Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

EVIDENCE OF AIRFIT P10 VENT OBSTRUCTION CAUSING HYPERCAPNIA
#21
RE: EVIDENCE OF AIRFIT P10 VENT OBSTRUCTION CAUSING HYPERCAPNIA
In order to keep mdmarmd’s thread on topic, the posts discussing the differences comparing the ResMed P10 mask and the F&P Brevida have been moved to their own thread.

http://www.apneaboard.com/forums/Thread-...ResMed-P10
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#22
RE: EVIDENCE OF AIRFIT P10 VENT OBSTRUCTION CAUSING HYPERCAPNIA
Hooly Dooly thats some next level research right there!

  [Image: homerun1.jpg]

Argue with that will ya.....

Well done.
Post Reply Post Reply
#23
RE: EVIDENCE OF AIRFIT P10 VENT OBSTRUCTION CAUSING HYPERCAPNIA
(02-24-2019, 11:29 PM)mdmarmd Wrote: The Resmed Airfit P10 user manual instructs and warns:
 
GENERAL WARNINGS
 
·      The vent must be kept clear.
 
·      The mask should only be used with CPAP or bilevel
      devices recommended by a physician or
      respiratory therapist.
 
·      The mask should not be used unless the device is
      turned on.
      Once the mask is fitted, ensure
      the device is blowing air.
 
Explanation: CPAP and bilevel devices are intended to be used with special masks (or connectors) which have vent holes to allow continuous flow of air out of the mask. When the device is turned on and functioning properly, new air from the device flushes the exhaled air out through the mask vent holes. However, when the device is not operating, insufficient fresh air will be provided through the mask, and the exhaled air may be rebreathed. Rebreathing of exhaled air for longer than several minutes can, in some circumstances, lead to suffocation.
 
·      As with all masks, some rebreathing may occur at
     low CPAP pressures.
 

 
·      Make sure that you keep changing your CPAP filter
     regularly.  Don’t wait until it has a significant layer of
     grey dust over it. (I recall reading a post that
     questioned why one needs to use a filter on the
     CPAP.  The response was it retards the
     accumulation of dust on the blower blades.  In this
     instance, it serves a much more
     critical function.)
 
·      Wash your vents regularly and visually inspect them
      carefully.  (Make sure to press something
     white like tissue paper behind the inner surface of
     the vent during your inspection as this
     accentuates the appearance of accumulated dust.)
     
     When they begin to look slightly darker or
     grey/brown compared to a new P10, be aware that
     they might occlude if there is condensation and may
     need to be replaced.
 
·      Try to minimize conditions that promote
     condensation, especially during colder weather;
     adjust ambient temperature, use a heated supply
     line and a warming jacket.  However, I have
     experienced occlusion even when there is barely
     detectable condensation.
 
·      Consider avoiding the use of the Expiratory
      Pressure Reduction feature in conditions when
     the risk of condensation is greater since a reduction
     in average pressure might reduce
     ventilation of CO2, and increase the risk of vent
     occlusion
 
·      Frequent replacement of the frame may be
     necessary, particularly if you live in a dusty
     environment.

·      Remember: Some members have reported
     obstructed vents with NEW P10's so in certain
     circumstances, condensation alone may be
     sufficient to cause occlusion

This is great stuff! I'm a bit concerned now as a new user (about to get my stuff, and locally to you, as well!) and the P10 was recommended for me. 

I guess keeping the filters clean/properly replaced, possibly running an air purifier in the room, and making sure the air vents out on exhales should be "good enough" at this time? 

My pressure per my RX was indicated as 6-10. Should I ask for them to keep it higher or increase the floor? You mention above that the risk for rebreathing is higher in low pressure settings.
Post Reply Post Reply
#24
RE: EVIDENCE OF AIRFIT P10 VENT OBSTRUCTION CAUSING HYPERCAPNIA
It appears that moisture in the vent mesh is the main cause of occlusion in the real world. I am guilty of rarely cleaning the mask frame, and that may be a key to why I have never experienced the occlusion. Have you tried comparing the flow rate and leak rate data from an occluded mask vs an open mask?
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#25
RE: EVIDENCE OF AIRFIT P10 VENT OBSTRUCTION CAUSING HYPERCAPNIA
I was never a fan of P10, finally some real data as to why.

@Sleeprider

You may have very well been using an unintended EERS from the beginning. Ever tried your therapy with a different nasal mask?
Post Reply Post Reply
#26
RE: EVIDENCE OF AIRFIT P10 VENT OBSTRUCTION CAUSING HYPERCAPNIA
(02-28-2019, 03:16 AM)crowtor Wrote: I was never a fan of P10, finally some real data as to why.

@Sleeprider

You may have very well been using an unintended EERS from the beginning. Ever tried your therapy with a different nasal mask?

I started on the Comfort Gel nasal mask with a M-Series, and moved to the Swift II. The Swift LT was released in June 2008, an I was one of the first to buy. The Swift FX came out in 2010 I think, and I also bought that as they became available. The Airfit P10 has not really been around more than 5-years and is the first and only mask to use the quiet mesh vent.  I recall my AHI was higher before the Airfit, but until I finally upgraded my machine in 2014 from the M-Series to PRS1, I did not have any idea what events were OA or CA.  I find it is very easy to know that the P10 is venting properly. I can feel the venting and if you cup your hands over the vents, the movement of air is very noticeable.  I think the key here is that I have never had condensation that could block the vents. I have always used a tube cover and heated tubing.

So this is where I started, and it had a gale of air coming out of that barrel.

[Image: Mirage-Swift-II-Nasal-Pillow-System-720x576.jpg]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#27
RE: EVIDENCE OF AIRFIT P10 VENT OBSTRUCTION CAUSING HYPERCAPNIA
I’ve been using the P10 since 2014 with no problems at all.  I’ve tried other masks, but end right back with the P10.

I clean the vents once a month, using Dawn soap and a soft toothbrush.  Scrub lightly, rinse well, then shake the mask in the shower so as not to make a mess, and hang to dry.  

Although, just because I’ve never run into a problem with the mask, doesn’t mean that it doesn’t exist.

I remember back to the first time at the DME’s picking up my machine and mask.  The RT told me to make sure that I could feel the air coming out of the vents when exhaling.  She repeated this several times, like it was really important.  Now I have to wonder if they were aware that the air vents could possibly become occluded.   Dont-know
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#28
RE: EVIDENCE OF AIRFIT P10 VENT OBSTRUCTION CAUSING HYPERCAPNIA
(02-28-2019, 11:03 AM)OpalRose Wrote: I remember back to the first time at the DME’s picking up my machine and mask.  The RT told me to make sure that I could feel the air coming out of the vents when exhaling.  She repeated this several times, like it was really important.  Now I have to wonder if they were aware that the air vents could possibly become occluded.   Dont-know

They must have heard from some patients that this could be an issue.  I use a heated hose and humidification, both set at mid-level.  I clean everything once a week and alternate my mask/headgear/frame so that each setup has a week to dry between uses.  In spite of that, my P10 masks sometimes clogged up, making it hard to exhale.  I assumed it was from moisture clogging the vent, so I blew air through the vent to clear the tiny holes and found that fixed the problem, at least temporarily.  I read where some users have poked holes in the vents and decided to try.  I used a standard size sewing needle to enlarge the holes, 2-3 on each side.  No more clogging.  I am *not* recommending that everyone poke holes in the vents, but it works for me.
Sleepless No More
Post Reply Post Reply
#29
RE: EVIDENCE OF AIRFIT P10 VENT OBSTRUCTION CAUSING HYPERCAPNIA
It appears that moisture in the vent mesh is the main cause of occlusion in the real world. I am guilty of rarely cleaning the mask frame, and that may be a key to why I have never experienced the occlusion. Have you tried comparing the flow rate and leak rate data from an occluded mask vs an open mask?


Sleeprider,
 
I do think that moisture is probably a prerequisite for the vent occlusion to occur.  The fact that some report occlusive type symptoms even with new P10s suggest that this may be all that is required in some cases. 
 
But others, like myself, report having an initial, problem free interval and then had the abrupt onset of vent occlusion.  That's why I think that there needs to be a exlplanation for this delayed onset.  That's why I think ther needs to be a sufficient period of use for dust to accumulate before occlusion occurs in  such cases.
 
Obvious a lot of confounding variables are involved such as ambient temperature, humidity and particulate air quality; individual habits regarding cleaning, use of filters, replacement schedules, etc.
 
Regarding the flow rate and leak rate data.  Because everyone seemed to put so much emphasis on this in their analysis, I considered attaching SleepyHead graphs alongside my hypercapic graphs.  In the end, I didn't  because I really couldn't make sense of the correlation. (I think it was also confounded by they fact that my AirSense 10's time was off by about 6 minutes plus wasn't set up for daylight savings time, which the CO2 was set up for. So this confused the relationship between the two sets of data.
 
Aside from this, I have to admit, I had developed a rather dim view of the leakage determinations since they seemed to be a primary source used to refute the presence of vent obstruction in the earlier threads. It was like, "It's not happening...just look at the leakage data!!" 

Kind of like, "Of course the earth is at the center...just look at the sun!"
 
I did include Graph 8 which does show SleepyHead data for the brief interval when I wanted to see, "Where is the expired air going?"

https://photos.google.com/photo/AF1QipOC7Rj3FPVHeysfhaDIQ73TIkb3j7IXoeU6iwhy

I completely occluded my vents with tape. This was also to test the hypothesis that a person could not overcome the pressure of the CPAP blower and push expired air down the tube.  In fact, you can push CO2 all the way down and out the CPAP, though only a small proportion of your breath. You can immediately see a small rise in CO2 within the CPAP intake port.  The leak rate graph shows no leak at all until I exhaled extra hard during the middle of the period when I wanted to see if I could push the CO2 up.  Only then did the leak graph register anything--But the only leak was going out the back of the CPAP!  There was no leak out the vents or around the pillows or from the tubing as far as I know.  So I just don't know where the accumulating CO2 goes then.  As I kept rebreathing the air, the CO2 at the port didn't continue to rise and yet, when I switched to sampling inside the P10, the CO2 was over 35,000 ppm.
 
If anyone can explain what was going on here, I'd like to hear it.
Post Reply Post Reply
#30
RE: EVIDENCE OF AIRFIT P10 VENT OBSTRUCTION CAUSING HYPERCAPNIA
Lots of good info here -- OP, thanks for taking the time to post.

I haven't attempted to clean my P10 with an ultrasonic cleaner, but I have been using a Waterpik water flosser on a weekly basis. I've been using the same P10 mask for 18 months and I haven't noticed any darkening of the mesh. I just opened up a new P10 that I've had on standby, and the mesh in the new one appears identical to the mesh in the old one. So if anyone has a water flosser handy, that might be worth a try. (My technique is to soak the mask, pillows and hose in soapy water in a small tub, then use the water flosser aimed toward the tub to minimize mess from the spray.)

Finally, I hope anyone reading this thread and interested in trying to use an air compressor to clean their masks should recognize that many air compressors, especially the larger ones, are provided with an oil reservoir that is intended to lubricate the compressor's piston by spewing tiny amounts of oil into the air stream -- not something I would want to end up in the mesh. Oil-free air compressors wouldn't present this problem.
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  Introducing the ResMed AirFit F40 MrIvanDrago 20 1,457 03-17-2024, 06:47 PM
Last Post: mecutl3r
  AirFit F20 Irritating Nose Bridge SavvApnea 40 6,784 03-10-2024, 01:38 PM
Last Post: TechieHippie
  [Equipment] Loud noise from AirFit F20 mask SleepyLuke 2 1,541 03-04-2024, 12:38 AM
Last Post: SleepyLuke
  AirSense 11 & AirFit F30i Mask, new CPAP user TreeSky 0 268 02-25-2024, 09:47 AM
Last Post: TreeSky
  Cpap causing Central Apneas shedu1337 1 253 02-24-2024, 05:46 PM
Last Post: Sleeprider
  [Equipment] Hybrid mask discontinued, new AirFit 30 leaks! LessSleepyHalf 3 947 02-18-2024, 11:06 AM
Last Post: Jay51
  Cervical collar causing sore throat? TechieHippie 6 405 02-14-2024, 10:24 AM
Last Post: TechieHippie


New Posts   Today's Posts


About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.