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New F&P Simplus user
#11
PaytonA, thanks for the tip. I will try to move the top straps. The leakage on my right eye (in my case) can be eliminated if there is about two fingers space from forehead to front band. My DME initially tried a size M and then went on to give me the S size pillow. Down loaded the sizing tool from F&P and think either S or M may work.

Regards
Roy
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#12
Using the sizing tool, I needed a size M. That is what I purchased and after using it a little I decided that I needed a S. Got the small cushions and have finally decided that I get less leaks with the Medium. I find the Simplus a well designed mask but to me it seems a little finicky.

My standby mask is the Resmed Mirage Quattro. It is a little clunkier than a lot of the newer masks but it makes up for a lot of facial differences due to the adjustable forehead stabilizer and for me it is pretty much set it and forget it. Once I get it adjusted properly I do not need to readjust it from night to night and I don't need to readjust it during the night. My pressure goes up to 20.6 on occasion.

Best Regards,

PaytonA
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#13
Sleeprider, very interesting results with EPR 1 and pressure max at 15. Only had mask on for 2h 14m. No OA but 7 CA. Woke up feeling like drowning and very nauseous. I was in REM as having a nightmare. Scanning through charts the rise in pressure was in response to flow limits. My breathing in presence of high pressure (above 12) becomes very ragged. Also mask has lot of side leaks at pressure above 14. Will try same setting tomorrow night.
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#14
Very interesting. You might want to go fixed pressure at your minimum. Post a chart for the couple hours of use, and let's see what happened.

Edit to add: your arousal came at the time when you were in a heavy cluster of OA in the previously posted chart. That may not be a coincidence. There is no reason to suspect the small reduction in EPR would account for what you described, but I think it's worth trying again. If you have another arousal, I would suggest putting the mask back on and starting at the minimum pressure.
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#15
Sleeprider,

Last night had AHI 3.72 with equal number of OA/CA (11). Most of the night flow rate was erratic which likely represents poor quality of sleep. The OA/CA appear to be a response to the rising pressure differential.

Plan to try a night in CPAP mode as you suggested at pressure of 9.

[attachment=2896]
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#16
Roy, I think event-wise that is a success. We're trying to find out what is most comfortable at this point. Fixed pressure is one approach, or narrowing down APAP range by going to 14.0/8.0 would make sense to me. For some reason, you don't like higher EPR, and that cleared up some issues all by itself.
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#17
Sleeprider, Your suggestion of trying fixed pressure (CPAP mode) was a breakthrough for my therapy. Thank you!

Last night had AHI 1.51 and 2 CA, 2 OA, 7 H with 5 LL (these were during mask adjustment).

At 9 there is still some flattening of the inhalation so likely improvement (rounded inhalation) can be achieved at pressure between 7 to 9.

Perhaps eliminate the 20 min ramp at 7 and turn off EPR. Set pressure ot 8.5 (CPAP).

Initially my sleep Dr had me on CPAP at 7. In Ontario our health plan recently allowed coverage for the A10 so had Dr change prescription to APAP.

Once again thanks for support.

[attachment=2906]
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#18
Roy, that's a big change from were we started. The main thing is you have a decent shot at getting rested and feeling well. I'll be honest, my "hunches" or wild guesses as to what will work for any given individual don't come from an elegant knowledge set, but the awareness everyone is different. What worked for you may or may not be good advise for someone else. I do like when things come together! Smile
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#19
Sleeprider,

Changed back to APAP with pressure window of 7-9.6. This resulted in 17 OA which were primarily in two clusters. Zoomed into first cluster which consisted of quite long OA, the last one 54sec in length. The OA clusters occur during time when pressure is at max. Not sure what to make of this outcome.

My mask was leaking worse than normal although not above 24l/m.

Interested on your interpretation of this result.

[attachment=2912]
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