AirFit P10 vent blocked?

[herbm]

That sounds like a problem with your humidifier or in having the unit too high (so water condenses and moves downhill to you.)

I simply stopped using water completely and don't even have to do any maintenance anymore.

[BadGoodDeb]

That sounds like a problem with your humidifier or in having the unit too high (so water condenses and moves downhill to you.)

I simply stopped using water completely and don't even have to do any maintenance anymore.

Me too, on both counts .... but I still need to cut slashes in my nasal mask (pillows thingie) or I can't breathe through it.   I guess I've always got restricted nasal flow (non-allergic rhinitus)  and so need something which responds to lower effort?  Dunno -- but once I cut enough holes so it was similar to my Swift ... LX??  ...  then I loved my P10.

Oh, and to state both of my "fixes" in one place: my DME said I should be a size SMALL in pillows. I moved up to MEDIUM, and after a year, tried out a LARGE. It lets SOOO much more air into me, that I'm never going back from the LARGE that I'm still using. So, the size of the opening in the pillows themselves, made a huge difference to me.

[OpineCone]

Sweagen, what makes you think it's the P10 that's causing your problem if all the other masks you tried were even worse? Did the excessive humidity happen with other masks or just the P10?

Where and how does the humidity show up - visible condensation in the clear tubing and pillows, or blockage of the vents, or gurgling in the tubing from the machine, or something else?

You might try leaving your P10 disconnected while you warm up your humidifier, and only connect it when you go to bed. The warm-up can cause condensation in the tubing and mask before you even put it on.

[rx77310]

Don't know if anyone posted something similar, but I think someone wanted to see sleepyhead data that indicated a problem with ventilation for the p10.

The attached graph shows how my vent rate and pressure responded to running my humidifier for the first time in a long time, with condensation forming inside the tubing.

This was actually done with a modified mask that's been punctured with a needle over a dozen times on each side in the past.

Notice how the total leak rate in L/min starts at 19 at a pressure of 4 cmH2O, which is in line with the technical specifications listed in the p10 manual from resmed.  Then, as condensation begins to form in the tubing, the total leak rate drops all the way down to a low of 9 liters per minute at a pressure of 4.9.

Just wanted to post this up as evidence that suggests there is in fact a ventilation problem that's directly related to humidity and the diffuse ventilation in the p10.

Also, are there any alternatives to the p10?  I do really like the p10.

According to sleepyhead, without the humidifier on I maintain normal vent rates that are in line with the p10s technical specifications.  I usually use no humidification and moisturize my nose with some AYR nasal gel, once before I sleep, and once more during my planned midnight awakening and that seems to workout just fine, but the sensitivity to humidity does worry me a bit.

[Sleeprider]

rx77310 I can promise you about 80% of us would tear off the mask and run from the room using a minimum pressure of 4.0 You really need to change your settings so your needs are better met. The vent rate does appear to reduce in the graph you showed and appears to be a total leak less than 10 L/min. That is low, but what is your minute vent rate on your graphs? Half? If so, you still have pressure and are not re-breathing air.

Any chance you might post up some data in one of your threads? I know you started from settings of only 4 to 6 cm and your profile suggests you are at 4-20 and something about a CPAP pressure of 8.4. I understand there is some resistance in the P10 vent diffuser, but I really think your problems stem from low pressure. I'll just say I have used this mask since it was released (Previously Swift FX). I have never had this problem through about 4 different masks.

[rx77310]

rx77310 I can promise you about 80% of us would tear off the mask and run from the room using a minimum pressure of 4.0  You really need to change your settings so your needs are better met.  The vent rate does appear to reduce in the graph you showed and appears to be a total leak less than 10 L/min. That is low, but what is your minute vent rate on your graphs?  Half?  If so, you still have pressure and are not re-breathing air.

Any chance you might post up some data in one of your threads?  I know you started from settings of only 4 to 6 cm and your profile suggests you are at 4-20 and something about a CPAP pressure of 8.4.  I understand there is some resistance in the P10 vent diffuser, but I really think your problems stem from low pressure.  I'll just say I have used this mask since it was released (Previously Swift FX).  I have never had this problem through about 4 different masks.

I have attached my minute vent rate along with my pressure and total leak rate information.  It appears my minute vent rate is actually higher when the total leak rate goes down.

I have also attached my machine settings over time.  I have tried increasing the minimum pressure to 6 and I don't know if it really made a difference, seems about the same as 4 to me except I'm more likely to get a smidgen of blood in my nose at a pressure of 6 if I'm not on top of my nasal saline gel regimen and my nose felt a little bit more irritated in general.

I typically don't have any issues at all with my CPAP, and usually find it pretty comfortable, especially with the p10.  I've only ever had issues when I turn on the humidifier, which is practically never these days, because of a fear of blocking the vents.

I honestly don't really feel a need for using the humidifier anymore with the nasal gel as well, but I did try the humidifier recently and figured I might as well share what I saw, especially since I think someone asked for sleepyhead data relating to leak rate earlier in this thread.

[herbm]

I agree that practically none of us could use a mask with a pressure that low.  (There might be one or two out there.)

Most find 6 low, many find even 8 to be low -- ignoring what they NEED for the OSA.

Also note that the odds of your being able to "improve" one of these very carefully designed masks with pin holes are very, very close to NIL.


High humidity and/or a cold room can easily cause condensation in the hose -- the water is condensing and collecting in the HOSE, not in the mask (to a virtual certainty.)

Biggest mistake I have made is a loop of hose DOWN from the machine so there is a place for it to collect -- THEN picking the hose up for some reason so it runs into the mask end.

This is a main reason for keeping the machine lower than your bed so the hose NEVER has it's low point where YOU ARE.

Hose covers can help with the cool air condensation problem (as can a heated hose) if you sleep in a relatively cool room.

We have heard of rare P10's that seemed to have some type of film blocking the vent exhaust (though I am not sure this has ever been 100% confirmed) -- just replace those if you run into one.

You should feel a bare ooze of air up to about 4 inches in front of the UNMODIFIED P10 -- no stream or jets or obvious leaks.  The best word I have is "ooze", and it only goes out a few inches.  

If you have screwed it up with holes just replace it.

[rx77310]

My attachement in the previous post shows that I've logged over 300 days at a 4-20 pressure range. It also shows that I've logged over 300 days at a 6-20 pressure range.

That being said I'll try putting it back at 6, mostly because I have a feeling it will be easier to keep things dry at 6, and probably will make breathing easier. I do notice I have to sort of watch my posture or sleep position more at 4 to feel comfortable breathing.

My vent was definitely wet in this case, I felt the mesh, and it was definitely wet. Maybe it's possible exhaled air from my nose carries moisture in it that contributes to condensation in the mask and on the vent?

A previous poster in this thread theorized that the film on the vent some people reported was actually moisture blocking the vents. He also theorized surface tension would make the moisture particularly difficult to remove. Perhaps a blocked vent could explain the massive drop in total leak rate at the same pressure and a much higher minute vent at that?

Like I said previously, I honestly hardly have any issues with my current set up. It seems like as long as I focus on keeping things nice and dry everything works fine. So, no humidification or passive humidification only for me, and nasal gel to keep my nose from drying out and bleeding. Whenever I check the data on sleepyhead, usually my total leak rate is where resmed says it should be, as long as I don't experience any condensation at all.

I just wanted to share an observation I have made for an extremely rare occurrence for me. While not the first time this has happened, it's very rare, and I think easily avoidable. That observation seemed relevant to this thread and various theories that have been proposed in this thread.

[herbm]

Yes, you exhaled air can certainly be very wet.

Especially if you are breathing in air that is very wet (e.g., humidity set too high.)

The film I am hypothesizing is something cohesive enough it doesn't wash off trivially so it would be more than JUST moisture.

(Maybe mucus residue but that is a pure guess.)

If the mask isn't oozing air out of the grill within 3-4 inches while the machine is running then something is wrong with it -- either the grill is blocked or the extra holes are causing it to work improperly.

[rx77310]

My vents seem to have some kind of coating on them preventing air from escaping.  

I can disconnect the mask tube from from the heated line tube, plug the hole at the end of the mask tube, put on the mask and blow air into it and almost no air moves out of the mask-next to nothing comes from the exhalation ports.  

When disconnected from the machine and the hose end plugged I need to blow hard enough to blow up a balloon.  It was not like this when I got it.

Any one else have this problem or a solution?

Thanks.

After a personal encounter with P10 vent blockage last night, I offer an answer that worked for me and that may help at least some of you who are despairing about the inexplicable behavior of your P10.

Prior to last night my P10 had worked perfectly, and so last night I confidently donned my headgear, gently lowered myself into bed, used the mask leakage function on my CPAP while I adjusted the position of my nasal pillows, and then turned on the CPAP. Immediately I noticed that it was difficult to breathe normally. There was less air than usual available for the inhale part of the breathing cycle, and the air moved less than usual during the exhale. I also observed that the CPAP was making an unusual sound, a brief moaning noise, once during each breath. The CPAP display showed a normal pressure reading. Remembering what other P10 users have reported about vent blockage, I reached my fingers up to the area just in front of my mask and found that there was no detectable air movement. Knowing exactly what normal vent discharge feels like, I immediately concluded that both sides of the P10 vent were blocked.

I considered switching to my full face mask, but I love my P10 so much that I decided to attempt to solve the problem first. Fortunately, I had a wealth of information available in the form of the many contributions to this thread, for which I thank you all. I noticed that at least two people had claimed that they could see a plastic film covering their P10 vents, and so I held my mask up to the light and, sure enough, it looked as though my P10 vent had grown a plastic film. But my mask had been working perfectly less than 24 hours ago! How could this be?

Fascinated, I grabbed a small flashlight, put on my reading glasses, and took a good look at that vent. What I saw was puzzling: I had never seen anything quite like it. Each side of the vent seemed to be a perforated plastic screen with very small holes, with the screens consisting of two or more layers of the same material. The screens were not uniform in appearance, with a large central area the shape of a less-than-half moon and a narrow boundary area that somehow looked different. The vent holes seemed to be larger in the boundary area than in the central area, and I wondered whether the central area was blocked by something, perhaps the plastic film that others had observed. Or perhaps the central area was water trapped between two layers of perforated plastic. I squeezed it between my fingers but the shape and size of the central area did not change. I tried to dry it with a clean, soft washcloth. I tried pushing the bristles of a tiny, soft brush into it. I blew warm air from a hair dryer onto it. Whatever I tried, the water or plastic film or whatever did not change its appearance even slightly.

Obviously I needed to know more about the vent material. One of the early posts in this thread described it as micro-mesh, and so I did a DuckDuckGo search so as to better understand micro-mesh technology. Then I grapped a 14X loupe magnifier and took a much closer look at the P10 vent fabric. Fascinating. It’s essentially a densely packed arrangement of fibers of different thicknesses. The central area is very dense with a lot of very small fibers, and the boundary area is somewhat less dense and lacking the tiniest fibers of the central area, although light still cannot pass straight through it. This inspection under magnification revealed that the appearance of a plastic film or trapped water in the central area of each vent is an illusion caused by the different fiber thicknesses and densities in the central and boundary areas.

Yes, the plastic film is an illusion. So what was blocking my mask? Can you guess?

I found clues to the answer in three places. First, when I took my mask off last night after my brief attempt to use it, I noticed some condensation in the mask and its short hose. Not surprising, because the bedroom temperature was my preferred 55 degrees, but still worth noting.

Second, someone posted that he washes his mask “every night,” which got me wondering whether some people wash their masks in the evening rather than in the morning as I usually do.

Third, my cleaning routine had been interrupted yesterday and it was early evening before I removed my mask from its soaking bowl, rinsed it, shook the water out of the attached hose and set the mask to dry. Several hours later, I connected the mask to the CPAP and turned on the warm-up feature but ended up watching TV in the living room for long enough that the CPAP would have completed its warm-up, held the temperature for a while, and then cooled down again. In the past, when I was using a full face mask, allowing the CPAP to warm up and then cool down again before I put the mask on had sometimes caused a rainout event when I finally went to bed. And so yesterday, not wanting another rainout, I removed the humdifier tank and completed another warm-up to remove moisture from the CPAP, hose and mask. I then replaced the humidifier reservoir and did another warm-up.

Thinking about all this, I realized that it is possible, or even likely, that the micro-mesh vent of the P10 does not dry out as easily as one might assume, and the air blockages are being caused by water temporarily trapped in the micro-mesh fabric. After all, we know that the vent is designed to limit the amount of air that flows through it under pressure, and the vent is made of densely packed fibers. This suggests that the two sides of the vent may behave somewhat like a couple of sponges, but without the option of removing water from the vent by squeezing. Attempts to blow the water out of the vent are futile because the water is securely held in the tiny spaces between the fibers of the fabric by a phenomenon called surface tension. The only way that water is going to escape is by evaporation.

Using my 14X magnifier again, I took a good look to see whether there was any sign of moisture trapped in the vent, or whether evaporation had already changed the appearance of the vent from when I first examined it under magnification. I was encouraged to see that even more tiny fibers were now visible. With increasing hope, I reassembled the mask, connected it to the CPAP, and ran a test. The result was that the mask now operated perfectly and so I went to bed very happy.

Today I performed one further experiment. I immersed one side of the mask frame in tepid water, keeping the other side dry, and then did a side-by-side comparison of the two sides of the vent under 14X magnification. Somewhat remarkably, I could not directly see the water in the wet side, but I could easily tell which side was wet because the smallest fibers were no longer visible as separate and distinct but tended to merge together.

If you want to see a photo that clearly shows what the P10 vent looks like to the naked eye, including the central and boundary areas, go to scott1965's post of  06-10-2014 09:23 AM, which is Post # 7 in this thread, and click on the photo at the bottom of the post to open the full-size photo of the P10 frame. You must go to this original post. Clicking on the thumbnail picture included in some other post will only open the thumbnail, not the full size picture. Unfortunately I don’t have the equipment to take photos of the vent under 14X magnification. If someone else does, pictures of wet and dry vents would be most helpful.

Out of all this I offer the following suggestions for keeping your P10 functioning correctly:

1. Clean your mask components well in advance of going to bed, so that water has plenty of time to evaporate from the filter before you use it.

2. Try not to run the CPAP warm-up function and then delay going to bed, so as to avoid condensation in the hose and/or mask, which may get into the mask vent.

3. If, in spite of your best efforts, you go to bed and find that your P10 vent is blocked, consider it almost certain that you have moisture trapped in the micro-mesh fabric of the vent.  Remove the pillows from the frame. Don’t let your naked eyes fool you into believing that there is are plastic films over the two sides of the vent. Remember that there is no way to blow the moisture out of the vent, you must rely on evaporation. Treat it like a sponge that you cannot squeeze. Gentle heat may help. If you have a hair dryer, gently blow warm air onto the vent and remember that you are only trying to accelerate the evaporation, you are not attempting to blow the water out of the vent, because you can’t.

If your experiences show up something I have missed on this issue, please post the information promptly.

I wish you a very good night.

Here is the theory I was talking about.

In my experience, the vent works when dry, it doesn't work when wet, and it stay stays wet for way longer than one would think.

I do the hand check in front of the vents too.  When it's wet, don't really feel much of anything.  When it's  dry I feel the air coming out.  I keep it dry and don't worry about a thing.