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[CPAP] Why are masks designed with holes? (probably a dumb question)
#1
Why are masks designed with holes? (probably a dumb question)
I'm not sure if it was Confucius that once said that if you ask a question you look stupid for 5 minutes, but if you don't, you'll be stupid for the rest of your life.
So here I am, claiming my five minutes.
 
I am trying to understand if my mask leaks air, but before I do that I need to understand why my CPAP mask is designed the way it is designed, i.e. with two "openings" in different parts of the mask that are obviously "leaking air by design".

I am attaching a picture that illustrates the area of the mask with the (manufacturer's) "holes". When I wear the mask, I can feel air coming out from both areas. Isn't the mask supposed to be air-tight? What am I missing about how those masks are designed? How can they guarantee a certain pressure if the masks leak?

Thank you

Fillmore


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#2
RE: Why are masks designed with holes? (probably a dumb question)
Where does your exhaust air go. If nowhere you are constantly rebreathing the same air. This contains CO2 which needs to be vented. There is a constant engineered vent rate in all masks that is designed to clear your exhausted air so that it doesn't become a problem.

Pressure is maintained by sending air to the mask fast enough to make up go the leaks

When you have a large enough leak that the pap machine cannot keep up with a large leak is indicated on your charts.
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#3
RE: Why are masks designed with holes? (probably a dumb question)
Think about your breathing without mask. Unmasked, you breathe in then out, either by nose or mouth. Once the mask is introduced, you need to maintain inhale and exhale abilities. The airflow from the PAP is one way however and represents inhale only. Next, add in the vent holes. Now you've reintroduced the exhale ability.

Vents are required on a nasal or pillows mask as you can't reliably inhale nasally and exhale via the mouth and maintain the positive pressure. It also would hinder accurate therapy monitoring.

Full face masks need vents even more than the other masks as mouth and nose are covered by this mask. The full face mask also needs an anti-asphyxiation valve typically found in the elbow in case of power outage.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Why are masks designed with holes? (probably a dumb question)
Gideon, Dave, you guys are Rock stars. Thanks a ton for the explanation.

Fillmore
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#5
RE: Why are masks designed with holes? (probably a dumb question)
Another way to think about it is a CPAP is not a ventilator. It's not literally breathing in and out for you. A basic CPAP is just trying to elevate the air pressure in your airway by about 5%, to help keep things open. While it's less efficient to maintain pressure with all the leaks but it's not a big deal. And the leaking is important for CO2 exchange.
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#6
RE: Why are masks designed with holes? (probably a dumb question)
(10-24-2021, 01:33 PM)NelsonM Wrote: Another way to think about it is a CPAP is not a ventilator. It's not literally breathing in and out for you. A basic CPAP is just trying to elevate the air pressure in your airway by about 5%, to help keep things open. While it's less efficient to maintain pressure with all the leaks but it's not a big deal. And the leaking is important for CO2 exchange.

Thank you Nelson. I see you are using ResMed. Do you happen to also have experience with the DreamStation? In that case can you comment on how the two machines compare?
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#7
RE: Why are masks designed with holes? (probably a dumb question)
I can comment some to using DreamStation 1 Auto BPAP and several ResMed 10 series machines, AutoSet, ASV, ST-A.

Each are very different levels of treatment, so I'll focus on generalities.

Form factor is obviously different ResMed vs Respironics, especially with the humidifier. ResMed's is integrated while Respironics is a separate, piggy back unit. On the Auto CPAP machine level, ResMed has EPR vs Respironics Flex, EPR tends to be more effective at boosting therapy. Both brands respond to different key events, ResMed keys on flow limits for example on CPAP. ResMed has been commented on as being more effective and comfortable for users of both. Just a few items.

From myself, I have both Central Apnea and COPD, so I need a high level device, my RT stated if I prefer ResMed's breath pattern to stay with it then. Respironics will be very different in pattern and feel. However don't let that stop you from getting the best machine for yourself. If you think ResMed will improve your therapy, go ahead and switch.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Why are masks designed with holes? (probably a dumb question)
The AutoSet is sooo much more capable.

ResMed AutoSet Dreamstation Auto comparison
Why ResMed?
1. Faster algorithmic response to events than PR.
2. ResMed Responds to Flow Limits
   PR responds to Snores
3. Lower average pressure (PR require a higher pressure to ward off obstructive events)
4. Better to avoid Aerophagia.
5. Flex is not the same as EPR
6. EPR provides for better treatment of hypopneas, RERAs, Flow Limits, UARS, and snores
7. EPR acts like a BiLevel up to a limit of 3cmw (1,2, or 3cmw) and a max pressure of 20 cmw
8. EPR follows your breathing whereas Flex predicts it with a feeling of fighting to get a breath when it predicts incorrectly
9. More flexibility in treating a greater variety of Apneas and respiratory events.
10. In general ResMed provides better therapy.
I have frequently told many DreamStation users that they need to get either the ResMed AutoSet or BiLevel to get better therapy. 
11. DS1 has been recalled
12. DS2 has encrypted the detailed data on the SD card "so that you, the user must uti, IMHO this alone is a deal breaker.  IMHO a machine I use MUST allow OSCAR to access the detailed data. A reply from a PR rep " I can say that with the DreamStation 2 machines, we have moved away from patients being able to read the SD cards themselves (the SD cards can still be read by your doctor and medical supply company though)."
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#9
RE: Why are masks designed with holes? (probably a dumb question)
Incredible posts.

fillmore50 these participants that responded have done so much for me. Although I've been compliant for almost 35 years I never felt better due to my treatment. Now I do after following the recommendations given to me here. I have a ResMed S10 "for her" machine. I set it up following those recommendations. And I feel so much better.
DaveL
compliant for 35 years



I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

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#10
RE: Why are masks designed with holes? (probably a dumb question)
(10-27-2021, 10:45 AM)DaveL Wrote: Incredible posts.

fillmore50 these participants that responded have done so much for me. Although I've been compliant for almost 35 years I never felt better due to my treatment. Now I do after following the recommendations given to me here.  I have a ResMed S10 "for her" machine. I set it up following those recommendations. And I feel so much better.

Incredible is the right word, Dave. I can see that this place is chock full of rock stars. Thank you, guys. You are worth your weight in gold. You have my gratitude.

I hope I'll have the chance to return the favor one day.

Fillmore
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