Two Noise Issues - Mask/Breathing and Machine Noises

[restoresleep]

Been using an AirFit F20 and ResMed AirSense 10 AutoSet for about 2 months. Overall the treatment has been peachy and has massively improved my day-time tiredness and fogginess.

When I first got the machine it was virtually silent and my breathing also went from heavy deep breathing to silent. However, over the past 2 weeks, two noise issues have developed that are affecting my wife's sleep in particular.

My details: 37 year old male, 4 years day-time tiredness, resulted in time off work. Sleep study (link to jpg of report: https://ibb.co/6D8CWPr) revealed moderate OSA (AHI = 15.2 on home sleep study).
APAP details: I'm a mouth breather so use full face mask (AirFit F20). Used for 65 out of 71 days. Average of 7 hours 51 mins of use per night. Average AHI = 3.95. Machine is set to 4.0 minimum and 20.0 maximum pressure. Average pressure = 5.88 (min = 4, Max = 13.28).

Issue #1: Heavy Breathing While Wearing the Mask
My wife is now waking up as a result of hearing me breath heavily while I'm using APAP. This was previously an issue before I started APAP but has now started while I'm using it. I've never had the 'classic' cartoon type snore, mine is more of whooshing as I breathe out.

Roughly 2 weeks before this heavy breathing started I had reduced the humidity and tube temperatures because I was waking up with a significant amount of drool in the mask. These changes have greatly reduced the drooling, however I'm wondering if potentially the drop in humidity could have any impact on this re-appearance of the heavy breathing?

I have made no other changes to the treatment settings, have not gained or lost weight, have not increased/decreased alcohol intake etc. The heavy breathing happens regardless of the position I sleep in.

From what I have read online, if I am snoring while using APAP it indicates the pressure is too low, so would this suggest that I need to increase the minimum pressure? However, based on the second noise issue below, I'm wondering if they could be at all related and there could be something wrong with the machine that it's not detecting this breathing and ramping up the pressure to reduce it. At the bottom of this post I have included the recording from last nights sleep. The snoring that woke up my wife occurred at approximately 4:40am. The "Respiratory Rate" graph at this time shows a big increase but the "Snore" graph shows no snoring occurring so I'm wondering how to maybe get the machine to 'respond' to this breathing to potentially reduce the noise.


Issue #2: Whine Noise from Machine
As a result of waking up my wife (and myself as a result), we are hearing a whine from the machine for every inbreath. This noise doesn't occur when I breath out and doesn't occur when I first turn on the machine and go to sleep - I believe this noise only occurs when the pressure ramps up but the maximum pressure the machine has ever reached is 13.28 while I'm wearing it so this still seems pretty low compared to other OSCAR reports I have seen posted here. This is a link to the recording of the noise - https://voca.ro/11YgLDaPz63K. On PC speakers the sound is duller than it actually sounds but on an iPhone it sounds more accurate.

Whilst my wife is a bit sensitive to noises at night I would fall asleep to heavy rain, strong white noise, listening to podcasts etc. but this whine noise even bothers me a lot. I have to turn the machine off and on again to get the noise to stop so I can get back to sleep.

The machine was brand new (0 hours of use) and has approximately 550 hours of use by me in the 2 months I've had it. Would this noise indicate a fault in the machine? I've seen multiple posts about noises and based on them have checked all seals are tight (e.g. humidifier correctly seated), the filter is spotless, the machine sits on a thick towel and is below the level of the mattress.

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[Julie]

Raise your min. pressure to 6 or 7 for a few days and see how that works (it should certainly help) as 4 is the machine default low and most cannot breathe well at that setting.

[Miss Emerita]

It sounds as though you've checked what you need to check on the machine, so I would take the machine issue up with whoever provided it. It shouldn't be making that noise. Tell the provider it's bothering your spouse as well as yourself.

Try experimenting with the humidity and tube temp to see what happens. I can't myself think why that should matter, but actually returning the settings to where they were is the best way to see if there's something going on there.

I also wonder whether the heavy breathing mainly reflects an elevated respiration rate. In turn, I also note that the increased RR more or less correlates with periods of flow limitation. (FLs occur when the tissues lining your airway relax a bit, causing you to work harder to complete inhalation.)

The main tool for reducing FLs is pressure support -- on your machine, EPR. So in addition to raising your minimum to 7, as Julie recommends, I'd also recommend setting the EPR to 2 to see what happens. If that goes well, you can then raise it to 3. I'd also suggest turning off the ramp. If you feel you need it, I'd recommend changing the ramp settings to a pressure of 6 and EPR of 2.

[Rokitman]

Hi Restoresleep, this noise on inhalation you have attached to your message is identical to the noise we are getting from my husband's machine. He had a trial machine previously and it was quiet but since owning this brand new machine it is very noisy each night. We too have checked out a few connections but can't work out what the problem is. The sound seems to be coming from the machine itself where the hose connects. The only changes we have made to this machine by memory are his pressure may be set higher than what we were trialling and also he doesn't use the humidifier. Did you have any luck working out what the problem is? Could it be we have faulty machines? Thank you

[loggerhead12]

. . . I would take the machine issue up with whoever provided it. It shouldn't be making that noise. Tell the provider it's bothering your spouse as well as yourself.

Seconded.

[LSAT]

Here is something to try....use the humidifier, put water in but leave the humidity turned off. The water buffers the sound but it will not heat up and form humidity.

[bernieb]

I had a very similar problem of noise when inhaling. I called my DME and let them listen on the phone and they diagnosed it as bad bearing sound, so they replaced my machine.

[restoresleep]

Thanks for all the replies, really appreciated!

Raise your min. pressure to 6 or 7 for a few days and see how that works (it should certainly help) as 4 is the machine default low and most cannot breathe well at that setting.

Will give this a try and see how it goes!

The main tool for reducing FLs is pressure support -- on your machine, EPR. So in addition to raising your minimum to 7, as Julie recommends, I'd also recommend setting the EPR to 2 to see what happens. If that goes well, you can then raise it to 3. I'd also suggest turning off the ramp. If you feel you need it, I'd recommend changing the ramp settings to a pressure of 6 and EPR of 2.

Will do this too, thanks for the suggestion!

Hi Restoresleep, this noise on inhalation you have attached to your message is identical to the noise we are getting from my husband's machine. He had a trial machine previously and it was quiet but since owning this brand new machine it is very noisy each night. We too have checked out a few connections but can't work out what the problem is. The sound seems to be coming from the machine itself where the hose connects. The only changes we have made to this machine by memory are his pressure may be set higher than what we were trialling and also he doesn't use the humidifier. Did you have any luck working out what the problem is? Could it be we have faulty machines? Thank you

I had a very similar problem of noise when inhaling. I called my DME and let them listen on the phone and they diagnosed it as bad bearing sound, so they replaced my machine.

Rokitman, I got the machine directly from ResMed here in Ireland. I spoke with one of their nurses and she said it sounded like the motor is faulty (so very similar to bernieb), so they have sent me a brand new machine. They didn't actually want to hear the recording I made, just trusted my description of the issue and my own best verbal replication of the noise. If yours is making a similar noise then it may be the motor is kaput already, perhaps a manufacturing fault that thankfully shows up quite quickly since my machine was only 2 months old with a bit over 500 hours of use.

Here is something to try....use the humidifier, put water in but leave the humidity turned off. The water buffers the sound but it will not heat up and form humidity.

I trialled removing the humidifier for two nights and woke up with a desert mouth, so do need a small level of humidity. ResMed have said the noise sounds like a fault so thankfully I've got a new machine and don't need to try to buffer the sound, but thanks for the suggestion!

[Rokitman]

Thanks restoresleep and bernieb for your replies. My husband's machine is also only a few months old and i would say the noise has been present from the start. I will contact Resmed here in Australia where we purchased it from

[restoresleep]

Just to provide a follow-up for others in a similar situation.

I got a brand new machine from ResMed. This one came fresh out of the box with a consistent humming noise that became louder on exhale. When I placed my hand on this machine there was a vibration coming from it when I exhaled - this vibration wasn't on the first machine that also had a noise issue, so likely two different issues. Although not particularly loud neither my wife or I could get to sleep with the humming noise. Here's a link to the humming noise, though the recordings don't do it justice and it sounds duller on this recording (you can hear it most when I stop the inhale): https://vocaroo.com/1l0yDkZqOADp

Got back onto ResMed, had to send them both machines for some diagnostic testing. They came back saying both were too loud and both were faulty so I'm now the owner of a third machine in as many months.

The service I've received from ResMed has be stellar in fairness to them, been extremely responsive and quick to get me new machines. However, the machines have made things a tad frustrating.

Keeping my fingers crossed all goes well with my third machine.

[zonker]

Just to provide a follow-up for others in a similar situation.

thanks for the update, so many people don't.

Keeping my fingers crossed all goes well with my third machine.

good luck!

[restoresleep]

Saga continues...

This might get confusing, but when I got the third machine I felt that the 'typical' noise from the machine (not a whine, just the whooshing that it makes naturally with each breath) was louder than the first machine while the first machine was working well. Called ResMed and they sent a fourth machine. The fourth machine had a whistle straight out of the box which ended up being sent back and accepted as faulty.

Going back to the third machine... they checked it and said it was within normal noise limits so I have been using the third machine since then. However, as of a day or so ago, this third machine has started to whistle...and I'm starting to become paranoid that there is something I'm doing to these machines that is causing them to fail or be faulty...

Summary
Machine #1 - Confirmed Faulty by Resmed - Noise it made after ~550 hours of use = https://vocaroo.com/11YgLDaPz63K
Machine #2 - Confirmed Faulty by ResMed - Noise it made straight out of the box (zero hours) = https://vocaroo.com/1l0yDkZqOADp
Machine #3 - Unconfirmed Yet - Noise it is now making after ~350 hours of use = https://vocaroo.com/1mTft1uj7QIP
Machine #4 - Confirmed Faulty by ResMed - Noise it made straight out of the box (zero hours) = https://vocaroo.com/1fcRN01Hl34u

I use ResMed AirFit F20 Full Face Mask with ResMed AirSense 10 AutoSet. I use the climateline and as I struggle with drool I found the best solution is to keep the humidifier in place with water in it but not use the humidifier. When I removed the humidifier I had too dry a mouth and would wake up. I don't wake up with any condensation in the mask.

The machine sits on a folded towel and when checking the white filter piece it is as clean as a whistle, so it doesn't appeared to be dust getting into the machine or anything. Given that two of these machine have been faulty straight out of the box is it possible that ResMed where I am have a bad batch or something?