[Equipment] ResMed Quiet Air Diffuser Vent F30

[hegel]

You could always get a needle and hook the packing/gauze out if the quiet elbow is an issue or concern

that's my plan if it comes to that. And if the mask works as well as I hope!

[raylock1]

For those who have repacked the elbow/diffuser, I am anxiously waiting to hear if the black spots reappear!

[SevereApnea]

There are quite a few posts with similar concerns: Let me see if I am allowed to post links...

http://www.apneaboard.com/forums/Thread-...ypercapnea

http://www.apneaboard.com/forums/Thread-...YPERCAPNIA

http://www.apneaboard.com/forums/Thread-...Airfit-P10

http://www.apneaboard.com/forums/Thread-...-Poisoning

and there may be more I have not found.

So this is a recurring theme, certainly concerning enough for those of us it affects.

Some have this problem but others don't.

My own feeling is that the holes between the mesh are tiny, really tiny, too tiny, which means surface tension causes moisture to get trapped in there, either from washing or just from your expiration breathe.

Thinking laterally: could there a relationship between this and the level of air pollution? Most folks responding to these posts don't reveal their city/location in their profile, so it is not easy to see if there is a correlation there. There are a number of websites that allow us to look up pollution levels city by city. That might be an avenue to explore.
Gross out warning: Google search: carbon trapped in lungs pathology images, not for the squeamish.

In addition we don't know what material the manufacturers put in there and whether this is consistent from batch to batch.

PS: I have switched to the N30i with some success. I asked my supplier to try the P30i nasal cushion (which fits the same headgear) in different sizes. The one was provided with quiet diffuser ("borrowed" from a  for sale package) and the other was provided without the mesh diffuser (for loan). But they did say if I wanted to buy a particular size they could order it in as an "on loan" article without the mesh and sell that to me instead. Interesting that they let you trial the one and then sell you other with no mention of needing to change PAP pressures or humidity levels.

Good heavens, There are enough variables for those of us starting off with PAP therapy as it is!

[Hydrangea]

Thinking laterally: could there a relationship between this and the level of air pollution? Most folks responding to these posts don't reveal their city/location in their profile, so it is not easy to see if there is a correlation there. There are a number of websites that allow us to look up pollution levels city by city. That might be an avenue to explore.

That's intriguing. And expanding on that, one might consider which machine they're using and how well the filter on their machine works. 

I primarily use a DreamStation, which has 2 stages of filters (a larger mesh, and then a fine mesh/fabric).  My ResMed (which I use for travel) only has a large mesh filter, which I have to assume lets in a lot more dirt & dust.

Personally, I haven't seen any black dots on the mesh in my quiet elbows.  But I've also not pulled out that mesh (which is when it seems it's more able to be seen).  I haven't pulled mine out yet because I don't know how to do it without ruining the elbow.

[Big Guy]

Several months ago, I was intrigued by all this talk about the elbows and the "black spots". 

I can't recall if I posted about this already or not. Anyways, I decided to sacrifice one of my old elbows and cut it open, so that I could get a better view of the dots in question. 

I did so, and the spots were very uniform in size and color. By my examination, they did not appear to be a variety of mold or such. 

I can't speak as to why they are there, but they didn't look to have appeared there on their own accord. If there was any indication of such, I do believe that I would have picked up on it. 

I failed to mention, that I have two, still sealed in their factory bags, complete masks #63462. I have another one being delivered today with other supplies.

The two mask assemblies that I do have, do not appear to have any black dots in them. I'm now curious to see if the one being delivered today is any different than the two I already have.

[RayBee]

The first step is to admit you have black spots on your elbow... 

All kidding aside.  I was one who swore up and down that my QuietAir elbow didn't have black dots on the diffuser material.  Then I used my jeweler's loupe and peered through the tiny holes with a good light shining through the translucent cover from the side.  And to my horror  (yeah, a bit much  ), I could see the tiny fibers covered in black.  And a few stragglers hanging out the side, also black.  

I happened to have a new elbow as a backup.  It was entirely white upon close inspection.  So I swapped to the new one and dumped the old one in white vinegar to soak for several days.  After several weeks, the new one showed darkening dots that slowly turned to black too.  I'm not a smoker and use a HEPA filter on my AirCurve 10.  The HEPA filter definitely has a finer filter than the factory or standard replacement filter.  So probably not too much gunk coming into the system.  And I replace the filters on the 1st of every month.

Rinse and repeat...  I bought a third elbow, inspected and tried again with same results.  It also went from white to black over time.  So if it isn't a tiny bit of mold, I don't know what it is.

Replace and repeat...  Several weeks ago, I modified an elbow and posted how I replaced the diffuser fiber with strips I cut out of an intake filter.  I just inspected the elbow and found that the replacement material is turning black in the tiny holes as the original material did.  Still light right now, but definitely on the way to turning black.

As mentioned previously, you're not inhaling through these holes.  So aside from the gross-out-factor, I'm still alive and kicking and have no health issues from using these elbows.  And as far as I know, nobody else is either.

On the discussion regarding the holes being too small and restricting your exhaling feeling...  I masked-up, off xPAP and plugged the elbow's anti-asphyxiation vents and supply hose hole, and only left open the tiny exhaust holes.  And it feels incredibly restrictive when exhaling.  But that isn't the real world when everything is operational.  I suppose if you wanted to, you could easily get a tiny drill bit set and a pin vise and drill out each hole to a slightly larger diameter.  I think in the grand scheme of things, it isn't going to disrupt the machine from administering proper therapy as it would probably view the change as a slightly higher leak that it would compensate for anyway.  Also, from manufacturer to manufacturer, these exhaust vent systems are not going to be that exact.  So drill away if you like.  Simple.

Back to the black dots...  I'm not a gambling man, but I am almost willing to bet that everybody who has one of these diffused elbows will have black dots develop in a few weeks to months of regular use.

There are those who have black dots.  There are those who will get black dots.  And there are those who are not willing to admit they have black dots.

[Hydrangea]

Great info, RayBee!!!

Re: the restrictive breathing from the quiet elbow... The only reason I suspect that is because I was getting the same rebreathing symptoms that I get with the P10 after some time. Severe headache, severe grogginess, severe exhaustion, toxic feeling. I don't get it with any other mask (just P10 and the F20/F30 with quiet elbow). And I don't get it with the non-quiet elbow.

[Big Guy]

My new AirFit F30 complete headgear / mask assembly arrived today. No black dots. 

I also just checked the existing diffused quiet elbow that I've been using now for at least 6 months. No black dots.

[hegel]

At this point I think that I'm less concerned about the black dots...unless they really are mold...and far more concerned about the quiet elbow limiting co2 exhalation.

hydrangea, I used the P10and loved it for years, until recently I began having the old oxygen deprivation symptoms I had before cpap. It turns out it was my mouth breathing rendering the mask ineffective. Or that's my assumption. You're suggesting that the p10 has the same blocked outflow problem. Interesting. My ahi with the p10 is fine, but I've come to believe that it' s inaccurate.

Now I have to go see if I can find blockage...

[lacro]

Back to the black dots...  I'm not a gambling man, but I am almost willing to bet that everybody who has one of these diffused elbows will have black dots develop in a few weeks to months of regular use.

There are those who have black dots.  There are those who will get black dots.  And there are those who are not willing to admit they have black dots.

 And.... there are those that really don't have the dreaded black dots.

I too have  a jewelers eye loupe and a powerful light. I closely inspected my elbow, and I can assure you I don't have black dots after 4 months use. I have a spare unused elbow that looks exactly like the one I use - no black dots. I do wash the elbow weekly.

Here's a photo of my elbow with light source illuminating through the holes from the back side: