I am having an extreme problem getting used to this. I prefer the mask that completely covers the nose because I feel like my nostrils will stretch with the one that goes in the nostrils. But I am still having a problem with exhale. I feel like I'm breathing the same warm exhale air. I have used respirators at work for dust that have checkvalves and when I put my hand over it, I can feel significant amounts of exhale and warm air. Upon inhale you feel nice cold air. With the CPAP full nose mask, it's quite the opposite. I feel like I slowly begin to suffocate because it's not letting enough exhale out fast enough. When I put my hand over it during exhale to feel it, the warm exhale air is very minimal which tells me it's not exiting fast enough and I'm rebreathing it in because I also feel like I'm breathing in warm air as well. Also I know its not letting exhale out fast enough because if I lift the mask slightly while breathing and let it leak a little bit, I get nice cool air during inhale and exhale everytime and it actually feels great and refreshing.
Why don't they have proper exhale ventilation on any of these masks? I have a few other styles and it's the same thing with all of the . I really want this to work, but the exhale feeling is like I'm breathing in and out of a balloon slowly depriving myself of oxygen with every breath to the point where I need to pull it off my face to get a deep breath of air. Yes I tried different pressure and its the same result. It just feels to me that the exhale does not escape fast enough. Please help.
Is there a mask with a decent enough check valve to release your exhale?
Re: Is there a mask with a decent enough check valve to release your exhale?
Welcome to the forum.
What brand and model machine are you using?
What are your pressure settings?
Are you using any form of exhale relief? If so, at what setting?
How long have you been trying to use cpap?
Exactly what masks have you tried and are currently trying?
What is your humidity setting?
Are you using a heated hose? If you are...at what setting?
All these masks have been tested extensively and they all vent well enough that we don't rebreathe bad air but sometimes temps and pressures can make it feel uncomfortable. Answer the above questions and I suspect we can come up with some ideas to make things more comfortable for you. Everything you have complained about has been discussed here many, many times in the past. Nothing new and there are some things which can be done but we need to know what the settings and equipment are to be able to offer more than guesses at how to overcome your discomfort.
What brand and model machine are you using?
What are your pressure settings?
Are you using any form of exhale relief? If so, at what setting?
How long have you been trying to use cpap?
Exactly what masks have you tried and are currently trying?
What is your humidity setting?
Are you using a heated hose? If you are...at what setting?
All these masks have been tested extensively and they all vent well enough that we don't rebreathe bad air but sometimes temps and pressures can make it feel uncomfortable. Answer the above questions and I suspect we can come up with some ideas to make things more comfortable for you. Everything you have complained about has been discussed here many, many times in the past. Nothing new and there are some things which can be done but we need to know what the settings and equipment are to be able to offer more than guesses at how to overcome your discomfort.
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Re: Is there a mask with a decent enough check valve to release your exhale?
You didn't say what machine you have so it's hard to guess, but the latest models of both ResMed and PHillips have exhale relief features - one's called EPR and the other A- or C-flex... and you set the level you're comfortable with. Try it at e.g. a medium level tonight and see if it helps.
Re: Is there a mask with a decent enough check valve to release your exhale?
Pugsy wrote: ↑Thu Jan 02, 2020 4:11 pm
What brand and model machine are you using?
- System One REMstar Auto A flex
It's set on C-Flex+ in settings menu.
What are your pressure settings?
- Right now 8. I've tried 6 -11 so far.
Are you using any form of exhale relief? If so, at what setting?
- I have it on highest 3. I have tried 1&2 as well. They all feel the same to me anyway, so I leave it on 3 since from what I understand is the most pressure drop and least restrictive during exhale.
How long have you been trying to use cpap?
- About 4 days. I've been using it while watching TV to get use to it as well.
Exactly what masks have you tried and are currently trying?
- F&P Eson Nasal mask which I use now and find the most comfortable. I was thinking about the Resmed Airfit P30, but I don't like the nostril intrusion. Anyone know if they have this style with full nose cover? That would be great.
- Phillips Respironics Comfortgel Blu full face mask
- F&P Simplus full face mask
- Also have the one that goes directly in nostrils with single tub attached. Not sure of brand because I've lost directions.
What is your humidity setting?
- 0. I've turned it off to eliminate that being the cause of warmer air for now.
Are you using a heated hose? If you are...at what setting?.
- I don't believe so.
Thank you for your time.
Re: Is there a mask with a decent enough check valve to release your exhale?
Forgot a couple of questions....are you using the ramp feature at anytime during the night and what is your ambient bedroom temperature?
What is the model number on the bottom of your blower unit? Should be either 550 or 560 with maybe DS or REF in front of the 3 numbers? How come you got this discontinued model machine? Was it new from a DME or equipment supplier or did you get it privately?
It's been discontinued probably close to 5 years now. Nothing wrong with having it but it is unusual for someone new to cpap therapy to be using an older model machine.
Where are you located?
Can you explain in detail exactly what it is that is so uncomfortable? Is it just the warm air or do you feel like you are suffocating and not enough air is moving?
If you are using the ramp feature.....turn it off and don't use it and see if that helps whatever it is that you don't care.
https://www.cpap.com/productpage/resmed ... illow-mask
I can't find a plain P30.
They make an under the nose cushion...the N30i that is interchangeable with the P30i headgear and frame
https://www.cpap.com/productpage/resmed ... -cpap-mask
There is no over the nose cushion for the N30i or P30i model mask though.
Take a stroll through all the various nasal cushion masks here and see if something else looks interesting to you.
https://www.cpap.com/cpap-masks/nasal-cpap-mask
Nasal pillow masks don't actually go up inside the nostril or touch any portion of the inside of the nostrils. If it does then it is the wrong size or fitted way too tight and pulled up inside the nostrils. Only the teeny tiny tip of the inner cone of a nasal pillow mask goes inside the nostril but it never touches anything inside the nostrils. It should never be felt. Most common mistake people make with a nasal pillow mask is they crank down the headgear way too much.
Take a look at the Bleep that I use...it's a nasal mask but no part of it goes inside the nostril. It looks like a nasal pillow mask but it's technically a nasal mask. See the link to it in my equipment profile at the bottom of this post.
Now there is a N30 mask that is fairly new but so far we haven't seen a P30 version but I wouldn't be surprised to see a pillow version of it come out in the future
https://www.cpap.com/productpage/resmed ... h-headgear
If you can get a nasal mask with less dead space to hold warm exhaled air you might find the incoming air temp a bit cooler.
Since you have the humidifier turned off you are only getting ambient room temp air to start with. If you keep your house on the warm side then your exhaled air won't take much to get it warm.
What is the model number on the bottom of your blower unit? Should be either 550 or 560 with maybe DS or REF in front of the 3 numbers? How come you got this discontinued model machine? Was it new from a DME or equipment supplier or did you get it privately?
It's been discontinued probably close to 5 years now. Nothing wrong with having it but it is unusual for someone new to cpap therapy to be using an older model machine.
Where are you located?
Can you explain in detail exactly what it is that is so uncomfortable? Is it just the warm air or do you feel like you are suffocating and not enough air is moving?
If you are using the ramp feature.....turn it off and don't use it and see if that helps whatever it is that you don't care.
Did you mean the P30i?
https://www.cpap.com/productpage/resmed ... illow-mask
I can't find a plain P30.
They make an under the nose cushion...the N30i that is interchangeable with the P30i headgear and frame
https://www.cpap.com/productpage/resmed ... -cpap-mask
There is no over the nose cushion for the N30i or P30i model mask though.
Take a stroll through all the various nasal cushion masks here and see if something else looks interesting to you.
https://www.cpap.com/cpap-masks/nasal-cpap-mask
Nasal pillow masks don't actually go up inside the nostril or touch any portion of the inside of the nostrils. If it does then it is the wrong size or fitted way too tight and pulled up inside the nostrils. Only the teeny tiny tip of the inner cone of a nasal pillow mask goes inside the nostril but it never touches anything inside the nostrils. It should never be felt. Most common mistake people make with a nasal pillow mask is they crank down the headgear way too much.
Take a look at the Bleep that I use...it's a nasal mask but no part of it goes inside the nostril. It looks like a nasal pillow mask but it's technically a nasal mask. See the link to it in my equipment profile at the bottom of this post.
Now there is a N30 mask that is fairly new but so far we haven't seen a P30 version but I wouldn't be surprised to see a pillow version of it come out in the future
https://www.cpap.com/productpage/resmed ... h-headgear
If you can get a nasal mask with less dead space to hold warm exhaled air you might find the incoming air temp a bit cooler.
Since you have the humidifier turned off you are only getting ambient room temp air to start with. If you keep your house on the warm side then your exhaled air won't take much to get it warm.
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raisedfist
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Re: Is there a mask with a decent enough check valve to release your exhale?
Some masks if the cushion is too small it can feel like it's hard to get enough air...I had that with the P10 pillows until I swapped in the larger pillows. Same with the F30 full face mask. They all vent air properly to spec but the sensation is another story.
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Re: Is there a mask with a decent enough check valve to release your exhale?
Pugsy wrote: ↑Thu Jan 02, 2020 5:18 pmForgot a couple of questions....are you using the ramp feature at anytime during the night and what is your ambient bedroom temperature?
- I found the ramp feature to be another feature that didn't really make much difference to me. So I keep I off. I keep my house at 65F.
What is the model number on the bottom of your blower unit?
- It is REF560P
How come you got this discontinued model machine?
- It was my father's. He hated using the machine and finds that the mouth piece works better for him. I actually don't like the mouthpiece so I'm hoping this will work.
Where are you located?
- I am in Long Island
Can you explain in detail exactly what it is that is so uncomfortable? Is it just the warm air or do you feel like you are suffocating and not enough air is moving?
- It feels like I'm slowly not getting enough oxygen where after 5 minutes, I have to pull it off my face so I can take a proper deep breath to relax. The warm air just tells me that exhale is lingering. I find it hard to believe that all my exhale is exiting because when I take the first deep breath, everything feels cool and normal. As soon as I exhale and breath in again, I feel the warmer air and less oxygen rich like breathing in and out of a balloon. Like I said before, when I put my hands around the mask and exhale, I feel a little bit of warm air come out, but nothing in the amount of air I'm actually exhaling. This tells me that the exhaled air is not exiting fast enough and must be filling up the tube or going somewhere beside out, and then going back into my lungs upon inhale. Also to prove this, I slightly lifted the mask off my nose as to let it leak a little bit, and I get nice cool comfortable oxygen rich air upon inhale and also feels cool exhaling as well.
Did you mean the P30i? Yes sorry. That's the one I meant. Any good? What's the difference between p30i and n30i?
I actually was thinking about getting a bigger nasal mask but what you mentioned makes sense about dead space. This one is pretty small but not too small. Is the one I have just outdated maybe?
Re: Is there a mask with a decent enough check valve to release your exhale?
How about removing the optional diffuser filter on the ESON and see if that makes things more comfortable for you.
Did you know that little diffuser is removable? Removing it will allow more air to vent and move around.
I think it just clips in place.
Most people like diffusers since they reduce air vent noise but some people don't like them because they feel like there isn't enough air movement to be comfortable.
You won't suffocate but it can sure feel like it. Some people will go up a size and the extra volume seems to allow for more movement. My idea to use a mask with less dead space was mainly for the unpleasant air temp that you are experiencing.
Any mask with N as part of the model name is going to be a nasal cushion type of mask. Some cover the end of the nose and some just fit under the nostrils. Any mask with P as part of the model name is going to be classified as a pillow type of mask. Pillow masks have a little inner cone that stands up higher than the rim of the pillow. The rim is supposed to rest GENTLY against the nostrils. At no time is any part of the pillow supposed to be inside the nostril except for the tiny inner cone and it doesn't touch anything once inside the nose and it barely is inside anyway. Nasal pillows will try to crawl up inside the nose if they are too small for the nostril opening. Not only is it uncomfortable but the pillows get squished and the air doesn't move around like it should.
Any mask has to be able to fully inflate to work properly but most people tend to crank things down in an effort to keep things sealed.
Cranking the headgear down actually defeats the purpose because these masks need to inflate to seal correctly. Common mistake people make.
For now try to remove the clip on diffuser on the ESON. That might be enough to get you more comfortable with the air venting and keep the air temp a little cooler.
Did you know that little diffuser is removable? Removing it will allow more air to vent and move around.
I think it just clips in place.
Most people like diffusers since they reduce air vent noise but some people don't like them because they feel like there isn't enough air movement to be comfortable.
You won't suffocate but it can sure feel like it. Some people will go up a size and the extra volume seems to allow for more movement. My idea to use a mask with less dead space was mainly for the unpleasant air temp that you are experiencing.
Any mask with N as part of the model name is going to be a nasal cushion type of mask. Some cover the end of the nose and some just fit under the nostrils. Any mask with P as part of the model name is going to be classified as a pillow type of mask. Pillow masks have a little inner cone that stands up higher than the rim of the pillow. The rim is supposed to rest GENTLY against the nostrils. At no time is any part of the pillow supposed to be inside the nostril except for the tiny inner cone and it doesn't touch anything once inside the nose and it barely is inside anyway. Nasal pillows will try to crawl up inside the nose if they are too small for the nostril opening. Not only is it uncomfortable but the pillows get squished and the air doesn't move around like it should.
Any mask has to be able to fully inflate to work properly but most people tend to crank things down in an effort to keep things sealed.
Cranking the headgear down actually defeats the purpose because these masks need to inflate to seal correctly. Common mistake people make.
For now try to remove the clip on diffuser on the ESON. That might be enough to get you more comfortable with the air venting and keep the air temp a little cooler.
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Re: Is there a mask with a decent enough check valve to release your exhale?
Thank you for the help. It's funny that you mentioned that clip on thing. I was just sitting on the couch and started taking it apart. I actually disconnected the hose too and just tried inhaling and exhaling to see if the holes were adequate enough to release the exhale without the clip. I inhaled and then when I exhaled I covered the hose hole. After a couple of inhales and exhales with hose hole plugged, it was actually worse and harder to exhale than with the hose attached. This tells me that since the holes don't let enough exhale out fast enough during normal breathing, the only other place the exhale would go is up the tube. 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. So just to reiterate, with hose detached and diffuser clip off, I inhaled through the mask, then I covered hose hole and exhaled......uncover hose hole and inhale, cover hose hole and exhale. There is no way you can exhale through those tiny holes alone and live. The tube is definitely taking on the majority of the CO2.
So now I think I am definitely going to go for the p30i or n30i but first, can you tell me how the exhale feature works on these? I assume in general the experience has to be better since the cup is not covering your nose and the pillow is only underneath. That covers half the battle, but what about exhale? Any good? Which one is better in general?
So now I think I am definitely going to go for the p30i or n30i but first, can you tell me how the exhale feature works on these? I assume in general the experience has to be better since the cup is not covering your nose and the pillow is only underneath. That covers half the battle, but what about exhale? Any good? Which one is better in general?
Re: Is there a mask with a decent enough check valve to release your exhale?
I have never actually used either the N30i or P30i. So I can't really comment of them specifically.
I am a nasal pillow user for over 10 years now. I recently did get hold of the P30i but I haven't had the chance to actually use it and I don't know that I will. The medium/standard frame is too large for my head and I will need to do some fiddling to maybe make it snug enough to stay put on my small head.
It does come in a smaller frame but I would need to purchase the small frame and I just can't spend the extra money right now on something just to play with it.
I prefer a no head gear at all mask and have no desire to switch so I am not real motivated at this point to even try the P30i.
That's why I use the Bleep....no headgear at all.
Now in general between a nasal pillow mask and a nasal cushion mask (that goes under the nostrils) I have always preferred the pillow but then after over 10 years of using some sort of nasal pillow mask that is pretty much to be expected. Someone else using a nasal cushion mask for 10 years would probably prefer the under the nose cushion.
You are going to find that almost everything pertaining to cpap or masks or whatever will come with a huge YMMV sticker because we all have different preferences, wants and needs.
FWIW....I did try the ESON once (hated the headgear crap) and I tried it with the diffuser and I use lower pressures than you and high humidity with a rather warm heated hose and had none of the issues you are complaining about. Not a single one.
That's where the YMMV sticker comes into play and most people who use the ESON don't complain or mention issues like yours.
You are the outlier here. It happens....one person just hates something and the next person thinks it's the greatest thing since sliced bread.
The mask journey is going to be your most difficult part of this whole cpap experience. Finding the one that suits your own personal wants, needs and preferences.
I am a nasal pillow user for over 10 years now. I recently did get hold of the P30i but I haven't had the chance to actually use it and I don't know that I will. The medium/standard frame is too large for my head and I will need to do some fiddling to maybe make it snug enough to stay put on my small head.
It does come in a smaller frame but I would need to purchase the small frame and I just can't spend the extra money right now on something just to play with it.
I prefer a no head gear at all mask and have no desire to switch so I am not real motivated at this point to even try the P30i.
That's why I use the Bleep....no headgear at all.
Now in general between a nasal pillow mask and a nasal cushion mask (that goes under the nostrils) I have always preferred the pillow but then after over 10 years of using some sort of nasal pillow mask that is pretty much to be expected. Someone else using a nasal cushion mask for 10 years would probably prefer the under the nose cushion.
You are going to find that almost everything pertaining to cpap or masks or whatever will come with a huge YMMV sticker because we all have different preferences, wants and needs.
FWIW....I did try the ESON once (hated the headgear crap) and I tried it with the diffuser and I use lower pressures than you and high humidity with a rather warm heated hose and had none of the issues you are complaining about. Not a single one.
That's where the YMMV sticker comes into play and most people who use the ESON don't complain or mention issues like yours.
You are the outlier here. It happens....one person just hates something and the next person thinks it's the greatest thing since sliced bread.
The mask journey is going to be your most difficult part of this whole cpap experience. Finding the one that suits your own personal wants, needs and preferences.
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Re: Is there a mask with a decent enough check valve to release your exhale?
Thank you for your help and input. I gotta say out of all the ones I have, the nasal mask I like. Its just that exhaling issue. From what I've read on the forum, the exhale is not supposed to go down the tube, but what I've explained seems like that's exactly what's happening.
Before when you mentioned the bleep I didn't realize that was an actual mask. I just looked it up and I'm very interested in that one now along with the p30i and n30i.
1) Where does your exhale breath go on the bleep, p30i, and n30i? I am wondering if I'm going to have the same issue with not being able to exhale fast enough like the eson.
2) What is the difference between the p30i and n30i?
3) What is the difference between a nasal pillow and a nasal mask or are they both the same thing?
4) So it looks like you have to constantly buy bleep sticky strips for the bleep? Is that correct?
5) One of the reviews for the bleep said that the hose that comes directly off the bleep is more rigid than the hose that it connects to that goes to the machine and this causes it to pull strips off your nose. Do you have this problem?
I would love to sleep on my back, but unfortunately for me, the CPAP doesn't help with snoring on exhale. When I lay on my back, as I fall asleep, my tongue relaxes and pushes back my uvula and it gets in the way of my nasal passages when I breath out causing an exhale snore. Kind of weird, annoying, and frustrating. So I'm forced to sleep on my stomache I guess until they figure out something for that.
Thank you.
Before when you mentioned the bleep I didn't realize that was an actual mask. I just looked it up and I'm very interested in that one now along with the p30i and n30i.
1) Where does your exhale breath go on the bleep, p30i, and n30i? I am wondering if I'm going to have the same issue with not being able to exhale fast enough like the eson.
2) What is the difference between the p30i and n30i?
3) What is the difference between a nasal pillow and a nasal mask or are they both the same thing?
4) So it looks like you have to constantly buy bleep sticky strips for the bleep? Is that correct?
5) One of the reviews for the bleep said that the hose that comes directly off the bleep is more rigid than the hose that it connects to that goes to the machine and this causes it to pull strips off your nose. Do you have this problem?
I would love to sleep on my back, but unfortunately for me, the CPAP doesn't help with snoring on exhale. When I lay on my back, as I fall asleep, my tongue relaxes and pushes back my uvula and it gets in the way of my nasal passages when I breath out causing an exhale snore. Kind of weird, annoying, and frustrating. So I'm forced to sleep on my stomache I guess until they figure out something for that.
Thank you.
Re: Is there a mask with a decent enough check valve to release your exhale?
They do, raise your pressure.
All my exhaled breath is gone before I start a new inhalation.
Raising pressure raises the vent rate, (look at the data in the back of the manual for whatever mask you have).
You didn't try enough of a different pressure.
Most masks vent around 20 liters per minute at 4cm pressure, up to around 50 liters per minute at 20lpm.
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Re: Is there a mask with a decent enough check valve to release your exhale?
And yet, tens of thousands of people do it every night, and don't die.
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Re: Is there a mask with a decent enough check valve to release your exhale?
It goes part way, then flushes out between breaths.Johnds wrote: ↑Fri Jan 03, 2020 1:11 amThank you for your help and input. I gotta say out of all the ones I have, the nasal mask I like. Its just that exhaling issue. From what I've read on the forum, the exhale is not supposed to go down the tube, but what I've explained seems like that's exactly what's happening.
Out the vent, like every other mask.
Pillows just press against the nostrils, nasal masks cover the nose. Look at cpap.com at the mask selection page.
If you're snoring with cpap, your pressure is too low
What are your pressure settings, anyway?
I'd suggest auto mode, min 10, max 20.
They have. more pressure.Johnds wrote: ↑Fri Jan 03, 2020 1:11 amWhen I lay on my back, as I fall asleep, my tongue relaxes and pushes back my uvula and it gets in the way of my nasal passages when I breath out causing an exhale snore. Kind of weird, annoying, and frustrating. So I'm forced to sleep on my stomache I guess until they figure out something for that.
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TropicalDiver
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Re: Is there a mask with a decent enough check valve to release your exhale?
Let me be clear that the OP feels what he feels. That said:
a) You are not able to directly discern (without instruments or something like a flame test) whether any air is "rich" in oxygen. This is why confined space work requires extensive safety measures -- we can't really tell whether something has too little (or too much) oxygen other than through the effects (hypoxia and/or O2 tox) or instruments. We are fairly sensitive to CO2 levels though...
b) This is not like a respirator mask. Air is constantly flowing into the mask (with some amount going out the vent). I have a hard time imagining how a mechanical check valve could even work (without needing to be computer controlled).
c) In terms of warmth, please remember that compressing a gas increases the temp while decreasing pressure lowers temp. None of this happens with a respirator mask.
d) As others have noted, many thousands of people use the current technology. It works. IIRC, SCBA work it sort of a similar way.
In other words, you have convinced yourself that because the air is warm, you are not getting enough oxygen. This is almost certainly not the case (assuming you have not blocked the vent holes). That said, your perception of being short on air is a real thing to address. Others have offered some ideas.
a) You are not able to directly discern (without instruments or something like a flame test) whether any air is "rich" in oxygen. This is why confined space work requires extensive safety measures -- we can't really tell whether something has too little (or too much) oxygen other than through the effects (hypoxia and/or O2 tox) or instruments. We are fairly sensitive to CO2 levels though...
b) This is not like a respirator mask. Air is constantly flowing into the mask (with some amount going out the vent). I have a hard time imagining how a mechanical check valve could even work (without needing to be computer controlled).
c) In terms of warmth, please remember that compressing a gas increases the temp while decreasing pressure lowers temp. None of this happens with a respirator mask.
d) As others have noted, many thousands of people use the current technology. It works. IIRC, SCBA work it sort of a similar way.
In other words, you have convinced yourself that because the air is warm, you are not getting enough oxygen. This is almost certainly not the case (assuming you have not blocked the vent holes). That said, your perception of being short on air is a real thing to address. Others have offered some ideas.
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