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Missing Time (no, it's not alien abduction!)
#1
Ohmy 
I've had my ResMed S9 Autoset for exactly one week. Things are going pretty well overall, but I've noticed something that concerns me. When I check the "usage" option on the ResMed menu, it has significantly fewer hours than I actually slept. I religiously use my CPAP all night, every night. I do turn it off when I disconnect my mask to make a trip to the restroom, but as soon as I get back, I reconnect and turn it back on. The on/off button is far enough away that I couldn't have hit it during the night to turn off the machine. There haven't been any power outages in my room based on other clocks that would have to be reset if the power went out.

I first noticed the problem with the data for 12/13. Sleepyhead has a gap in the data that looks like the machine was turned off between 3:47AM until 4:23AM. No data is captured at all during that time. But I didn't turn the machine off, so why was nothing captured? I thought it was odd, but I still had 7:49 hours of sleep, so no big deal. But then the data for 12/15 is really weird. It shows I turned it on at 23:45, which matches my sleep log. But it abruptly ends the data at 4:53AM. I actually slept until 9:15AM. What happened during those 4+ hours?? The data for 12/16 showed that I started the machine at 22:42, and the data abruptly ends at 3:06, but I slept until 6:30!! During the night, I did wake up several times and felt like I wasn't getting any air, so I thought the machine had shut off. I would wave my hand in front of the valve on the front of my nasal pillows and I could feel a stream of steady air, so I knew it was still on and working. I went back to sleep, only to wake up later and go through the same routine. When I got out of bed at 6:30, I turned the machine off and then looked at the "usage" screen and was stunned when I read 3.06 hours!! After breakfast, I loaded the data into Sleepyhead and it showed the same thing. (Sleepyhead shows "Sleep" at 22:42, "Wake" at 1:53 and "Hours" of 3:06:04)

So what is happening? I called the RT at the DME and explained the situation. He said that the machine is only recording the therapy time minus the leak time, not the actual blower time, so that's why it only shows 3+ hours. He said that my mouth probably came open and because of the leak, I wasn't getting the pressure that I needed, so that's why it didn't record it. That sounds a little strange to me, but I admit I'm too new to this to prove or disprove his theory. So I decided to ask the "experts" (i.e. actual users on the forum) instead. Can anyone help me understand what's going on? I'm pretty sure alien abductions aren't involved, so why am I "missing time?" :grin:
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#2
Leak time? Sheesh. Leak time, in this regard, is when the machine does not detect any breathing. This is like if you are drying out the house and having the machine running. This keeps folks from running up compliance hours without actually using the machine.

If your mouth is open, the machine is still going to detect your breathing. Your supplier is an idiot.

However, if you take the mask off, then yes, the machine would stop recording data.

As with any electronics that is acting wonky, unplug it from the wall for about 5 minutes then plug back in. See if it gets the time right. Also, check to make sure it has the right time on the clock.
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#3
(12-17-2013, 08:54 PM)RockABye Wrote: I called the RT at the DME and explained the situation. He said that the machine is only recording the therapy time minus the leak time, not the actual blower time, so that's why it only shows 3+ hours. He said that my mouth probably came open and because of the leak, I wasn't getting the pressure that I needed, so that's why it didn't record it.
I don,t know what this guy is talking about, the machine keep deliver therapy with mask leak or mouth leak, are you using stop/start by chance. Try unplug the machine from wall outlet, wait a while and plug back, sometimes rebooting fix the problem

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#4
(12-17-2013, 09:02 PM)zonk Wrote: I don,t know what this guy is talking about, the machine keep deliver therapy with mask leak or mouth leak, are you using stop/start by chance. Try unplug the machine from wall outlet, wait a while and plug back, sometimes rebooting fix the problem

No, I'm not using the autostart/autostop option and I unplug the machine each time I remove the SD card just as an extra measure, so the machine is basically getting "rebooted" every day. I am going to move the plug from the surge suppressor strip tonight and plug it directly into the outlet to see if that makes any difference.

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#5
RockABye,

I've had my S9 Autoset for 4 days now (loaner). There have been two times I've woken up and realized that my S9 wasn't running. It is set to auto-start which means it also auto-stops.

I installed ResScan and Sleepyhead today. ResScan enabled me to document those two instances. It also showed me that I have a major leak issue with my system. I will be meeting with the sleep doc next week to review my progress.

The only thing I can figure out is that the S9 mistook the leak as me taking off the mask - so the S9 shut itself down. When I woke up the second time this occurred, I put my hand on my mask and took a deep breath. The S9 immediately started up.

I plan to do a mask fit test tonight and check the data in the morning.

Even with a ffm, a full beard does make for a drafty fit.

GeezerScouter
S9-101-25, Eagle Patrol
"I used to be an Eagle, and a good old Eagle too..."
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#6
That's could be the problem, might help to check the power brick is 90W not 30W
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#7
RockABye,

It's a stretch, but is Auto ON/OFF set to On or Off. If Auto ON/OFF is set to On and you're using nasal pillows and there's a really bad leak, then it is possible for the machine to lose track of your breathing, decide nobody's home on the mask end of the hose, and turn itself off. While you would think Auto ON would then turn the machine back on, sometimes the Auto ON feature just doesn't work all that well with nasal pillows.

How likely is this scenario? I don't know. But it is one thing you want to eliminate.

Next:
(12-17-2013, 08:54 PM)RockABye Wrote: So what is happening? I called the RT at the DME and explained the situation. He said that the machine is only recording the therapy time minus the leak time, not the actual blower time, so that's why it only shows 3+ hours.
I now use a PR System One machine. And what the RT is telling you makes at least a small bit of sense for PR machines. Under certain strange circumstances, a PR System One can indeed lose track of your breathing. My DME calls it a "patient disconnect"---I don't like that language, but I don't have anything better to use. When a PR machine experiences a patient disconnect, it's true that the recorded number of "sleep" hours in Encore is the therapy hours and not the blower hours. And therapy hours are the hours where the machine is on and detecting breathing. But SleepyHead records the session time, which is the blower hours, if I recall correctly.

The thing is: If the PR System One is not turned off during a patient disconnect, there's a break in the Flow Rate data, but the pressure data and the leak data curves are still there in SleepyHead. (But it is NOT there in Encore.) And under the list of "Sessions" in the Details sidebar of the Daily Data in SH, there's no "Start" or "End" times on any of the sessions that correspond to the break in the Flow Rate data. So you know the machine wasn't actually turned off. Here's a picture of one of my rare "patient disconnects" on my System One:
[Image: patient_disconnect_close_up_zpsb4a5f5c2.jpg]
See how the pressure data and the leak data continue to be recorded? That's the evidence that the machine was not turned off---at least for a PR machine. Large leaks (and in Official Large Leaks) are one thing that can trigger a patient disconnect on a System One, but they can also happen when there is no large leak, since this one clearly happened at a very low leak rate.

But you say that no data was recorded? As in no leak data? and no pressure data? Did you look at the data in Sleepy Head or ResScan or both?

Also what do the Flow Rate data and the leak data look like just before the gap? Anything funky going on before the gaps start? If there is a really large leak going on just before a gap starts or there's really funky Flow Rate data (as in my example), then the RT's hypothesis that the problem is being caused by the leak creating problems with the machine's ability to record the data.

But if the leak data and the flow wave data look pretty normal just before the gap, then I think the idea that the gap was caused by a mouth leak is a bit far fetched.

And for what it's worth, my DME did replace my first System One BiPAP after I woke up one morning and the machine was clearly off and it was in the process of rebooting itself for the second time in two weeks. So if the problems persist AND your leaks are under control, you might want to point out that you really don't trust this particular machine and you are wondering if it needs to be returned under warranty.


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#8
(12-17-2013, 09:51 PM)robysue Wrote: It's a stretch, but is Auto ON/OFF set to On or Off. If Auto ON/OFF is set to On and you're using nasal pillows and there's a really bad leak, then it is possible for the machine to lose track of your breathing, decide nobody's home on the mask end of the hose, and turn itself off. While you would think Auto ON would then turn the machine back on, sometimes the Auto ON feature just doesn't work all that well with nasal pillows.

How likely is this scenario? I don't know. But it is one thing you want to eliminate.

Excellent suggestions, Robysue, and you made me pull out the Clinician's manual and check the settings, which I had been meaning to do anyway but hadn't gotten around to yet. lol I made a note of all the settings so I'll know what they were when I got the machine, since I'll probably change some of them. But most importantly, SmartStart was set to "Off". So we eliminated one possibility anyway.

(12-17-2013, 09:51 PM)robysue Wrote: But you say that no data was recorded? As in no leak data? and no pressure data? Did you look at the data in Sleepy Head or ResScan or both?

I looked at the data with SleepyHead only (I'm struggling to understand Sleepyhead graphs, so I didn't want to tackle ResScan yet. lol) No data was recorded during these gaps. No leak data, no pressure data, nothing. Just a big gap in the timeline. For the data on the 14th, I can see a lot of leaks right before the big gap. I'm not sure exactly which graphs to show you, so here's my attempt to show you the data. There is a small gap from about 1:08 to about 1:27 that was not a time that I shut it off to go to the restroom so I don't know what caused that gap, and then the big time gap occurs around 2:43 until 4:37. That's a LONG time!
[Image: sleepdata1_zpsdf460e7f.jpg]

Let me know if this isn't the data you need. Thanks!


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#9
RockABye, this proves your DME is incorrect, prior to the gaps you have leaks and they are still being recorded, this looks like either you are turning the machine of or it's turning itself off for some reason.
If you are not turning it off then on, you need to get the CPAP looked at.
For the time that it is recording the data, it looks Ok, you may want to post the AHI graph as well. I would stick with using one lot of software or the other at the start, I stick with Sleepyhead so I don't get confused.
Your leaks are fine as long as they are under 24 and your pressures are not going too far above 10, I have mine set at the same pressures and I hardly ever go above 10 as well.
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#10
RockABye,

Those leaks are largish, but they're still well below the 24 L/min line. In other words, according to Resmed the machine should have no real problems compensating for leaks in that range.

Could you post the Flow Rate graph for us? We don't need the Respiratory Rate graph, the Mask Pressure graph or the Snore graph. Also could you show the Sessions data? That's at the bottom of the left side bar of the SleepyHead Daily Data page. You may have to scroll down to see it. The Sessions data includes time stamps for every time the machine was turned on and turned off.

It would also be useful if you could take another screen shot that shows a close up of the Flow Rate graph just before the big gap starts---a ten minute window would be about the right amount of data to show. I'd like to see the individual breaths just before that big gap. There's a lot of things that might potentially show up in that Flow Rate data.
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