[CPAP] Rebreathing Issues

[Geri Monsen]

I have a ResMed S9/H5i CPAP machine and am using a full face mask. I’ve come to realize that at least for the last few months, I’m rebreathing a lot and am getting headaches and poor sleep because of it.

When I exhale, the air all goes back down the tube and then comes back up for the next breath. I don’t feel any air escaping out of the mask or elbow anywhere. I replaced my mask (Airtouch F20) and the same thing is happening. Where is the exhaled air supposed to escape?

I originally thought it was supposed to escape at the elbow, but those valves always stay closed when the air pressure is on no matter how hard or soft I exhale. This is really affecting my sleep/life.

[Geri Monsen]

Wait. Was I supposed to remove this plastic cover/piece on the elbow?

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[LindanHotAir]

On my F20 elbow there are exhaust ports that are partially covered by a white deflector ring. There are two flaps that cover the anti-suffocation ports when the elbow is pressurized, and allow you to breathe air in if the machine quits.  The exhaust vent holes need to be cleaned periodically. My previous F20 elbow did not have the deflector ring over the vents.

[Geri Monsen]

I get how the anti-suffocation ports work now. Those are fine. It’s the exhaust ports that seem to be covered by the white deflector ring too much. Basically no air was allowed to get through - and this is a practically brand new elbow piece. I’m going to try prying the deflector ring open a little to see if I can get more air flow. Is it something I can remove entirely? I’m not sleeping next to anyone, so some extra noise is fine.

[SideSleeper]

I feel next to no air escaping on exhale with my F20 AirTouch also, but don't seem to have any problems that re-breathing air would cause.  I have wondered about it since I seem to be breathing warm air, despite the fact my humidified and hose are off for the warmer weather.  I use passover humidification---water in tank but no heat.  There have been other threads on this subject on masks using that same elbow.

[legrunt]

What you are describing is the QuietAir elbow. It is covered by that plastic cap, and inside that cap there is a mesh material that makes the air diffuse out very quietly. That is its main selling point, as it is the quietest mask I have ever used. And trust me, it is venting sufficiently. If you try to cover the entire perimeter of that cap with your fingers in an "ok" position, you will hear the air start to hiss.

If noise is no concern to you, you could reach under the cap with some tweezers and remove that mesh material, but I gotta warn you, it is LOUD if you do. And it's debatable if that even increases the venting. On top of that, once you remove the mesh, it is really difficult to replace it.

I would suggest instead, to look online for the older style non quietair elbow. If only for peace of mind, as you can really feel the air gushing out of those.

[Geri Monsen]

I appreciate the response, but I need you to trust me that the elbow I have I isn’t venting sufficiently at all. My exhaled air is (mostly?) going back down the pipe and I’m definitely breathing in a significant amount of exhaled air.

Last night, I pried it open partially, and it was the best night’s sleep I’ve had in a long time. I’m not sure if I should just remove it entirely or as you suggested, try to find an older elbow. I’ll have to think about it.

[Gideon]

A few comments
1. It is an engineered part and as such should have sufficient leakage.
2. If mesh gets wet it will significantly reduce airflow
3. What is/was your situation with Central events. We occasionally suggest increasing rebreathing as a potential treatment (EERS)

[Geri Monsen]

1. But it clearly doesn’t. The difference in the quality of the air on my first breathe versus, say, my fourth breath is very significant. Also, when I blow into the elbow after plugging up all other holes, there’s enormous resistance - to the point that I’m not sure if any air is going out of the vent. Also, I’ve been waking up multiple times a night with headaches as described as symptoms of rebreathing issues.

2. This has gone on for weeks with use of this brand new elbow, so it’s not caused by a water spill or dirty vent.

3. I don’t know how to get stats like that. The machine display doesn’t seem to give those kind of stats, and as I don’t have health insurance now, I don’t have a doctor or breathing specialist to go to to ask these kinds of questions - which is kind of why I’m here.

[SarcasticDave94]

Dave's tablet glitched and sent a bad post copy...