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Resmed A10 flapper valve driving me crazy
#11
(06-23-2015, 03:31 PM)under pressure Wrote:
(06-23-2015, 01:08 PM)justMongo Wrote: That would defeat the purpose of having an auto. Some people lower the max pressure to the 95% pressure found while running wide open in "Magpie Mode." The minimum pressure is generally raised such that the machine does not have to increment pressure multiple times to squelch obstructive events. Moving the minimum toward the median pressure is better advice.

Mongo,

I may have not expressed myself very well, but I think we are saying basically the same thing here.

It turns out for Birdies (original poster) that it's not an issue for him because he is running straight cpap.

But what I was trying to point out is that often times someone that is new to cpap will have an Auto machine that is running in the default wide-open as in 4 cmh20 to 20 cmh20, this way of running the machine might be ok for a few nights to self-titrate your pressure, but after you have a good idea of the pressure your Auto machine is settling on for most of the night, then thereafter you should not continue to run in the wide-open pressure settings, it's very inefficient and will not result in optimum therapy for the patient.

The upper pressure setting for most people is not really all that important because if it's set at 20 cm the machine will only raise the pressure as much as it needs, usually won't be as high as 20 cm for most people with standard OSA.

The more important pressure is the lower setting, if you leave it at 4 cm the machine takes much longer to reach optimal therapy pressure and the patient experiences much wider pressure swings in the process, which can, on it's own, cause unnecessary arousals. Setting your lower pressure up from default of 4 cm in the case of the Airsense to a pressure that is closer, but still lower than the 95% pressure will result in much more efficient therapy from your machine and will maintain better airway patency overall. The machine will not be constantly behind the pressure curve, so to speak. In the example I am stating lets say the 95% pressure is 12 cm...........what I would do is then set your lower pressure somewhat below that figure, say around 9 cm or 10 cm so that the machine has a better chance to maintain your airway in the first place. As opposed to leaving the lower pressure down way low like the default of 4 cm where the machine takes a long time to get up to optimal pressure, and in the process may be letting more Apneas/Hypopneas needlessly occur. Having the lower pressure set too low simply leaves the door open for events to occur that otherwise could be eliminated by raising the lower pressure closer to where it needs to be to maintain the airway.

I think that is the point that both of us are getting at in terms of the most efficient way to run an Auto machine.

Agreed.
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.
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#12
Now, back to the OP. Running straight CPAP at 10 cm alarms me that the anti-asphyxia valve flaps after some hours of use.
Mine flaps only for about one breath when I first hit the start button. It could be the mask. But, the OP now also reports that the pressure/flow seems to drop. It's possible that the machine or power supply has a fault.

A manometer is the cheapest way to measure pressure. Also, the Dwyer Magnehelic Series 2000 Differential Pressure Gauge can be obtained in a cm-H2O range of 20 or 25. (model 2000-25CM is the 25 cm-H2O version.) Tee'ed into the CPAP line, it is easy to read at night.
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.
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#13
Ok, this issue developed immediately upon putting the mask on last night. I am an occasional mouth breather due to a deviated septum and some sinus issues. The first few nights of therapy, I mostly breathed through my mouth. The humidifier has opened up my nose to where I have been focused on breathing though it.

Last night, exhaling through my nose created some kind of pressure lock that collapsed the mask, and interrupted the exhale for a really quick fraction of a sec. I also got a couple of series of this event which mimicked a flutter. There is a noise associated with this event that sounds like the valve when it in fact some kind of pressure sound inside the mask....maybe from my nose...don't know.

The first two times I experienced this event, it was at the latter part of the nights rest and I was half asleep. It sounded just like the flapper valve closing and there was a weird pressure created that interfered with the exhale. Thus, I thought that it was the valve.

Can there be some kind of negative pressure on exhale that creates a pressure lock(don't know what else to call it) that creates this event?

I played with the humidity, pressure, etc and could not get rid of it. I got up to go to the bathroom without the mask and the issue went away when I reinstalled the mask. Weird huh?
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#14
(06-24-2015, 09:25 AM)masbirdies Wrote: Ok, this issue developed immediately upon putting the mask on last night. I am an occasional mouth breather due to a deviated septum and some sinus issues. The first few nights of therapy, I mostly breathed through my mouth. The humidifier has opened up my nose to where I have been focused on breathing though it.

Last night, exhaling through my nose created some kind of pressure lock that collapsed the mask, and interrupted the exhale for a really quick fraction of a sec. I also got a couple of series of this event which mimicked a flutter. There is a noise associated with this event that sounds like the valve when it in fact some kind of pressure sound inside the mask....maybe from my nose...don't know.

The first two times I experienced this event, it was at the latter part of the nights rest and I was half asleep. It sounded just like the flapper valve closing and there was a weird pressure created that interfered with the exhale. Thus, I thought that it was the valve.

Can there be some kind of negative pressure on exhale that creates a pressure lock(don't know what else to call it) that creates this event?

I played with the humidity, pressure, etc and could not get rid of it. I got up to go to the bathroom without the mask and the issue went away when I reinstalled the mask. Weird huh?

I am not sure what you meant when you said, "collapsed the mask". I think what you might be describing is the seals collapsing which would happen with reduced pressure. During the normal function of the mask and CPAP, there should not be any negative pressure when exhaling. If anything the positive pressure should increase.

The only way that I can see for the pressure to decrease and the mask seals collapse is for a fairly substantial leak to occur. For instance, if your lower jaw dropped far enough that your lower lip came out from under the seal. If it happened quickly, it could cause the silicone seal to "snap" when it escaped from your skin.

Another scenario might be that your lower straps might be just tight enough to maintain the seal normally but if you take a deep breath and exhale rapidly it may create enough additional pressure to blow the seal out under your mouth. After it happens the first time, it will happen more easily because the seal will not reseat itself fully. That would correct itself if you took the mask off and put it back on.

A lot of conjecture but maybe something will ring a bell.

Best Regards,

PaytonA
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#15
Leave it to me to be the guy with the strangest problem ever.

If I leave my mouth open, this event is not able to be duplicated. If I close my mouth, I can get this event to happen. I watch the mask and it makes a quick (very quick) compression...a bump towards my face with an audible noise and definite interruption (again, very quick) of the exhaled breath, it's as though the exhale overwhelms the pressure coming into the masks and creates a momentary lock or stalemate in all the processes going on. Again, EPR is OFF. The mask seal is perfect with zero leaks. In fact, I am unable to create this event with a slight leak. It's seeming to be a pressure situation. UGH, GRRRR! It's fugly!
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#16
What do you do to get the event to happen? If you could describe in detail, it might be helpful.

Best Regards,

PaytonA
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#17
(06-24-2015, 03:52 PM)PaytonA Wrote: What do you do to get the event to happen? If you could describe in detail, it might be helpful.

Best Regards,

PaytonA

Put the mask on and get s good seal. Take a few deep breaths though the nose and exhale out of the nose. Within a couple of exhales the mask will bump as I described earlier with an brief interruption to exhale pressure. Nasal exhale causes this
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#18
Have you disassembled your mask and do you still get the same problem after each re-assembly? Have you cleaned the vent with a soft bristled brush per the user guide?

Best Regards,

PaytonA
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#19
Yes, everything is clean and put together properly. I described this to the RT today. She said so...a momentary vacuum is created upon nasal exhale? That is the best description of what is going on. A vacuum is created on nasal exhale causing a noticeable sound, movement of the mask, and disturbance in my sleep.

She had no clue what could be causing it but is checking on it
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#20
If a momentary vacuum is created on exhale, it would allow the anti-asphyxiation valve to open and when it slammed shut would probably cause the noise that you are hearing. When you start to exhale, you start blowing on one end of the hose and the CPAP is blowing on the other end. This would cause a pressure spike not a vacuum. On the other hand, if you are using EPR and that cuts in just after the machine has readjusted the pressure when you started to exhale, it might cause a short lived vacuum. So if you are using EPR, try shutting it off. If that works but you like the EPR try setting it lower.

Best Regards,

PaytonA
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