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Mask 'Pulsing/Jumping' - Plus leakage issues
#1
Mask 'Pulsing/Jumping' - Plus leakage issues
I've read a little about people's masks sort of 'pulsing', as in the mask sort of moves up and down as you breathe in and out. I've seen where EPR might be the culprit, but I'm currently using a BIPAP machine so the pressure difference is part of it. I believe my machine is set to 15/10 (it's a very new machine and I'm fairly new to bipap). What else could cause this mask pulsing? I feel like it affects the seal and I end up with leaks.

Speaking of leaks, I still can't find a good solution for this. I use a full face mask and I've tried it on its own, as well as with mask liners. I recently switched to the memory foam cushion, but even they seem to leak at times. I find myself having to overtighten but still experiencing leaks when moving in certain directions...the tightening also causes red marks on my face specifically the bridge of my nose. Any advice or remedies for leaking?

Side note: I'm sure there are probably threads out there that cover these topics, but I decided to make a new one with my specifics to hopefully find some help.

I've been on bipap for a week with little to no results. I was on CPAP before with miserable results.. the bipap hasn't been AS awful but still not good yet.
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#2
RE: Mask 'Pulsing/Jumping' - Plus leakage issues
I don't know if you have reviewed this article, so I am listing it here.

Mask Primer: http://www.apneaboard.com/wiki/index.php/Mask_Primer
Crimson Nape
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#3
RE: Mask 'Pulsing/Jumping' - Plus leakage issues
I've experienced the pulsing you described and always find it's because I have not completely seated the humidifier in the Resmed machine. I suspect it's due to leakage where the humidifier connects to the machine. If it occurs with the humidifier fully seated ir may be due to damage or wear to the seal between the humidifier and machine.
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#4
RE: Mask 'Pulsing/Jumping' - Plus leakage issues
Hi Jake B,
The posts above are good to consider. I'm just adding in my own thoughts as well. Learn about how to adjust the mask properly, and include making sure the mask you're using fits well for you specifically. The mask cushion plays a vital part in whether or not leaks are controllable. I would say that you are tightening the mask too much as indicated by you saying red marks caused by you tightening. Being overly tight will almost always cause leaks to increase, as it causes the cushion to become distorted or otherwise misshaped. Also, maybe you may want additional cushioning, such as cushioning materials that Pad A Cheek has for sale. They can be found listed as Supplier #31 in our supplier list for your convenience.

I have adopted a method described by another member of this forum. Lie back on your bed and hold the mask in place as it would be for sleeping. Do not strap it on yet. Turn on your PAP to regular therapy settings, as in just turn it on and not the Mask Fit. While your pressures are running, hold the mask at the proper tension to eliminate most leaks, especially those that will disrupt your sleep. OK, now keep in memory what tension was needed to hold the mask in place. Now, strap the mask on and adjust the straps to duplicate that same tension your fingers were applying to hold it there. No tighter.

No leaks at all is not the goal, only those that disrupt you and larger leaks that are not reasonably controlled. Move the mask around to keep leaks from blowing in your eyes or wherever they will disrupt. Again a zero leak is not required, just the disrupting and large leaks. If it's absolutely not possible to get it right while trying this way, shop for a different sized cushion or the whole mask should be replaced as it's proved to be wrong for you. You alone decide this.

The ResMed machines have a technique called FOT or Forced Oscillation Technique and is described on the ResMed page here: https://www.resmed.com/us/en/healthcare-...ology.html
Here's the text of the applicable section;

"Central sleep apnea (CSA) detection
ResMed Air Sense 10 AutoSet and AirSense 10 Elite devices also include CSA detection. This advanced technology uses the forced oscillation technique (FOT) to determine whether a patient’s airway is open during an apnea. When an apnea is detected, small oscillations in pressure (1 cm H20 peak-to-peak at 4Hz) are added to the device pressure. If flow is detected, the airway is open and the apnea is from CSA. If no flow is detected, the airway is closed from an obstruction. The device responds by either increasing pressure for an obstructive apnea or maintaining current pressure and recording the event for the patient’s apnea–hypopnea index (AHI) report."

The machine is supposed to use this to see if times of no breathing are due to airway blockages or not, and if blockages are not detected, this is what is called Clear Airway or more accurately a Central Apnea where you stop breathing but no effort or blockage is present. Anyway it could be the FOT that you feel and is disrupting to you.
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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