Love RespCare Hybrid but ASV doesn't???

[NateS]

Note: Before posting this new thread, I did an extensive search on cpaptalk and read many, many threads about the acclaimed RespCare (Innomed) Hybrid Universal Interface Mask, trying to see if my particular problem below was addressed, but I was unsuccessful so am posting as a new thread.

After I could never resolve the loud and noisy leaks with the AirFit F10, I just bought a RespCare (Innomed) Hybrid Universal Interface Mask brand-new from our hosts. I did not spend the extra fifty dollars for the return insurance because I would never give up on a mask in only 30 days and I certainly am unwilling to give up on this Hybrid because I L-O-V-E the way it fits and all five of my senses tell me that it is NOT leaking air ANYWHERE but my ResMed S9 VPAP Adapt insists otherwise and SCREAMS (Leak Alert) every time I have it on for more than 2 minutes!

I think I know what a LEAK sounds like and feels like - my AirFit F10 kept having noisy rushes of air coming out from around it no matter how I adjusted it, but this Hybrid is totally SILENT and I can feel the therapy working great, but my VPAP won't shut up!

My normal settings on my 3 yr old ResMed S9 VPAP Adapt, has for years been set for:
Mode: ASV; EPAP: 8 cm; Max IPAP: 23 cm: PS Min: 3 cm; PS Max: 15 cm
and has been working okay with my Wisp and with older masks I have used before. I am not satisfied with the Wisp because I am a mouth breather, and I really like this new Hybrid, and I have read and heard a TON of good things about it here on cpaptalk from Rooster, Black Spinner and many, many others.

I have repeatedly studied the videos and the printed Sizing and Fitting Guide - 06035 Rev C. The medium cushion was too small but the large cushion seems to fit just right. The medium pillows seem to be the correct size, but the leak alarm screams with both the medium pillows and with the large pillows and also with the lower and higher height adjustments for each of the pillow sets.

I thought I got everything adjusted perfectly. Every time I turned on the machine, the Hybrid seemed to fit snugly and with no apparent leaks anywhere. I could feel the therapy pressure working and I could breathe comfortably.

After about two minutes, the ResMed leak alarm would go off and would not stop screaming, no matter what I did - I felt all around the entire Hybrid mask and its nasal pillows and could not feel any air leaking out nor could I hear any leaking sounds from the mask. I tried pulling the straps - upper, lower and top strap, first a little bit tighter, then a little more and then a lot tighter but no matter what I did, the leak alarm on the ResMed would not shut up. Loosening the straps didn’t silence the leak alarm either.

All this was happening while I set the Mask fit adjustment on the ResMed to FFM; but I even tried setting it back to Pillows and the leak alarm would still scream.

I finally had to go back to my usual mask - the Wisp - for the rest of the night so that the leak alarm would stop going off, but I am a mouth breather and am determined to switch permanently to my new RespCare Hybrid, if at all possible.

I even considered re-setting the leak alarm on the VPAP to OFF but I am not sure this can be done, and if it would be safe to do even if it can be done.

Therefore, I turn to the geniuses and veterans here on cpaptalk, and would very much appreciate your advice and guidance.

Best wishes, Nate

[Hang Fire]

setting the leak alarm on the VPAP to OFF

I never thought a leak alarm had any value.

I have never used a VPAP, so I really can't help you.

That Innomed Hybrid is a sweetheart of a mask.

Good luck.

[Pugsy]

I have no idea why the Adapt doesn't like the Hybrid but you can turn off the leak alert if you wish.
I just checked my Adapt and I had leak alert already off.
If it were me I would turn the leak alert off and use the mask for a night and then evaluate the leak line data. Maybe the Adapt doesn't like the venting or something. I have never seen anyone have this problem with the Hybrid but then I don't know of anyone using the Adapt and the Hybrid. I don't have a Hybrid to check it out or I would give it a try.

[bwexler]

What were your actual pressures when you experienced the leaks?
I use the Wisp and the last few days I also noticed some large leaks near the beginning and end of the night. My pressures were correspondingly high, over 21. I also had many events of all kinds during that period. The middle of the night was uneventful so my AHI looked good even with all the events clustered at the beginning and end of the night.
I had a problem with mouth breathing and used a chin strap for a couple months, now I seem to have cured myself of the mouth breathing, but my Wisp was definitely leaking during those high pressure events.
I don't have any facial hair but some time allow 2 or 3 days of stubble.

I have also had some allergy issues causing a stuffy nose.

[Jay Aitchsee]

Nate, does the VPAP have a mask setting? It could be that the vent rate of the Innomed is much greater than the vent rate of the F10 and if the mask setting is not selected properly, the VPAP could see the increase in vent rate as a leak. Though, I don't know if there is a setting for hybrid masks.
May not apply, but I have seen my S9 register hi leaks with non-ResMed masks, even in the absence of leaks.
Anyway, something you could check.
Edit: rereading your post, I see you checked the setting. Have you looked at the literature for the mask to see how the vent rate compares with a ResMed FFM?

[RogerSC]

Did you change the mask type that you're using in the settings? This brings up two other questions, what is the idle venting rate at your pressure? And what does your leak data look like on the sleepyhead graphs?

Sorry that I can only ask questions *smile*...never used vpap or the mask in question. But if you're feeling that there aren't leaks, and you're getting a leak alarm, I'd be looking to see what the leak alarm timing looks like in your leak line in your sleep data, and make sure that the vent rate of your mask makes sense relative to what your cpap is expecting.

[Hang Fire]

I just bought a RespCare (Innomed) Hybrid Universal Interface Mask brand-new from our hosts

When this mask was introduced, it had a high design vent rate which cause havoc with APAPs. The manufacturer quickly revised the vent and the mask has worked well with APAPs (I don't know about VPAPs) ever since.

That was about 10 years ago when the "correct" mask frame came out, so I can't imagine you got one of the originals unless someone at cpap.com was cleaning out an old closet.

[Hang Fire]

Another thought, do you still have the correct style hose selected on your machine.

[robysue]

I'll throw my two cents in: I agree with pugsy. Turn the alarm off and sleep with the mask for one night and see what the leak line looks like in the morning. It's also a good idea to check the owner's manual for the mask and see what the published intentional leak rate at your pressure is supposed to be and then compare that number to a Resmed FFM's intentional leak rate.

[NateS]

Thanks so very much to those who have responded thus far -
Hang Fire, Pugsy, bwexler, Jay Aitchsee, RogerSC, and RobySue!
I really appreciate it!

Status so far based on advice and observations you wise ones have provided is that I verified from the Clinician's Manual that the default factory setting for my VPAP is Leak Alert: OFF and I went into Settings and turned it off, so hopefully I will be able to run my machine with the Hybrid Mask on all night tonight, and have charts to throw up tomorrow to see what is going on.

The Hybrid's Passive Exhalation Port Flow Chart found on the 'net for Rev E (I have Rev F) is:



Is that the intentional leak rate?

As for ResMed masks, I refer to the thread at:
viewtopic/t98768/How-does-ResMed-determ ... -rate.html
"How does ResMed determine the intentional leak rate?"
and just wish I better understood the discussion which took place there and how it would apply to resolving my problem.

Regards, Nate

[Jay Aitchsee]

Here's the flow rates for the ResMed Masks:
http://z5.ifrm.com/5902/67/0/p1032022/R ... _rates.pdf
The hybrid is a little greater which the ResMed machine would call a leak. But it doesn't look to be that much. Static vent for the Quattro at 10 cm is 37 l/min and the hybrid is 40.

[palerider]

Nate, does the VPAP have a mask setting? It could be that the vent rate of the Innomed is much greater than the vent rate of the F10 and if the mask setting is not selected properly, the VPAP could see the increase in vent rate as a leak.

there's no hybrid setting, and while I've never found it documented anywhere, evidence indicates that mask setting performs the same function as the 'system one resistance' that respirs has, NOT leak calculations.

[palerider]

The Hybrid's Passive Exhalation Port Flow Chart found on the 'net for Rev E (I have Rev F) is:

Is that the intentional leak rate?

As for ResMed masks, I refer to the thread at:
viewtopic/t98768/How-does-ResMed-determ ... -rate.html
"How does ResMed determine the intentional leak rate?"
and just wish I better understood the discussion which took place there and how it would apply to resolving my problem.

yes, that's the intentional leak rate, and if you compare it to a half dozen other masks, (nasal, pillow, ffm) you'll find that the leak rate is in the same ballpark... around 20lpm@4 to around 50ish@20cm. (give or take a few).

[Sheffey]

The hybrid is a little greater which the ResMed machine would call a leak. But it doesn't look to be that much. Static vent for the Quattro at 10 cm is 37 l/min and the hybrid is 40.

I have used the Innomed Hybrid for years and the last 16 months with ResMed AutoSet S9 with pressure range 10 - 20. I have always had widely varying pressure needs and the Innomed and ResMed machine perform flawlessly for me. The machine ramps up quickly when I hit a REM stage and drops down in a reasonable amount of time when I come to stages that require less pressure.

Nate, I hope this works out for you, because I have found the Innomed Hybrid to be da bomb.

[Mikes]

I don't use my leak alarm. I, have set mine off inadvertently to many times by just moving at night.