I am a new two-week user.   The DME that brought my CPAP machine did not have the Opus that I used during sleep study.  The nearest he had was the ComfortLite2.  It included to nose pieces and a full nose pieces. It came with M and L sizes of each.

Responics web page states they come with "the NEW Pillows Cushion, the Simple Cushion™ and the Direct Seal".   From the pictures, I cannot tell if I have the NEW Pillows Cusions or the Direct Seal.   The one you have determines where you are to wear it.   Does someone have good pictures of the two?

I am have a terrible time getting used to it.   I can go to bed at 10:00 and sleep to maybe 1:30 or 2:30 (longest).  The mask does not stay in place.  I wake up with it blowing in my face.   I end up bending the two nasal pieces together almost.   I wake up more tired than without the machine.

Am I doing something wrong?   Thanks for any help.

I believe the direct seal looks like a mini full face mask that only fits around the nose. The pillows fit into the nasal opening.
The Opus I believe is a pillow style. It's a shame that an RT didn't fit you properly and explain your options. Advice to all "Not all DME companies are the same."

The simple cushion fits directly over the nose.  The direct seal plugs up against the nose, & is not inserted into the nose. (the ends are rounded)  The nasal pillows are inserted into the nose. (the ends are tapered to fit up into the nose)  I've been using the Comfortlite 2 since January & it works great for me.  Initially I used the nasal pillows, but my nose became sore.  The simple cushion leaks too much for me.  The best fit for me is the direct seal==in the size 5.  You'll have to try the different interfaces to see which works best for you.


_________________
REMstar Auto M Series w/C Flex & Smart Card
Heated Humidifer
ComfortLite 2 w/Direct Seal Size 5
Encore Viewer Software
Pressure: 10

I know what djmv meant to convey, so just to make sure it wasn't misunderstood:  The nasal pillows do NOT go inside your nose.  

Your nostrils should rest on top of them, well, like pillows so they should be large enough to stay outside of your nose.  The seal is formed around the edges of your nostrils.  Yes as djmv wrote they do have a bit of a volcano like shape so that part will extend upward into the nostril just a little bit.  

Blessings,
--pseudonym

Oops, sorry about that.  I did kind of explain it wrong.
Thanks~~  


_________________
REMstar Auto M Series w/C Flex & Smart Card
Heated Humidifer
ComfortLite 2 w/Direct Seal Size 5
Encore Viewer Software
Pressure: 10

•      NASAL PILLOW CUSHIONS are highly contoured to fit directly into the nostrils
•     SIMPLE CUSHIONS act like a traditional nasal cushion but it reduces bulk and weight by covering only the tip of the nose and the nostrils
•     DIRECT SEAL CUSHIONS have two gently curved seals that rest against the nostrils without actually inserting into them

I found pictures in resp web site under sales sheets.

I believe that this company is introducing a new one as well. I think that next month they will be offering a rectangular seal that rests up against the nostrils. with one rectangular opening. I think it is for this mask.

I also have the ComfortLite 2. All of the nasal fitting are referred to as Cushions in the resprionics catalog. This mask has three different types. Pillows, Simple and Direct Seal. My mask came with the simple (the triangle looking nose cover that is adapted using a elbow) and the direct seal. The pillow type was omitted from my package. The pillow type is the one that will fit into the nose. The direct seal rest against the nose and the simple cover the entire nose. I took all this information off the Respironics website.

Now my question. I am a newbie as well. Second night on CPAP was last night. I am having general troubles with getting a good seal using the direct seal cushion and the simple won't seal because of my mushtache. I have ordered the pillows type. Tonight I will try KY to try and effect a better seal.

My main concern is the irritation and burning feeling I am getting at the entrance to my nostrils. Not raw or red but very
painful to the touch and makes positioning the mask painful. Have you had any simular experiences. Is there any thing that I can do to solve this irritation. The burning sensation has woke me up both nights in a row. Thanks.

I had the sore nose initially, but thank god after about a week it stopped.  Also, I switched from the size 4 to the size 5.  That probably helped also in my case.


_________________
REMstar Auto M Series w/C Flex & Smart Card
Heated Humidifer
ComfortLite 2 w/Direct Seal Size 5
Encore Viewer Software
Pressure: 10

The CL2 nasal pillows do NOT go inside your nose.  There is yet another type of interface, the nasal *prong*, this type DOES go inside your nostrils.  The CL2 doesn't offer this interface type.

The nasal pillows should be wide enough that your nostrils rest on top of them.  The slight volcano shape will project into the nostril a bit, but the seal is formed by the edge of nostril resting on the pillows.  

The nasal prong interface type, makes a seal inside the nostril.

Please be sure to ALWAYS select a large enough pillow size so that it WON'T go up inside your nose.

Blessings,
--pseudonym

My apologies to all reading here, if my above post seems harsh.  

My sole intent is to make clear the distinction between nasal pillows and nasal prongs.  Nasal pillows masks need a large enough size so nostrils rest on top of the pillows to form the seal around the outside edges of the nostrils.  The majority of non-cushion style nasal masks are nasal pillows masks.

Then there are the few masks which are nasal *prongs* (see a Nasal Aire II mask as example), these DO fit up inside the nostril and make the seal inside the nostril.

There are many posts here from people who have been given no real information on correct fitting of nasal pillows.  They are sent home to use the mask for awhile and see how it goes, the mask leaks or is uncomfortable so they put the pillows further up in the nose, thinking that is the problem.  They may even select a smaller size so the pillows will go inside the nose more easily.

The real problem is that the people were left to figure this out on their own, their doctor/DME/lab should make sure they understand they correct fitting before they go it alone.  But given that it happens, and all too often, that people are left to sort it out for themselves, I want to make sure if they come here that they get the right understanding about the fitting of nasal pillows vs. nasal prongs.

Again my apologies to all who felt my above post was harsh.

Blessings,
--pseudonym