I use the nasal pillows and no issues with comfort. More of an inconvenience to wear it and take it on trips. I would love to go without it, but prefer to be able to breath at night and get some sleep. I will ask for all options at the sleep study and see what they can do. I figure if my airway was so restricted while awake, once the muscles relax they close right up. If I have to go back to a CPAP after surgery and recovery, I will probably just not do the surgery. I'm guessing the doctor will increase pressure to start off with.