Love RespCare Hybrid but ASV doesn't???

I am putting up the following SleepyHead data/charts from last night, in which I ran my ResMed with the Leak Alert turned off, wearing the RespCare Hybrid. I do not feel I am in a position to interpret these charts and numbers considering the entirely bizarre nature of the experience, and am looking for guidance and interpretation.

I am only adding these preliminary bits of information or impressions:

1) I fully understand that the 0.00 AHI/Smiley Face is meaningless because the large leak rate (144.00!) is literally through the roof;

2) I turned off the first 6 minute session because I don't think I had the mask on my face then;

3) During the long break starting a little after 3AM, I removed my existing long hose (although it appears flawless) and replaced it with a brand-new sealed in the package new long hose, just to rule out the possibility that the large leaks reported by the VPAP were coming from the hose rather than the mask;

4) I still don't understand what is going on with this Hybrid mask - although I made minor adjustments from time to time, I was unable to notice any air leaking out anywhere from the mask, although obviously my VPAP says there are huge, continuous leaks.

And here is where I lay my cards on the table, and would appreciate interpretation, guidance and suggestions:







Respectfully, Nate

do you have another machine you can test the leak rate on?

something isn't right somewhere.

palerider wrote:do you have another machine you can test the leak rate on?

something isn't right somewhere.

Unfortunately, no I do not have another machine, but with my Wisp mask and older model masks from previous years I do not have leaks being reported on this machine, and get good AHI reports but I can't tolerate the dry mouth anymore and have run the whole gamut of chinstraps, gels, headbands and even taping.

With the AirFit F10, I agreed with the large leak reports because I could see and feel and hear the leaks coming from the mask, but the Hybrid seems airtight and nice to me.?????

Nate

Sheffey wrote:

Jay Aitchsee wrote:The hybrid is a little greater which the ResMed machine would call a leak. But it doesn't look to be that much. Static vent for the Quattro at 10 cm is 37 l/min and the hybrid is 40.

I have used the Innomed Hybrid for years and the last 16 months with ResMed AutoSet S9 with pressure range 10 - 20. I have always had widely varying pressure needs and the Innomed and ResMed machine perform flawlessly for me. The machine ramps up quickly when I hit a REM stage and drops down in a reasonable amount of time when I come to stages that require less pressure.

Nate, I hope this works out for you, because I have found the Innomed Hybrid to be da bomb.

I really appreciate your encouragement, Sheffey! This is a mystery to be solved somehow, because I really love this Hybrid!

Best wishes, Nate

where did you get the hybrid?

can you take it back, perhaps there's a manufacturing defect where the vent holes are larger than they should be?

I seem to remember the pre S9 ASV machines having mask incompatibility issues but I thought that with the S9 there was no longer any such issue. Something about the machines having to learn the circuit...whatever that meant. I never paid much attention way back then.
Yesterday I looked in lots of places but I could find any such compatibility issues with the S9 ASV machines. I even tried looking up the Resmed Liberty which is a hybrid to see if maybe there was some sort of issue with that particular mask but if it's out there I couldn't find it. I would think if the Liberty is okay to use that the Innomed Hybrid wouldn't be any different.

I am scratching my head over this one too. Too bad you don't have a different machine to test it on...or too bad I don't have that mask anymore for me to test it on my S9 Adapt.
Alternately does anyone have the Liberty that they could maybe test? I don't have one of those either.

Nate, you mentioned that you bought the Hybrid from our forum host. But is there a brick & mortar DME anywhere near you where you could bring the mask in and ask if they'll let you hook up for a few minutes to one of their machines? Might at least help clarify if the mask is defective in some way -- like if it sets off leak alarms on another machine.

nate, things to check.

you shouldn't be able to feel air from anywhere except the six holes at the top of the front part of the mask.

make sure the two oxygen ports are stoppered properly.

make sure the anti-asphyxiation valve is completely closed.

you've gotta have a massive leak somewhere.

palerider wrote:make sure the two oxygen ports are stoppered properly.

The little stoppers can pop off when washing the mask.

palerider wrote:make sure the anti-asphyxiation valve is completely closed.

This looks like it could break easily, although Gramps has used the Innomed hybrid for years without a valve breaking.

NateS wrote:replaced it with a brand-new sealed in the package new long hose

Did you think to take it out of the package?

When all else fails try going back to the source. Contact our host and or Resmed and ask for help. Someone may inform you of the simple solution we are all overlooking.
With my brother in law it was as simple as the mask goes on your nose not the back of your head. And yes you need to fasten the headgear on both sides of the Wisp mask. This was for real. No joke.

bwexler wrote:When all else fails try going back to the source. Contact our host and or Resmed and ask for help. Someone may inform you of the simple solution we are all overlooking.
With my brother in law it was as simple as the mask goes on your nose not the back of your head. And yes you need to fasten the headgear on both sides of the Wisp mask. This was for real. No joke.

I was going to ask if he'd called the nice folks who you bought it from and say "wtf, over?"

kaiasgram wrote:Nate, you mentioned that you bought the Hybrid from our forum host. But is there a brick & mortar DME anywhere near you where you could bring the mask in and ask if they'll let you hook up for a few minutes to one of their machines? Might at least help clarify if the mask is defective in some way -- like if it sets off leak alarms on another machine.

That is a good suggestion, kaiasgram and I wish I could do that. There is a DME about 5 min. from where we live and from whom I had bought a mask before Medicare went to competitive bidding by large mail-order companies. Shortly after the switch, I stopped in there for help and all I got from the manager was anger over the new Medicare regs as if it was my fault and "go where the govt. sent you" and I walked out. Since then, I get regular calls for replacement supplies from my assigned mail-order DME, but in instances when I want to get a new mask style before Medicare says I am eligible for replacement, I prefer to buy from cpap.com and did in this instance, but it seemed silly to pay $50 extra for return ins. on a $116 mask, especially since I don't usually give up on projects in only 30 days anyway, and will continue to persist for longer than that with the Hybrid.

I did speak to someone from Innomed today, and he is to get back to me tomorrow, but he sounded baffled too.

Best wishes, Nate

Here is Night Two. I actually felt as if I had slept soundly during the two long sessions, despite the Large Leak chart being literally through the roof:



Before going to bed last night, and to supplement my study of the Hybrid discussions had previously here on cpaptalk, I spent a couple hours reading through many of the over 500! reviews - pro and con - on cpap.com's webpage for this mask, searching for more possible clues from people who overcame initial difficulties with the mask, although most of the reviews were either instant love or instant disdain.

Then on to bed. Although again I could not detect any rush of air from anywhere around the mask, I may finally have a clue - I woke up feeling well-rested BUT with a very dry mouth! So maybe there is massive albeit silent leakage around the chin flap!? Could this be? The design of this Hybrid is the main reason I bought it - to try to get rid of my dry mouth (as well as getting away from the confined feeling around my nose from the Wisp), and I thought the chin flap was resting snugly against my lightly -bearded chin but maybe not? I don't want to cut off the chin flap because I think I need it but, thinking like the Pink Panther, maybe it needs a little "insulation" to complete the seal?

http://image.cdn.ispot.tv/ad/7biN/owens ... arge-9.jpg

I think I will try to attach some moleskin to the inside of the chin flap tonight and see what happens.

Best wishes, Nate

Wow Nate, that's really strange. I would think the most logical places for an accidental leak would be the oxygen ports or perhaps the anti asphyxiation valve which PR mentioned previously.
Have you tried to use the Mask Fit feature? Maybe strategically pressing on the area around the chin with "Mask Fit" on would allow you to find if the leak was there.
It just seems with a leak that large you could feel it. You've mentioned a couple of times no air leaking from around the mask, but I assume there is air coming from the exhaust ports?
Did you hear back from Innomed yet?

Jay Aitchsee wrote:Wow Nate, that's really strange. I would think the most logical places for an accidental leak would be the oxygen ports or perhaps the anti asphyxiation valve which PR mentioned previously.
Have you tried to use the Mask Fit feature? Maybe strategically pressing on the area around the chin with "Mask Fit" on would allow you to find if the leak was there.
It just seems with a leak that large you could feel it. You've mentioned a couple of times no air leaking from around the mask, but I assume there is air coming from the exhaust ports?
Did you hear back from Innomed yet?

Thanks for reminding me about the "Mask Fit" feature on my S9, Jay. I will have to refresh my recollection as to how to make it work. I was thinking that if I couldn't stop the Leak Alert by pulling and tugging experimentally that the "Mask Fit" feature wouldn't work either, but I shouldn't rule anything out to try to solve this mystery. I will try it.

Yes, air seems to come out the exhaust ports just fine; the plugs seem secure in the oxygen ports; and when I hold the mask in my hand and blow through the bottom tube, the little flapper on the anti-asphyxiation valve seems to flip to the closed position; but I should try that with the mask connected to the machine and running. Many thanks too to palerider and ChicagoGranny for also suggesting that I check those parts of the mask!

Have not heard back from the Innomed guy yet today. When I spoke to him yesterday, he was very pleasant to talk to, but it soon became obvious that he had not read my email carefully nor looked at my charts though I had understood him to say he had; so some of the time on the phone was spent correcting his assumptions as to what the problem was that I was having. The more he permitted me to re-adjust his initial impressions though, the more I felt he was willing to put some effort into trying to solve the problem - said he was going to review several manuals before calling me back today.

Best wishes, Nate