[Equipment] ResMed Quiet Air Diffuser Vent F30

[hegel]

throughout his post Mr.dbotas is speculalting with no real data for his claims. "it could easily be possible that..." "the quiet air may be..." etc, etc which leads to "resmed is sticking with their false explanation..."etc

this is a series of conjectures resulting in a condemnation that claims to be factual. Sorry, that doesn't cut it.

Hey, I'm as concerned as anyone about re breathing Co2 in my mask. I haven't experienced this with this mask. I doubt that, years down the line, I'll have a terminal disease that I won't be able to tie back to Resmed, as Mr, dbotas suggests.

I've been usiing masks for years. I think I'd know if I was suffering from oxygen deprivation; or my pulse oximeter would. Nada so far.

[Vamurphys]

Good info all around. I’m trying filter-less “quiet” elbow as I cut out the black dotted filter. Seemed like I slept better, will continue for a few days - not to much noisier, either.

[dbotas]

One way u can tell more definitively perhaps is to look at your sleep record in myair.  If there is an improvement u might see a diiference in tbe number of hourly events between your pre modification nights and your post modification nights

If ur machine is set for full reporting that figure ... along with others... will also show on the machines screen’s sleep report

Everyone’s lungs r different re: the amount of O2 that they can process into the bloodstream.  Marathoners for instance have a very good capacity for that

Mine are particularly bad at that because I have reactive airway disease

I suspect that’s why I feel like I feel like i am borderline asphyxiating ... that I feel quickly like i am not getting enough “air” ... when I wear the F 20 but others do not.

I and others who report waking with headaches etc when using Quiet Air masks may functionally be acting somewhat like “canaries in a coal mine“ simply because we have less efficient lungs.

It could be that others lungs who don’t experience those symptoms are processing enough oxygen out of the Quiet Air elbow’s air.  If such were true, whether or not they would also have elevated CO2 blood levels I am not sure.

The definitive test to tell whether the Quiet Air elbow’s pinhole vent design is actually causing more CO2 to be re-breathed, would be a blood CO2 test upon wakening ... which would essentially require wearing a “Quiet Air elbow mask during a sleep test I guess.

And maybe another sleep test where the same person wears an older design mask so that a blood CO2 comparison could be babe

I’ll be curious to know whether your removing the filament material results in a better sleep experience

DB

[SarcasticDave94]

Most of us here on Apnea Board are using OSCAR to review their sleep data. It's going to give quite a bit more data than MyAir ever would as far as I remember. The little bit of cheerleader info it provided was not nearly enough for me to self titrate when I'd first gotten my ASV. Or for it to be useful at all, as far as that goes.

And as far as 2 sleep studies to verify QuietAir does cause rebreathing of CO2, I'm sure that would be an impossible sell to ones insurance. I would not be willing to pay out of pocket for this either.

The bottom line really is if you don't like the QuietAir elbow, get the older elbow and use that. Or if you must, pull the packing out of the QA.

[hegel]

There are inexpensive pulse oximeters that you simply clip on to the end of your finger which tell what your O2 level is. You can even wear many of these all night and then print out a record of your O2 and heart rate while you slept. Or check immediately when you waken.

Sorry dbotas if I was too critical; sometimes I get on a high horse. You're right of course to be concerned. I am too; I don't want to be rebreathing co2 and this quiet elbow is a bit concerning.

[dbotas]

Thanks for saying so Hegel, 

With user groups, like with texting, it’s easy for attitudes to get out of hand or be misinterpreted because disjointed text is so un-emotive ... which real time face-to-face visual conversation or even telephone conversations naturally tend to prevent

Regarding O2 pulse o meter: i’m waiting for the upcoming software update on my Apple 5 watch to give me that function without paying for it separately

But also my damaged Reactive Airway lung surfaces have kind of made me a crude walking O2 pulse o meter for the last 15 years.   Almost any exertion makes me feel like I am not getting enough oxygen... leaves me panting ... even though I am not overweight etc.

And that’s exactly the reaction I quickly had when I donned the new Quiet Air elbow F 20 masks I was recently upgraded to after wearing the original Quattro air normal elbow mask for five years.  

When the vendor gave me a second new F20 I had the same shortness of O2 reaction.

When they then gave me an new F 10 with the older elbow design, there was no breathing ... shortness of breath… problem.

I would have just left it there but I much prefer the F 20’s new improved, much more comfortable silicon face seal and it’s nifty magnetic attachment straps

There was another factor that makes me suspect my lungs were not be able to process enough O2 because a higher proportion of  re-breathing CO2 was replacing some of the O2 being inhaled with new quiet air elbow F20 mask  

my HVAC career experience designing & installing heating and cooling systems repeatedly taught me how air and liquid ALWAYS take the path of least resistance and resistance is caused by either decreasing ducts, vents or pipe sizes or making them turn sharp angles

In running ducting or pipe from one furnace or air conditioner to various rooms or areas of a building, if I didn’t keep all the runs balanced in terms of restrictions and angles in the ducting or piping, then the customers were quickly complaining that one room or area of their building was too hot or too cold when compared to the others.

That was because if I accidentally or carelessly restricted one particular run in the system proportionally more than the other runs, all the heating and cooling would immediately go to the other runs and areas/ rooms instead.

That’s just my guess as to what is happening with the relatively new “pinholed, right angle covered with fibers inside” Quiet Air elbow.

Instead of my CO2 exhale going out the pinholes as intended because of the pinhole and right angle and fabric packing extremely restricted passage, the CO2 rich exhale is just taking the path of lesser resistance and mostly being inhaled back up the elbow into my lungs along with the fresh air that’s being pumped by the CPAP unit.

For me i’m guessing it’s a matter of my notably physically compromised lungs not being nearly as good at separating out oxygen in such a proportionally less oxygen rich environment as healthy lungs are.

I’m guessing that my breathless reaction is not detecting the CO2 but instead detecting the proportionally lesser amount of O2 being pumped into my lungs because the exhaled rebreathed CO2 is replacing some of it

I also quickly get the same breathless feeling when I am at an altitude or if I try to run etc. Even though  I’m otherwise healthy ...not a pound overweight etc.

So I am guessing with the Quiet Air elbow F20’s i am kind of functioning like a “canary in a coal mine“... and healthy efficient lungs aren’t noticing.

They don’t notice because they can still extract sufficient oxygen out of the less O2 rich air coming through the Quiet Air elbow mask into their lungs. 

But there’s another seperate issue to consider.


Everyone’s lungs / brain combo sense a shortage of oxygen ... Think about running up a steep hill… but only the occasional person… usually because of a disability… can detect the result of breathing CO or CO2 

That’s why CO is called an invisible killer.

With CO most everyone will pass out before they will ever know they’re being exposed to carbon monoxide.

CO2 is not that lethal but it’s still not healthy to have in your bloodstream ... and like CO most will never sense it physically...  & it leads to long-term lesser slow developing impairments that often go undiagnosed

If you look it up you will see that some people do get headaches from it and if you look in this user group & the other CPAP group posts, you can see there are a few people who do complain about morning headaches after upgrading to the newer Quiet Air elbow masks.

It’s not an either or situation… Your lungs can process both O2 and CO2 ... or CO ... into the bloodstream.

Another thing to think about is that the previous elbow design used with the F10 was designed about six or eight years ago at the same time as the APAP Air Sense 10 pumping mechanism and at that time the output of the brand new combined system would have been exhaustively designed and tested for every aspect of its output.

That degree of engineering testing may not have happened when Resmed decided to make a quieter mask venting elbow five years later.  The elbow design could’ve even been outsourced to a separate smaller company perhaps

And unfortunately the elbows are not physically interchangeable. You have to switch masks to switch elbows

As an easy test, put your hand up to your mouth and sense the volume of CO2 rich exhale that you expel with a normal breath.

Ask yourself:  and wearing a mask, with every exhale can u feel that same volume of air passing through the pinholes, around the cap bend and through the fabric to where you can feel it with your hand or detect it with a bit of down fluff?

If not, where is the bulk of that CO2 rich exhale going?  

And how much CO2 could be generated and take the arguably easier path back up the tube with the next inhale and into your lungs in an entire night’s worth of sleeping?

We’d like to think Resmed could not have overlooked such an end resulr with their newer Quiet Air elbow design ... if that indeed is what is occurring...  but look around at the huge number of recalls that have been generated every year by most all corporations manufacturing machinery, electronics etc.

And yes… Someone’s comment that the only way anyone can definitively know if such unintentional CO2 redirection and buildup is occurring is with an expensive Sleep Test followed immediately by a CO2 volume blood test.

I can’t afford it… But I raise the question because of what seems to have transpired in my case and may be unknowingly affecting others.

I’ll just wear the F10 they recently gave me as a result of my issue but I hope it gets sorted out so I can wear the  F 20‘s more   comfortable seal on my face  

I suspect I truly quiet CO2 exchanger album  can’t be built.  If it could, we would breath soundlessy and have soundless fans, hair dryers, jet engines, and air heating heating and coolng systems.  

That’s why people like hot water in the floir heating.  It’s quiet and forced air heating /cooling is not

Air in any volume makes sound as it moves... especially if it passes in any great volume through any restriction.

Very sorry I’m so long winded.

Just trying to logically examine the issue as best as i know how.

fwiw...

Best

DB

[SarcasticDave94]

BTW I just noticed something. This was in the ResMed PDF for an F20, however I think it may apply here as well. In the PDF was an image of taking a toothbrush to the elbow vent holes, saying something about cleaning them on occasion. See image below.

PDF location: https://www.resmed.com/us/dam/documents/...er_eng.pdf

Image I mentioned:

[attachment=23317]

[Hydrangea]

DB - What you're saying resonates with me. I have asthma, so I know that at least my lungs are not super awesome. So perhaps I'm one of those who is more sensitive to the rebreathing.

I would definitely be willing to do a pulse-oximiter experiment with both elbows. But I don't own a pulse-oximeter. I wonder if my phone could measure it adequately, upon waking up. Oy. I'd hate to submit myself to those symptoms, if whatever I'm measuring with isn't going to measure it well. My quiet elbow symptoms (and my P10-after-a-couple-weeks/months-of-use symptoms) are headaches, toxic feeling, and nightmares that cause screaming in my sleep.

[dbotas]

But both of the F 20 masks that precipitated the problem for me were brand new.

Once you guys pointed out where the pinholes were and I took a magnifying glass to them I couldn’t see any dirt buildup or manufacturing defect. 

I never wore either of them more than 10 minutes before I ... with my pansy lungs…  was panting

I got a bit of down from my down pillow to test with and the vent hardly disturbs the down.  

Not true at all when I remove the mask and hold the down in front of my mouth when I do a simple mouth exhale.  the down Teally notably flutters around then


It seems to me the pinholes are just too small to start with and too restricted with the restrictive 180 cap and the fabric to be able to pass an entire exhaled CO2 breath throw that maze every few seconds like the older elbows do.

The black dirt or mold buildup that people are experiencing after some usage with the Quit Air elbow, indicates there is some air passing but my guess is it’s not nearly passing a whole exhale breath

And if not, where is the rest of that exhaled CO2 going?

That’s why the older elbows are noisy and you can physically readily feel a lot of exhale air venting out the elbow.

Seems to me by quieting the new elbow they  also inadvertently prevented most of the passing of the exhaled air.   

Not all of it of course but significantly a lot of it.


It’s quiet mainly because nothing much is passing thru it....

?

DB

[dbotas]

Hydrangea,

As far as i know a pulse oximeter only measures the O2 amount in your blood.

By my reasoning of the symptoms u report, your lungs are allowing u to transfer enough oxygen or you would be quickly panting / fealing like ur r asphyxiating like I do after just a few minutes wearing a quiet elbow mask.

Our bodies do very quickly warn us if we’re not getting enough 02

I suspect with my really damaged lungs i need the unadulterated full amount of oxygen in the air I inhale in order to be able to process enough of it into my bloodstream oh I don’t start getting oxygen neediness symptoms.

I think an oximeter test will show me that i get enough with the old elbow and not enough with the new elbow and will probably show you that you get enough 02 with both elbows

But what else are your lungs picking up from the quiet air elbow mask?

If the newer quiet air elbow’s CO2 venting aperture’s is indeed essentially restricting too much CO2 from venting and thereby causing more CO2 to be rebreathed, then your lungs will be transmitting CO2 into your blood along with oxygen.

And bodies don’t Automatically sense CO2 (or CO) because they don’t need it like the do O2.   

They don’t need it at all.  It’s either spmewhat toxic like CO2 or very toxic to the system as is CO

 I’m not sure if the body can sense inhaling too much oxygen but we know it can’t usually quickly sense inhaling too much CO or CO2.

After some time ... hours etc... some people ... but not all ... get headaches or twitches or sense confusion with CO2,

When inhaling CO u usually simply die after not too long of breathing a concentrated amount

I don’t know if they have meters similar to oxometers ... to measure CO2 in the blood but they can do it in the lab with a blood test i know

I guess we should look to see if there such a thing as a inexpensive Pulse carbon dioxide meter that you can clip to your finger

Otherwise I think the only way to answer the riddle is to wear the quiet air mask for some time and immediately have a blood test for blood CO2 levels.

I’m not familiar with a P 10 mask.  Does it have a quiet air elbow?

DB