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[CPAP] Drinking & CPAP & Stopped breathing 120 Seconds? (Missing Data)
#1
Surprised 
Drinking & CPAP & Stopped breathing 120 Seconds? (Missing Data)
So.. Yeah....   I sorta created this mess..  And the CPAP machine says you shouldn't do it again..

Besides not breathing for 120 Seconds ..  The leak rate says that it was attached to my face just fine..  So I am pretty sure the data holds..  


Has anyone seen where there are GAPS in data..  Again.. I was really drunk..  And I have never seen where the data is not recorded.. 


[WARNING: Worse CPAP screenshot EVER ]   

13 Minute window:   https://images2.imgbox.com/3f/6b/DFYyQNJE_o.png
  

Then through the same night there was just data missing there after?  Has anyone seen this before..   The machine was still working and it was one session as you see the pressure is still high..  

IMG Url: https://images2.imgbox.com/7e/41/EhInbXwQ_o.png
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#2
RE: Drinking & CPAP & Stopped breathing 120 Seconds? (Missing Data)
I've had this happen, and I decided that it was caused by mouth breathing while wearing a nasal mask, and that whatever was happening represented a complete meltdown of the AirSense 10 software. I'm wondering if your takeaway should be that you can't successfully use a nasal mask without mouth breathing if you are intoxicated. My takeaway is that I can't successfully use a nasal mask without mouth breathing even if I'm cold sober!

The key is that the machine shuts itself off, and then when it turns back on it's still at the old high (actually pegged-to-maximum) pressure that it was at when it turned off. What I think I see happening is that the machine is underestimating the leak, I pretty much entirely stop inhaling through my nose, the machine uses inspiration to calculate what's going on, even though it's measuring and logging exhales, it logs it as not breathing. You really need to look at the whole parallel set of the graphs at once to figure out what it's thinking -- so those periods where the exhales are very clearly there and the inhales aren't, the machine stops EPR and logs the respiration rate as zero. Even though the expirations on the flow rate curve are there.

The key piece of data is that when the machine returns after the break, does the pressure reset to your minimums, or does it start at the same pressure that it left off at? If it powers on at minimum, that's a proper shutoff. If it guiltily sneaks back on at the same pressure that it was running when it turned off, that's because it's realized that it shouldn't have shut off. (A note about how a ResMed machine comes back on after a power flicker -- it comes back at the pressure that it was running when the power dropped. You can test this by unplugging the power cord and plugging it back in.)

We had another brand-new cpap user (midwestguy) whose machine was doing this. In all of his data, the machine didn't record itself detecting ANY leaks. Even when he was awake and deliberately pulling the mask away from his face he would look at the data later and no leaks would be shown. It became obvious from looking at his data that he was mouth breathing, the machine's leak sensor(s) was not operational, and the machine couldn't figure out what to do. His DME replaced the machine.

Here's my pictures from a particularly ugly night a year ago.

First the whole night:
[Image: overview.png?raw=1]

A series of shutoffs over 72 minutes:
[Image: Sequence1.png?raw=1]
[Image: Sequence2.png?raw=1]
[Image: Sequence3.png?raw=1]
Notice that the last break is real -- that's me turning the machine off, which is why it reset to minimum pressure.

Finally, here's a closer view of the period leading up to a shutoff:
[Image: Closeup.png?raw=1]

Notice how the respiration rate is logged as zero when I'm clearly measurably breathing. And the leak rate is below redline for all but that brief period.


What's absolutely terrifying is that the machine is logging data which the algorithms obviously have no freaking clue how to interpret and how to react in response. And while the machine is faithfully recording this, it's not reporting any of it. This represents a catastrophic failure of the machine to deliver therapy. We all know from our experience that the medical "professionals" who are supposed to be monitoring our therapy only look at the summary reports that the manufacturers' software spit out. If the manufacturer's software reports that the manufacturer's product is "successfully controlling your apnea" then the "professionals" are completely uninterested in the fact that the machine recorded terrible failure.

My interpretation of this data is that I have to use a full-face mask.

I had a sleep clinic appointment two weeks after this trainwreck of a night. I brought my card, and a "professional" analyzed the data, for which the clinic billed $144, and my insurance allowed a charge of $82.66. This is what "expert analysis" looks like:
Code:
Today's CPAP download shows an apnea-hypopnea index of 1.3 events/hr, minimal mask leak, and excellent compliance, wearing CPAP 100% of the time for an average of 6.5 hours per night.

CPAP Download:
CPAP Pressure (cm):............................. 7-8
Machine Type:.......................... AirSense S10
Days of use?..................................... 95
Percent (%) of days used?....................... 100
Hours of use on days used?........................ 6
Minutes of use on days used?..................... 34
Average daily hours of usage, all days?........... 6
Average daily minutes of usage, all days?........ 34

Three months later they wrote me a prescription for a new machine, which included a prescription for nasal pillows. (Fortunately Apria ignored that and sent me the full-face mask I asked for.)
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#3
Wink 
RE: Drinking & CPAP & Stopped breathing 120 Seconds? (Missing Data)
Wow.  Thank you so very much for this insightful great reply,    I have the "auto on/off" enabled, I wonder if I should disable that.  Maybe that could be part of the issue.  But really for it fail to log / or reset / or just stop working is crazy.  I would have loved to see the machine when this is happening.  What does the machine actually do via sound and video.   And also what I am doing.  

See if my I am mouth breathing,  (* I have a this thing to prevent my mouth from opening (can't post the link Amazon: "ParaFaciem Reusable V Line Mask Facial Slimming Strap Double Chin Reducer Chin Up Mask Face Lifting Belt V Shaped Slimming Face Mask" in PINK ) )  and it seems to work well.  Nor did I wake with dry mouth..      

I have not been using the machine very long, but I figured if I was going to drink I should really attempt to use it, as it seems it really should do it's job.,    But to stop breathing for long amount's and unable to clear the blockage....  at 20  the max..   and then it just turns off! LOL Thanks!  

When I turn off the machine in the AM (* even if it has the auto off/on)  the air like stops 100% and like putting a plastic bag over my face..   God I would hate if that happened when I was drunk and had was in the middle of the night.   

I can only figure that the machine had not a clue what to do as well.  But why would the LOGGING turn off..   OMG.  I get that it was "not on" but again, like not doing anything?     

"Professional"  -  Nice..  Something OSCAR can tell you for free.   Really the manufacture should be explaining what happened as it clearly is a problem.    As soon as it comes back on, it's at the exact same pressure as it left off with, as if it knew it messed up..   (* and not a ramping, as it normally does on startup )  

But I digress,  the machine is not a life saving device,  it is a assisted breathing machine..   Once I reached max pressure, and not breathing it doesn't start the next breath..  And that is very scary as you can see from the first 17 minutes of my sleep I almost wasn't breathing, at all, only a slight gasp.   My heart rate was at 110 due to the lack of O2.  ( watch heart rate monitor ).    

Reviewing you picture closer you had "Smart start" on..  So did I.    It also is "Smart off"..    don't think it maybe that smart..     Going to disable that as it may be the root cause.   At least that would be a good next step that I can do..    I am sure there will be the next night of drinking with the buddies that will give me the next data sample..  

Sleeping last night was nearly perfect..  So this is only a event that is triggered by drinking.. But won't drink like I did that night..  That was really bad..  120 seconds of not breathing (so it says with a data break in the middle)..    

Thanks again for sharing the info,  I hope maybe resmed watches some of these forums.  Sure some of the employees are on here..  ( YEAH I AM TALKING TO YOU developers ! )  LOL.. 

Thanks Cathy!  What a great reply.   I too may need to get a full face mask if this happens again.  Crazy stuff. .  

Thanks

Robert
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#4
RE: Drinking & CPAP & Stopped breathing 120 Seconds? (Missing Data)
While the SmartStart/StupidStop setting definitely makes things worse, I've had it happen a few times even without it. Everybody here told me to turn it off, and I did right after that.

Here's an attempt at a nasal mask using a vauto 6 weeks later.

[Image: vautoShutoff.png?raw=1]
Here's my attempt at zooming in and stretching the window sideways so you can see what's happening closer-up.
[Image: vautoWideCloseup.png?raw=1]

Look at it starting 4:32, where the expiration time and inhale time go to zero and the mask pressure graph shows that the machine gives up on the EPR, even though you look at the flow rate curve and it's still going up and down quite regularly. The leak is high, but still below redline. At 4:34:45-4:35:15 there's a disturbance and kind of recovery, but then the SHTF again and at 4:36:32 the machine gives up and stops blowing. But it kicks right back in at 4:37:21, for ten breaths -- which we can all count, but the machine can't. Notice looking over there at the session information -- the machine doesn't count the break from 4:36:32-4:37:21 as a session break, but the longer break from 4:38:22 to 4:45:25 does count as a new session. But when it DOES come on after the 7 minute break, it comes back at the 16.60 it left off with rather than the minimum.

As I say, look at the data and you can almost hear the machine muttering WTF?!? But it doesn't flag any events, doesn't give any clue that it noticed anything odd at all. It recorded its confusion quite faithfully, but didn't alert anybody that anything odd had happened.

For a device that delivers therapy when the patient is unconscious and none of the medical professionals are there to see it -- as I said before it's freaking terrifying that the machine doesn't flag anything.
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