Is Expiratory Puff Possible with FF Mask, Chinstrap, and Mouth Tape?

I sometimes get about 30 minutes of the attached breathing flow pattern that I think are called expiratory puffs. I get them on left, right, and back sleeping positions, and in this case with my normal F20 full face mask + chinstrap + mouth tape (the latter two added just as an experiment). Question for anyone knowledgeable on this stuff: Am I correct that this is expiratory puff and is there anything that can be done to eliminate it, or is it worth even trying to eliminate? Thanks for any help anyone can provide.

Tyler2 wrote: ↑

Wed Mar 12, 2025 1:09 pm

Am I correct that this is expiratory puff and is there anything that can be done to eliminate it, or is it worth even trying to eliminate?

while we wait for the experts, let me blither for a bit.

your ahi is 0. that is the absolute best ahi you can get. it's like golf in that the lower the score, the better.

unless this is interfering with your sleep, I see no reason to do anything.

My AHI is not always 0 but always below 2 so I agree basically a non-issue, but these expiratory puffs (if that's what they are) sometimes precede a wakeup, which is why I'm interested in eliminating them if able.

Tyler2 wrote: ↑

Wed Mar 12, 2025 3:56 pm

My AHI is not always 0 but always below 2 so I agree basically a non-issue, but these expiratory puffs (if that's what they are) sometimes precede a wakeup, which is why I'm interested in eliminating them if able.

AH! then i'll step aside and let the more knowledgeable folk answer.

good luck!

What is an "expiratory puff"? Did you read that someplace?

Can't remember where I got the term "expiratory puff," but this link (https://www.apneaboard.com/wiki/index.p ... imitations) says my flow rate pattern is ""Expiratory mouth breathing", but I don't see how that can be true since I have a chinstrap, mouth tape, and full face mask.

Tyler2 wrote: ↑

Thu Mar 13, 2025 8:45 am

... I don't see how that can be true since I have a chinstrap, mouth tape, and full face mask.

Zackly. The exhalation needs to be lost, and the inspiratory and expiratory volume look to be the same (you can get an app to measure Area of Irregular Shapes but it costs $$$).

Might be some palatal interference, but IMO looks more like a settings issue.

What are Ti min: and Exhalation: set to?

Nocibur wrote: ↑

Thu Mar 13, 2025 10:41 am

What are Ti min: and Exhalation: set to?

Ti min/max: 0.3-3.0
Cycle: Med
Trigger: Very High (reduced CAs)

Tyler2 wrote: ↑

Thu Mar 13, 2025 10:54 am

Cycle: Med

no, Exhalation, should be right after Ti Min.

Nocibur wrote: ↑

Thu Mar 13, 2025 11:02 am

no, Exhalation, should be right after Ti Min.

There's no setting called "exhalation" (The user flags shown in the screenshot are set to detect a 20% or greater flow restriction for 8 or more seconds since my AHI is always low; not sure how useful this experimental function is).

Tyler2 wrote: ↑

Thu Mar 13, 2025 11:34 am

There's no setting called "exhalation"

Try the Menu:

No setting called "exhalation" on my AirCurve 11. Perhaps "Cycle" is the same thing (which I have left at the preset setting of medium): "Cycle– This is the sensitivity setting that tells the device to switch back from IPAP to EPAP on exhalation. It is adjustable from Very Low to Very High and comes preset in Medium. Patient with unique conditions may benefit from adjustments here" (https://cpapmyway.com/blog/aircurve-11- ... p9AoN_pA0a).

Look to be slightly different, but WTH give it a shot.

So which way would you adjust the exhale sensitivity (right now set at medium)? Make it lower sensitivity so there will be less tendency for the sharp downward exhale (so "low" or "very low" setting)?

IDK why you're doing those blips or if in fact it's even an issue (you might load up a night with that into SleepHQ to try to figure out if it really causes arousals) and it's a comfort measure so you might not even like your choice. Why not fiddle with it now to see what's most comfortable, then test with both extremes to get some data.
If it doesn't budge consider palatal interference.