rainout and suffocating vs poor mask seal

i cannot deal with the re-breathing the breath i just exhaled. my breathing becomes so labored. and, i bet the pulse ox is down.... which was my whole purpose for cpap.
I cannot deal with the rainout to the point that water goes into my nose. it is frightening and wakes me.
i am so disappointed in my supplier. they are discussing the rainout, but, IGNORE the re-breathing problem. i do not want heated air. it is hot enough in this house. bought the climate tubing, but went back to the plain one. got a new humidifier chamber. wrapped the tubing. machine is 6" below the mattress. no kinks nor sharp turns in the tubing.
humidifier is set down to 2. settings are 7 and 20.
My remedy? well, this may not be a good idea, but, i have begun to keep the nasal pillows away from my nostrils so that i can breathe better. there is no more rainout. there is no struggle to breathe. it is close enough that the machine does recognize my breathing. but, i get the red face on my screen every morning, and ignore it.
my biggest concern is that I DOUBT THE MACHINE CAN ALWAYS DETECT MY EVENTS AS I HAVE LOOSENED THE NASAL PILLOWS TO POOR SEAL. i am ready to give up on this thing. i doubt that going back to the doctor would be a remedy: he is not a technician. he likely does not understand much about the machine... i assume.
Using Resmed Airsense 10, auto, 7 and 20, nasal pillows, non-climatized tube, https://myair.resmed.com/Default.aspx , sign in is 1st.sam.3.10@gmail.com , pw is myAir.17
please advise.

I think you're fooling yourself that you can get full therapy from pillows held away from your face... you're not using Cpap but playing at it. I realize you're uncomfortable with things as they are, but they need working on, not what you're doing. If you feel you're rebreathing CO2, are you making sure the vent is not covered by bedding when you're asleep? That's the usual source of rebreathing problems. If it's a matter of difficulty getting enough air however, again, you need to try either a different size of pillows, a different type of mask altogether, or at least post some Sleepyhead graphs here so we can see what is happening while you're not-breathing the Cpap air, though you're right that the machine will have trouble gauging anything meaningful if your pillows don't seal at all. You might just need a different type of mask - most of us go through more than a few when getting started, until we find what works well and delivers adequate therapy.

If you don't like using the heat, then don't use it - it's there for comfort and convenience, not therapy in itself. Many people don't want ot need it depending on many things such as local climate, indoor heating, etc. And if you have rainout, have you located the machine at a slightly lower (even by a couple of inches) level than your head? Water will then run back to the machine rather than your face.

Your machine has a feature called EPR....(Exhale Pressure Relief). Is yours turned on? If it is, what is it set at?

Czech Daughter wrote:I cannot deal with the rainout to the point that water goes into my nose. it is frightening and wakes me.

It's likely the moisture in your own exhaled breath that is condensing.
See this thread post #2 and #3 for some options.
viewtopic/t94035/Pugsys-Pointers-3Deali ... -road.html
Since you don't want to use a heated hose...I strongly suggest a barrel cozy.
http://www.padacheek.com/PACSwiftII_Barrel_cozy.html
It does work. I have used it.
Due to the way nasal pillows are constructed the "have the machine lower than the bed" isn't going to help much if the water is just in the nasal pillows. There's never a suitable "downhill" when it comes to nasal pillows.

And BTW....even if you turned off the humidifier you could still get condensation in the nasal pillows from the moisture in your own breath.

Czech Daughter wrote:i cannot deal with the re-breathing the breath i just exhaled. my breathing becomes so labored. and, i bet the pulse ox is down.... which was my whole purpose for cpap.

Try going up a size or two in the nasal pillows. You might be surprised at how much the extra air space helps with that feeling you are experiencing.

Use EPR too.

thank you all for offering suggestions. it is good to know that there is a helpful community to guide me w/o an agenda (like, can't bill medicare for a phone call from me).
as stated in the orig post, the machine is located 6" BELOW MATTRESS LEVEL, the tubing is WRAPPED. i agree. i do not see how the machine can possibly read my breathing. in fact, it sometimes reads that i have had only 0.5 events/hr, when the previous normal for me was 4-5. am doubting the RT at the supplier, who states (only) that my numbers look good, therapeutic. he did not even bother to compare current numbers with those previous to loosening the mask.
additionally, i SLEEP ON MY BACK, on 2 pillows. i agree that my breath going back into the tube is causing the condensation. the condensation is in the tube + the pillows. i have previously drained about 1/8 cup from the tube (when i actually heard it gurgling). but, that much is not par.
my GRAPHS can be viewed at the myAir website using the sign-in i included in the orig post.
the EPR is set at 1. OFFER A Recommendation?
i guess that my biggest disappointment is that this is my 3rd machine! all the same model. but, previously, i had no prob with breathing, nor with rainout.

Czech Daughter wrote:the EPR is set at 1. OFFER A Recommendation?

Try all available settings including Off and see if you like one better than the others. I have no idea which setting you might prefer...just try them all and choose one that is the most comfortable for you.

If you don't want to add heat to the air to prevent the condensation in the hose or mask...and using a hose cozy or barrel cozy doesn't prevent the condensation the about the only other option is to raise the ambient temperature in the bedroom.
The condensation is just physics in action. When air that has some moisture in it cools to the point that the air can no longer hold on to the moisture condensation occurs.

You have to prevent the air from cooling and releasing that moisture. Either warm the air up in the hose which you say you don't like or use a hose cozy or barrel cozy in an effort to keep that air warm enough to not release the moisture or warm up the ambient room temp so that it doesn't cool off the air in the hose.

Nasal pillow masks typically have a short hose and most hose wraps/cozies don't cover the short hose. If yours doesn't you might try making a little hose cozy for the short hose. An old thick sock works great. Just cut the toes out and slide over the short hose making sure to stop short of covering the vent holes. May need more than one sock depending on how think and how long the sock is.

thank you for suggesting to try all of the EPR settings. hopefully, there are not many!

Czech Daughter wrote:thank you for suggesting to try all of the EPR settings. hopefully, there are not many!

There are only 4 choices
Off
1...which gives you a 1 cm reduction during exhale
2...which gives you a 2 cm reduction during exhale
3...which gives you a 3 cm reduction during exhale.

And depending on what the starting pressure is you may not get the full reduction.
The machine can't/won't go lower than 4 cm...so if you choose a setting of 3 and your starting pressure is 6 cm...you will only get a 2 cm reduction because the 6 starting point isn't high enough to get full reduction. You would need a starting pressure of 7 to utilize the full 3 cm reduction available at the EPR setting of 3.

Czech Daughter wrote:https://myair.resmed.com/Default.aspx , sign in is 1st.sam.3.10@gmail.com , pw is myAir.17
please advise.

MyAir is only giving you basic compliance data which is not helpful enough if you want to take some control of your own therapy. You need to download and use the free SleepyHead Software to do this properly. Get some SH data screenshots on here and people will help you to interpret and make suggestions on how to improve your therapy. Good luck.

EPR is set at 1.
thanks for the sleepy head advice.

Thank you all for the advice. i am still not satisfied with the outcomes nor with the supplier's lack of critical thinking skills. Today i will be returning my cpap to them. i choose not to pay for non-therapeutic cpap use, and poor customer service from them. Some of the most valuable advice i rec'd was from my Dr, who told me that persons who have Obstructive Sleep Apnea and are not on cpap therapy are those who have strokes and heart attacks in their sleep. but, if i do not get honest therapy from the device, i am just paying the supplier. so, for now, i will use a mouth guard which thrusts my lower jaw frwd and seek to get an adjustable bed to raise my head w/o injuring my back. Thank You All! We all know that not everyone would be successful.

What is the minimum pressure set to on your machine?

I think the pressures were set at 7 and maybe 30.
with the poor mask seal, it was blowing up my nose so hard that i often awakened with a fierce force of air going up my nose, a sore throat and a headache. these headaches worsened and did not resolve for days... the last one was 8 days long. the resolution was stop using cpap. it was loose mask, or aspirate water and have difficulty exhaling. i objected to the water; i objected to labored re-breathing my exhaled breath; i know a loose mask is not therapeutic, but at least it did not flood me with water; and, i knew re-breathing my exhaled breath was dropping my pulse ox. at this rate, i was gonna stroke or have an MI, anyway.
the supplier insisted that my numbers were good, therefore in his opinion, i was getting good therapy from using it with a very loose fit.
the supplier's RT/owner insisted that he only needed to look at the past 30 days, since that was Medicare's protocol. But, i'd been using the loose mask for 60 days, already. there was no comparison made. he felt that my events coming down from 5.4 to 0.5 per hour in a 24 hr period was evidence of great therapy. then the numbers erratically jumped around like this. i am an RN, and a CPR Instructor. i will never be convinced that i was getting good cpap therapy with the loose mask.
Thank You for reading and i hope my testimony will help you with someone else.

Czech Daughter wrote:I think the pressures were set at 7 and maybe 30.
with the poor mask seal, it was blowing up my nose so hard that i often awakened with a fierce force of air going up my nose, a sore throat and a headache. these headaches worsened and did not resolve for days... the last one was 8 days long. the resolution was stop using cpap. it was loose mask, or aspirate water and have difficulty exhaling. i objected to the water; i objected to labored re-breathing my exhaled breath; i know a loose mask is not therapeutic, but at least it did not flood me with water; and, i knew re-breathing my exhaled breath was dropping my pulse ox. at this rate, i was gonna stroke or have an MI, anyway.
the supplier insisted that my numbers were good, therefore in his opinion, i was getting good therapy from using it with a very loose fit.
the supplier's RT/owner insisted that he only needed to look at the past 30 days, since that was Medicare's protocol. But, i'd been using the loose mask for 60 days, already. there was no comparison made. he felt that my events coming down from 5.4 to 0.5 per hour in a 24 hr period was evidence of great therapy. then the numbers erratically jumped around like this. i am an RN, and a CPR Instructor. i will never be convinced that i was getting good cpap therapy with the loose mask.
Thank You for reading and i hope my testimony will help you with someone else.

The CPAP masks all have CO2 ventilation so that you do not re-breathe your exhaled breathe. So no need to worry about re-breathing.

The water condensation in your mask is a completely different issue. The best way to deal with that is to lower the heat setting (or turn the heat off) on your humidifier AND/OR increase the temperature of your bedroom. There are other minor things that can help like insulating the hose and mask or using a heated hose.

As long as you do not maintain a proper mask seal, the CPAP therapy is not going to be effective. So job one is to NOT worry about CO2 re-breathing and then work on mitigating mask condensation so that you can get and maintain a proper seal. The mask is always the most difficult part of this therapy and why so many people fail. Get the mask fit and seal under control and the rest is easy peasy.

It's already been pointed out that all masks are supposed to have exhalation vents. However, it's a good idea to make sure they're not blocked and that they are functioning correctly.