you have a cold/stuffy nose, I suggest just giving things a try as normal and seeing how it goes. So far it has worked for me.

  4. Thank you thank you thank you!
    Thank you for taking the time to post this. I’m a new user (less than 3 months) and I’ve had WEEKS of discomfort trying to get my mask to fit correctly. I get the odd night of full rest but most nights have consisted of multiple mask adjustments (some full removals) only to wake up with a sore nose and lines on my face. I read your article, used the tips to adjust my mask and after two full nights of rest, feel like a million bucks!

  5. Thanks for all of the info. I tried this my first couple of nights with the small size the DME recommended, but had trouble getting enough air. I tried the mediums and they were better, but still didn’t work great for me at the low pressure.

    When they upped my minimum pressure +2, I tried the pillows again and it worked MUCH better!

    I also started the falcon sleeping position last night which doesn’t use a pillow for your head (normal pillow, not CPAP), hoping that would help keep the nasal pillows in place better.

    I keep trying to get the nasal pillows to work as I find them more comfortable than the nasal mask. I’m going to try your fitting idea of turning the machine on before adjusting the strap, as well as your other suggestions.

    Thank you for this helpful info!

    • Okay, I just read your post again. I’ve been putting the outside of the nasal pillows, inside my nasal passage. I thought this was why the DME said I needed the small instead of the medium, maybe I misunderstood him. Can’t wait to try re-fitting these tonight on the outside of my nose to see how that works!

      • OMG!

        DMEs are really STUPID sometimes and we are at their mercy!!! They are supposed to know better.

        Once you get your mask to fit well, please go back and give that DME a lesson so he/she doesn’t do this to others, too!

  6. I went back after my first 3 days, telling them I couldn’t breathe with the FX. My insurance allowed another mask (minus deductible). I brought the mask with me, but it didn’t occur to me to check if I was wearing it correctly. I thought of this as putting air in your nose, so I stuck it in my nasal passages. It was just inside my nose, but still it sounds like I’ve been wearing it all wrong. The funny thing is I still prefer it over the nasal mask, even though I was wearing it wrong. I’ll update after I try it the correct way tonight.

    I’m sure a lot of people are either wearing the strap too tight for the pillows to properly inflate or sticking the outside of the nasal pillow inside their nose, like I was!

    • Jan,

      I think I was actually doing it correctly. The wide “ring” of each nostril is just outside my nasal passages. I have only been putting the tip of the outside of the nasal pillows inside my nostrils.

      I thought you were saying the tip of the outer ring was supposed to rest on the outside of the nostril.

      I look at image 5 on page 2 of the Swift™ FX user guide, and I now understand what you mean and I think I have been doing it correctly.

      Swift™ FX user guide:
      http://www.resmed.com/us/assets/documents/product/swift_fx/user_guide/608259_swift-fx_user-guide_amer_eng.pdf

      Sorry if I confused you. and thanks again for your helpful advice for us newbies struggling to learn all of this.

  7. I’m new to wearing the RESMED Swift FX For Her Mask after not being able to wear a full-face mask. I noticed that while I sleep it makes popping noises. I know it’s not normal. I’m not sure what to do. The tech guy has lost patience with me. Do you know how I can fix this?

    • Can you be a little more specific? Where are the popping noises coming from–the pillows, the hose connector, the machine, your mouth???

      • If you are using a humidifier and it’s too full (above the fill line) it will cause bubbling/popping sound. If that’s not it, I don’t know!
        Good luck!

  8. New to this CPAP machine. Really finding it hard to keep putting it on night after night. Only 2 weeks in, and I have turned it off more then I have it on.
    My problem is I feel the ResMed Swift FX pillows are too big for my nose. The tech that fitted me hardly wanted to touch me, walked me through the set up, she had a personal phone call and a tex message that was more important then me. Anyway, they don’t seem to fit in my nose right. I get the air leak around my nose, my ears pop. I have to turn the machine off to get the pressure to stop. Anyway I see on the board that they have pillows for her. She gave me the medium size pillows for him. She told me I could exchange them one time within 30 days, I tried to take them back yesterday, but she laughed and made fun of me because I didn’t have the head strap on correctly. Has anyone else had this problem? I didn’t get to exchange them, she said if I put it on correctly they would fit. What to do, feel like just taking the entire machine back and saying no thanks.

    • This is horrible treatment and I’m about to tell you some things that will make your blood boil:
      1. The Swift FX comes in a package with THREE sizes of nasal pillows. If it’s a blue Swift FX, it comes with small, medium and large pillows. If it’s a pink “For Her” Swift Fx it comes with Extra-Small, Small, and Medium. Whichever you received, YOU SHOULD HAVE RECEIVED ALL THREE PILLOWS!. The DME stole two sets of pillows from you, which they are now going to resell to someone else for pure profit. Technically you only paid for one set of pillows, but also technically, the manufacture that sold the Swift FX to the DME wholesale only charged the DME for one set of pillows, too. There are three sizes so that you can find the right size for you. The size that seems correct in a store fitting, probably while you were sitting up and probably with the machine OFF may not work for you lying in your own bed over the course of the night. You are meant to have all three sizes so you can experiment as you need to.

      2. The DME had NO business laughing at you. The Swift FX is confusing and it takes time to get used to all this. This is the worst case of customer service I’ve ever heard and should be reported to the DME’s manager and above if necessary. You deserve a formal apology and kid glove treatment from here on out. Complain to your doctor, too! Perhaps there are better places your doctor can send referrals from now on.

      My suggestion is that you go to the DME tomorrow and DEMAND to speak to the manager. You need to stay calm and polite, but explain that you are having trouble with the size of nasal pillow you were given, that you had a poor fitting and were treated horribly by the tech, and that you know that THREE nasal pillows come packaged with the mask from ResMed so you would like to have the other two pillows. Don’t let them play games with you like telling you you only paid for one set (so did they, but THREE are included in the package you paid for). They will also try to say that it wasn’t packaged and they may even show you a bill showing they billed for each part (headgear, nasal interface, nasal pillow) as separate components. They are allowed to do the billing that way, BUT the mask does not come as separate components (It would cost the DME more to order them that way!), they come as packages with THREE nasal pillows. And if the small size nasal pillow doesn’t work for you, then this DME has surely stolen a lot of other people’s extra small from their Swift FX for her packages, so don’t let them charge you if they give you that one to try too!

      Finally, when you get the other pillow sizes, you can try my fitting tips, in your own bed, lying down, machine on. If you have confusion over the straps, ResMed has some videos on their website that will help.

      Don’t let your frustration over lousy, terrible customer service harm your health. You MUST use CPAP–all night every night, so you need to be an advocate for yourself and get what you need so that you are able to sleep with CPAP all the time.

  9. Thank you so much for your help. This does make me mad. If I was suppose to get all three sizes and I only got one size. I am two weeks in and I have been so uncomfortable, I did have some confusion on the straps, but she explained that to me on my second visit. I was able to use the machine for 5 hours last night, but I was awake ALLOT. Now this morning, my nose is red and a bit swallon. thanks again for your help.

    • If your nose is red and swollen, the straps are TOO TIGHT. Please review my fitting tips and loosen them up. You many need another size of nasal pillow, but having those straps too tight is going to cause pressure sores and you’ll be back to square one. Call the DME immediately and do NOT let them charge you for other pillow sizes.

  10. You poor thing, what a negative way to start treatment! I know I was very upset to be diagnosed but the people helping me along the way were so helping and supportive so I’m sorry you haven’t had the same. I love my Swift FX (I have moved from the head strap to the Swift FX Bella). Hang in there, it’ll be so worth it when you get it working correctly! You’re not alone!

  11. thanks for the kind words. What is the swift FX Bella? I know I should hang in there, but it is keeping me awake. I need sleep. thanks again.

    • Swift FX Bella is the regular FX, but you can replace the headgear on the Swift FX with “Bella Loops” that go behind the ears. I haven’t tried it, but some people find it’s very comfortable and a little more stable. You can buy Bella Loops to add to your existing mask. Google it to see a picture.

  12. Well, I called back out there and spoke with her manager, told him my problem. He told me the pillows should have came in a set a three just as you explained to me in the above post. I told him I only got one size. He said well maybe that is the way it was written up and that my insurance might have only paid for one. He was going to look into it and call me back. That was 5 days ago and I am still waiting. I guess I don’t get the other sizes. I hope my insurance didn’t pay for all three. He could have at the very least called me back with an answer. I guess I know now why she was so crappy at her job because her supervisior isn’t any better. thanks again for the help.

  13. Hey, so you got the manager to admit that they should have given you all three (don’t take any baloney that you/your insurer only paid for one set, so did the DME–they gave you one and kept two to sell at pure profit)? WHY are you rolling over and saying “never mind” just because the manager never called you back. This is your HEALTH we’re talking about–if you roll over and play dead you won’t get anywhere.

    GO to the DME, politely ask to speak to the manager, and then let him tell you to your face that you only get one set. If he plays that game, take your current Swift FX and tell him you want to return it for a defect (or ask for the Swift for Her instead), and then ask for a brand, new UNOPENED one factory sealed in the package. With it’s three sets of pillows. Don’t let him tell you that there’s no return, either. He can get a full credit for a returned mask from ResMEd.

    If you still get nowhere, it’s worth complaining to ResMed. ResMed wants you to have all three sizes to find a comfortable fit so you’ll keep using their products. If you are unhappy with the product because of the stupid actions of the DME, then ResMed will want to know about it.

    Meanwhile, you MUST get a comfortable mask that you can use EVERY moment you sleep. If they are not helping you, then you need to advocate for yourself–let the doctor and the governing agency know.

  14. Yes, Jan you are right. I guess I just needed to hear that. I should stand up and let them know how I feel. I think I am going to call my insurance company and find out what my insurance is paying for. If I am suppose to get all 3 then I want all three. I have had the machine a bit over 2 weeks now. And I have only used it a total of 41 hours. I figured if I used it a total of 7 hours a night I should have used it over 100 hours by now. I just can’t bring myself it wear it all night. On night I had it on for 5 hours, but most nights I average 3-4 hours. One night I even went to bed at 7 and tried watching TV a couple of hours with it on just so my mind was on something else. Hoping I would get use to it. The pillows are just too big, they fold over and bend in my nose and my nose is so sore. I find it hard to believe I am suppose to get use to this pain in order for it to work for me. Tomorrow when I get off of work I am going to stop by the office and tell them I want all three. I did go to another medical supply store to see if I could just buy the small pillow from them, but they couldn’t help me. Said I would need a presciptsion from my doctor. I did notice I could buy them on the internet for $22.00. Which made me pretty mad. The little cost for all this pain just doesn’t seem right.

  15. “The pillows are just too big, they fold over and bend in my nose and my nose is so sore. ”

    Oh oh, please tell me you are not putting the pillows IN your nose!!!???

    The pillows go AGAINST the nose, resting lightly on the outside of your nostrils. Only a tiny little bit of the tip goes in your nose, and that little bit should NOT be touching any part of the inside of your nose. The only contact with the surface of the cone-shaped nasal pillow should be outside, on the rim of your nostrils–and it should NEVER be tight.

    Some stupid DME’s think that they go in the nose like nasal canulas, but they do not. So if you were told that, you were poorly instructed and fit by the DME.

  16. yes, I am only putting a tiny little bit in my nose, but that folds over because I have to have it tight with my head gear to keep it from loosing air. I guess the DME that helped me was useless, never told me that. She told me it need to be tight to keep it in place. I did today finally after ALMOST a month get the small pillows. May I rest better tonight. Keep your fingers crossed for me. Jan thank you so very much for all your help.

  17. Great, I’m glad you got the smaller pillows. Be sure to follow my fitting instructions above. If you fit it while LYING DOWN and with the MACHINE ON, you should be able to get a good fit.

  18. Thank you for this information. I just got my FX for her and the first night (last night) I could breathe in but not out, except through my mouth. Obviously I did not last very long and I took it off. When I got home from work today, I decided that I would google how to breath using the FX for her and found your site. I now realize that I had the straps way to tight and was possibly blocking the two way valve, so I couldn’t breath out through my nose. As a brand new user, other research that I did indicated that to help get use to the mask, to try while sitting around a bit before going to bed, to try and ensure the fit is good and to get use to the feeling, so I am doing that now and with the looser straps, all seems to be going well at the moment. Guess the true test will be tonight trying to sleep. Thanks again!

    • I hope it helps, good luck!

      If you’re still having difficulty, go up a size in nose pillows–larger holes mean easier breathing.

  19. I have the same setup you have. I just got the Swift FX to try after 3 weeks of the comfortlite 2. Can you please point to info about about your ‘homemade’ hose hanger and snuggie?

  20. I just got the Swift FX after trying face mask and nasal mask and being unable to sleep. I love the way the Swift FX fits, but the inside of my nose gets this piercing pain after it is on for about a half hour. It feels like someone is stabbing the inside of my nose and I have to stop using it due to the pain. I have read some of the forums about the size of pillows and will try a different size tonight to see if that helps, but has anyone else experienced something like this and have any suggestions on how to make the pain stop. Please let me know because I really want to make this work.

  21. Oh wow! This is my 3rd mask and I thought it was perfect until I started getting a really, really sore nose. Turns out I was shoving it way too far up there! Thanks so much for this info – I’m lucky the first google hit was your site. Too bad bedtime is so far away yet – I’m excited to try the new fit!

    • I hope it helps.

  22. I’m getting my cpap tomorrow – newly diagnosed. Wanted to thank you for these tips. I feel a lot more confident about what to expect, what I want to try and how to get started on a good nights sleep.

    I can’t wait – I’ve been miserable for months. Ah, to have my memory working again! And hopefully stop taking naps two or three times a day. 🙂

    Thanks again for real life good advise. I’ll be back on this page going through the fitting steps when I get ready for bed tomorrow night. 🙂

    Amy

  23. Dear Jan
    We have been struggling with our swift fx for over 6 months. It kept causing endless problems. Numerous trips to the technicians and the doctors failed to solve the leakage issues. We have now tried your method and we have had absolutely no problems for the last 3 nights. I just can not thank you enough. Bless you for sharing your knowledge and experience.

  24. Big question I have the fx nose mask and going to start on for her nasal
    Pillows. Can I use the same slimline tubing. Resmed s9

    • Yes, of course.

  25. Do you happen to have a pic of your hose hanger? I find the weight of the hose pulls messes with the seal too and constantly annoys both my husband and I. I need to resolve this issue SOON!

  26. Having trouble getting my supplier to provide the replacement supplies that I am due. Started CPAP on January 25 and, like other users, was not given all three sizes of pillows — just the small. This has not yet been replaced, although I see that I am allowed two replacement pillows per month!. Saw my physician’s PA around the first of March and they faxed an order while I was there, but have received absolutely nothing from the supplier. I went back to the supplier, walked in and asked for an appointment with the therapist as I am having a lot of trouble with the pillows — sore nose, difficulty adjusting (waking up constantly to adjust, etc), and reluctance to use the machine. Got a call this afternoon asking why I had made an appointment about getting a different mask, as I am only allowed one replacement every three months!!! I use just the straps that go around my ears, and don’t find the ear part uncomfortable, just the nasal pillow itself. Could this be because it needs to be replaced? Don’t know if I can continue this therapy unless things improve. What is worse, not sleeping because of apnea or not sleeping because of the therapy for the apnea??????

    • Your supplier doesn’t want to replace the nasal pillows because it’s a lot of work for little profit. You have to get pushy. If your doctor’s on board (or the PA), see if they can call the supplier and find out why they are not providing you with replacement pillows. When they hear a doctor is displeased they may pay better attention.

      Even though the replacement schedule for nasal pillows is 2 sets a month, if you are Medicare there’s now a rule that you have to have a reason for the replacement–you don’t get it automatically. So tell the DME they are torn and need to be replaced.

      Have you tried my Swift FX fitting tips? If your nose is sore it’s a good bet you are tightening the mask too much–and that may be why it bothers your ears, too. It has to be fitted with the machine on and then as loose as possible. Make sure the nasal pillows rest against the outside of your nostrils, nothing should be touching the inside of your nose. The tips of the cones go just slightly past the opening of the nostrils, not up into your nose.

      You might be more comfortable with the standard Swift FX headgear instead of the Bella straps, but the Medicare replacement schedule for headgear is only every 6 months so you may have to buy your own headgear. CPAP.com has it for $31, or you could try other online suppliers to compare prices.


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