resmed swift LT OOOUUUCCCHHH!

elader wrote:OK, spent some time adjustnig the mask - slept with it looser than I thought possible, but it did not seem to leak. Wife heard no snoring, I felt no leaking, and absolutely no discomfort. Much better.

For sure, the nasal pillow thing is strange as compared to the mask, particularily in regard to exhaling resistance, but its not a deal killer.

elader, I have felt this resistance too. For me one size larger mask reduces the resistance considerably, but it might bring back or increase the 'pressure pain' you had before. Usually this implies the straps are still too tight. Sometimes the straps are kept too tight to prevent the back strap from slipping. You may want to check into this fix:
viewtopic.php?f=1&t=35274&p=302473#p302473

I just received my Swift LT and have had similar pain problems. For me it was the tip of my nose. The pillow base pushed up against my nose and was surprisingly painful for such little pressure. I tried loosening the straps, but then it started leaking, and I couldn't position the barrel to make it stop reliably. I also tried ripping it off and throwing it to the floor (mask problems at 2AM do that to me), but that didn't seem to help either

I started with a medium and then went to large, which made it worse. Going to a small appears to have solved the pain and leakage problems, although it's hard for me to believe my nose is a "small". If I use the top clip, though, it tends to turn the barrel enough to bring the pain back, unless I leave the hose so loose that you could fly a small plane underneath. I would rather have the Swift II pillow in this design. The LT pillow seems much fatter and looks to be the cause of the problem.

But I have another question. I've read a few reviews of the Swift LT and many like the way the vents blow down instead of out. That's not happening with mine. It blows straight out, and I can't see any way to have it blow down. The vents seem to point perpendicular to the hose. So, basically, I can't face my wife with this thing on. The blowing in the ear idea is nice, but that works only for a very short time. Maybe when it gets warm out again, it can double as a fan.

So am I somehow adjusting this wrong? I can't see how, as it's a pretty simple thing. But if I'm doing something wrong, then that could explain the nose-rubbing and leaking.

And one last question - Do any of you have air leaking out of the other end of the mask's hose, where it connects to the main hose? It seems to be coming from the joint between the hose itself and the clear plastic connector. And if the hose bends a little too much, air really gushes out. It doesn't seem like a venting design, so I'm thinking of sealing it, either with some silicone sealant or maybe just electrical tape.

Well I tried the large pillows but they were just too large. Aming the three sizes, I was definitely a medium. That pain you describe was what I was feeling unless I kept the thing looser than I thought was practical. I also hated exhaling into it - inhaling was fine though. I never had that leak you are describing, but yes, the vent shot straight into my wife's face.

MarcNH wrote:I just received my Swift LT and have had similar pain problems. For me it was the tip of my nose. The pillow base pushed up against my nose and was surprisingly painful for such little pressure. I tried loosening the straps, but then it started leaking, and I couldn't position the barrel to make it stop reliably. I also tried ripping it off and throwing it to the floor (mask problems at 2AM do that to me), but that didn't seem to help either

I started with a medium and then went to large, which made it worse. Going to a small appears to have solved the pain and leakage problems, although it's hard for me to believe my nose is a "small". If I use the top clip, though, it tends to turn the barrel enough to bring the pain back, unless I leave the hose so loose that you could fly a small plane underneath. I would rather have the Swift II pillow in this design. The LT pillow seems much fatter and looks to be the cause of the problem.

But I have another question. I've read a few reviews of the Swift LT and many like the way the vents blow down instead of out. That's not happening with mine. It blows straight out, and I can't see any way to have it blow down. The vents seem to point perpendicular to the hose. So, basically, I can't face my wife with this thing on. The blowing in the ear idea is nice, but that works only for a very short time. Maybe when it gets warm out again, it can double as a fan.

So am I somehow adjusting this wrong? I can't see how, as it's a pretty simple thing. But if I'm doing something wrong, then that could explain the nose-rubbing and leaking.

And one last question - Do any of you have air leaking out of the other end of the mask's hose, where it connects to the main hose? It seems to be coming from the joint between the hose itself and the clear plastic connector. And if the hose bends a little too much, air really gushes out. It doesn't seem like a venting design, so I'm thinking of sealing it, either with some silicone sealant or maybe just electrical tape.

MarcNH wrote: I started with a medium and then went to large, which made it worse. Going to a small appears to have solved the pain and leakage problems, although it's hard for me to believe my nose is a "small". If I use the top clip, though, it tends to turn the barrel enough to bring the pain back, unless I leave the hose so loose that you could fly a small plane underneath. I would rather have the Swift II pillow in this design. The LT pillow seems much fatter and looks to be the cause of the problem.

The position of the pillow up/down (turning on the two small side swivel wheels) and the pull/push by the hose when is routed overhead interact. You need to adjust one for the other, to work together properly.

But I have another question. I've read a few reviews of the Swift LT and many like the way the vents blow down instead of out. That's not happening with mine. It blows straight out, and I can't see any way to have it blow down. The vents seem to point perpendicular to the hose. So, basically, I can't face my wife with this thing on. The blowing in the ear idea is nice, but that works only for a very short time. Maybe when it gets warm out again, it can double as a fan.

I do not think it is straight out. You can put the back of your hand a little farther away to feel the air stream. It is at about 30 deg away from straight out, dispersed. Since that swings with the tube, when your route it overhead vs straight down to under the covers, there may be a 60 deg change in the direction. BTW, I was a fan of the overhead routing, and was convinced that I absolutely liked that better, my training from my first mask, the Headrest

Now I have tried routing it straight down -- thanks to some encouragement from a few good users here --, and my whole hose is under the covers (I do have a 10' one), and I liked this much better; especially when the weather started turning cold. BTW, this reduces the rainout problem immensely.

And one last question - Do any of you have air leaking out of the other end of the mask's hose, where it connects to the main hose? It seems to be coming from the joint between the hose itself and the clear plastic connector. And if the hose bends a little too much, air really gushes out. It doesn't seem like a venting design, so I'm thinking of sealing it, either with some silicone sealant or maybe just electrical tape.

Yes! This is a problem! Some model swivels may be better than others. It is supposed to swivel very freely when loose under no air pressure inside; the air pressure should stretch out that loose slip joint and seal it. But some times it does not. Unfortunately, when it seals well, it is no longer a nice swivel I have seen other swivels that work much better with less play or a thin nylon pressure gasket inside.

If it is a real problem you can actually tape it shut with a masking tape in the stretched out position. Do not use things like silicone in breathing circuit; while curing they can be extremely toxic. My son always reminds me that when I fixed a tiny leak in his aquarium with one drop of silicone glue, about 20 years ago, all the fish died within a day--- NO EXAGGERATION! Masking tape is easy to remove, and experiment with.

For most users such tiny leaks are inconsequential. Since I use very low pressure (4.1cm was my avg last night) and very low out flow, any leaks like in that joint would register as unwanted leaks in my detailed studies of leaks over the past many months. I actually tried that by plugging the nasal pillows and finding all the other hose leaks --- yes, it may be non trivial compared to the intended out port flow.

MarcNH wrote:I just received my Swift LT and have had similar pain problems. For me it was the tip of my nose. The pillow base pushed up against my nose and was surprisingly painful for such little pressure. I tried loosening the straps, but then it started leaking, and I couldn't position the barrel to make it stop reliably.

You've gotten a whole lot of great suggestions here which will probably result in success. I'll risk becoming redundant since I think this mask is amazing. Do take time with the machine turned on, to very very slightly touch each nostril thingy to make fine adjustments to how each one seats against your nose. I have been surprised at how small an adjustment can change the overall effect, and equally surprised that the air pressure then seems to hold it right from then on for the night, once I get it right.

One more thing--be sure your pillow is right side up on the side arm hinges. The fatter part of the pillow should be down toward your mouth, and the thinner edge of the pillow with the printed ResMed logo toward your nose. Double check this to be sure, as it can throw everything off really badly if upside down.

I will add my vote for not using the clip on top of your head, and just let the hose stay straight down under the covers. In 3 months with this mask, I have only had rainout one time, and it was when I tried the top of the head clip. Major major rainout. I keep my house at 65 degrees when I go to bed, and with the hose under the covers, do not have any rainout. The vent also then blows somewhat downward rather than straight out. I also have not had painful nares since the first couple of weeks while my nose was toughening up, and after figuring out that I could safely loosen the straps.

I've never had a problem with air leaking out the bottom swivel hinge, and think if it were me, I'd return it for an exchange.

Good luck. Don't give up on it yet. Loosen those straps!

Thanks for all the great ideas. I don't plan on giving up, since I'm actually pretty close. And I really like the design of it. I know that it will work with the small pillows, but I'm going to work more with the medium. That's the size I used with the Swift II, and I would assume (even though I know the meaning of ASS-U-ME ) that the company would be consistent in mask sizes from one model to another. Also, I think the medium was quieter and I felt less resistance when exhaling.

I'll start by running the hose under the covers and see what that does. With the Swift II I had to turn the humidifier way down to prevent rainout. It'll be nice to be able to turn it up.

I'm pretty sure it's right-side-up. I go by the pillows themselves. They're set at an angle, and should be wider at the bottom, like an upside-down "V".

I think I'll fix the swivel end myself. I could try to return it, but that's more of a hassle than tape. Good call on the sealant, though. I thought of the fumes, but felt the positive pressure in the hose would keep them out. However, it's not worth the risk, as tape is easy enough. I like electrical tape because it's more flexible and stretchy. Most of the time there's very little leakage, but bending it a little makes it leak a lot.

Anyway, I'll let you know how things turn out.

OK, here I am a day later and a lot wiser. Routing the hose under the covers did the trick! I think the biggest difference is that the hose stays in basically the same position the whole time. Before, I had it going to my side and it would rotate whenever I move, which would, in turn, reposition the pillows so that they either leaked, or the base hit my nose, or both. And I really didn't like routing it through the top clip. Last night I had very few interruptions because of the mask, and no nose-rubbing at all. I was able to loosen the straps so that I almost don't feel it on me. It was a little disconcerting at first, as it felt like it would slip off at any time, but the darn thing held perfectly. And the medium size is the best. I do think it's quieter than the small and much less resistance when exhaling. I know it's a whole lot quieter than the Swift II. I'm looking forward to the warmer weather when I can open up the windows and listen to the night. What a great design!

Routing down also sends the vented air at a lower angle, as was mentioned above. Now it aims mostly at my wife's torso, where a blanket takes the brunt. All in all, this is a success. Now I just need a way to keep the hose from sliding off to the side. Maybe I can fasten the clip to my jammies Or maybe I could tie it to something, but since this forum is family friendly, I'll leave out those details. Actually, I may look into a longer hose, as I like having the machine on the floor at the head of the bed. I would lose a little pressure due to the extra length, but at these volumes, probably not much.

Also, I fixed the hose leak just fine with electrical tape. The leak wasn't on the swivel, but between the hose itself and the thin, white, plastic hose cap that goes into the swivel. If I squeezed the hose at that point, air would gush out. And even without squeezing or bending, I could feel air coming out. Now, no air escapes at all.

Thanks again for the help. Hope I can return the favor in the future.

--Marc (now OOOUUCCCHHH-less)

MarcNH wrote:Routing the hose under the covers did the trick!

Glad to be able to help out.

Now I just need a way to keep the hose from sliding off to the side. Maybe I can fasten the clip to my jammies

Route it down the middle of your bed around behind the pillow and fasten it to the bedspread with rubber bands and safety pins. Better still, route it down the middle of the bed, have the machine at your foot end of the bed at the middle. You may be able to get away with a 6' hose.

Actually, I may look into a longer hose, as I like having the machine on the floor at the head of the bed. I would lose a little pressure due to the extra length, but at these volumes, probably not much.

The pressure drop is negligible for all practical purposes at normal intended vent (leak) rates. I had measured it and reported it about 8 months ago here, when I started on cpap.

But a more relevant issue is that the increased hose volume would change your cflex/aflex type of pressure relief behavior and you may have to readjust that --- a very crude rule of thumb: setting 3 with 6' hose can be changed to a setting 2 with a 10' hose. But this depends on your pressure settings, your machine, and mostly on how you feel.

A second relevant issue is if you are very sensitive to CO2 ratios for your proper breathing (this is the case only for a small portion of the users), then the hose length increase will retain a bit more CO2 and one tends to breath a bit deeper, or in the worst case have a feel of gasping for air. In fact those, with central apneas caused by low co2 margins, may even see a significant benefit from the increased hose length -- Hs will come down!. Bottom line: after your switch to 10', monitor the data and compare with that of your 6' setup. You can also get 2 ft peices of hose and increase by just the required amount.

Also, I fixed the hose leak just fine with electrical tape. The leak wasn't on the swivel, but between the hose itself and the thin, white, plastic hose cap that goes into the swivel. If I squeezed the hose at that point, air would gush out. And even without squeezing or bending, I could feel air coming out. Now, no air escapes at all.

In that case, I consider your short hose that came with the mask to be defective, and easy to show it to whomever you bought it from. Reasonable seller should replace it. The leak I had mentioned at the swivel is a bit more difficult to prove as abnormal.