ASV, hybrid mask, leaks, TONS of air pressure

digitalepiphany · Post by **digitalepiphany** » Sat Jan 11, 2014 2:42 am

I just my got my new Resmed S9 VPAP ST in today.
These are the settings on the machine:
IPAP - 16
EPAP - 12
Resp. Rate - 10
Ti Max - 2
Ti Min - 0.3
Rise Time - 300
Trigger - Med
Cycle - Med
Start EPAP - 4

Before I get into the mask issue, I have to say that I never got this much air coming at me on my S9 Autoset. It was set at a pressure range of 8-18 (initially, at least. I fiddled with the settings a bit), but I never experienced this amount of pressure. Any idea why this is so much more?

I'm also using a new Mirage Liberty hybrid mask. I set it up according to the instructions (I also watched 2 videos), and the pressure was making the damn thing leak like a sieve. I know that it's double-walled so that the entering air pressure creates a seal between the outer edge of the mask and my face, but this pressure just wound up blowing air out instead of creating that seal. I wound up tightening the hell out of it so it wouldn't leak, but it was just too uncomfortable. It's also really loud. I'm not sure if it's the air pressure, the mask, or a combination of the two.

If anyone has any ideas on how to fix any of this, I'd really appreciate it.
Also, any tips on my settings would help as well. Such as whether I should change anything, what some of it means, etc.

Thanks.

49er · Post by **49er** » Sat Jan 11, 2014 2:57 am

digitalepiphany wrote:I just my got my new Resmed S9 VPAP ST in today.
These are the settings on the machine:
IPAP - 16
EPAP - 12
Resp. Rate - 10
Ti Max - 2
Ti Min - 0.3
Rise Time - 300
Trigger - Med
Cycle - Med
Start EPAP - 4

Before I get into the mask issue, I have to say that I never got this much air coming at me on my S9 Autoset. It was set at a pressure range of 8-18 (initially, at least. I fiddled with the settings a bit), but I never experienced this amount of pressure. Any idea why this is so much more?

I'm also using a new Mirage Liberty hybrid mask. I set it up according to the instructions (I also watched 2 videos), and the pressure was making the damn thing leak like a sieve. I know that it's double-walled so that the entering air pressure creates a seal between the outer edge of the mask and my face, but this pressure just wound up blowing air out instead of creating that seal. I wound up tightening the hell out of it so it wouldn't leak, but it was just too uncomfortable. It's also really loud. I'm not sure if it's the air pressure, the mask, or a combination of the two.

If anyone has any ideas on how to fix any of this, I'd really appreciate it.
Also, any tips on my settings would help as well. Such as whether I should change anything, what some of it means, etc.

Thanks.

Hi,

Sorry you are having so many difficulties with this mask.

You might want to see if using a mask liner might help. I would check out http://www.padacheek.com or http://www.remzzzs.com/default.asp.

And if you PM Becky, who is with remzzzs, she will send you a free sample pack. so you could check it out to see if it would work before making a financial commitment. Do a forum search to find her name.

If for some reason, you can't get this mask to work, do you need to stick with full face masks? Many people have had success using these machines with nasal masks or pillows. But many medical professionals don't seem to realize that.

Best of luck.

49er

digitalepiphany · Post by **digitalepiphany** » Sat Jan 11, 2014 3:06 am

I can't afford anything out-of-pocket, so any liner is out of the questions.

I was using pillows before (Swift FX), but too much air was escaping through my lips. Not a mouth-breather, but I can't forcibly keep my lips closed when air wants to escape during an obstructive event. But, I like the pillows.

I was given a nasal mask to begin with, but I tend to roll onto my stomach at night, and that would dislodge that mask, so I went with the pillows. This is also the reason I went with the hybrid mask when I realized that I needed a FFM.

At this point, though, I'm more concerned with the amount of air that's coming through the hose. It's really loud. I can deal with the mask being overly tight (for a few days at least), but I can't get to sleep with all that noise so close to my face.

49er · Post by **49er** » Sat Jan 11, 2014 4:30 am

digitalepiphany wrote:I can't afford anything out-of-pocket, so any liner is out of the questions.

I was using pillows before (Swift FX), but too much air was escaping through my lips. Not a mouth-breather, but I can't forcibly keep my lips closed when air wants to escape during an obstructive event. But, I like the pillows.

I was given a nasal mask to begin with, but I tend to roll onto my stomach at night, and that would dislodge that mask, so I went with the pillows. This is also the reason I went with the hybrid mask when I realized that I needed a FFM.

At this point, though, I'm more concerned with the amount of air that's coming through the hose. It's really loud. I can deal with the mask being overly tight (for a few days at least), but I can't get to sleep with all that noise so close to my face.

Have you tried using a chin strap? Also, many people take their mouth shut although it is controversial.

Not sure about all the air coming through the hose. Hopefully, people who use a hybrid mask can comment on that.

49er

digitalepiphany · Post by **digitalepiphany** » Sat Jan 11, 2014 4:36 am

I've tried taping, polygrip cream, and polygrip strips. None worked well enough.
The chin strap does nothing for me, as I don't open my mouth when asleep. Air just escapes through my lips, so the chin strap is useless.

Thanks though.

Sludge · Post by **Sludge** » Sat Jan 11, 2014 4:38 am

Your thread title says ASV, but your machine description is ST.

What's up with that?

Julie · Post by **Julie** » Sat Jan 11, 2014 8:09 am

You can rig a liner (in pieces if necessary) from an old T shirt or something similar... not rocket science.

BlackSpinner · Post by **BlackSpinner** » Sat Jan 11, 2014 9:07 am

lab rat fixes for Hybrid

wiki/index.php/Hybrid_Mask_Modifications

squid13 · Post by **squid13** » Sat Jan 11, 2014 9:49 am

Here is some info on the ST. http://www.resmed.com/us/assets/documen ... er_eng.pdf

sawinglogz · Post by **sawinglogz** » Sat Jan 11, 2014 11:30 am

digitalepiphany wrote:I just my got my new Resmed S9 VPAP ST in today.
These are the settings on the machine:
IPAP - 16
EPAP - 12
...
Before I get into the mask issue, I have to say that I never got this much air coming at me on my S9 Autoset. It was set at a pressure range of 8-18 (initially, at least. I fiddled with the settings a bit), but I never experienced this amount of pressure. Any idea why this is so much more?

Well, 12 cmH2O is a lot more pressure than 8. Why did they use these settings?

I'm also using a new Mirage Liberty hybrid mask. I set it up according to the instructions (I also watched 2 videos), and the pressure was making the damn thing leak like a sieve. I know that it's double-walled so that the entering air pressure creates a seal between the outer edge of the mask and my face, but this pressure just wound up blowing air out instead of creating that seal. I wound up tightening the hell out of it so it wouldn't leak, but it was just too uncomfortable. It's also really loud. I'm not sure if it's the air pressure, the mask, or a combination of the two.

That's what I use too. A few tricks that have helped:

1) Don't crank it too tight. That just hurts and crinkles the silicone so that you get more leaks. Set it up looking in the mirror so that it's just resting gently against your face. Cover the hole where the elbow attaches and blow to see if you're getting leaks. You'll be surprised how loose it can be.

2) Use a mask liner. That lets it move a little and keeps slight leaks mild instead of blowouts.

3) Experiment with washing vs. not washing your face before bed. When my skin is too dry, I get more leaks.

I don't know what to say about it being loud. It's louder than straight nasal pillows, but the exhaust on mine is totally silent. I only hear the echo of my breathing in the rigid plastic.

digitalepiphany · Post by **digitalepiphany** » Sat Jan 11, 2014 12:30 pm

Sludge wrote:Your thread title says ASV, but your machine description is ST.

What's up with that?

Resmed uses VPAP instead of ASV. ST stands for spontaneous/timed.

I used ASV in the title because everyone knows what that is. Not eeryone would know that VPAP=ASV.

digitalepiphany · Post by **digitalepiphany** » Sat Jan 11, 2014 12:31 pm

Julie wrote:You can rig a liner (in pieces if necessary) from an old T shirt or something similar... not rocket science.

I'll try that tonight. Maybe.

digitalepiphany · Post by **digitalepiphany** » Sat Jan 11, 2014 12:33 pm

BlackSpinner wrote:lab rat fixes for Hybrid

wiki/index.php/Hybrid_Mask_Modifications

I actually read over that the first day I got the mask (I got it the day before the new machine, so I actually used it with CPAP first).

It seems that no matter what I do, I get leaks. I'll just keep adjusting it in the mirrors each night until I get it where it needs to be.

digitalepiphany · Post by **digitalepiphany** » Sat Jan 11, 2014 12:40 pm

sawinglogz wrote:That's what I use too. A few tricks that have helped:

1) Don't crank it too tight. That just hurts and crinkles the silicone so that you get more leaks. Set it up looking in the mirror so that it's just resting gently against your face. Cover the hole where the elbow attaches and blow to see if you're getting leaks. You'll be surprised how loose it can be. That's how I've been adjusting it, except for the hand on the hole part (I'll try that tonight). I know about the looseness from when I used just the pillows. This mask, for some reason just doesn't wan to cooperate. Couple that with the high pressures...

2) Use a mask liner. That lets it move a little and keeps slight leaks mild instead of blowouts. I'll try this as well.

3) Experiment with washing vs. not washing your face before bed. When my skin is too dry, I get more leaks. I didn't wash my face last night, so I guess I'll do that tonight.

I don't know what to say about it being loud. It's louder than straight nasal pillows, but the exhaust on mine is totally silent. I only hear the echo of my breathing in the rigid plastic. I have no idea either. I changed my settings last night, and it was MUCH quieter. I'll comment on this more in my next post.

digitalepiphany · Post by **digitalepiphany** » Sat Jan 11, 2014 12:58 pm

Mask fit: I still couldn't get the damn thing not to leak without cranking it down a LOT. It was quite uncomfortable; my nose is really tender right now. I'll try out the mask liner idea and the covering-the-hole-while-fitting-it-in-front-of-the-mirror-to-test-for-leaks idea tonight.

Pressure: I have no idea why the pressure was set so high. I've never had a titration done. This is the VA, so it takes a LONG time to get anything done there. Managed care. YAY!! On my worst night on CPAP, my 95% pressure was 14.28 (with a 98.36 AHI), but most nights, it was usually below 12. So, I'm not sure why my VPAP was set to 16. Regardless, I changed my settings last night (IPAP: from 16 to 12, EPAP: from 12 to . This cut down the vast majority of leaks (the mask still had to be overtightened to accomplish this). My 95% IPAP and EPAP last nights were 12 and 8, respectively. So, I think I'll stick with those settings for now (unless someone has a reason otherwise).

I still feel like crap, so I'm not sure what else to do at this point, other than what I plan to do tonight.

I was going to post a screenshot of SleepyHead from last night, but dropbox isn't working right now. As soon as it is, I'll edit this post.

ASV, hybrid mask, leaks, TONS of air pressure

ASV, hybrid mask, leaks, TONS of air pressure

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Re: ASV, hybrid mask, leaks, TONS of air pressure

Re: ASV, hybrid mask, leaks, TONS of air pressure

Re: ASV, hybrid mask, leaks, TONS of air pressure

Re: ASV, hybrid mask, leaks, TONS of air pressure

Re: ASV, hybrid mask, leaks, TONS of air pressure

Re: ASV, hybrid mask, leaks, TONS of air pressure

Re: ASV, hybrid mask, leaks, TONS of air pressure

Re: ASV, hybrid mask, leaks, TONS of air pressure

Re: ASV, hybrid mask, leaks, TONS of air pressure

Re: ASV, hybrid mask, leaks, TONS of air pressure

Re: ASV, hybrid mask, leaks, TONS of air pressure

Re: ASV, hybrid mask, leaks, TONS of air pressure

Re: ASV, hybrid mask, leaks, TONS of air pressure