H3i humidifier problems

Staedtler · Post by **Staedtler** » Thu Nov 09, 2006 9:18 pm

So having spoken to someone different at my DME, I seem to be getting actual assistance with my sleep apnea, and not with emptying my bank account. :-)

I was doing a CPAP trial using a ResMed Sullivan V Elite (a unit at least 5 years old), set at 7 cmH2O. I also had a ResMed Sullivan Humidaire, and a ResMed Mirage II full-face mask. My adventures with that setup are documented here and here.

My DME is finally upgrading their loaner units, and I now have an S8 Elite, with H3i heated humidifier, and an Ultra Mirage full face mask. The CPAP is now set at 10 cmH2O (since I wasn't really experiencing significant improvements at 7 cm after 5 weeks). One of the big benefits of the switch is that the S8 records data, and I'll finally get to know what's happening while I'm asleep.

Already I have a significant problem: my mouth is bone dry in the mornings. I set the H3i humidifier to 5.5 (out of 6), which is comfortable for me at night before I'm asleep. I fill the tank to the max line at night, and in the morning it seems to have dropped almost 2/3 -- the water level is at the clip where the H3i's lid latches into place. Even though there still seems to be a significant amount of water there, the air I'm breathing has no apparent moisture (otherwise I figure I'd be able to swallow).

I am a mouth breather at night, which is why I have the full face mask. I'll point out that when I wake up (still quite groggy and extremely tired), my mask leaks significantly (mostly around the sides and bottom of the mouth), and it's difficult for me to reposition it to stop the leaking -- mostly due to the oils on the mask lining from my face. The mask fits fine before I fall asleep.

I've been trying to find posts about the H3i, and it seems that this problem is unique to me. So I'm wondering if the dryness can be due to the mask leak? Or is it something to do with the design of the humidifier itself?

rested gal · Post by **rested gal** » Thu Nov 09, 2006 9:35 pm

The 2i heated humidifiers I used with a resmed's Spirit autopap and VPAP III bi-level never seemed to put out as much humidification even when cranked up all the way as the Respironics integrated humidifier or the Fisher & Paykel HC 150 humidifier do at just the halfway mark for heat adjustment.

Aside from that, I have to say I get an extremely dry mouth from breathing through my mouth with a FF mask, no matter how good the heated humidifier is.

Dry mouth with a FF mask is just one of the many reasons I tape my mouth at night -- so I can use nasal pillows masks I find much more comfortable and more leakproof than a FF mask.

Of course, if a person absolutely cannot breathe through at least one nostril all through the night, that kind'a leaves you stuck with using a FF mask.

dsm · Post by **dsm** » Thu Nov 09, 2006 9:39 pm

Know what you mean,

I have an Escape with 3i but am
currently using my Remstar Auto with its integrated h/h
usually use I would an F&P HC150 h/h (with a PB330)
I also often use a VPAP III with its 2i h/h.

But lately, I too find my mouth dry even though I nealry empty these tanks. The only one that doesn't always feel this way is the F&P HC150 but to avoid dryness I have to crank up the dial on it & if I do mostly nose breathing I get to much moisture.

This problem of mixed mouth / nasal breathing is a real 'bummer' & one that is hitting me just at the moment & I don't yet have a good answer for.

DSM

GoofyUT · Post by **GoofyUT** » Thu Nov 09, 2006 9:40 pm

I have a ResMed S8 AutoSet Vantage/H3i, as well as a REMstar Auto w/ REMstar humidifier. I find that the H3i humidifies as effectively as the REMstar humidifier does, but I do need to set the H3i somewhat higher than the REMstar (3.4 -v- 1).

I'd look into mask leaks if I was you. BTW, I think that the ResMed S8 Elite is the very best staright CPAP made.

Cheers!

Chuck

Snoredog · Post by **Snoredog** » Thu Nov 09, 2006 10:22 pm

I had the H2 humidifier on my Spirit, I thought it worked very well. Yours is about the same design just changed to fit the newer machine.

You will go through more water if you have excessive leaks or mouth breathing.

You need to get a handle on any type of leak as that can cause you to go through a lot more water and still end up dry (ask Nurse33 how she does it ).

Try putting in warm water to start and see if that helps. On that machine I would get a small plastic 3" diameter funnel from hardware store and some 1/2" ID clear tubing, try and get tubing at the end of a reel or that has been rolled on a reel it will have a natural curve to it, cut a curved piece about 6" long slip it over the funnel end.

Now you can remove the hose from the machine, insert the funnel tube where the hose goes and pour water directly in that horizontal hose port via funnel without removing the tank from the machine each time.

If you only use distilled water in the tank, you only have to clean it every couple weeks.

Pete · Post by **Pete** » Fri Nov 10, 2006 4:55 am

Staedtler

I've got the S8 spirit (uk version) (same as US S8 the only thing changed is the name and the price... only $985 and thats just the machine no h/h or mask....) the H3i h/h and the Mirage full face mack....

I am also very very dry after only an hours use, with the h/h set on max, I think this problem is nothing to do with the equipment but the patient, some of us are obviously just dry...

I think the answer is to try to use a nose mask and not mouth breathe

I suffer numerous allergies so my nose is always blocked, I have been trying nasal irrigation for only a couple of days now and already I can notice a big difference... so hopefully I will be able to try this soon

My wife also like the idea of mouth taping and has asked if I could do it first thing in the morning for that nights sleep.....LOL

I'm also going to take up the dijjereydoe when I've learnt how to spell it...

Pete

Staedtler · Post by **Staedtler** » Sat Nov 11, 2006 1:35 pm

I wrenched my mask tighter, and leaks don't seem to be an issue anymore (I'll only know for certain once I get to see the data at my DME). But the morning dryness continues. Plight of the mouth breather, it seems.

I'm convinced now the H3i has a design flaw. My poor verbal description is as follows: back when I had the old Sullivan Humidaire, I noticed the water tank had a plastic "wall" in it that forced air to travel farther across the water's surface. The wall prevented the airflow from going directly from the in valve to the out valve. It seems obvious that the longer the air is over water, the more humid it will get.

The H3i seems to ignore that tenet. As air enters the water tank, it meets a little tiny "wall" that stops it from going straight to the out valve. However, this wall is so short that, as the water level drops, it seems air can pass right under it and into the out valve. By morning, the water level is low enough that it seems the airflow might not even touch it at all.

If this weren't a loaner unit, I'd be willing to modify the water tank to increase the size of that internal "wall" and see if that really is the cause of the dryness. But as it stands, the H3i simply doesn't work for me, and I'd never purchase one for myself.

birdshell · Post by **birdshell** » Sat Nov 11, 2006 3:02 pm

It is a mystery to me why there would be inadequate humidity from the Humidaire 3i. I have the S8 Compact (see, I'm getting the correct name now.)

Since childhood, humidity has been a big issue for me, as without sufficient humidity I have much more of a tendency for nosebleeds. (Of course, there are other factors.) I also disliked air conditioning for its drying effect. (I do love air conditioning for its cooling comfort, though.)

I have also had to have a winter humidifier that keeps a relatively high percentage of humidity in the winter.

I find the Humidaire 3i to provide MORE than enough humidity for me. In fact, if the XPAP is warmed up for a few minutes, the CL 2 direct seal is fogging when I put it on. I run it on 4+ most of the time.

I'm no engineer, but it does seem to me that the "wall" or baffle in the 3i need not be any larger IF it is providing sufficient air flow. In other words, it isn't the size of the wall that counts, it is what it does to the air. Seems to me that without conducting one's own airflow tests, that would be a tough call to support.

As a species we are always trying to improve (I think....) and the humidifier design may have been a result. ResMed DOES seem to have a flair for design, as Chuck points out. Now, their policies and marketing may be a different story, eh?

With all of that said, we all have to find the methods of treating our CPAP that work best for us. Choosing the mask/interface is not the only important factor in effective treatment. Staedtler--I truly hope that you find a machine with a humidifier that works well for you.

Staedtler · Post by **Staedtler** » Sat Nov 11, 2006 3:25 pm

Well, it certainly baffles me that ResMed would release a product that doesn't work; and yet there's water in the tank, the heater is at max, and dry air is being pumped to my mask. It is foolish of me, though, to assume a design flaw when I don't know enough about the technology (I'm sure sleep apnea and depression aren't the only reasons I dropped out of university engineering. :-) ).

Pete and I seem to have the same experiences with the H3i. I did not experience this problem at all with the old Sullivan Humidaire. And finally, many people have great success with the H3i. Perhaps Pete is right, and the H3i just doesn't do the job with some patients. :-/

birdshell · Post by **birdshell** » Sat Nov 11, 2006 3:35 pm

Even the best product can be defective...

billbolton · Post by **billbolton** » Sat Nov 11, 2006 5:41 pm

Staedtler wrote:Well, it certainly baffles me that ResMed would release a product that doesn't work; and yet there's water in the tank, the heater is at max, and dry air is being pumped to my mask.

If I run my H3i at a knob setting of about "2 o'clock" I go through about half a tank of water a night when using a Fisher and Pykel nasal mask. If it is set at maximum (which happened once by mistake) I go through pretty much a full tank. This is for usage in a temperate seabord/maritime climate with moderate to high ambient humidty in the incoming air, most of the time.

If everything is connected properly to the H3i, the water has no place to go but up the hose... what happens after that is up to you and your mask

Cheers,

Bill

Staedtler · Post by **Staedtler** » Sat Nov 11, 2006 6:33 pm

I'm going to try a setting of 3 tonight, and I'll see how I feel in the morning.

gsacca · Post by **gsacca** » Sat Nov 11, 2006 6:50 pm

I have been on treatment for 9 days and have had similar issues with the humidifier. I have only had 3 nights that the tank showed any signs of evaporation. When I asked the DME, her response was "maybe that is how it is supposed to work."
I have been having ongoing problems with the DME and my doctor to try to get the proper equipment. Since I am on a rental program right now, I will continue to fight and will not allow the insurance company to purchase this until I am 100% convinced that the machine and humidifier are working properly and what I need.
The mask is another issue and adventure entirely!

dsm · Post by **dsm** » Sat Nov 11, 2006 7:09 pm

[quote="Staedtler"]Well, it certainly baffles me that ResMed would release a product that doesn't work; and yet there's water in the tank, the heater is at max, and dry air is being pumped to my mask. It is foolish of me, though, to assume a design flaw when I don't know enough about the technology (I'm sure sleep apnea and depression aren't the only reasons I dropped out of university engineering. ).

Pete and I seem to have the same experiences with the H3i. I did not experience this problem at all with the old Sullivan Humidaire. And finally, many people have great success with the H3i. Perhaps Pete is right, and the H3i just doesn't do the job with some patients. :-/

Staedtler · Post by **Staedtler** » Sat Nov 11, 2006 7:13 pm

At a setting of 5.5 (out of 6), last night used up 28mm of water in the tank.

Machine	Mask

Additional Comments: Airmini, Medistrom Pilot 24, CMS 60C Pulse Oximeter, ResScan 6