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Extremely difficult to exhale, even with the machine off.
#31
RE: Extremely difficult to exhale, even with the machine off.
With the Resmed Airfit P10, users frequently need to use a larger size than they intuitively believe. In your case, a size Large might do the trick. Provided the fit is reasonably comfortable it will flow more air in both directions with less effort. I am glad to see your results look so good. At 7-20 pressure with EPR 3, your pressure fluctuates within a very narrow range and flow limitation is practically not present. Respiratory statistics seem normal and leaks are in an acceptable range. Well done! Building on your 4-hours of therapy will be the next task, and I'm sure you can do it as you become more comfortable.
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#32
RE: Extremely difficult to exhale, even with the machine off.
Hi


I have  same experience with N30I I find it also very difficult to exhale even with very low pressure. 
Every time I tried to use it I had to take it off shortly and use my old N20. 

I talked about it with my therapist and she said that she heard it before from her patient.

In my case contributing factor could also be COPD and expiratory flow limitation.

In any case, N20 works for me just fine as it has different vents then N30I.

Mila
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#33
RE: Extremely difficult to exhale, even with the machine off.
(08-24-2019, 11:09 AM)bonjour Wrote: OK, your numbers are good, they do not warrant making changes in and of themselves.  Changes should be symptom driven.

Because you are still sensing issues with exhale, post a 2 minute zoomed view of a time where you feel you likely have a problem.  Include these charts
Events
Flow Rate
Minute Volume
Tidal Volume
Mask Pressure (not Pressure)

as well as a full night chart as you posted above for reference.

NO promises that we will find or see anything, just for a look.

I've attached a full night for the night of August 24th and a zoomed in portion.  I did a 7 minute to try and encapsulate a couple additional little things, but I really don't think that it shows anything.  I think that the anatomy of my nose, just really doesn't appreciate something pressing on it.  I do appreciate you doing so much to help, though.

(08-24-2019, 11:14 AM)Dormeo Wrote: I come bearing congratulations!  It’s good to hear you’re using the mask longer and feeling more comfortable. I wouldn’t be surprised if you’re right that your sinus and allergy problems are a big factor in your perception of difficulty exhaling.

The next step will be to keep the mask on longer, ideally all night. Given your thoughtful approach, I bet you’ll be making quick progress.

I managed to improve by almost an hour and a half from night 2 to 3.  It's weird, I clearly remember waking up, ripping the mask off, and falling right back to sleep.  I felt even better about how the machine and I were working together, so I'm not sure why 4:15AM me was so annoyed, but he clearly was.  I do see on my Oscar charts that things had gotten a little more eratic for 30 minutes or so prior to this happening, maybe that has something to do with it.  On the event flags section of Oscar, it shows that there was an obstruction at the beginning.  Maybe I couldn't get back into the groove after.

(08-24-2019, 12:39 PM)SarcasticDave94 Wrote: FWIW I'm thinking this N30i should have size Wide. I think it's color coded gray.

My mask only came with Small, Small Wide, and Medium.  I'm using the small wide.  The DME opened the packaging right in front of me, so I don't think that they removed anything.

(08-24-2019, 09:07 PM)Sleeprider Wrote: With the Resmed Airfit P10, users frequently need to use a larger size than they intuitively believe.  In your case, a size Large might do the trick.  Provided the fit is reasonably comfortable it will flow more air in both directions with less effort.  I am glad to see your results look so good.  At 7-20 pressure with EPR 3, your pressure fluctuates within a very narrow range and flow limitation is practically not present.  Respiratory statistics seem normal and leaks are in an acceptable range.  Well done!  Building on your 4-hours of therapy will be the next task, and I'm sure you can do it as you become more comfortable.

I only have Small, Small Wide, and Medium cushions.  I'm using the Small Wide, because it doesn't push on the sides of my nostrils like the Medium does.  I don't know if a Medium Wide exists, but I wouldn't mind trying it.  I just don't know if I'm willing to spend $31 to do so.  I kind of want to try an N20 mask.

I'm really happy with how much I improved from my horrible first night (no charts for that one).  I improved significantly in all aspects (it looks like to me, at least) again from 2 to 3, so I'm excited to see how this goes.

(08-25-2019, 03:13 AM)Mila Wrote: Hi


I have  same experience with N30I I find it also very difficult to exhale even with very low pressure. 
Every time I tried to use it I had to take it off shortly and use my old N20. 

I talked about it with my therapist and she said that she heard it before from her patient.

In my case contributing factor could also be COPD and expiratory flow limitation.

In any case, N20 works for me just fine as it has different vents then N30I.

Mila

I actually really want to try an N20.  I think that I'm only allowed one exchange though and I would hate to regret it.

This may sound dumb, but how much and where does the N20 touch your nose.  Having pressure pretty much anywhere within an inch of my nostrils does reduce how much air I can get through.

I want to sincerely thank everyone who has posted in this thread.  After my first horrible night and a couple of frustrating hours trying to figure things out by myself, with no support from my DME, I was feeling horrible about having to face this for the rest of my life (I'm only 28).

All of the encouragement and advice has been huge.  I'm feeling so much better about this and am extremely optimistic.  Thank you.


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#34
RE: Extremely difficult to exhale, even with the machine off.
I received a similar mask kit without Wide. I’m guessing that maybe it’s offered upon request. It is listed for the mask on the ResMed site, but not necessarily included in the mask kit. I’m probably going to get one of these myself. Or maybe I should say trying to get one.
Dave

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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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#35
RE: Extremely difficult to exhale, even with the machine off.
(08-25-2019, 03:45 PM)spenc938 Wrote: This may sound dumb, but how much and where does the N20 touch your nose. Having pressure pretty much anywhere within an inch of my nostrils does reduce how much air I can get through.

The N20 goes around your nose and doesn't push on it anywhere except the bridge of your nose - it's a completely different design than the P10.

My nostrils tend to seal close with any outside pressure on them and the N20 wasn't a problem. But I had a problem keeping a good seal on it when I slept. I sleep on both sides, and the tossing and turning didn't work well for me. Nor did the P10 - it just plain hurts the underside of my nose and can be hard to breath through. Surprisingly to me, the original dreamwear (not the original, not the "pillows" verson, works well for me and is easier for me to breathe through. Fit is very individual, so it might not work for you, but I would say that even if the P10 doesn't work for you another type of under the nose mask might.
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#36
RE: Extremely difficult to exhale, even with the machine off.
I use the N20.  I can only relate my own experience, but here goes:

It was the second mask I tried.  I tried the full face mask, can't recall which, and it was...meh.  Not compelling either way, so onto the second mask.  That was the N20, seemed weird just covering the nose after trying the full face one.  Onto nasal a pillow which was waaayyy weirder for me, possibly because it was the wrong size. I went back to the N20 and decided to give it a try.  I'm still using my original N20 closing in on two years later.

I feel it in two places, the second I'll mention quite a bit more than the first.  The first is the bridge of the nose, and the second is over my top row of teeth, but under my nose, of course. If I feel any pressure, it's above my upper lip.  

If mine leaks, and it usually does some, it will be immediately on either side of the bridge of the nose, where the sharp curve is.  When it does leak, I feel the fluttering in my eyelashes.

I have to tape, as I soon learned.  It's no problem for me, but I'll soon leak between my lips if I don't use tape over them.  If you use nasal pillows or a nasal mask, mouth breathing or mouth exhaling might turn out to be an issue.  Even with a full face mask, some report that their mouths are dry at times during the night.  This is usually an indication of mouth breathing.
Serial Tapist
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#37
RE: Extremely difficult to exhale, even with the machine off.
In my experience N30I is cradle, you have to position it carefully and line it up with nostrils - N20 is easier to position it sits on bridge of you nose and below nose above lips. There is more air space between mask and your nose.

    As I mentioned,  I discussed my problem with N30I exhale with my therapist and she let me try for a few days Phillips Wisp and it's cushion is similar to N20, but it sealed much better and I liked headgear better.  It will  probably be my next mask.

   I hope you will find some solution soon - I know all about anxiety when it's hard to exhale.

   Good luck      Mila
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#38
RE: Extremely difficult to exhale, even with the machine off.
I just wanted to update just in case anybody stumbles upon this in the future. I ended up giving up on the p30i and I bought a medium n20. Immediately it was a huge improvement, though it did introduce a new problem. Everywhere it would touch my face, I would sweat. This sweating caused horrible itching as it evaporated. I bought a pad a cheek liner and installed that. It pretty much eliminated the sweating, but it added pressure back onto the sides of the bottom of my nose, making it difficult to breathe again. I switched out my medium cushion for a large and it was perfect. The very first night, I wore the mask the entire night. I had had my CPAP for 1.5 months at this point and I had never kept the mask on all night. I do miss the top-of-the-head hose inlet, but it was completely worth it.

I'm now 12 days in a row wearing the mask for the entire night and I've been sleeping great. If anyone that is struggling reads this, don't give up. Thanks again to everyone that responded.
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#39
RE: Extremely difficult to exhale, even with the machine off.
gotta love a success story. persistence pays off! thanks for the update.
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#40
RE: Extremely difficult to exhale, even with the machine off.
Terrific! This is a wonderful example of the importance and value of working hard on mask issues. Thanks so much for sharing it.
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