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[Pressure] Sefam S Box APAP mode sudden failure
Sefam S Box APAP mode sudden failure
Hello everyone!

My husband (severe OSA, pre-treatment AHI 63) got his first CPAP device, Sefam S Box a few weeks ago. His physician set it to APAP mode, with pressure ranging from 4 to 16. But it seems that the APAP mode doesn't work properly. Short summary: it went from bad to good to worse and we can't find the reason.

His first mask was Airfit P10 (nasal pillow) but he sometimes had a very hard time breathing out with this one, especially when the device randomly increased the pressure level to the maximum, several times throughout the night, eventually waking him up. This is how it went: I wake up from noise - he wakes up - he checks pressure - it's 16 - he pushes the ramp button to lower the pressure. It happened several nights in a row. His AHI ranged from 5.1-5.9. There was no significant leakage. He woke up semi-refreshed.

One night i decided to stay up and watch. I sat at his bedside and check the pressure every once in a while. It fluctuated but mostly stayed between 8 and 11. About 2 hours passed and I suddenly heard the noise. Checked pressure, it was 16. He woke up and pressed the ramp button again. He was visibly annoyed.

With this nasal pillow mask, he also had air leak from his mouth a lot so his mouth was very dry and he woke up frequently due to the sensation and the sound. So we upgraded to a full face mask (Airfit F20). 

The first night was ideal, he said he doesn't recall waking up even once and didn't feel like it was difficult to breathe out. I stayed up and witnessed no snoring and no stops in breathing. AHI in the morning was 5.1. No significant leakage. He woke up refreshed.

But on the second night, things changed. For absolutely no reason, S Box suddenly decided it won't raise the pressure over 6 anymore. There was a lot of snoring and he stopped breathing almost as often as he did pre-treatment. I checked the mask and there seemed to be no leakage, it was sealed tight. I hoped it would get better and stayed up the entire night, just to discover it didn't get better at all. To our confusion, his AHI in the morning was still 5.1. No significant leakage. He felt tired when he woke up. 

So I looked up how to check the clinical settings. There was still an A in the top right corner, indicating APAP mode. I ramp was still on. In the clinical settings APAP pressure was still on 4 to 16. Nothing had changed.

We were suspicipus of F20 mask secretly leaking so we decided to go back to Airfit P10 nasal pillow mask. I stayed up and nothing changed, he snored loud with that as well. I could hear him gasp for air frequently. Pressure never went above 6. AHI in the morning was 5.0. No significant leakage. He felt tired upon waking up again.

The device itself is on a stable, hard and clear surface with plenty of ventilation. We have tripled checked all the hose and mask connections. We are out of ideas so we will be taking his S Box back to his physician. However, it will take a long time. He's exhausted. How can I help him sleep again during the wait?

Sorry for the long text,
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RE: Sefam S Box APAP mode sudden failure
Its very hard to support individuals using the Sefam X-box because we are reliant on data to give us an idea of the effectiveness of CPAP. If you know what range is comfortable and effective, it is critical to raise the minimum pressure to approximate what minimizes obstructive apnea, then set the maximum pressure below the tolerated maximum pressure. It is much better to use a CPAP in a range of 10 to 14, than from 4 to 16. My suggestion with this device is to start experimenting with different ranges, starting with 8.0 to 12.0 and observing the AHI and comfort. Titrate upwards to 9-13, 10-14, etc. At some point through trial and error, you are going to hit on an optimum APAP range. This will be far superior to relying solely on the APAP algorithm. The Sefam x-box like Philips CPAP has a reputation for being far behind in providing for effective therapy pressure, and you must increase the minimum pressure until you observe effective therapy.
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RE: Sefam S Box APAP mode sudden failure
Sefam s. Box are notorious for random pressure increase, I would suggest to change the cpap to resmed Or others
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RE: Sefam S Box APAP mode sudden failure
Thank you very much for the advice! I will try and adjust the pressure range and see if it still behaves erratically. I did see it randomly increase to 20 once, even though the range is set at 16. I sure hope making changes allowed, as these settings are locked for the patients by default. 

The wait times for medical care are horrendously long in my town and there's no way to directly contact the sleep specialist who prescribed this treatment, so we have no other choice than to experiment on our own. Thanks again!
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