Should a mask have a valve to let air out?

Airehead · Post by **Airehead** » Tue Aug 27, 2019 11:03 am

Hi, I am a new CPAP user, and have a question I can't find an answer to. It sounds like with most of us new people it takes a bit to get used to the masks, but I honestly think that there is something wrong with the mask. I have a AirFit 30, I think it is a "nasal pillow", and a Dream Station (6-12) machine. I have had it for about a week, so I have tried to be patient with the "suffocation feeling", but honestly last night I thought I was going to die. My concern is when you exhale, the exhaled air goes into the tube, and then you breathe that air back in. If I take my hose off my mask/put my mask on my face; occlude the hole where the hose should go on and try to exhale-its impossible to either breathe in or breathe out!! Shouldn't there be a valve that lets out the expired air, otherwise you just keep breathing the same air in/out??? I honestly feel like I did almost die last night. i "woke up" (never really slept-kept waking up gasping for air/clawing off the mask) feeling obtunded, almost disoriented, horrible headache. I have left messages for my DME company for 3 days with no response. Can someone shed some light on the mask and needing an exhalation valve? I would think that the expired air should go out of the mask, not back down the tube???

LSAT · Post by **LSAT** » Tue Aug 27, 2019 3:08 pm

WRONG !!! When you exhale nothing goes back into the tube...the constant pressure stops it. There is an exhaust vent that takes the CO2 out of the mask. If you put your hand in front of the mask you will feel the exhaust. The suffocation feeling may be because your pressure is set too low.

palerider · Post by **palerider** » Tue Aug 27, 2019 3:23 pm

Airehead wrote: ↑
Tue Aug 27, 2019 11:03 am
Hi, I am a new CPAP user, and have a question I can't find an answer to. It sounds like with most of us new people it takes a bit to get used to the masks, but I honestly think that there is something wrong with the mask. I have a AirFit 30, I think it is a "nasal pillow", and a Dream Station (6-12) machine. I have had it for about a week, so I have tried to be patient with the "suffocation feeling", but honestly last night I thought I was going to die. My concern is when you exhale, the exhaled air goes into the tube, and then you breathe that air back in. If I take my hose off my mask/put my mask on my face; occlude the hole where the hose should go on and try to exhale-its impossible to either breathe in or breathe out!! Shouldn't there be a valve that lets out the expired air, otherwise you just keep breathing the same air in/out??? I honestly feel like I did almost die last night. i "woke up" (never really slept-kept waking up gasping for air/clawing off the mask) feeling obtunded, almost disoriented, horrible headache. I have left messages for my DME company for 3 days with no response. Can someone shed some light on the mask and needing an exhalation valve? I would think that the expired air should go out of the mask, not back down the tube???

Every cpap mask has a built in vent that flushes out around 20 to 50 *liters* of air per minute (depending on pressure) which means that all of your last breath is all gone before you start to take in another one.

Some masks vent in a hard stream of air that you can feel blowing a couple feet away, some have a gentle diffused vent that you can't feel more than a couple inches away.

Regardless, they all vent air.

Dog Slobber · Post by **Dog Slobber** » Tue Aug 27, 2019 4:10 pm

Airehead wrote: ↑
Tue Aug 27, 2019 11:03 am
Shouldn't there be a valve that lets out the expired air, otherwise you just keep breathing the same air in/out??? I honestly feel like I did almost die last night.

There's a vent. If you put the back of your hand up near the mask you should be able to feel it.

I have a AirFit 30, I think it is a "nasal pillow", and a Dream Station (6-12) machine.

The AirFit F30 is a full-face, but some might classify it as a hybrid because it cradles the nose.

I have had it for about a week, so I have tried to be patient with the "suffocation feeling", but honestly last night I thought I was going to die.

Two things come to mind. Your ramp or minimum pressure is two low, increase it greater than 6 cm. Or the nasal cushion holes don't line up well because it's not size properly.

Below is a youtube link for an F30 review where he experiences poor breathing, because of an ill-fitting mask.

https://www.youtube.com/watch?v=WTBsvlQG5Og

If neither of the above addresses your problem, consider a different mask.

I found a considerable improvement in breathing when I went to Nasal Pillows with the P10, then the P30i. If you require a full-face than consider the DreamWear Full Face with Gel Pillows.

Pugsy · Post by **Pugsy** » Tue Aug 27, 2019 4:23 pm

OP might be thinking about the AirFit P30i and not F30 full face mask since nasal pillows were mentioned.
The vent holes for the P30i nasal pillows are diffused and up at the top where the hose attaches and won't be felt unless the hands are placed right on the holes.

If the OP is using the ramp feature...he's starting out at 4 cm...and that is so low that most people feel like they are suffocating from lack of air movement.
Even the 6 cm isn't enough air movement for some people.

To reaffirm what so many have already said...all cpap masks have vent holes...and some venting is more diffused and harder to feel than other masks...and at low starting pressures even harder to feel the air being vented out even if you know where the vent holes are.

Dog Slobber · Post by **Dog Slobber** » Tue Aug 27, 2019 4:35 pm

Pugsy wrote: ↑
Tue Aug 27, 2019 4:23 pm
OP might be thinking about the AirFit P30i and not F30 full face mask since nasal pillows were mentioned.
The vent holes for the P30i nasal pillows are diffused and up at the top where the hose attaches and won't be felt unless the hands are placed right on the holes.

Or even the n30i, though resmed refers to it as a cradle.

When I first tried the the N30i I felt air starved. When I tried P30i and medium pillows I felt air-starved. When I switch to larger pillows felt terrific.

OP, could you clarify mask type and size.

Pugsy · Post by **Pugsy** » Tue Aug 27, 2019 4:43 pm

Dog Slobber wrote: ↑
Tue Aug 27, 2019 4:35 pm
Or even the n30i, though resmed refers to it as a cradle.

When I first tried the the N30i I felt air starved. When I tried P30i and medium pillows I felt air-starved. When I switch to larger pillows felt terrific.

OP, could you clarify mask type and size.

Very true...nasal pillow users often have to use more pressure or step up in size to fix the air starved feeling.

We know the OP's mask has a venting system but he doesn't know that because his supplier probably never mentioned it or showed it to him and the combination of maybe the small space volume in the mask to move the air and low pressures equals being air starved feeling so he thinks there is no venting....but of course there is venting happening.

billbolton · Post by **billbolton** » Tue Aug 27, 2019 6:48 pm

Pugsy wrote: ↑
Tue Aug 27, 2019 4:23 pm
The vent holes for the P30i nasal pillows are diffused and up at the top where the hose attaches and won't be felt unless the hands are placed right on the holes.

There are two sets of vents on a P30i.

One is a set of pin-holes immediately below the pillows in the removable cushion assembly, and has a filter built into it after the pin-holes to reduce any exhaust flow noise. The pin-hole exhaust vent is a separate sub-assembly that can be carefully removed from the cushion assembly.

https://www.thecpapshop.com/media/catal ... atures.jpg

The other vent is in quick release elbow of the mask hose connection.

Pugsy · Post by **Pugsy** » Tue Aug 27, 2019 6:53 pm

billbolton wrote: ↑
Tue Aug 27, 2019 6:48 pm
There are two sets of vents on a P30i.

One is a set of pin-holes immediately below the pillows in the removable cushion assembly, and has a filter built into it after the pin-holes to reduce any exhaust flow noise. The pin-hole exhaust vent is a separate sub-assembly that can be carefully removed from the cushion assembly.

Ahhh..similar to the placement of the vent hole on the Respironics DreamWear pillows but diffused where the DreamWear isn't diffused.
Likely wouldn't be felt unless finger directly over the holes and probably made even more difficult by the low pressures.

I have never actually seen the P30i...but I have used the DreamWear pillow version. So I knew about the vent on top of the P30i but didn't know about the one near the pillow.

All this is of course assuming the OP meant P30i.

chunkyfrog · Post by **chunkyfrog** » Tue Aug 27, 2019 11:03 pm

Some masks have such diffused exhaust that sometimes I need to lick my finger
in order to feel the breeze. Or I can dip it in the pond . . .

Dog Slobber · Post by **Dog Slobber** » Wed Aug 28, 2019 8:10 am

Coincidentally Jason (Lanky Lefty) posted a review of the P30i yesterday.

https://www.youtube.com/watch?v=3SNoDqOXiFE

Interestingly, the venting on the P30i has changed. Perhaps his was a prototype.

p30i_vents.jpg

In his video (top image) you can clearly see the venting holes. On the current P30i the venting has changed (bottom image), the holes are there, but covered with a very fine mesh.

On the current P30i the diffusion is such that, it is very difficult to notice there is venting on the pillows.

Pugsy · Post by **Pugsy** » Wed Aug 28, 2019 8:12 am

Maybe Jason's P30i didn't have the vent cover included or he lost it.

Dog Slobber · Post by **Dog Slobber** » Wed Aug 28, 2019 8:27 am

Pugsy wrote: ↑
Wed Aug 28, 2019 8:12 am
Maybe Jason's P30i didn't have the vent cover included or he lost it.

It's appears to be single part. Although, the mesh might be a filter that one *could* try to remove, but it would require some effort.

Here's a pic of front and back. The hole pattern and number of holes is also different.

P30i_Vent_2.jpg

Pugsy · Post by **Pugsy** » Wed Aug 28, 2019 8:47 am

Dog Slobber wrote: ↑
Wed Aug 28, 2019 8:27 am

Pugsy wrote: ↑
Wed Aug 28, 2019 8:12 am
Maybe Jason's P30i didn't have the vent cover included or he lost it.
It's appears to be single part. Although, the mesh might be a filter that one *could* try to remove, but it would require some effort.

Here's a pic of front and back. The hole pattern and number of holes is also different.

P30i_Vent_2.jpg

Hmmm....Jason might have had a different vent part then. Since I haven't actually seen a P30i and got my grubby little paws on it I have no way to know.
I do know that Jason runs a sleep lab and ResMed donates masks to sleep labs and the masks that are donated don't always match up to what is sold retail so maybe what he got to use in his demo probably was a donated mask and it very well could be simply different in terms of that filter part over the vent holes.

Dog Slobber · Post by **Dog Slobber** » Wed Aug 28, 2019 9:06 am

Pugsy wrote: ↑
Wed Aug 28, 2019 8:47 am

Dog Slobber wrote: ↑
Wed Aug 28, 2019 8:27 am

Pugsy wrote: ↑
Wed Aug 28, 2019 8:12 am
Maybe Jason's P30i didn't have the vent cover included or he lost it.
It's appears to be single part. Although, the mesh might be a filter that one *could* try to remove, but it would require some effort.

Here's a pic of front and back. The hole pattern and number of holes is also different.

P30i_Vent_2.jpg
Hmmm....Jason might have had a different vent part then. Since I haven't actually seen a P30i and got my grubby little paws on it I have no way to know.
I do know that Jason runs a sleep lab and ResMed donates masks to sleep labs and the masks that are donated don't always match up to what is sold retail so maybe what he got to use in his demo probably was a donated mask and it very well could be simply different in terms of that filter part over the vent holes.

That makes sense, in the video you can read on the headgear, "Not for resale".

Should a mask have a valve to let air out?

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Additional Comments: Airmini, Medistrom Pilot 24, CMS 60C Pulse Oximeter, ResScan 6