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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Cokomo
 
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HELP ! CAN'T EXHALE

Postby Cokomo on Sun Feb 17, 2013 9:38 am

I have been using Qattro FX with Sys One since December, 2011. For the last year, AHI < 1.
3 days ago AHI has shot up to 12-14. Auto pressure 15-20 unchanged. For first time ever, I hear the flap in the swivel close , making exhalation most difficult . Took it out and cleaned it. No help. Last night it was replaced with another swivel (both well over a year old) and still no help. The asphyxiation flap in both swivels, shuts and is audible when it does and exhalation is greatly reduced . I was sure it was a swivel issue until last night when a different swivel was used with same result. During last night I tried switching to cflex from auto ..no help. I always X1use for most comfortable breathing and have left that alone. Could it be something wrong with the Sys. One? It still purrs like a kitten but I'm beginning to wonder. Please help .

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Machine: PR System One REMStar 60 Series Auto CPAP Machine
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Humidifier: PR System One Heated Humidifier
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khauser
 
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Re: HELP ! CAN'T EXHALE

Postby khauser on Sun Feb 17, 2013 10:20 am

Hi Cokomo,
It doesn't sound like a problem with the machine to me. I know I have problems exhaling on and off depending on body position, congestion, and I think the phase of the moon! Usually when on my back there's no problem. On my side I sometimes have problems.

For me the exhalation problem feels like nasal passages are open but I can't exhale unless I force it. This turns out to be a pretty common problem. A-flex/C-flex is one way to cope ... you could try increasing it to 2 or 3.

I use nasal pillows. When this happens to me I'll find myself exhaling occasionally through my mouth. Then it slowly builds up until I have to do so again. Since I can't sleep like that I put about 5 to 10 minutes in to see if the problem clears (sometimes it does) and if not I'm back on my back (that's sometimes a different problem because I have a bad back). I guess with a full face mask that really isn't an option for you. Unfortunately I have no real experience with full-face masks so I don't know if the anti-asphyxiation flap is causing the problem ... hopefully someone else will have more info on that.

If the increase flex doesn't help and it isn't the mask, you might become a candidate for Bi-Pap.

Good luck!!!

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Machine: PR System One REMStar 60 Series Auto CPAP Machine
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zoocrewphoto
 
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Re: HELP ! CAN'T EXHALE

Postby zoocrewphoto on Sun Feb 17, 2013 12:42 pm

Does it feel like you are getting the same pressure that you used to get? The anti asphyxiation valve shouldn't be opening unless there isn't enough air pressure.

Have you checked your filter? Do you have a DME you can take it into and have it tested?

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Who would have thought it would be this challenging to sleep and breathe at the same time?

Cokomo
 
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Re: HELP ! CAN'T EXHALE

Postby Cokomo on Sun Feb 17, 2013 1:31 pm

Checked filter. Am I correct in saying the valve should always be open while there is air pressure? What is happening is, I wake up to hear/see the valve close and then I can't exhale properly. I wonder if the machine is cutting out? Sending Sleepyhead graph of last night . The straight line is when switched to cpap.

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Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Humidifier: PR System One Heated Humidifier
Additional Comments: Sleepyhead. APAP 14-16. A1

Cokomo
 
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Re: HELP ! CAN'T EXHALE

Postby Cokomo on Sun Feb 17, 2013 2:04 pm

Here is my SleepyHead data from last night. Would appreciate any input. Thanks!

Image
Image
Image
Image
Image
Image

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Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Humidifier: PR System One Heated Humidifier
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archangle
 
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Re: HELP ! CAN'T EXHALE

Postby archangle on Sun Feb 17, 2013 2:43 pm

What do you mean by "shut?" Is the valve in the position it is in when the machine is off? In one position, you're connected to the hose. In the other position, you're connected to the room air.

Does it open and close as you breathe in and out, or does it shut and then stay shut?

With the machine running and the valve shut, does air come out the exhale vent holes above your nose? Does any air come out the hole over the anti-asphyxia vent? Continuous or on and off as you breathe?

If you lift up the edge of the mask, does air gush out?

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Cokomo
 
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Re: HELP ! CAN'T EXHALE

Postby Cokomo on Sun Feb 17, 2013 3:26 pm

Shut as in the position it is when machine is off. Once machine is turned on, it stays completely open during inhale and exhale. Air blows constantly out the designed holes in mask. Nothing around the valve. Air does gush out when mask is loosened . Everything works fine when I try it now but during the night the pressure must be stopping because I hear the valve membrane close and can also see it closed out of the corner of my eye. I am having apneas and waking up to exhaling issues. I change the white filter weekly and am well aware of the importance of a clean filter. System One seems to run smoothly. I am perplexed as to why the pressure is stopping during sleep. During the past year, any AHI greater than 1 would get my attention. I bought the machine outright so I have no DME to check it . The difference in the way I feel these last 3 days is tremendous....to the bad.

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Machine: PR System One REMStar 60 Series Auto CPAP Machine
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Humidifier: PR System One Heated Humidifier
Additional Comments: Sleepyhead. APAP 14-16. A1

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ChicagoGranny
 
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Re: HELP ! CAN'T EXHALE

Postby ChicagoGranny on Sun Feb 17, 2013 3:40 pm

Am I correct in saying the valve should always be open while there is air pressure?


No. It should be closed when the CPAP is running.

It only opens when the machine shuts down. It's purpose is to prevent CO2 buildup should your machine stop or not be attached to the hose. It is sometimes called an anti-asphyxiation valve.

The exhaust vents (not the anti-asphyxiation valve) are for preventing CO2 buildup when the machine is running. If the anti-asphyxiation valve is also open. then there is too much exhaust and the machine is unlikely to be able to maintain the prescribed pressure.
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archangle
 
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Re: HELP ! CAN'T EXHALE

Postby archangle on Sun Feb 17, 2013 4:47 pm

ChicagoGranny wrote:No. It should be closed when the CPAP is running.


That depends on which position you call "open" and "closed." It sounds like Cokomo calls "shut" the position when there's no pressure and you're breathing room air through the hole in the elbow.

Cokomo, the next time it happens, disconnect the hose from the mask and see if you have pressure in the hose. If not, listen to see if the machine is blowing, listen for leaks, and try the other end of the hose, then check the blower, open the humidifier lid, etc. until you figure out how far the air is getting.

Could you be lying on the hose or kinking it somehow?

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Machine: S9 AutoSet™ CPAP Machine
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Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Also SleepyHead, PRS1 Auto, Respironics Auto M series, Legacy Auto, and Legacy Plus
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Click here for information on the most common alternative to CPAP.
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BlackSpinner
 
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Re: HELP ! CAN'T EXHALE

Postby BlackSpinner on Sun Feb 17, 2013 4:59 pm

Those flaps have nothing to do with exhale relief. They are there only in case the power goes off. There should be no air coming from them when the machine is on. The only air that comes from the mask is from the vent holes.

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ChicagoGranny
 
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Re: HELP ! CAN'T EXHALE

Postby ChicagoGranny on Sun Feb 17, 2013 5:32 pm

archangle wrote:
ChicagoGranny wrote:No. It should be closed when the CPAP is running.


That depends on which position you call "open" and "closed." It sounds like Cokomo calls "shut" the position when there's no pressure and you're breathing room air through the hole in the elbow.



But he does say this,

The asphyxiation flap in both swivels, shuts and is audible when it does and exhalation is greatly reduced .


The "audible" is indeed the valve closing.

It does make sense when he says it is more difficult to exhale when the valve is closed. That is true for all of us. It's the difference between having pressure on the system and having no pressure on the system.

I wonder if he has become oversensitized to the pressure on exhale?

Look at the graphs he posted. The pressure line looks like he changed the setting to straight CPAP shortly after starting and changed it back to APAP shortly before ending. What is going on there?
ChicagoGramps

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Otter
 
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Re: HELP ! CAN'T EXHALE

Postby Otter on Sun Feb 17, 2013 6:04 pm

ChicagoGranny wrote:Look at the graphs he posted. The pressure line looks like he changed the setting to straight CPAP shortly after starting and changed it back to APAP shortly before ending. What is going on there?

Good question.

Cokomo, can you zoom in your flow rate trace during one of these strange AA valve events? I'd like to see if your breathing pattern is unusual, or if the machine is able to track your breath at all.

_________________
Machine: S9 AutoSet™ CPAP Machine
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Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Software: SleepyHead 0.9 beta

Cokomo
 
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Re: HELP ! CAN'T EXHALE

Postby Cokomo on Sun Feb 17, 2013 6:06 pm

"Look at the graphs he posted. The pressure line looks like he changed the setting to straight CPAP shortly after starting and changed it back to APAP shortly before ending. What is going on there? "


Switched to CPAP in hope it might help but didn't . The pressure is not getting to throat and it seems I'm waking up due to apneas and finding it difficult to exhale. I've ordered a new mask but do not think the mask is the problem.

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Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Humidifier: PR System One Heated Humidifier
Additional Comments: Sleepyhead. APAP 14-16. A1

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zoocrewphoto
 
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Re: HELP ! CAN'T EXHALE

Postby zoocrewphoto on Sun Feb 17, 2013 6:12 pm

Any chance your hose has a hole or is being squished somehow? Could something have fallen into the hose and it is clogging it sometimes?

Does your machine have an auto on and off based on your breathing? Could it somehow be messing up?

Can you think of anything else that has changed around the same time as this started happening?

_________________
Machine: S9 AutoSet™ CPAP Machine
Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: pressure range 11-17
Who would have thought it would be this challenging to sleep and breathe at the same time?

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ChicagoGranny
 
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Re: HELP ! CAN'T EXHALE

Postby ChicagoGranny on Sun Feb 17, 2013 6:15 pm

The pressure is not getting to throat and it seems I'm waking up due to apneas and finding it difficult to exhale.


How is your health otherwise?

I suspect a preoccupation with breathing when you wake up. This is not uncommon.

When you wake up, try deep slow exhales as if you are trying to get all the air out of your lungs. Relax on the inhale and let your body do it "naturally". Repeat this anywhere from five to twenty times and it should help with relaxation. Visualize a pleasant scene (warm beach works for me in this dreadful Chicago winter).

You can exhale against the pressure when you are sleep or you would have much bigger problems than you describe. This is why I suspect it is some sort of anxiety when you are awake.

Good luck for quick relief.
ChicagoGramps

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