Brevida - one long night

Coming off of a cold with bad congestion and coughing. Diabetic Tussin has some very negative side effects - especially when it comes to lucid thought. My Brevida mask arrived from Canada a day earlier, but because of the cold I held off one night. Last night, however, I used it for the first night. Initially, I had some difficulty going to sleep - not from negative characteristics, though. Rather, I stayed awake trying to determine how it was working - it is extremely quiet, air output from the diffuser is extremely light and soft (that raises one question to be brought up later), and the feel on the nose is very soft and gentle. The headgear is very well designed and easily adjusted. The detents on the adjustment are very firm and secure, though they might be a tiny bit too far apart - that may be the price paid for the security of the settings. The straps do leave a bit of a mark on the cheeks, but I suspect PadaCheeks may provide welcome relief. This period of observation led me to believe any changes from my experiences with the P10 are neither massive nor negative. They are more noticeable, though. This is because the Brevida is somewhat quieter, thus any amplification of sound is more noticible. The leaks were noticeably well contained. The only reported large leak data were short spikes during the first hour and 10 minutes of use and the longest period was under 4 minutes. Many of these short spikes are, I think, attributable to adjustment and/or open mouth. All-in-all, thus far this is a very good new mask and I look forward to F&P moving aggressively once the get market approval. Since pre-market approval has been completed, this should be soon. Personally, I think this mask could serve F&P as a means to test a more consumer-focused marketing effort that enlists the ultimate consumer (those of us who use xPAP) as demand agents in pulling the product through distribution. I think the wide proliferation of on-line sales of CPAP related goods should be seen as outstanding evidence that the conventional DME model, while initiating the demand, does not effectively serve to continue the demand except for those who depend on insurance as their payment means.
This night of sleep was also unusual for other reasons: a long night - 13 hours 18 minutes (with a six minute break six hours in); an effective night - AHI 0.38; a low pressure night - 95% 14.07 cm (but, to mirror pugsys' caution about the 95% number, it doesn't tell the whole story) the median number (that number with an equal number of events above and below) is 11.02 - that is two above the floor and three below the 95% number. With only elevations just before getting up for the break and following the return to bed, the night's pressures were remarkable flat.
My early enthusiasm for a mask has caused me to regret it later, though. I will continue to use it, though, until it bites me in the nose and I say "no more, please".

JimW159 wrote: ...it is extremely quiet, air output from the diffuser is extremely light and soft (that raises one question to be brought up later)...[/i]

The second night was not as long (5 hours 12 minutes) but was very informative. The question-to-be was, I think answered for me. Q: what happens when the diffuser is not used? A: Three things - none of them particularly negative for me.
1) Without the diffuser, there is much less pressure build up that contributes to puffy cheeks, air expulsion through the lips, and, possibly, aerophagia. This conclusion is based solely on the fact that, when the diffuser was removed, the excessive air pressure and clusters of leaks disappeared. The diffuser was removed about 1 hour 35 minutes into the session; all the pressures above the median occurred during that period with all those following being less.
2) Fewer incidents of large leaks (virtually all large leaks were prior to diffuser removal - all leaks following look like open mouth. The mask is so quiet that open mouth alerts one quickly to shut up and breathe.
3) Somewhat more noticeable, but not troubling to me, noise during expiration.
AHI 0.7; 95% pressure 14.70 cm (median 9.70 with a max of 15.58)

Is the Brevida a nasal pillow mask like the P10 or a nasal prong like the Pilairo?
I have irritation problems using the Pilairo as the prongs extends into the Nostril.

jtravel wrote:Is the Brevida a nasal pillow mask like the P10 or a nasal prong like the Pilairo?
I have irritation problems using the Pilairo as the prongs extends into the Nostril.

the pilairo Q is not a nasal prong mask.

this is what a nasal prong mask looks like:

jtravel wrote:Is the Brevida a nasal pillow mask like the P10 or a nasal prong like the Pilairo?
I have irritation problems using the Pilairo as the prongs extends into the Nostril.

In many senses, I would characterize it as both. While the structural profile seems a bit "prong-like," the material is so soft and thin it virtually disappears, in terms of feel, when in contact. It lacks the heavy, more rigid nature of most nasal prongs I have seen. In no way does it "capture" the interior of the nostril to form a seal. Rather, the surrounding cup combined with the conical interface with the nostrils forms a balloon-like surround that, when inflated, seals well but very gently. This, combined with a ball-and-socket elbow, provides a very smooth connection with the hose that minimizes the tension and tugging that often moves the pillows and away from an effective seal. Thus, while the conical interface directs the stream of air into the nostrils, the cup inflates to form a stable platform with the exterior portion of the nose, providing an environment where the directedness of the flow is combined with a fixed structure that gives it a natural location from which to operate. In no way does the pillow structure compete with the nose to establish the interface - it combines with this fixed location and relationship to form a cooperative relationship for the delivery of therapy. The only downside I can see at this early date is that the pillows seem possibly less robust than many others. Users may have to wash them more carefully and handle them with a bit more care. Only extended use will show if this is correct.

The Pilario I purchased had one size fit all and I guess they call it a pillow but I personally found it more of a prong myself. It was a single layer prong/pillow that extended into my nostril.
The p10 in comparison I considered a true pillow as came with three different sizes in pillows in the fit pack they sell. These pillows are double layer and don't extended into the nostril. the
double lawyer pillow instead cushions against the nostril.
Does the the Brevida come with multiple pillow sizes for the end user to try?
Are they true double layer pillows like the P10 or single layer like the Pilario?
I really like the idea of the removable diffuser and 360 degree swivel at the mask connection.

jtravel wrote:The Pilario had one size fit all and call it a pillow or and prong I personally found it more of a prong myself. It extended into my nostril and that is why i called it so.
The p10 in comparison I considered a true pillow and came with three different sizes in pillows in the fit pack they sell. These pillows don't extended into my nostril very much and have a true double lawyer pillow to cushion against the nostril.
Does the the Brevida come with multiple pillow sizes is the main question i'm asking?

I'll trust cpap.com's categorization over your 'opinion'.

plus, it's nothing at all like a prong mask, which has tubes that go up into your nostrils, look at the picture.

jtravel wrote:Does the the Brevida come with multiple pillow sizes for the end user to try?
Are they true double layer pillows like the P10 or single layer like the Pilario?

So far all I have seen are Small/Medium and Medium/Large. It does have an overall smaller footprint than the one size fits all Pilairo.
It is single layer like the Pilairo though and if you didn't like the Pilairo cushion I have my doubts as to whether you will like the Brevida. It reminds me of a Pilairo but just a bit smaller over all.

The Pilairo is a nasal pillow though. If you had ever really tried one of the real prongs there wouldn't be discussion. The prongs go WAY up into the nostrils. If the Pilairo was crawling up inside your nostrils then the pillow/cones were too small.

These two videos may provide some insight into the design and use of the mask:
1) Is from F&P and contains no dialog https://www.fphcare.co.nz/brevida
2) This one is from a dealer CPAP Direct in Australia https://youtu.be/peoueoCIaE4
One should be able to see from these videos how minimal and unobtrusive the pillows are. The Material is so soft the pillows are virtually undetectable in their feel.