New User with a Mask Venting Question

Mornin Everybody!

I've been using my apap and P10 mask for a bit over a week, and I'm realizing a slight issue. So far this has happened three times, and the most recent one was weird enough that I decided it might not just be me. Most of the time, the mask feels great, and I get to sleep with no problem. Occasionally I start feeling like I'm suffocating even though I'm getting plenty of air, and the air I'm breathing starts getting hot (humidifier set to 2, does the same thing without the humidifier). I was thinking this was largely anxiety or something due to having a chunk of plastic on my face, but last night, I went to bed just fine and woke up really struggling two hours later.

I've been able to observe a few things when this happens:

1) When I put my hand in front of the vent, I feel no breeze at all. When all is well, I feel a very faint gentle cool breeze.
2) My leaks on sleepyhead usually drop pretty dramatically. My total leaks are usually around 24 L/min (a bit below what the manufacturer specifies), but when this happens, they will drop to as low as 5 L/min.
3) When this happens, the vent is very moist.

So am I crazy, or could my own hot air be causing problems? I am certainly full of it. When everything works well, which is most of the time, I feel better than I have in over a decade. I'm only a week and a half in, and I've already dropped a couple pounds and have the energy to exercise at the end of the day instead of just weekends. I'm completely sold on using this happy little air compressor; now I just have to work out the kinks!

-pete

Why don't you try lowering the setting and/or not even using the humidifier at all?

I wonder if condensation is clogging up the mesh.
I hope not, as I just ordered this mask.
OP could try blowing through the vent to clear it.

You might try the next size up in nasal pillow size.
Also you might try pulling the nasal pillows away from your nostrils for just a couple of seconds to let the inflate again. I had something similar happen when one of the nasal pillows would sort of get suck into my nostril a bit. Sealed a little bit too good and created a vacuum of sorts which with only one nasal pillow working the already minimal vented air was even less. I didn't think to check the venting because it was obvious to me the nasal pillow was sort of collapsed into my nostril. Wasn't painful but pulling it out to reseat and reinflate fixed it. Then I decided to use the Small instead of XSmall and it doesn't happen anymore.

Julie wrote:Why don't you try lowering the setting and/or not even using the humidifier at all?

flyingcow says same the thing HAS happened without the humidifier:

flyingcow wrote:and the air I'm breathing starts getting hot (humidifier set to 2, does the same thing without the humidifier). [emphasis added]

I'm inclined to go with pugsy's suggestion to pull the pillows away and allow the pillows to fully inflate. But it is also possible that perhaps the vents are getting clogged from moisture from your exhalations since the problem is happening with both minimal and no added humidification.

To flying cow, if moving up on a size of pillows doesn't do the job or if pulling the mask away from the nose for a few seconds doesn't work, you might want to try out the Swift FX as an alternative to the P10.

chunkyfrog wrote:I wonder if condensation is clogging up the mesh.
I hope not, as I just ordered this mask.
OP could try blowing through the vent to clear it.

This is what I'm suspicious of. One time it happened, I got up out of bed and hung up the mask and hose for about 15 minutes, it then worked fine. Blowing through it didn't seems to help.

I tried it without the humidifier, and still had the problem, and sadly the large pillows leak like crazy on my face, so medium it is.

Next time it happens try to get a sense of air movement through the pillows before you do anything. Just to see if the pillow hasn't sort of created the vacuum I was talking about. Just a couple of inhales to get a feel for air movement in the nose..then pull the mask away for a couple of seconds and reseat. If it is nasal pillow inflation issue that should fix it real quick. If it is moisture in the vent holes it won't be so easily fixed. This will maybe help you isolate the cause then you can maybe implement a fix. Need to try to figure out the cause first if at all possible.
I understand if going up in size isn't an option. For some people it isn't. I have always been able to use either the XSmall or Small in almost all nasal pillow masks that offer those sizes. I guess I am sort of in between but for me to use a medium wouldn't work either. So I can understand if Large is leaky for you.

I forget...are you using a heated hose? If not, that might help with any potential moisture issues in the vent holes (if that is the cause). I use a max humidity setting with my AirFit P10...never have had any moisture build up in the vent holes but then I use a heated hose.

Pugsy wrote:Next time it happens try to get a sense of air movement through the pillows before you do anything. Just to see if the pillow hasn't sort of created the vacuum I was talking about. Just a couple of inhales to get a feel for air movement in the nose..then pull the mask away for a couple of seconds and reseat. If it is nasal pillow inflation issue that should fix it real quick. If it is moisture in the vent holes it won't be so easily fixed. This will maybe help you isolate the cause then you can maybe implement a fix. Need to try to figure out the cause first if at all possible.
I understand if going up in size isn't an option. For some people it isn't. I have always been able to use either the XSmall or Small in almost all nasal pillow masks that offer those sizes. I guess I am sort of in between but for me to use a medium wouldn't work either. So I can understand if Large is leaky for you.

I forget...are you using a heated hose? If not, that might help with any potential moisture issues in the vent holes (if that is the cause). I use a max humidity setting with my AirFit P10...never have had any moisture build up in the vent holes but then I use a heated hose.

Pulling the mask away from my face does make it easier for about two or three breaths. The air then gets hot again, and feels very uncomfortable. I'm not using a heated hose yet, and I don't have hose rainout issues, but it could be a source of the issue. The vent is very wet when this happens. I've been considering pulling the trigger on the conversion kit, maybe I should.

The heated hose feature on your machine will allow for more constant temperature control as to air temperature in the hose. It doesn't have to mean that the air is hugely warmer. I use it even in the summer but just turn the temp down so that I can maintain the humidity my nose likes and I can breathe in cooler air in the summer and warmer air in the winter with increasing the temp.

It is possible that there is condensation only at the mask level from the moisture in your exhaled breath. Maybe just enough to clog the vent holes.
Condensation at the mask level can happen even if a person doesn't even use a humidifier and live in the high desert.

The "hot" air feeling you are sensing may be more of a reaction to the lack of air movement than it is that the air is actually warmer unless you are rebreathing mostly your own exhaled warmer air.

Check with your DME....insurance covers a new hose after whatever replacement period has elapsed and you might have coverage available for heated hose now. Insurance does cover heated hoses...there's just a special code for it and that should also cover the conversion kit. DME might not want to do it but it can be done if they would just do it. They won't make as much money though and that's why they might tell you it isn't covered.

Quick update:

So after fiddling with the mask while awake and trying to see if the pillows would reinflate, I decided to put my hard earned engineering experience to use... yup that's right, I threw money at the problem and hoped it would go away. I pulled the trigger on the heated tube conversion kit and a Swift FX mask on cpap.com. I just sat down and tried both my P10 and the FX with the new heated tube. Even laying on the couch, the difference was staggering. With the P10, I felt like I always did... working to breathe. With the FX, I was breathing completely normally at 8 cm w.c. I'll report back tonight after giving it a full night run. Thank you guys so much for all your help and wealth of information! While there have been a couple of bumps in the road, I think I'm taking to my happy little air compressor very well!

-pete

A quick update for record in case someone searches this...

I'm not 100% sure if it was the condensation, or a bad headgear fit causing the pillows to collapse, but switching to the Swift FX got rid of every problem I was having. It's possible the non adjustable headgear was too small for my noggin. The FX was way more comfortable the second I put it on. Thanks everyone for your help, and many good nights to you all!

-pete

I'm having this same problem with my P10 and I've confirmed it is condensation clogging up the vents that is resulting in difficulty exhaling, and subsequent increase in respiration rate and eventually my having to take the nosepiece off to slow down. Blotting the water out of the vents solves the problem completely. So I'm really glad to finally find that someone else had encountered this issue- apparently not everyone does- and even moreso that there's an alternative that might work. I'll have to see if I can get a Swift FX too- thanks pete!