Problem with mask and EPR

[jomama]

Trying to combat flow limitations, I have been trying to experiment with raising EPR, but I have a baffling problem. I use an F&P Simplus FFM, and when I set the EPR to 3 I feel this kind of balloon like inflation around the mask on inhale, and deflation on exhale. I just spent over 20 minutes resting and trying it and it's just so disruptive. 

It happens much less on EPR 2, but I'm still getting FL, even at higher pressures, around 10.5, so I need to try a higher EPR to try to get those FL down, but I can't because of this issue. I can't imagine what it would be like with a BiPAP at even higher differential. I can't even think of trying Bilevel if I'm having this problem at EPR 3. Any ideas?

[Gideon]

Physics: A given given pressure applied to a large area will lift with more force than the same pressure applied over a smaller area.

a pressure of 10 cmw applied to a 100 square cm mask lifts with a force of 1000 gms, will lift 1 kg of weight.
a pressure of 10 cmw applied to a 10 square cm mask lifts with a force of 100 gms, will lift 0.1 kg of weight.
The physics solution is to try a smaller mask
This is also why nasal and pillow masks are much less problematic from leaks than full face masks.
This physics in the principal on which hovercraft operate.

[jomama]

Unfortunately, I tried smaller masks and cannot use them, for one reason or another, such as issues with air escaping from mouth, so it's gotta be FFM for me. Also, I had more leak issues fit wise with the nasals than the Simplus. I do get leak issues at higher pressures, but less so. I can't really do higher pressures though unless I can use EPR, hence this problem.

Does anyone else use a FFM with EPR 3, or a BiLevel at even higher pressure support? And do you not have this issue?....

[Gideon]

What happens with a pressure of 7 and an EPR of 3?

[SarcasticDave94]

Welcome to Apnea Board,

FWIW my ASV is set to give max IPAP of 26. And my PS is basically the same in concept as your EPR (PS adds pressure while EPR reduces pressure) but my PS range is 4-13. I and my F20 AirFit full face mask handle it OK. If you just started CPAP therapy, it'll get better with more use. Try some mask on time while reading or TV time while not exactly expecting to sleep, it'll add to your getting used to CPAP.

[Crimson Nape]

I do!  I have been using the Simplus at 15 cm and an EPR of 3 without any problems.  Recently, I started using the Simplus next generation replacement, Vitera.  It provides even a better seal.

[jomama]

What happens with a pressure of 7 and an EPR of 3?

What I described. Lower pressure makes no difference. :/

[jomama]

I do!  I have been using the Simplus at 15 cm and an EPR of 3 without any problems.  Recently, I started using the Simplus next generation replacement, Vitera.  It provides even a better seal.

Hm. So, are you saying that you don't feel the inflating/deflating sensation? I don't understand why I do. Even taking small, light breaths I feel it. Argh.....

[Gideon]

I can't change physics. My suggestion is to use it and get used to it. Why is it disruptive? Why can't you get used to it? Try another mask, what about a hybrid mask that doesn't cover the nose like the Amara View.

[Hydrangea]

Is it the pressure changes (up & down ballooning) that you're not liking? Or is it causing leaking?

I experience the ballooning, and dislike it greatly. But when I'm asleep, I don't think I notice it.

My bigger problems is maintaining the seal, especially in the early morning hours. I had to get away from silicone, and switch to memory foam (F20), and that maintains the seal for me.

(As far as your other stuff, I'm afraid I can't help. I had to turn off EPR because it causes me ear problems.)