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Exhalation issues
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ISnoreBadly Offline

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Posts: 117
Joined: Jul 2015

Machine: PR System One REMStar Pro 560
Mask Type: Nasal pillows
Mask Make & Model: PR DreamWear Nasal Mask
Humidifier: PR System One
CPAP Pressure: 12
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Lawn Guyland, Noo Yawk

Post: #1
Exhalation issues
Since I've been using CPAP I've found that I don't seem to exhale "all the way". I was using nasal pillows and now a DreamWear, so I'm always breathing through my nose. Every once in a while I feel like I'm bottled up and exhale through my mouth then feel like I get everything out. I have the C-Flex+ turned on so that's not the issue.

Does that make any sort of sense? Has anybody else experienced this?
11-13-2015 11:24 AM
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OpalRose Offline

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Posts: 3,167
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #2
RE: Exhalation issues
What setting do you have the CFLEX plus set at, 1,2 or 3?
Experiment and try a different setting.

You should also check in the Provider menu and change your mask resistance setting, based on whether you are using a nasal pillow mask or nasal mask. The new Dreamwear is a nasal mask and should be set at X1.

OpalRose
11-13-2015 11:38 AM
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ISnoreBadly Offline

Advisory Members

Posts: 117
Joined: Jul 2015

Machine: PR System One REMStar Pro 560
Mask Type: Nasal pillows
Mask Make & Model: PR DreamWear Nasal Mask
Humidifier: PR System One
CPAP Pressure: 12
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Lawn Guyland, Noo Yawk

Post: #3
RE: Exhalation issues
(11-13-2015 11:38 AM)OpalRose Wrote:  What setting do you have the CFLEX plus set at, 1,2 or 3?
Experiment and try a different setting.

I have it set up on 3, I found that worked best for me.

Quote:You should also check in the Provider menu and change your mask resistance setting, based on whether you are using a nasal pillow mask or nasal mask. The new Dreamwear is a nasal mask and should be set at X1.

That's the "System One resistance" setting? It's currently set to 0 (which is off, I think). Would setting it to 1 provide more or less resistance? Also what should it have been set to when I was using the P10?
11-13-2015 11:45 AM
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PoolQ Offline

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Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

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Sex: Male
Location: Sillicon Valley

Post: #4
RE: Exhalation issues
I fought that feeling for quite some time. I had major issues exhaling into pressure that caused most of it in the beginning. Changed to BiLevel and found a new source called T1 & T2 settings on the machine. Once I got all these tuned that feeling went away.
11-13-2015 12:10 PM
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OpalRose Offline

Monitors

Posts: 3,167
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #5
RE: Exhalation issues
Go to the Phillips Respironics site, there is a Resistance Mask Control Chart there.

OpalRose
(This post was last modified: 11-13-2015 12:33 PM by OpalRose.)
11-13-2015 12:31 PM
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AshSF Offline

Advisory Members

Posts: 356
Joined: Oct 2014

Machine: PRS1 D560TS
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10, Bkup: Airfit F10 & Quattro Air
Humidifier: PRS1 60 series with Heated Tube
CPAP Pressure: 8 - 8 w/ Aflex 3
CPAP Software: SleepyHead

Other Comments: Using APAP mode with fixed pressure

Sex: Male
Location:

Post: #6
RE: Exhalation issues
Check your tidal volume median in your sleepyhead charts. If it is in range for your ideal weight for your height, you have nothing to worry about.

The feeling you describe only happens if you are focusing on your breathing while falling asleep. And somehow, you try to exhale more forcefully than usual and you feel the pressure's resistance.

You can see your breathing waveform and flow rate for these breaths and you will typically find that your flow rate on these breaths is higher than your flow rate while asleep.

Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
11-13-2015 12:39 PM
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ISnoreBadly Offline

Advisory Members

Posts: 117
Joined: Jul 2015

Machine: PR System One REMStar Pro 560
Mask Type: Nasal pillows
Mask Make & Model: PR DreamWear Nasal Mask
Humidifier: PR System One
CPAP Pressure: 12
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Lawn Guyland, Noo Yawk

Post: #7
RE: Exhalation issues
(11-13-2015 12:39 PM)AshSF Wrote:  Check your tidal volume median in your sleepyhead charts. If it is in range for your ideal weight for your height, you have nothing to worry about.

Where can I find a good source for determining what my range should be?

Sleepyhead shows that (depending on the night) anywhere from 540 to 600. Last night, for example, the minimum was 13, median was 560, 95% was 980 and maximum was 3633. That seems like kind of a large range but I don't know what those numbers mean. Dont-know


(11-13-2015 12:31 PM)OpalRose Wrote:  Go to the Phillips Respironics site, there is a Resistance Mask Control Chart there.

Thanks. I set it to x1, I'll see how I do tonight.
(This post was last modified: 11-13-2015 01:09 PM by ISnoreBadly.)
11-13-2015 01:09 PM
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Sleeprider Online
Wiki Editor
Advisory Members

Posts: 3,335
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #8
RE: Exhalation issues
For tidal volume, focus on the median. The minimum and maximum are meaningless and can reflect an incomplete breath or large sigh. There is a great deal of variation, and yours appears to be quite normal. Overall tidal volume is generally reduced in sleep compared to waking respiration. This Wikipedia article is a fair explanation, and it call "normal" 500 mL, or 7 mL/kg ideal body mass: https://www.google.com/url?sa=t&rct=j&q=...3XNGNOf4sw

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11-13-2015 03:40 PM
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AshSF Offline

Advisory Members

Posts: 356
Joined: Oct 2014

Machine: PRS1 D560TS
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10, Bkup: Airfit F10 & Quattro Air
Humidifier: PRS1 60 series with Heated Tube
CPAP Pressure: 8 - 8 w/ Aflex 3
CPAP Software: SleepyHead

Other Comments: Using APAP mode with fixed pressure

Sex: Male
Location:

Post: #9
RE: Exhalation issues
(11-13-2015 01:09 PM)ISnoreBadly Wrote:  
(11-13-2015 12:39 PM)AshSF Wrote:  Check your tidal volume median in your sleepyhead charts. If it is in range for your ideal weight for your height, you have nothing to worry about.

Where can I find a good source for determining what my range should be?

Sleepyhead shows that (depending on the night) anywhere from 540 to 600. Last night, for example, the minimum was 13, median was 560, 95% was 980 and maximum was 3633. That seems like kind of a large range but I don't know what those numbers mean. Dont-know

Median value is the only relevant value. 560 seems like a good tidal volume. You must be a tall person.

According to Wikipedia article on tidal volume, ideal TV for healthy individual is 7ml/kg of ideal weight.

You can google 'tidal volume calculation' and use the mdcalc site to calculate your values.

Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
11-13-2015 03:41 PM
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ISnoreBadly Offline

Advisory Members

Posts: 117
Joined: Jul 2015

Machine: PR System One REMStar Pro 560
Mask Type: Nasal pillows
Mask Make & Model: PR DreamWear Nasal Mask
Humidifier: PR System One
CPAP Pressure: 12
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Lawn Guyland, Noo Yawk

Post: #10
RE: Exhalation issues
(11-13-2015 03:41 PM)AshSF Wrote:  Median value is the only relevant value. 560 seems like a good tidal volume. You must be a tall person.

Not really, I'm 5 foot 11 (and a half when I stand up straight).

Quote:You can google 'tidal volume calculation' and use the mdcalc site to calculate your values.

Using that calculator, based on my height and 7ml/kg of ideal weight for my height (which is not what I am) it said 535.1 ml. So I'm a little higher than that on most nights.
11-13-2015 03:51 PM
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