Water in mask

[Shannon1dempsey]

I've been buying new pieces for my CPAP machine. It is a few years old. Mask came first, but for some reason I bought from Amazon and didn't buy Resmed. Tight fit but don't enjoy putting it on because of the clips on the straps. Also, my hose did not fit properly to the new mask and I had to buy something to give it a tight fit. I've replaced the water container with Resmed. I have to have the water or I dry up and can't breath, but I've been getting water in my mask instead of a mist or steam. Why is water coming through the tube into my mask? Do I need to buy everything new? I really feel exhausted some days and hope it is just because I'm not getting enough sleep.

[Julie]

Have you placed your machine on something lower than your head - water will then run down to it, not yourself. Why do you want a tight fit - it should 'hover', because too tight is counterproductive... new little leaks open up instead. What number is your humidifier at?

[robysue1]

I have to have the water or I dry up and can't breath, but I've been getting water in my mask instead of a mist or steam. Why is water coming through the tube into my mask? Do I need to buy everything new? I really feel exhausted some days and hope it is just because I'm not getting enough sleep.

Water in the tube and/or mask is called rainout. It comes from water vapor (from the heated humidifier) condensing in the tube (or mask) for the basic reason that the air temp in the tube (or mask) is cool enough to trigger condensation based on the amount of water vapor the air contains.

It would help us help you if we knew the following things:

1) What machine are you using?

2) What do you have the humidifier set at?

3) Do you use a heated hose? If so, what hose temperature are you using?

4) If you are not using a hose, how cold is your bedroom? Do you hang the hose? Do you run the hose on top of the bedcovers? Do you run the hose beneath the bedcovers?

5) Is the water condensing in the mask or in the hose itself?

You also write:

I've been buying new pieces for my CPAP machine. It is a few years old. Mask came first, but for some reason I bought from Amazon and didn't buy Resmed. Tight fit but don't enjoy putting it on because of the clips on the straps. Also, my hose did not fit properly to the new mask and I had to buy something to give it a tight fit.

What mask are you using? Your mask problems may or may not be connected to your rainout issues, but to get back to getting good quality sleep will require you to fix both the rainout problem and the mask comfort problem.

[chunkyfrog]

Rainout---evaporated water (which you want) touches a cold hose or mask,
and turns to liquid water (not wanted)
A warmer room or heated hose can prevent this; or you can use a hose cozy,
which can be fleece wrapped around the hose (in a pinch) or a special made sleeve.

[Shannon1dempsey]

It would help us help you if we knew the following things:

1) What machine are you using? Resmed Air Sense 10

2) What do you have the humidifier set at? 6

3) Do you use a heated hose? If so, what hose temperature are you using? No to heated hose

4) If you are not using a hose, how cold is your bedroom? Do you hang the hose? Do you run the hose on top of the bedcovers? Do you run the hose beneath the bedcovers? Temp varies between 66 and 72 with hose on top of bedding. Bedding usually gets kicked off.

5) Is the water condensing in the mask or in the hose itself? Water condenses in the mask.

I like the idea of a heated hose or a wrap around hose. I didn't have trouble until I moved to my current location and have been having trouble controlling heat in the bedroom, but I don't want it to get much over 70.

Thank you very much. I will keep in touch.

[D.H.]

The standard answers were mostly given already. I'll reiterate them anyhow.


1) Make sure that the unit is lower than your head.
2) Use a heated hose if you're not already doing so. If you are, try setting it higher.
3) Lower the humidity setting on your unit.
4) Raise the ambient temperature in the room.

[robysue1]

3) Do you use a heated hose? If so, what hose temperature are you using? No to heated hose

All the rest of my answers are based on this one.

1) What machine are you using? Resmed Air Sense 10

This handy little chart from Resmed explains the target humidification level for each setting of your humidifier when a ClimateLine hose is not being used. It gives an indication of minimum room temperature to avoid rainout in the hose.

It's worth noting that absolute humidity is the actual amount of water contained in one liter of air. Relative humidity is the ratio of the actual amount of water in one liter of air divided by the theoretical maximum amount of water the air can contain as water vapor---i.e. before condensation starts. As the temperature of the air goes up, its ability to hold more water vapor also goes up. What this means is that if you put 14 mg of H2O into one liter of air when the air temp is 45F, the relative humidity is higher than if you put that same 14mg H2O into one liter of air when the air temp is 80F.

Nose comfort, however, may depend on both the absolute humidity and the relative humidity. In other words, a particular nose might be happier with a constant relative humidity rather than specific absolute humidity. In theory, this means that you might be able to get away with turning the humidifier down when your bedroom is cool as compared to what you need to set it at when your bedroom is warm.

But note, not all noses have read that nose instruction manual: My own nose pretty much starts objecting to me turning the humidifier down from its maximum setting regardless of whether my bedroom is a chilly 58-60F (in the winter time) or a much too warm for comfort 75F on a hot, sticky humid night where we're not running the AC for some reason. (How much water my xPAP's humidifier uses under those two conditions is quite different, however.)

2) What do you have the humidifier set at? 6

In theory you shouldn't be getting rainout in the hose if your bedroom temperature is at or above 72F. But that doesn't mean you will get rainout every time you use the xPAP with the humidity set at 6 and your bedroom temp is below 72. More on this in response to your answer to Question 4.

4) If you are not using a hose, how cold is your bedroom? Do you hang the hose? Do you run the hose on top of the bedcovers? Do you run the hose beneath the bedcovers? Temp varies between 66 and 72 with hose on top of bedding. Bedding usually gets kicked off.

If your bedroom's air is already reasonably humid, the AirSense humidifier won't try to put as much additional humidity into the air that is going through the tube, and a lot of times that may be all that is needed to help minimize the rainout problems.

Even without a heated hose, the fact that the water in the humidifier is heated means the air in the hose is going to pick up a slight bit of heat as it absorbs the warm water moisture. Insulating the hose by using a hose cozy can help keep the air in the hose just a wee bit warmer than the ambient air temperature.

Running the hose under the covers dramatically increases the ambient temperature that the hose is running through, which keeps the slightly warmer than room temp air in the hose from losing additional heat and triggering rainout.

5) Is the water condensing in the mask or in the hose itself? Water condenses in the mask.

The fact that you're getting water condensing in the mask means that you are dealing with more than just the water from the humidifier. Every time we exhale, we exhale a certain amount of water vapor. And the air that we exhale is warm---as in pretty close to our body temperature.

So the air that is inside the mask has not one, but two sources of water vapor: The water vapor in the air coming in from the tube and the water vapor in your breath when you exhale.

The air inside the mask is also a mixture of very warm air (from your exhalations) and relatively cooler air (from the hose, which is most likely either at room temperature or very slightly above room temperature because of the heated humidifier and the fact that your hose is not a heated hose. When the warm moist air hits cooler air, the temperature of the warm moist air falls. And when the temperature falls, condensation can happen. Think about how you can "see" your breath when you exhale on a cold crisp winter morning: What you are seeing is the moisture from your exhalation condensing as it cools in the cold air you are exhaling into.

Now when you are exhaling into a reasonably small, mostly closed in container like the mask, that extra humidity from your exhalation can't just dissipate. It condenses on the relatively cool inside surface of the mask. And you get water in the mask and a wet, uncomfortable nose.

So what's the fix for this problem?

Basically you've got to do one of two things: (1) Reduce the absolute humidity in the air in the mask or (2) Increase the temperature of the air in the mask. Or both (1) and (2) at the same time.

The only way to reduce the absolute humidity in the air in the mask is by turning the humidifier setting down. That may or may not be enough to prevent the water vapor from condensing in the mask because most of that water vapor in the mask is coming from your own exhalations.

Increasing the air temperature in the mask is not always as simple as putting a hose cozy on an unheated hose. But even that little bit may make the air coming from the tube just a wee bit warmer because less heat will be lost between the time the air leaves the heated humidifier and gets to the mask. Running the hose under the covers can help quite a bit: The ambient temperature of the air under your covers is much closer to body temperature. That might help warm the air in the hose a bit and it certainly will prevent the air in the hose from losing additional heat as it makes its way from the heated humidifier to the mask end of your hose.

If you are using nasal pillows adding a pillows cozy may help. (Padacheek sells pillows cozies.) The pillows cozy will help keep the air inside the pillows a bit warmer and that can help prevent condensation. On the coldest nights, I've been known to double up on nasal pillows cozies, and that can make a bit of a difference when our bedroom is really, really cold.

Finally, a heated hose may help. But a heated hose will only help if the air temp for the hose is set above the ambient temperature in the room. The heated hose will keep the air in the main tube at the desired temperature if the desired temp is above the room temperature. But it won't prevent heat loss in the small hose that connects from a nasal pillows mask to the main hose. It also won't prevent heat loss if your main hose is attached at the top of your head and the air then travels through the mask frame.

If your mask has a short hose, adding a hose cozy for the short hose can help. If your mask has the hose attach at the top of your head and then routes the air through the frame, adding a frame cushion (also sold by Padacheek) can help keep the air from losing heat in that last little bit of its journey.

And, of course, you can increase the air temperature in the mask by increasing the temperature of air in the bedroom.


Finally, you write:

I like the idea of a heated hose or a wrap around hose. I didn't have trouble until I moved to my current location and have been having trouble controlling heat in the bedroom, but I don't want it to get much over 70.

If you're having trouble controlling the heat in your bedroom, that may be why you might see more of a condensation problem on some nights as compared to others.

But you should not need to make your bedroom over warm just to fix the condensation problem.

By preference, my husband and I keep our bedroom quite chilly---in the winter we have the night time thermostat set to 58F and we also have the heater vents to our bedroom closed most of the way. And yet I can manage the rainout problems caused by my nose's wanting the humidifier set to its maximum setting even though I don't use a heated hose. Do I get rainout on some nights? Yes. But it's not every night and its a manageable problem when it happens.

What do I do to prevent rainout in the mask even though I have an unheated hose in a cold bedroom with a nose that wants lots and lots of moisture?

• I use a hose cozy on the main hose.
• I use a hose cozy on the short hose.
• I use a pillows cozy on the nasal pillows.
• I run the main hose under the covers and along my body.
• I sleep with my head (and mask) under the covers. I do make sure the mask can vent, but the fact is I was sleeping with my head under the covers much of the night before I ever put a CPAP mask on my face. And one benefit of CPAP is that I've got a fresh air supply coming in through the hose without the need for me to figure out how to build a "breathing hole" the way I used to do in my pre-CPAP days.

Good luck with figuring out a way to keep your nose both happy from enough moisture and dry because there's no rainout in the mask.

[lynninnj]

I bet you lived physics in school RS.

You explained that brilliantly.

[robysue1]

I bet you lived physics in school RS.

Math yes. Chemistry yes. Geology yes.

I took physics, did well in it, but did not like it. Gravity didn't work right for me and my lab partner in one lab, and that pretty much made me not like physics.

However, if you teach as much calculus as I have in the last 40 years, you do learn some basic physics.

You explained that brilliantly.

Thank you!