Nasal Pillows Review

Joseph Krainin, M.D.2 comments

nasal pillows cpap mask

If you've seen a type of CPAP mask that you're interested in that just nestles underneath your nostrils, you've come to the right page. 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?

CPAP nasal pillows masks 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. These masks provide a superior field of vision to allow you to read or watch TV with your mask on. 
  • 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:

DreamWear  - Philips Respironics

 philips dreamwear nasal pillows

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 (shown below) of this mask, that is designed to fit by sealing underneath the nose without anything actually going inside your nostrils. This mask has been extraordinarily popular with our patients:

dreamwear under the nose nasal mask

 AirFit P10 - ResMed

 resmed nasal pillows mask

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. This mask has replaced the older Swift FX model.

Brevida - Fisher and Paykel (F&P)

brevida nasal pillows cpap mask

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.”

Aloha - InnoMed

 aloha nasal pillows

The aptly named Aloha (Hawaiian for "breath of life") features InnoMed's proprietary ArcedTrack pillow adjustment system for an individualized fit. This mask comes standard with all pillows sizes so there's no possibility of not getting a good seal.

Rio - 3B

rio nasal pillows cpap mask

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 nasal pillows CPAP masks. Just follow your nose...but armed with the information above, it won't lead you astray.


sleep apnea test home sleep study Joseph Krainin 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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    Andras Nagy
    Andras Nagy
    The key is keep trying. I have been suffering from lack of energy, alertness, irritability, depression, overeating for a decade before finally I went to my sleep study. I said up front – I NEVER WILL SLEEP with a MACHINE. You know what? Now I have my second mask as I am into experimenting to get that GREAT dreamy sleep, where I can be truly refreshed. I found that the Amara View forces by its design to breath through the nose, even thou it is a full face mask, so slowly I am becoming a nose breather (even if I must use a strap, or cervical collar). Airfit P10 is nice an quiet.
    David L Bean
    David L Bean
    When I bought my cpap machine, I bought two masks to try out: the dreamwear and the airfit. Both were comfy but I had a more difficult time exhaling through the airfit. I ended up using the dreamwear, and apart from looking like a demented unicorn, I like it. It does shift around a bit when I sleep on the side…the pressure on one side doesn’t stop the airflow (since both sides are linked) but it can push the nostril mask just a tad out of alignment. It’s apparently not enough to really affect things because my off-mask events are almost non-existent. As a first-time cpap user, I was not excited about the whole notion of wearing a mask, but the dreamwear just isn’t as bad as I was expecting. The tube stays out of the way, and the nostril thing isn’t bothering. I have a facial hair, and I have found that greasing down my mustache helps keep the mask from grabbing a stray hair here and there.

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