Sierra

I use the P10, and my wife uses the F&P Brevida. The P10 is a very minimalist mask and also very quiet. The con is that it has a flimsy headgear and in the original version a flimsy adjustment method. As a result I found it hard to keep my mask on. I still use it but have upgraded the headgear with one from the Swift FX mask. See this post for more information.

My wife likes her Brevida mask and it has more substantial headgear. I would try it over the P10, unless you are willing to upgrade the headgear on the P10.

I have not tried the newer AirFit masks (and DreamWear) with the double tubes and connection at the top of the head. To me they do not look minimalist at all. No experience though.

The main disadvantage of all nasal masks is that the leak big time if you open your mouth when sleeping. My wife manages to keep her mouth closed most of the time! But, I cannot and actually use tape on my mouth every night. Some are not willing to do that. For me it is a good tradeoff. I tried chin straps but they were bulky, uncomfortable, and really did not work unless they were really tight.

Hope that helps some,

If you look at my history of settings for my AutoSet machine you can see that in Auto mode I was achieving an AHI of about 3.4. When I changed to fixed CPAP mode I got down to about an AHI of 2.0. And after that a change to full time EPR at 2 cm brought it down to my current AHI of 0.9 on average. Have a look at this history. As you can see it takes a lot of playing around with pressures in fixed CPAP mode to get the best results. But, I am convinced that once you get there the AHI can be lower than in Auto mode.

ResMed has had three levels of CPAPs for some time. The most basic as I recall is the AirSense CPAP. It has no frills, and no memory card and does not record detailed data. The Elite version is still just a fixed pressure CPAP with no Auto mode but it does have a memory card and records detailed data.

This said I have the AirSense 10 AutoSet and now use it in fixed pressure CPAP mode only. The real advantage of the Auto mode is that you do not have to do a sleep lab titration test to determine your optimum pressure. You can just select a min and max and hopefully the machine will find the optimum pressure. My experience has been that once you find the optimum pressure, you can get better results in fixed pressure mode than you can in auto mode. So, my thoughts are that if you now know the best pressure there is no real advantage in an Auto machine.

My wife started CPAP a couple of years before me, and had always used the Mirage FX as it was selected by the sleep clinic. When I started out on CPAP I was given a ResMed P10, and it did not work so well for me. I could not keep it on my head due to the flimsy headgear. So I started out on a search for a better mask. I tried the Mirage Quattro and could not make it through the night due to leaks blowing in my eyes. I tried my wife's Mirage FX, and perhaps it was too small but it felt constricting. I tried the ResMed AirFit F20, and like the Quattro I could not make it stop leaking. At some point I tried the Swift FX to get better headgear and could not tolerate the high velocity and noisy vent air flow. And I eventually used the headgear from the Swift and adapted it to my P10. Somewhere along the line I also tried the Brevida. I found it OK but preferred the P10. My wife's only complaint about the Mirage FX was that it left heavy strap marks on her face that took some time to go away. That and the little prong things on the mask kept breaking. I offered her my Brevida and she has used it ever since. So we have a good collection of masks sitting in boxes somewhere!!

The AirFit N30i has come along since all my trials, and seems like a good idea. Not sure I would like the hose connection at the top of my head. I have gotten used to the hose coming down by my body. I recall some have had issues with it being noisy due to the air vent at the top, and the side tubes can restrict air flow if you sleep on them. But, in short all I know is what I read about it in posts. There is similar offering from Phillips and I think they were first with this design. You could try a search here for comments. CPAP.com keeps a long list of customer comments about each mask too.

In the end the P10 and Brevida are minimalist masks, and I think that is the main reason we like them. The P10 is exceptionally quiet, and the Brevida has better headgear. If I had to gamble on one, I would try the Brevida before the P10, as I am not so sure how good the headgear is even with the new adjustment method...

No I have no issues with irritation inside the nose due to the air flow going directly in. Both myself and my wife have ResMed AutoSet A10 machines. They have an auto humidity control mode when you use a heated hose. The humidity is set on auto and the temperature set to 27 C (81 F). We both use pretty much the full reservoir of water over a 7-8 hour sleep.

My initial issues were irritation of the entrance to the nasal passages by the prongs on the mask. The Brevida has less of a prong design, and you might find it more comfortable, and the harness is better on it. This is what the Brevida cushion looks like.

Yes, when I first started using the P10 I got some nose irritation, and it was particularly bad when I tried using a cushion that was too small and it went too far into my nose. I now use the large version. I bought it as a fit pack so I recall it included three sizes of cushions and I got tempted to try them all... What I also found is that you can minimize the nose irritation with some 1% hydrocortisone cream applied in the morning for a week or two to the external part of your nose until your nose gets used to it. Have not used the cream for years now. If the new headgear adjustment on the P10 is an improvement it may be a good mask. But the headgear on the F&P Brevida is definitely better. The cushion is a little larger and kind of fits more on the bottom of the nose than the P10. My wife and I tried both the P10 and Brevida. I decided on the P10 with an upgrade described here. My wife liked the Brevida better and still uses it.

What I find is that the smaller the mask the less likely it is to be dislodged from the nose during sleep. I sleep on one side or the other for 95% of the night and roll over several times during my sleep. I find the AirFit P10 generally stays in place, or at least it does with the Swift headgear on it. This is my sleep from last night. You can see that the leak rate basically stays quite reliably under the leak rate redline. My long term average % of time above the redline is 0.33%.

This is a graph of my wife's Brevida mask. Her long term rate is similar to mine but a bit higher. She mainly sleeps on her side too and makes a few changes of sides during the night.

Unfortunately with masks you never really know if they are going to work for you until you try them. Not sure where you get your masks but CPAP.com has a 30 day trial period for a free return on many masks if you are in the US.

I think the nasal pillow design is much less intrusive than the over the nose design. I recall my wife's FX was the standard size. I tried my wife's Mirage FX and did not like it all. The nasal pillow types typically are sold as a fit pack, which lets you try the different sizes and see which one works best for you. I use the ResMed AirFit P10, and my wife has tried it as well but prefers the F&P Brevida. With a nasal pillow you want the largest size possible so the cone portion does not go significantly into the nostrils. If you go too large it leaks, while if you go too small it is less comfortable and the cone can collapse and seal off the air flow. The Brevida has more substantial headgear than the AirFit P10.

The Brevida also has a grey felt like filter over the air vent. My wife has not had any issues with it besides having it fall out occasionally. It is to suppress noise and noise does go up a bit if it is not there. The only air restriction problems she has had is when she tries to use the smaller cushion which goes too far into her nose and collapses. I think it only comes in two sizes and she uses the larger one. I use the Large version of the P10. I also understand that the newest version of the P10 has an improved headgear adjustment method. The original one was very poor, and I have replaced my headgear with the one from a Swift FX mask that I tried and did not like. It is very noisy and the air flow out of the mask is very high velocity and disturbing. But I liked the headgear from it and now have modified it to work with my P10 mask. I have not tried the new P10 headgear, so can't comment on how good it is.

There is a sizing template for this mask on line, but it only gives you the width and height, but not the depth of the nose piece. My wife used to use this mask a few years ago, but has since switched to the F&P Brevida and likes it a lot better. It is more comfortable and leaves less of a mark on her face in the morning.

It would seem unlikely that the absolute pressure alone would be a cause. Compared to Denver the pressure at sea level is about 175 cm of water higher. That is a difference many times higher than the 20-25 cm pressure used by a CPAP or BiPAP. It is true that these devices increase pressure relative to the rest of the body though.