Is there a mask with a decent enough check valve to release your exhale?

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Johnds
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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by Johnds » Fri Jan 03, 2020 2:34 am

Thanks for that. I will definitely try increasing pressure. I just don't see how increasing pressure will help with an exhale snore. Isn't the pressure irrelevant on exhale? During an exhale there is no inward pressure from the machine to push my uvula out of the way(I am talking about with a nasal mask). What I was explaining was my uvula was getting pushed backward with my exhale and blocking the nostril passage, the air is only going in one direction at this point on exhale through nose.

I'm sorry, one of the questions from earlier was supposed to read "what is the difference between nasal pillow and nasal **cushion"
I will try the pressure increase. I haven't tried past 11.

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Jas_williams
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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by Jas_williams » Fri Jan 03, 2020 4:00 am

If you used to using a respirator at work with no warmth and humidity, turn the heated hose and humidifier off, I don’t like the warm moist air I removed the humidifier and use a non heated hose on my machine

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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by realshelby » Fri Jan 03, 2020 6:59 am

Let me give you some...confidence that help is coming. Most of these problems are easily solved. Some of the problems are likely not problems, but they still effect you until you understand them better.

Cpap pressure, even on exhale when it is reduced, DOES keep the airways open. Exhale means you are pushing against the incoming inhale pressure, but it still means your airway is "pressurized". If your machine is set on 8 with no exhale relief, there is always 8 inches of water pressure in your airway. Exhale relief will lower that up to 3 inches of water pressure ( in normal cpap use ) but you would still have about 5 inches of pressure keeping your airways open. Or at least trying to, and that is where the knowledge here will help you find what pressure you need to get to.

P30i vs N30i: I have both. They both vent at the top hose connection in the elbow. That seems a good distance for exhaled air to travel to get out, but you CAN feel warm exhaled air come out of this vent. They both also have a highly diffused venting system built into the cushion or pillow. You can hardly feel the air coming out of these, but wet your hand and then feel the air. More comes out than you might have thought! So, both models have TWO venting systems.

The N30i has a cushion style nose interface that seals up by simply sticking to the skin around your nostril area. The P30i seals with two cone shaped "pipes" that just touch and conform to the outer area of your nostril. While they may enter slightly, it isn't really what you would call inserted into your nostril. Both are comfortable. The P30i gives a more reliable seal and allows or forgives side sleeping better when you bury your head into the pillow. The size of the cushion/pillow you use makes a dramatic difference in how easy it is to inhale with them! You want the one that fits your nostril better for sealing, don't be tempted to go too large. The ResMed P10 is another nasal pillows style mask. It only vents out around the nose piece but it moves more exhaled air out of these highly diffused vents than you might guess. It is very comfortable and easy to "accept" as a new user. These masks are designed to allow enough air in and out when the power goes out and the machine is off for you to get enough air.

I have found that overall the pillows style masks with the cone shaped pillows are the easiest to breath through. That said, until you learn to calm down and settle down, there will be times when you find the mask feels restrictive while awake. You learn to deal with that and once you realize all is good, things are much better.
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Johnds
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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by Johnds » Fri Jan 03, 2020 8:33 am

Thank you. I really appreciate everyone's help. I'm gonna work on getting a more updated machine and get the Bleep and also the nasal pillow model. Cranking up the pressure to get air moving out of the mask makes sense too so I will be trying that as well. I will report back with results as soon as I can. Thanks again.

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Pugsy
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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by Pugsy » Fri Jan 03, 2020 11:08 am

If you do get a more current machine....go with the ResMed AirSense AutoSet 10 models. The exhale relief is superior to the Respironics and I think you might benefit from it more.

Respironics Flex exhale relief is flow based in terms of how much of a drop in pressure during exhale that you can actually get and the maximum available is a 2 cm drop and that's only if you breathe rather forcefully. Even at a setting of 3 the most drop a person can get is 2 cm. ResMed will let you drop 3 cm during exhale and that 1 cm more difference can feel rather substantial. It simply feels better and feelings or perceptions are very important.

I have used both brands in their auto adjusting models...trust me...there's a reason I recommend ResMed over Respironics.
Respironics are good machines but in most situations the ResMed is simply going to be better in terms of how the features come across to the patient. The auto adjusting algorithm is better IMHO and they are slightly quieter overall.

I will address your Bleep questions in a separate response.

Take a look at the ResMed Swift FX Nano if you really like the over the nose cushion kind of mask. IMHO...the only over the nose mask that I would want to try to use for myself. Which I know doesn't mean much but when you ask for mask options you are going to get personal experience responses. It's just how we work here. We are going to tell you what works for us. :lol: Take what we say with a grain of salt.

About supine sleeping....often when we are on our backs our OSA is made worse (same thing can happen in REM stage sleep) and we simply need more minimum/baseline pressure to better hold the airway open when we are on our backs than we might need when on our sides. Now sometimes the pressures needed are significantly different. Like I know one guy who needs a pressure of 19 when on his back and 9 when on his side. He preferred to alter his sleeping position and learned to be happy sleeping on his side. 19 cm is doable but it's a lot easier to use 9 in terms of leak management and comfort.
If you want to sleep on your back primarily the minimum pressure is going to be your most critical setting choice and if you are still snoring a lot when on your back then you simply need more minimum to do a better baseline holding open of the airway.
When people use any form of exhale relief....that also impacts that minimum baseline pressure and sometimes adjustments have to be made in the minimum so that people can use the exhale relief that they prefer.

I would really like to see a typical detailed report from your machine before offering actual setting options. I don't like guessing.

I think people should sleep in whatever position they want to sleep in because I think getting sleep is the most important thing here.
Without sleep none of this stuff really matters. I think if someone sleeps better on their back then we just adjust the settings to deal with any worsening of the OSA that supine sleeping brings if that is what they want to do.
It's usually fairly easy and it's really rare for someone to need 19 on their back and 9 on their side.

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Pugsy
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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by Pugsy » Fri Jan 03, 2020 11:56 am

Your Bleep questions.

The hose that comes with the Bleep is a shorter hose and it is less flexible than other short hoses that come with other nasal masks.
It is still flexible though...just not as flexible as other hoses. Part of that problem is the length...it's so short we don't really see the flexibility it does have because there's not much to be flexible.
Now some people don't like the shorter length or the less flexibility but they like the Bleep otherwise...easy solution...do a bit of surgery on one of the longer more flexible hoses and stick it on the Bleep. Easy solution.
I was okay with the shorter hose myself because I always found the longer short hoses with other masks more annoying and in my way....but that's me and how I prefer to route my hose in relation to where the machine is. My machine is very close to my head and so much hose between the 6 ft long hose and the 18 inch (typical short hose length) just simply made for a lot of hose around my head.

The biggest drawback to using the Bleep....those stick on ports because they are a one night of use thing. You need a new stick on port every night. There is simply no way to reuse them because the adhesive is designed to stick well for one night only. I have not been able to find a suitable alternative either that was less costly than the per night cost of the stick on ports. There are some adhesives that would maybe last longer than one night but to make your own ports by sticking them on a different adhesive would end up costing about 3 times what the Bleep port costs because the adhesive was simply very expensive. Not to mention the extra work needed to clean up the plastic port and stick it on the adhesive in a manner that would stay put all night.
Most insurance will pay for the nightly replacement ports equal to what they normally pay for replacement nasal pillows or cushions.
One box of 32 ports equals 16 nights...roughly 2 weeks...and replacement pillows or cushions are normally allowed at a 2 per month rate. Medicare allows 2 per month...so 2 boxes equals one month and at that rate insurance will normally cover the cost.
Now if someone has insurance that has a big deductible...that will be a problem or they happen to have insurance that doesn't allow 2 per month...obviously the cost is going to be a problem for some people.

What it boils down to is how much do they really want to be using the Bleep vs some other more traditional mask.
Is it worth the cost? For some people it will be and for some people it won't be.. That YMMV thing again.

I have had the short hose pop off the mask part but it has been a really rare occurrence....and every time it was my fault as I ended up laying on it in a way that put extra torque on it. It really doesn't come off very easily for most people but if it did there are things we can do to reduce that from happening.

As far as the hose causing the adhesive to pull off the nose...not if I do my skin prep prior to applying the ports. When done properly those suckers are stuck on like crazy glue and require a lot of effort to get off. Again a YMMV thing because some people have very oily skin and during the night the normal production of oils or sweat can affect the adhesive itself.

The Bleep has some vent holes where the exhale breath goes. They aren't diffused holes...the venting force is rather pronounced even at lower pressures (I use an 8 cm minimum inhale and 4 cm exhale since I use a bilevel machine).
Most of us found that forceful venting annoying so we made a little diffuser out of some material to lessen the force so it was less annoying. Another YMMV thing.
The vented air force is going to be very noticeable though and might make you feel better mentally about your problems with the air being vented.

I am still using my original Bleep mask and short hose that I got mid December 2018....so over 1 year of use and it's still working just fine.
A bit yellowed (all silicone will age and turn yellow with time when exposed to the air and sometimes even if not exposed to air) but doesn't affect function. Looks a bit ugly but that's it.
The nightly cost of the ports is the biggest money factor cost. Buying in bulk can help reduce that cost.

It's worth it to me...I hate the headgear side of cpap masks. Been over 10 years now and I still hate it no matter how comfortable it might be. I get dents on my face/cheeks from the straps even if I use padding on the straps. I hate the dents.
The strap pressure also causes me to have big huge bags under my eyes sometimes because they restrict the normal dispersion of the fluids under my eyes. I hate waking up with a huge bag under my eye that takes half a day to disperse.

My advice to anyone regarding any mask....if it looks interesting to you then give it a try. Looking interesting is a good enough reason to try something if that's what you want to do. I have tried probably well over 40 masks just to be trying something...I like to experiment.
I always learn from my experiments. Now sometimes all I learn is what a bad idea that experiment was but I learned something.
With any experiment we usually learn more about our own preferences, wants and needs and that enables us to make better educated decisions about trying the next mask that might look interesting to us.
Most of my experiments have been with used masks...either free used or at a really reduced cost used. This free return insurance thing is relatively new from cpap.com. We used to have to pay a little extra for return insurance.

Cpap.com does require a RX to be on file for complete mask package purchases and you only get free return insurance on complete mask packages.
Replacement parts don't require a RX and while it is often possible to combine replacement parts to build a complete mask...they don't come with return insurance being available.

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ChicagoGranny
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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by ChicagoGranny » Fri Jan 03, 2020 12:05 pm

Johnds wrote:
Fri Jan 03, 2020 1:11 am
So after this, I'm almost certain I'm rebreathing my own air upon inhale when everything is attached and running. What a poor design.
Trust the technology. It's been around for about 40 years. Nightly, tens of millions of people use it to sleep and breathe well. Between Gramps and I, we have about 35 years of successful use every night. At our advanced ages, we are both sure that we would have been dead now without CPAP.

With the help you are getting here, it seems you are beginning to gain confidence. Anxiety over the process and a new way of sleeping is common with newbies. Confidence, experience and the help of the support team here will overcome the problems.

Welcome and good luck!

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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by Johnds » Fri Jan 03, 2020 12:59 pm

Thanks again. I have some good news atleast for now. I set the machine to auto and set the min and max pressures at 10 and 20. The system now reads "A flex" instead of "C flex+". I didn't try laying down yet but I tried watching TV sitting up on couch slightly leaning back with my head at a 45 degree angle back. I don't feel the warmth anymore so I guess it's because of the increased pressure...and this is with the diffuser filter on and I was able to stay in that position for about an hour. I don't believe I went into a sleep, but I didn't notice any snoring on the way out with exhale. Everything felt comfortable. Only thing is I noticed my mouth was letting air out once once in a while. Going to bed and laying down flat is a different animal though and I'm hoping for the best tonight.
It's kind of frustrating and scary. Hopefully with these setting I don't feel so suffocated laying down.

How can I reset the chip from my father's use and provide you with the results of my own I have no idea how to do this.

I really appreciate how informative everyone is. Thanks so much. I will report back.

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palerider
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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by palerider » Fri Jan 03, 2020 1:18 pm

Johnds wrote:
Fri Jan 03, 2020 12:59 pm
Thanks again. I have some good news atleast for now. I set the machine to auto and set the min and max pressures at 10 and 20. The system now reads "A flex" instead of "C flex+". I didn't try laying down yet but I tried watching TV sitting up on couch slightly leaning back with my head at a 45 degree angle back. I don't feel the warmth anymore so I guess it's because of the increased pressure...and this is with the diffuser filter on and I was able to stay in that position for about an hour. I don't believe I went into a sleep, but I didn't notice any snoring on the way out with exhale. Everything felt comfortable.
NOW we're cooking!

Yes, the vent rate increases with pressure, below is a fairly typical pressure/vent chart:
Image

What I do is put my hand in the airflow, and I can feel the change in temperature as my breath is flushed out, when I exhale, the air is warmer, then as all the breath is flushed out of the mask, the air cools, before I'm ready to inhale again.
Johnds wrote:
Fri Jan 03, 2020 12:59 pm
Only thing is I noticed my mouth was letting air out once once in a while. Going to bed and laying down flat is a different animal though and I'm hoping for the best tonight.
Some folks end up using tape on their lips, or a double sided boil and bite mouth guard... or a stretchy headband over the lips to help with that when they're wearing a nasal mask or a pillow mask, or the bleep.
Johnds wrote:
Fri Jan 03, 2020 12:59 pm
It's kind of frustrating and scary. Hopefully with these setting I don't feel so suffocated laying down.
If you don't feel suffocated while sitting up, why would you feel suffocated laying down?
Johnds wrote:
Fri Jan 03, 2020 12:59 pm
How can I reset the chip from my father's use and provide you with the results of my own I have no idea how to do this.
Format the chip, pop it back in, then read this:
http://cpaptalk.com/wiki/index.php/Oscar:organize

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Pugsy
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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by Pugsy » Fri Jan 03, 2020 1:28 pm

I know that AFlex and CFlex aren't supposed to feel that differently but to me they did.
I tried both and CFlex was pretty much useless. Couldn't tell it did a damn thing but once I got a chance to try AFlex it was a game changer for me. Fell in love immediately.

Way back in the dark ages with my very first Respironics auto adjusting M series machine it only had CFlex available...worthless for me.
Now my second M series apap had AFlex available and that's when I got a chance to try it. Never used the CFlex only apap again. Sold it.

The difference is ever so slight on paper but in real life any small changes in anything can be huge.

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palerider
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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by palerider » Fri Jan 03, 2020 3:29 pm

Pugsy wrote:
Fri Jan 03, 2020 1:28 pm
I know that AFlex and CFlex aren't supposed to feel that differently but to me they did.
I tried both and CFlex was pretty much useless. Couldn't tell it did a damn thing but once I got a chance to try AFlex it was a game changer for me. Fell in love immediately.

Way back in the dark ages with my very first Respironics auto adjusting M series machine it only had CFlex available...worthless for me.
Now my second M series apap had AFlex available and that's when I got a chance to try it. Never used the CFlex only apap again. Sold it.

The difference is ever so slight on paper but in real life any small changes in anything can be huge.
Some people are much more sensitive to feeling the fairly slight pressure changes of the different flex variants than others... I really couldn't tell any difference, but honestly, back then, I didn't even know what I was supposed to be looking for :)

I figure that's why some people hate *flex, and some people don't care. :shrug:

I know that the EaseBreathe™ feature makes breathing feel completely natural to me.

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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by gv280z » Sat Jan 04, 2020 12:10 am

I have a Dreamstation Auto with Flex set to 3 and feel zero pressure on exhale, I just feel like I'm breathing comfortably, soothing really...kinda weird.
Yay :D For no more diaphragm cramps and dozing off while driving! :lol:

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ChicagoGranny
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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by ChicagoGranny » Sat Jan 04, 2020 7:25 am

gv280z wrote:
Sat Jan 04, 2020 12:10 am
I have a Dreamstation Auto with Flex set to 3 and feel zero pressure on exhale, I just feel like I'm breathing comfortably, soothing really...kinda weird.
That's how most of us feel. However, it's common to feel otherwise when first starting with CPAP.

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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by zonker » Sat Jan 04, 2020 12:12 pm

gv280z wrote:
Sat Jan 04, 2020 12:10 am
I have a Dreamstation Auto with Flex set to 3 and feel zero pressure on exhale, I just feel like I'm breathing comfortably, soothing really...kinda weird.
ain't it grand when it gets to that point? i remember one night thinking i hadn't even put my mask on. reached up and lo and behold! there it was.
people say i'm self absorbed.
but that's enough about them.
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Re: Is there a mask with a decent enough check valve to release your exhale?

Post by Johnds » Mon Jan 06, 2020 10:32 am

Hey,

I haven't had time to pull out the chip yet but just had a question after wearing last night. I'm actually able to sleep on my back now which is great but I guess since I haven't slept in this position in so long, I feel like I never really get into a deep sleep. So after about two hours, I turned over to my stomach. I don't snore really on my stomach so I removed the mask. What I have noticed is, without the mask, my lungs felt weird. Like more open almost like the feeling of taking shot of an emergency inhaler. It also felt like my lungs weren't exhaling all the way. The inhale and exhale felt like mostly at the top of lung capacity, probably like from the most inner breath and then exhaling to only halfway when breathing naturally. Actually, when I tried to exhale all the way, it was difficult.

Has anyone else experienced this? Could this be bad for your lungs, like maybe training them to be weak? During normal breathing with the mask, I assume when you're sleeping, you're not fully exhaling all the time because of the pressure coming at you constantly.

The reason I ask this is because I'm overweight and I know that has a lot to do with my sleep apnea. So if possible, i don't plan to use this machine forever since I'm on a plan to losing weight. And I don't want to cause any permanent damage to my lungs. Just curious if anyone knows about that or experienced that and I dont mean to scare anyone. Thank you.