Resmed P10 nasal pillows: inhaling exhaled air.

[Visitor]

I'm using the resmed P10 nasal pillow mask, which is great so far, but I'm inhaling too much exhaled air (the air feels warm like breath when I breathe in). It makes me nauseous and I can't keep the mask on at times. I have had trouble in the last two days despite two weeks of full compliance. I tried the nasal mask as well, which helped, but it still felt uncomfortable at times for the same reason. My min pressure is set at 4.0.

Is it possible to switch off the ramp on a Breas and increase the pressure to remedy this? (the manual says not in one place and in another it says it can be done, referring to parameter settings, but I did not find any more info in that section about switching it of). Or is there another solution?

[Pugsy]

http://www.apneaboard.com/adjust-cpap-p ... tup-manual

Which Breas machine? Go to above link and see if they have the provider/clinical manual for your machine and if they do you can request if via email and the clinical manual will explain how to adjust that minimum 4.0 minimum pressure and/or turn the ramp feature off.
A lot of people have a problem with that low of a pressure. Simply not enough air moving and it doesn't matter what mask they are using. Probably 6.0 or so would be more comfortable and resolve your issues.

[Visitor]

Thanks Pugsy, I'm on a Breas iSleepi20 (this is not included in the list in my user control panel).

I checked the manual and the ramp has a minimum of 5 minutes, where it says the ramp can't be switched off.

I did fine for two weeks with both my nasal pillow mask and more recently the P10 on that low pressure. In the last two days it became a big issue. I'll check with my sleep doc to see if I can switch to a higher pressure. It is good to know others experienced this problem on that low setting as well. It's strange it took two weeks for me to get the problem though (?)

[Pugsy]

It's strange it took two weeks for me to get the problem though (?)

Actually not all that strange. When we first start therapy even that 4.0 starting point can feel like a hurricane and as we get used to the pressure it becomes nothing more than a gentle breeze so we notice that stifled feeling a lot more.

Ramp can be turned off.
I see the choice in the clinical setup menu. Looking at it right now.

Give me a couple minutes and I will send you a private message with the provider manual for that machine.

[Tatooed Lady]

I'm also new to cpap, and have a minimum pressure setting of 4. There are times that I feel like the air is stale, already breathed, etc...I lowered the humidity setting, and I am using a jar of Vicks Vaporub as aromatherapy. Both have helped me to get past the feeling. The other thing I've found is that I need to keep the room a little cooler than without a mask. I suppose it makes sense...

[Visitor]

Thanks, will try lowering the temperature as well.

[SleepyToo2]

@tattooed lady and @Visitor: When your starting pressure is set at 4, raising that will do more than anything else to improve your view of CPAP! I started off at 4, and within 2 days I realized what was going on and had the ramp starting at 6, and within another 2 days I had it starting at 8 (my prescribed pressure). It is not clear to me why the "standard" seems to be to set these machines at the minimum of 4, when most people who actually use them find 4 to be stifling. It seems that it would be more sensible to start at 6 - if you really are disturbed by that pressure, it can be lowered. Much better than having to go the other way around, IMHO.

[DKC_apnea]

I started CPAP back in late February and have been using the P10 all along. Initially I was on the small pillows (with a pressure of , and it felt like a hurricane. It was very difficult to exhale as well. Once I moved up to the medium size pillows and it was so much better. If you can move up a size in the pillows you might find that helps a lot.

With the design of the P10, the fine mesh keeps the exhaling quiet, but may give you a false sense that you are not having adequate enough exhale. I sometimes hold my fingers close to the mesh just to reassure myself it is working as it should. Make sure when you sleep that your mask is not resting up against your pillow or anything else that could hinder air flow through the mesh. Also may sure to clean the mask weekly, and make sure it is rinsed and allowed to dry before using again. I've notice the fine mesh can hold onto water longer, so it is important that it is dry and clean.

[bavinck]

In two months I have not cleaned my mask and not had any problems with plugged vents. I use a heated hose to prevent rainout. Otherwise I am not sure why you would have problems with a plugged vent. Weekly cleaning, to me, seems like big time overkill.

[Visitor]

@tattooed lady and @Visitor: When your starting pressure is set at 4, raising that will do more than anything else to improve your view of CPAP! I started off at 4, and within 2 days I realized what was going on and had the ramp starting at 6, and within another 2 days I had it starting at 8 (my prescribed pressure). It is not clear to me why the "standard" seems to be to set these machines at the minimum of 4, when most people who actually use them find 4 to be stifling. It seems that it would be more sensible to start at 6 - if you really are disturbed by that pressure, it can be lowered. Much better than having to go the other way around, IMHO.

[Visitor]

Sorry, meant to add this to the above quote (can one edit on this forum?):

I think you're right. My sleep doc agreed to try a higher setting. One reason for starting with a low pressure might be that it is harder to adjust downwards once you are used to higher pressure (for the same reasons as we are discussing here, i.e. feeling you're not getting enough air etc). Just a thought. But I look forward to trying 6 or higher.

[DKC_apnea]

In two months I have not cleaned my mask and not had any problems with plugged vents. I use a heated hose to prevent rainout. Otherwise I am not sure why you would have problems with a plugged vent. Weekly cleaning, to me, seems like big time overkill.

Well ResMed actually recommends daily cleaning . http://www.youtube.com/watch?v=0j6YkYuqqk0
I didn't say the vents would become plugged, but they may not ventilate the air as well if they are allowed to get dirty. Remember you are exhaling moist air that has circulated through your sinuses and lungs. If you think that is free of any germs, think again.

I clean the pillows daily, and the mask once a week. Since the pillows are in direct contact with your skin, they should be cleaned regularly to prevent oil, germs and bacteria from accumulating. The mesh also can accumulate fine particles as you exhale. The tubing may take longer to get dirty, but some of your exhaled air is making its way down the tube, and with time will become dirty as well.

Ultimately it is your own personal choice how often you clean your equipment.

[bavinck]

Cleaning of equipment is a personal preference, sure. However, it should be noted that daily (or even weekly cleaning of hoses) of your cpap is a bit ocd. Some folks daily wipe the surface of the mask to remove face oils, that seems legitimate as a method of prolonging the life of silicone, although I will not do it. Germs and bacteria from your breath are a different matter though (keep in mind not all are small enough to be airborne - that's why nose hairs work), as they are coming from inside your body through air. How can they make you sick?

Furthermore, studying up on fluid dynamics and pressure in physics will show you that the air your breath, when the equipment is working as intended, will never go down the hose. The hose will only ever have air exchanging in your mask. Also, Assuming rainout is not a significant issue, a dry mask with constantly circulating air will be cleaner than any sink tap you use after washing your hands, and it will all be germs from your own body!

For peace of mind certainly clean however you want, nobody is going to fault you for that. Just don't post those ideas on an online forum, spreading bad science and expect nobody to call you on it.

Oh, yes resmed recommends daily cleaning. You don't think that is more about liability regarding equipment than actual health concerns?

[DKC_apnea]

Cleaning of equipment is a personal preference, sure. However, it should be noted that daily (or even weekly cleaning of hoses) of your cpap is a bit ocd. Some folks daily wipe the surface of the mask to remove face oils, that seems legitimate as a method of prolonging the life of silicone, although I will not do it. Germs and bacteria from your breath are a different matter though (keep in mind not all are small enough to be airborne - that's why nose hairs work), as they are coming from inside your body through air. How can they make you sick?

Furthermore, studying up on fluid dynamics and pressure in physics will show you that the air your breath, when the equipment is working as intended, will never go down the hose. The hose will only ever have air exchanging in your mask. Also, Assuming rainout is not a significant issue, a dry mask with constantly circulating air will be cleaner than any sink tap you use after washing your hands, and it will all be germs from your own body!

For peace of mind certainly clean however you want, nobody is going to fault you for that. Just don't post those ideas on an online forum, spreading bad science and expect nobody to call you on it.

Oh, yes resmed recommends daily cleaning. You don't think that is more about liability regarding equipment than actual health concerns?

Cleaning simply reduces the chances of bacteria accumulating either in the mask itself or along the tubing or in the reservoir. How often you feel that is necessary, is ultimately your choice.
Others in the forum may be interested to note that both the Canadian Lung Association and the U.S. National Heart Lung & Blood Institute recommend daily cleaning of masks, and weekly cleaning of hoses.

[Visitor]

A lot of people have a problem with that low of a pressure. Simply not enough air moving and it doesn't matter what mask they are using. Probably 6.0 or so would be more comfortable and resolve your issues.

Pressure 6 did the trick. Thanks Pugsy!