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Do you have a pacemaker, implanted defibrillator or any other implanted electronic device? If so you cannot use the AirFit F20. It has magnets in the clips that can interfere with the operation of such devices with some very bad results.
I have used the Simplus many times and like it a lot. It is gentler on the face than you current Quattro, especially round the nose and tops of the cheeks.
Have you considered the Amara View? It has been very popular since its release and may address some of the problems you mention. Google it to get some idea what it's like.
There is no reason a nasal (around the nose) mask wouldn't be fine for you, especially if you are getting sore nostrils. The Fisher & Paykel Eson 2 is my current favourite. Or you could consider the Respironics DreamWear in under nose configuration. It is like the intranasal (up the nose) mask you currently have except that instead of having 2 prongs that seal against you nostrils it has a little cup that sits under your nose. Try googling some pictures to get an idea. I suspect that you will find that any intranasal mask will produce similar irritation because they all fit in pretty much the same way.
How many hypopnoeas are you getting exactly?
Yeah, that one's pretty bad for slippage. You may find the Respironics Dreamwear with intranasal prongs more stable. The Respironics Nuance is also pretty good.
I am in Australia.
You could ask to have the pressure increased if you feel more comfortable with more air. It happens sometimes. Also, a different mask may suit you better, so that it would be looser and not leak.
I cannot recall a CPAP that goes over 25, but CPAP pressure of up to 30 are achievable by using a BiPAP and setting both the IPAP and EPAP to the desired CPAP pressure (28 for example). I have done this occasionally.
I would suggest trying a Fisher & Paykel Simplus if I were you, but you may not get anything to seal at that pressure. I have seen patients who require that sort of pressure. I have always found the Fit Life to be pretty useless, although I recently saw a guy use one in a way which was incorrect according to the manufacturer but it fit like a glove. He had the bottom of the mask under his chin. Respironics also made (I don't know if they still do) a mask called the Shield, which is even bigger than the Fit Life but not much better. I have seen it referred to as the Total Face Mask in more recent literature. The exhalation port is also very noisy. Have you tried sleeping propped up, in a chair for example? It is possible that this would reduce your pressure requirement and thus improve mask fit.
That is the machine responding to what it thinks you need while asleep. However, once you wake up you don't need all that air any more and the machine can't respond to reduce the pressure very quickly. The best thing for you to do is to stop the machine and start it again so that it goes back to it;s initial pressure. Hopefully, over time, it will become less of a problem.
The most common response I get is that my patient's can't tell the difference. However, it's an individual thing.
