Severe Rainout Issue – Nothing working

I have used a CPAP for a little over 5 years. I currently have a (almost new) Resmed Autoset and Resmed Elite (as a backup), both with humidifiers. For 5 years, I used the Swift FX nasal pillows, without a heated coil. I’ve always had a snuggle-hose cover and use a barrel cozy. About 5 months ago I began to experience intense rainout issues. I bought a heated coil and that kind of worked until I began to get rainout so bad I could not use my CPAP therapy. My current Autoset therapy level is around 7.5. I have tried: max temp on heated coil with humidifier set increasingly lower all the way to zero, placing a space heater near the unit, moving the unit from the night stand to the floor, using a hose holder to place the hose at different angles and above my head, using no humidifier (with and without heated coil). This last step made me realize my exhaled breath is causing the rain out. I found an article where someone was having this issue and he placed wick inside the nasal pillow. I tried many variations of this and it never worked.

I have a full-face mask, the Quattro FX, but find it so uncomfortable and intruding I have a tough time sleeping with it on (I am a side sleeper). Even with this I have to use the heated coil on max and the humidifier set a 2 or below. None of this addresses the fact that I wake up with dry mouth (but I need to fix the rainout problem first).

I am experiencing the same issue on both machines and at various sleeping locations. At this point I do not know what to do and I do not know why this is an issue. I have tried many variables but nothing seems to work. I am tired of being tired. I am getting desperate. Does anyone have any suggestions?

Can you recall what might have changed in the room environment about 5 months ago?
5 months ago, is some areas, late fall or winter started. Is it possible that the room temperature dropped significantly then? What is the room temperature compared to that of last year before this started?

Could you describe the rainout symptoms you are experiencing?
Is water collecting in the mask, in the hose, or both?

Rainout in the hose is caused by a too high level of humidity for the hose temperature. If the outside of the hose is cooler than the max humidity level inside the hose can tolerate, water will condense inside the hose. Mask rainout results from the same phenomenon but is likely caused by the humidity of the exhaled air in the mask.

Because I have the humidity in my system cranked up way beyond what is usual for CPAP, I have installed extra insulation on my hose (a hybenite heated hose) as well as extra insulation around the short hose attached to my mask. Even so, with a room temperature below 70 degrees F., rainout occurs. Hence, a room temp of about 72 degrees is needed.

It may be that the insulation provided by the Snuggle Hose cover is insufficient for your circumstances and needs to be augmented by adding a fleece fabric cover. Same thing applies to the short hose attached to your mask if it has one.
Not sure what a "barrel cozy" is or where it is installed in your system.

It would be helpful if you could use the User Control Panel to list your equipment rather than having to describe in in the text of your post. Selecting "TEXT" as a display mode is better. If you CPAP machine is a little older, it might not show up in the equipment list as displayed, in that case add it in your signature line.

ntb0111 wrote:I have used a CPAP for a little over 5 years. I currently have a (almost new) Resmed Autoset and Resmed Elite (as a backup), both with humidifiers. For 5 years, I used the Swift FX nasal pillows, without a heated coil. I’ve always had a snuggle-hose cover and use a barrel cozy. About 5 months ago I began to experience intense rainout issues. I bought a heated coil and that kind of worked until I began to get rainout so bad I could not use my CPAP therapy. My current Autoset therapy level is around 7.5. I have tried: max temp on heated coil with humidifier set increasingly lower all the way to zero, placing a space heater near the unit, moving the unit from the night stand to the floor, using a hose holder to place the hose at different angles and above my head, using no humidifier (with and without heated coil). This last step made me realize my exhaled breath is causing the rain out.

How old are the nasal pillows themselves?

When the Swift FX pillows start to get worn, that silly inner cone can collapse or partially collapse. In my case a partially collapsed cone can allow moisture to accumulate in the pillows themselves. (This does not make much sense to my analytical brain, but it's happened enough times where I accept that it happens.) In the middle of the night, checking those cones and getting the fulling "uncollapsed" usually helps. Replacing the pillows with a new pair seems to be the long term fix for me.

I keep my house at 72 in the summer and 68 in the winter. My bedroom has an air circulation problem and its always hotter than the rest of the house. I also never sleep with the window open. With that said, I do not believe there was a significant drop in room temperature.

I have never seen water being built up in the hose itself. Water does appear on the nostril part of the nasal pillow. There is enough water to flick off and feel water spray, put the mask back on and repeat 2 minutes later. A barrel cozy is a fleece blanket for the nasal pillow, removable with velcro tabs (purchased from Pad-A-Cheek). I have been using a 10' snuggle hose that is long enough to cover both the hose and short hose. I have switched out the nasal pillow for brand news ones and still get the same rain out.

Will extra insulation help the mask rainout issue? If so do you have any recommendations or DIY suggestions?

Rainout when using nasal pillows can certainly be a problem. Some things to try are ...
Use a "new" shoelace cut to about 2inches inside the pillows (or mask) for a wick.
Start from the beginning. Reduce or check room humidity first.
Try with no water in chamber and heat set too OFF.
Turning the heated hose up to high will only allow the heated air to hold more water so turn that off too.
So now you have no water in chamber and no heat and only the humidity in the room. If that is ok then add one thing at a time until you get rainout then turn back any dials half-way until the rainout stops going back up go slowly again until rainout just starts again. Keeping a notebook of any changes you have made will help to keep track of what changes were made when.

If your bedroom's too hot, but you never open the window, why not?

One reason I gave up on Swift fx was there was always condensation in the nasal pillows from me. Nothin I tried helped and I tried it all, too. I grew to really hate that wet dog nose feeling (and sometimes spraying out the vent holes!). I switched to the Wisp mask and problem solved. Now I'm using a DreamWear mask and getting some condensation, but as there are no nasal pillows holding the wet surface against my nose, it's not bothering me.

I tried a wicking material very similar to a shoe lace and it did not work. I tried many variations with no avail. I also have tried not using the humidifier, having no water, and very little water in the tank. The end result is the same, rainout.

My bedroom is hot but I never open the window because I face a busy street and the road noise is loud.

The one solution I did not think of was to just buy a new mask. Since most places have a mask fit guarantee, after doing some research, I decided to buy the DreamWear mask and give it a try. I appreciate everyone's input and assistance.

Update:

I tried to DreamWear mask and it was anything but a dream. As a side sleeper I found it to be very loud and difficult to keep in place. I also got rainout issues. I replaced it with the Wisp (because it looked the best out of the FX Nano and AirFit N10). I have been using it for seven days. The first three nights were amazing, but now I am getting rainout again. I am still using a covered heated tube and have water issues even when I have the heat turned all the way up to 86F and the humidity level off. So it is obviously the mask and the moisture in the my breath causing the rainout issues. Last night I turned my room up to 74F and still got rainout. I do not know what to do or what I am doing wrong. I have successfully used a CPAP machine for four years without any issues and cannot figure out what has changed or how to correct the issue. Any suggestions?

ntb0111 wrote:Update:
... I replaced it with the Wisp (because it looked the best out of the FX Nano and AirFit N10). I have been using it for seven days. The first three nights were amazing, but now I am getting rainout again. ... Any suggestions?

Looking at illustrations of the cushion on the Wisp, it appears that water could collect within the cushion itself.
Have you looked to see if there is water inside the cushion in the morning?
It may be that a small amount collects each night that is not really noticeable without looking closely and that by the fourth night it is enough to give rainout symptoms.

If water is collecting, is there some way to get it completely dry inside? Not even any droplets at all?

Without having one in hand, this is speculation based on your report of three days without issues.

JDS74 wrote: If water is collecting, is there some way to get it completely dry inside? Not even any droplets at all?
...this is speculation based on your report of three days without issues.

I have been taking the mask off in the middle of the night, not quite awake enough to notice water build up. I just inspected it from last night and do not see any moisture. I have been following the cleansing schedule of wiping it down every morning with CPAP wipes. I am due to wash it today. But what you said could make sense. I will wash it today and then every other day and see if that resolves the issue. I will report my findings (hopefully in a several days).

Julie wrote:If your bedroom's too hot, but you never open the window, why not?

You're a poet!