First night with Hybrid

[yardbird]

YB,

Do you think the chin flap could tend to cause leaks in those areas especially when the jaw slacks?

I only used the chin flap a couple of nights, so my experience with it is nearly none.

Not sure, quite frankly. I'm assuming your description of some folks taping the flap means taping it to the outside of the frame. I tried just kind of peeling it back that way but it seems to deform the bottom of the face piece when I do that. Maybe I'll try experimenting on the medium face piece. If I can diminish the leaks on that one at least I'll have a bit better idea of how the mask changes with the flap removal.

[Maryb]

I am one of those hybrid users who leaves the flap on. I tried cutting it off and the mask moved all over my face.
The chin flap seems to help anchor the mask in place for me and I get less leaks that way. It also seems to work sort of as a chin strap for me too and holds my jaw in place.

If you are using the large cushion, you might try removing the chin flap from the medium cushion and try using that, just as an experiment.


Maryb

[yardbird]

Thanks! Actually I went up, got the mask and all the pieces. Tried the medium again.... just not quite enough coverage I think. Went back to the large, but now have the medium pillows. Loosened up the headgear and methodically (following directions) readjusted. Now I have the large cushion, medium pillows, and headgear adjusted so it's not so tight and then I went and layed on the bed and tried various positions and it seems much better. It leaks LESS with the straps loosened up a bit. Anyways.... the proof is i the pudding so I'm going to try again tonight with it set up this way and see how it goes.

[yardbird]

OK... obviously I need to work on this some more... can you tell where I took the Hybrid off and switched to my SwiftLT?

night 23 with Hybrid

[roster]

Looks like a large leak in the third bracket and then later another one that may have wakened you.

Outside those periods your leak still looks a little bit high. I don't have my Hybrid manual with me. Do you have one for the latest version of the shell? What does it show for passive vent flow at say 8 or 10 cm?

What is 'M' on the chart?

Do you think those are snores or brief mask leaks?

What is your target for hypopneas?

[yardbird]

When they sent me the new shell I didn't get a manual with it. I'll have to do some hunting to see if I can find the vent flow numbers.

I think the "M" corresponds to non-responsive events, but I'll have to confirm that as I can't remember. I know I only see them when I have large leak episodes.

Target for hypopneas? Well I'd LIKE to get them to zero, but as a reality check I'm thinking about picking up one of those CMS50E pulse oximeters to see if the hypopneas are causing significant desats. If they are... then I want to try to eliminate them to the greatest degree possible. If they AREN'T, then in my mind they become medically insignificant and I'll still try to improve them, but I won't go nuts if they are simply recorded numbers and simply informing me rather than hurting me.

I slept with the Swift LT last night just because I needed a break. With THAT mask I have no issues with mask leaks but I have issues with mouth leaks. According to my wife, I am not mouth breathing. I'm simply expelling air out of my mouth, "and when you DO breathe while the air is coming out, you're breathing really badly".

Taping is really not kind to my mustache ,which I have trimmed back severely in an effort to get the Hybrid sealed, but I'm not willing to part with the mustache just yet. Been married 30 years and my wife's never seen my upper lip.

When my jaw goes slack, that's when the hybrid leaks. If I could keep my teeth together with the Hybrid on I think I'd have the whole thing solved.

Chin strap? Not sure how that works with a full face mask. But I may try it. I may also try to engineer something. PapCap? LOVE the idea, but hate the thought of having all that coverage on my head. Kinda like wearing a helmet liner to bed. I know there's an answer to this. I just have to put it together.

[roster]

..........

When my jaw goes slack, that's when the hybrid leaks. If I could keep my teeth together with the Hybrid on I think I'd have the whole thing solved.

..........

Not liking to regularly take drugs, early this week I discontinued the daily Claritin I had been taking during this pollen season. Yesterday was windy and we did a five-mile hike/climb up one of the 900-foot peaks in the nearby park and then the entire afternoon was spent mowing, trimming and blowing.

Discontinuing the Claritin was a mistake paid for by congestion and mouthbreathing last night. I will try to remember this experience and use the Claritin every night for the duration of the pollen season.

Even with a slack jaw, I had no leaks last night. I am wondering if the chin flap is contributing to your leaks when the mouth opens. But I hate for you to permanently modify one of the cushions and then find out it doesn't help.

I am now looking at the graph, Passive Exhalation Port Flow, for the current Hybrid shell. A pressure range of 8 - 12 cm corresponds to a port flow range of roughly 37 to 43 liters per minute.

Regards,

[yardbird]

Even with a slack jaw, I had no leaks last night. I am wondering if the chin flap is contributing to your leaks when the mouth opens. But I hate for you to permanently modify one of the cushions and then find out it doesn't help.

I think it's time to slice the flap off the medium cushion and see if it cuts down on leaks. That cushion size leaks a little easier than the large I'm using, so if it works on that one, it should mean it'll work on the large.

I am now looking at the graph, Passive Exhalation Port Flow, for the current Hybrid shell. A pressure range of 8 - 12 cm corresponds to a port flow range of roughly 37 to 43 liters per minute.

And it looks like when the vent flow rates are in that range I have no events at all. Which leads me back to... if I can get the damn thing to stop leaking I might be in really good shape with this mask.

[roster]

...........
And it looks like when the vent flow rates are in that range I have no events at all. Which leads me back to... if I can get the damn thing to stop leaking I might be in really good shape with this mask.

I have discussed "allowable leak" with some other Hybrid users and their consensus is the machines can control their breathing with the Hybrid mask up to a leak of 60 lpm. In my own case, I believe my breathing is controlled up to about 75 lpm. But since I don't often get leaks, I don't have much experience to make that claim.

[DyannaK]

I am now looking at the graph, Passive Exhalation Port Flow, for the current Hybrid shell. A pressure range of 8 - 12 cm corresponds to a port flow range of roughly 37 to 43 liters per minute.

Regards,

I don't want to hijack this thread I just want to ask a quick question... I received the old Hybrid mask last Monday and have been using it every night but the leak numbers have been crazy, last night was over 84. I am hoping the new, updated Hybrid arrives today and I can use it tonight. My question is.. My pressure is 12, so are you saying that a leak rate that stays under 43 is ok? I just want to make sure I understand this correctly Thanks Rooster

[yardbird]

The updated Hybrid main shell has smaller vent holes so your leak rates should go down actually pretty dramatically. And yes, Rooster's got the manual and at 12cm your leak rate should be about 43 with the new shell. I received the old style originally myself. I called the manufacturer customer service and they sent me the new updated shell and also the new headgear(free). The old style headgear is all black. The new headgear is black on one side and gray on the other and it has a buckle on the top strap instead of the simple overlapping velcro that the old style headgear has. The new style headgear is much better made.

[DyannaK]

Thank you Yardbird I originally won this mask at the cpap auction site. It was advertised as the new Hybrid, but when I received it I realized immediately that it was the old mask. I wrote and let the seller know a mistake had been made and when I provided proof that the mask I was sent was the old model the seller very nicely replied that he would send me the new mask free of charge and I am to keep the old style mask. I am hoping the new mask shows up today.

I appreciate you taking the time to let me know about the leak information. For some reason I have a heck of a time getting my mind around the leak information and how to figure it Thanks again Yardbird

[roster]

I am now looking at the graph, Passive Exhalation Port Flow, for the current Hybrid shell. A pressure range of 8 - 12 cm corresponds to a port flow range of roughly 37 to 43 liters per minute.

Regards,

........My pressure is 12, so are you saying that a leak rate that stays under 43 is ok? I just want to make sure I understand this correctly Thanks Rooster

YB is correct.

Going a little farther, at 12 cm pressure 43 liters per minute will flow through the exhalation port no matter what (within reason ).

If you see 60 lpm on your data, it means 43 went through the vent holes and 17 was "true" mask leaks.

My friends would say a leak rate of 60 or less will not adversely affect your therapy.

[DyannaK]

YB is correct.

Going a little farther, at 12 cm pressure 43 liters per minute will flow through the exhalation port no matter what (within reason ).

If you see 60 lpm on your data, it means 43 went through the vent holes and 17 was "true" mask leaks.

My friends would say a leak rate of 60 or less will not adversely affect your therapy.

Thank you very much Rooster I very much appreciate you taking the time to help me with this... I am going to copy this information down so I have it handy

[roster]

I just now realized you have a ResMed machine and I was talking about Respironics or IntelliPap.

We need to get a ResMed user to explain how the ResMed machines record leak. What I understand is you set your mask type and ResMed subtracts the exhaust vent design leak from the total leak. For instance where another brand of machine would record a leak of 43, a properly setup ResMed machine would subtract the design leak (43) and report a leak of zero.

So my comments about 60 cm leak being OK, do not apply to ResMed machines. With a ResMed machine a reported leak of 60 would actually be 60 plus 43 design leak equals total leak of 100 as a Respironics machine would report.

I think my examples are correct but it would be better if a ResMed user chimes in.