Resmed F20 mask flap valve trouble

I am new to CPAP and a sleep study showed I need a full face mask. The sleep tech fitted me with the memory foam version of the ResMed F20. Worked great in the sleep lab. Back home I attached it to my dream station machine. Switching on the machine, the flap valve changes the seal from the tube to the side vents. Whenever I inhale rapidly the flap valve moves away from the wall with an increase in air resistance and towards the end of inspiration it snaps back against the outer vents with a loud clunk. This makes this pleasant mask unusable unless I inhale very slowly. Any suggestions?

With the machine off, the flaps allow you to breath in through the hose, and will they will close when your intake of air stops. When you exhale, the flaps drop back down and the air flows out the sides of the elbow. This prevents you from inhaling the carbon dioxide you just exhaled. When the machine is working, the air flow coming into your mask from the machine should cause the flaps to go up against the sides of the elbow. If they are coming away from the sides of the elbow when you inhale, your pressure must be set very low. What kind of machine do you have, and what pressure is it set for?

Thanks for this explanation. Dreamstation. Settings Auto 5-15. Any solutions?

Raise the min. pressure to 7 and see how that works... leave the max where it is or even better raise it to 20.

Are you using the ramp feature?

Donag wrote: ↑

Fri Sep 20, 2019 7:10 pm

Thanks for this explanation. Dreamstation. Settings Auto 5-15. Any solutions?

Set your min pressure to 7

Raising auto to 7 - 20 worked. Now on a mission to reduce AHI below 7.5 (12 clears, 7 obstructive, total hypos 42. Min P 7.0, max P 19.9, 90% P 8.9. AutoCPAPwithaflex). Any thoughts on next best steps short of a tracheostomy? A link to previous discussions would be fine. Thanks all of you for your thoughtful engagement and suggestions

Donag wrote: ↑

Sat Sep 21, 2019 5:29 am

Raising auto to 7 - 20 worked. Now on a mission to reduce AHI below 7.5 (12 clears, 7 obstructive, total hypos 42. Min P 7.0, max P 19.9, 90% P 8.9. AutoCPAPwithaflex). Any thoughts on next best steps short of a tracheostomy? A link to previous discussions would be fine. Thanks all of you for your thoughtful engagement and suggestions

Post pics as detailed in the "newbies, read this before posting" notice on the front page.

I read the newbie thread and searched it - nothing about pics, aside from a comment that text is better than images. Please could you explain.

Donag wrote: ↑

Sat Sep 21, 2019 4:16 pm

I read the newbie thread and searched it - nothing about pics, aside from a comment that text is better than images. Please could you explain.

There is a link mentioned in the "newbies please read" sticky that will take you to a thread where how to post and what to post in terms of the software reports.
Reread #3 and #4 again.

Like this?
Remain interested in algorithm as to how to most efficiently get from AHI 7 to as low as possible - is this the holy grail? Links would be fine.

For obstructive apneas and hyponeas the most common way to reduce the numbers is more minimum pressure.

I increased the auto CPAP at your advice to 8.5 to 20. My AHI last night was 3.8 (I started at 35). This is an outstanding result. I am aware of few symptoms from OSA - Epworth 3. However, I am hoping a few weeks of this will give me something. I presented with syncope with a deep dream state - so, I still don't know if this was narcoleptic or a faint for some other reason followed by REM rebound due to sleep apnea. "Curiouser and curiouser". I am grateful to all of you for helping me get an AHI < 5. I will see what it takes to reduce this score some more. As a physician, I know that an iterative set of sleep center visits would have taken weeks to have tuned this. "Physician, heal thyself"!

What if the flaps stay open while exhaling? I’m assuming my pressure is too high. 19/25

I'm going to guess that you have the mask type/resistance set to X0. That is the official Phillips Respironics recommendation for any non-PR mask. It is what Respiratory Techs are trained to do, and also what some here will tell you. It is also utter nonsense unless you sleep with the end of the hose directly in your mouth. The mask type/resistance setting (along with the hose type setting) tells the machine how to compensate for the pressure drop in the mask (and hose) that is proportional to airflow. I recommend using X1 for the F20 (most of its resistance is in the elbow, but that still counts). The X0 setting is just their CYA means of absolving themselves of any liability for other companies' masks, but it unfortunately doesn't change the physics.

FWIW, even with the pressure at 13, those valves popping when I took an even moderately deep breath, and the mask sucking in toward my face every time I inhaled, drove me batty. X1 is much more comfortable.