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Humidity-related mask noise like a tea kettle
I have had my ResMed S9 CPAP machine for a bit over 2 months, and am struggling to find a comfortable combination. If I don't set the humidity pretty high (at least 5), I wake up several times a night with a bone-dry throat -- very uncomfortable. But if I set the humidity up, then about 2/3 of the way through the night, the machine or the mask start to make noises. I wouldn't call it a gurgle, and I have never found water in the tubing, but my face is wet under the mask when I wake up. I am not bothered by the wetness (though it may be part of making my nose sore), and I have never felt like water was getting up my nose.
I have tried nasal pillows, a nasal mask and a full face mask, and they all have this problem. An additional problem with the nasal pillows and mask is that I get a sore on the external nasal septum -- changing between pillows and mask helps, but each causes a different location to be sore!
Currently my most comfortable mask is an F&P Zest nasal mask, but this has the humidity-related noise problem. It sounds like an lower pitch and off-key tea kettle whistling. I can't tell whether the noise is coming from the CPAP or from the mask itself, but if I put a finger over the mask exhaust, the noise goes away and stays away for several breaths. Trouble is, several breaths later the noise is back. I can't quite figure out how this is being caused, though I imagine it is condensation somewhere and the back pressure when I cover the exhaust somehow clears it for a short time. It is bad enough to wake my wife as well as myself.
I am motivated to try to resolve my mask issues (soreness, dryness, noise), but there doesn't seem to be any mask or setting that will solve all of them. I plan to ask for a climate line sleeve, to warm the CPAP tubing, but I'm not convinced that this is the solution, since I have never found water in the tubing. BTW, my CPAP machine is 2-3 inches below the level of the matress.
Thoughts or suggestions?
Bruce
Views: 979
Replies to This Discussion
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Permalink Reply by Mary Z on
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Bruce, I'm sorry, I don't have a clue as to what's happening. A couple of times I have woken during the night to find water on my face and in the mask, but not in the tubing. I am able to sleep with really low humidity and have not had the problem sine I turned the humidity down. I don't know if my breath caused enough condensation inside the mask to cause this water build up- it was quite a bit, maybe 15 cc. The hose cozy may help by warming the air in the tubing closer to the temperature of the air you exhale. I may be completely off the mark here because I really don't understand the concepts involved. Also, even though there is no water in the tubing perhaps putting the hose higher would help. My machine is right at bed level because that's where my bedside table is.
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Permalink Reply by Terry Vella on
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Bruce, I use the same machine and don't have that problem, maybe you need to get it checked. A heated tube should help. A tip I have learn't is have the hose coming from above your head either on a stand or from over the bedhead, it helps the gravity of the mask to stay up. I use a Mirage Quattro FFM and it has taken a while but have finally got rid of all leaks. I don't hear any noises from either and I'm a very light sleeper, so much so I have to wear ear plugs. Both should be fairly quiet.
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What you're getting is condensation caused when the air cools and cannot hold as much moisture as the warmer air. A heated tube should help. Or you could just slightly decrease the heater setting to prevent condensation. If you're at the point where condensation occurs, you're losing humidity so you may as well decrease the setting. I have had patients complain of the Zest making noise with very small amounts of condensate. There is a new Zest, called the Zest Q which has a different and reportedly quieter exhalation. It may prevent this noise.
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Which Resmed S9 do you have? If you have the S9 Elite or S9 AutoSet? If either of these two devices ask your DME provider to give you a printout of the ENTIRE data download. Unfortunately, as I understand it Resmed has changed the way they report the Leak on the LED screen so you need the FULL data download to check to see what your Leaks are really like. A high Leak could well explain your dry mouth and throat. AND is the most common problem for newbies.
Getting the Leaks under control greatly reduces the humidity need which greatly reduces condensation.
Hanging your hose above your head is another likely solution to the gurgling sound.
Ayr Saline Nasal Gel is GREAT for healing and preventing the sore interior of the nostrils as well as soreness at the bottom of the nose and/or top of the top lip. It also helps w/nasal pillows sealing.
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Judy said:Which Resmed S9 do you have? If you have the S9 Elite or S9 AutoSet? If either of these two devices ask your DME provider to give you a printout of the ENTIRE data download. Unfortunately, as I understand it Resmed has changed the way they report the Leak on the LED screen so you need the FULL data download to check to see what your Leaks are really like. A high Leak could well explain your dry mouth and throat. AND is the most common problem for newbies.
A while back, I went through the exercise of figuring out which model I have -- very irritating that it isn't simply on the label! Anyway, my machine is an S9 Autoset, though it is in CPAP mode. I also found places where I can download the software to read the SD card, but haven't gotten around to it yet.
I did catch myself, last night, with my mouth open in spite of a chin strap, but that is the first time that I have been aware of that happening, and it is pretty obvious with a torrent of air gushing from my mouth! Perhaps I am going to have to look for a better chin strap, but I am already on my second one.
I have been looking at the clinician data, including average leakage, AHI, etc., but I gather the printout would give me more data. Can you tell me what to look for once I have the printout? Or is it obvious, "patient mouth open" or some such?
Getting the Leaks under control greatly reduces the humidity need which greatly reduces condensation.
I have been tracking overall leak rate, and it is not highly correlated with my dry throat problem, nor is AHI. The only correlation I see is the obvious with humidity setting - I more often have dry throat episodes at 4 or 4.5 than at 4 or 5.5. And even that is not consistent.
Hanging your hose above your head is another likely solution to the gurgling sound.
I'll see if I can figure out a way to do that. I know there are devices for it.
Ayr Saline Nasal Gel is GREAT for healing and preventing the sore interior of the nostrils as well as soreness at the bottom of the nose and/or top of the top lip. It also helps w/nasal pillows sealing.
Sounds like a great suggestion for that problem - I'll look for it.
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Bruce, I have the same machine, just some slightly different setting as I'm in Australia, I take my data card out about once a month and take it to my sleep centre and they read it and give me a printout. It won't tell you if the patients mouth was open just total litres lost through leaks. You can get the software to run it yourself on your PC. I think my mouth still opens with a chin strap but I use a FFM so it doesn't matter as much but I am trying to train myself to breathe through my nose. With the hose being above your head, if you have a bedhead put it over that, my machine sits in a wall unit, so I made a small ring on a clip and hang it through it. You can buy a hose lift off the net.
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Not all mouth leaks are the result of opening your mouth. You can have "the lip flutters" w/o being aware of them unless you are awake when they occur. Air escapes gently thru a small parting of your lips. Chin straps can't help w/"the lip flutters". That as my problem w/the nasal cushion masks. *sigh*
Terry, the problem w/full face masks is that they tend to push your lower jaw backwards. In my experience a full face mask makes it even more difficult to train yourself to breathe thru your nose. Its all right when you are awake or even in light sleep (stage 1 dozing) but the deeper into sleep you get and the more relaxed your muscles the jaw gets pushed back by the full face mask. *sigh*
It didn't take me long to master the art of positioning my tongue to keep the air flowing into my nostrils rather than my mouth - but as I finally had to either go to a full face mask or start taping my lips shut and opted for the full face mask gradually I began to notice a problem w/the air escaping around each side of the back of my tongue and bubbling into my mouth. From then on it was gradually down hill to where once I got into deeper sleep my jaw fell back and my tongue lost its seal against the roof of my mouth/back of my front teeth position and I was breathing w/my mouth open inside the full face mask.
Bruce, back to the Leak reporting. The software will give you more thorough reporting of your leaks thru out the night than what is available via the LCD screen. There is a continous graph of leak flow thru out the night rather than a reporting of the average Leak flow.
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Judy, your probably right, I'm no expert at it but trying to breathe through my nose during the day and when I'm dozing and waking up and hopefully will get used to it so much that I do it during the REM stage. I won't really know anyway because I'll be in deep sleep. I use a chin strap with a FFM but am sure the muscles in my jaw still open my mouth if they want. Aat the start, I used to get the bloated feeling in my stomach from breathing the air through my mouth but I don't get that anymore so I am improving. It is hard to change 49 years of habit.
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Boy!!! I DO understand that last sentence of yours, Terry!!!!! Boy, do I!!! *sigh*
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RE full face masks pushing lower jaw backwards, I noticed while looking at the F&P site (http://www.fphcare.com/) yesterday, that their full face masks fit beneath the chin. The FF masks I have tried were not like that. Perhaps the F&P FF masks would not push the jaw backwards.
I hung my hose high last night, and it definitely helped make it easier to turn over and to sleep on my side without pushing the mask to make it leak drastically. But it also put the hose right in front of the mask exhaust, making more wind noise. I think the solution to that is to get the F&P Zest Q mask (thanks, Seliina Coe), which has an exhaust diffuser.
Thanks for all your replies - it all helps understanding.
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Bruce, we're all still learning, I have been on CPAP for nearly a year now and last night increased the humidity on my mine by 3 degrees because I used to wake up with col air and that solved that problem. I never like changing my setting because once I get them right I like to leave them but a slight tweak helps.
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