is my machine working correctly?

[Chivalry]

Heyas... justa quick question for those in the know..
I have noticed over the last few nights that my machine seems to be blowing extremely hard, while im still AWAKE and obvoisly not having any apneas? surely this isnt right?
Its a resmes S9 auto.. and while i am aware it adjusts the pressure to suit the need... surely while im still awake it should be at its lowest pressure? maybe 7 or 8? as i am just breathing normally while listening to music or reading..
But i have noticed.. as soon as the ramp period ends it starts to climb.. .and keeps going till it gets up to 17-19.. and i have to turn it off and on again to go through the ramp cycle again so i can get off to sleep.
Any ideas what might be causing this?? i just cant see it as being proper behaviour ;0(

Thanks for any advice

[symmit]

If not detecting any obstruction then yes, it should sit at the minimum set pressure - now the question is what is that minimum pressure?

Do you have access to the settings on the machine? I have control over mine (not a resmed so can't help with how to access them) and currently have it set to ramp from 6 to a start of 9, minimum 9, maximum 20 - it's not peaked over 13 in a couple of weeks and those settings keep my AHI below 2 and I awaken relaxed, refreshed and make it through the day.

[Chivalry]

starts at 4(ramp)... min is 4.....max is 20...

[Tigers Fan]

Hi Chivalry

Can you confirm I understand you correctly? I understand that you go to bed, don mask and start machine then read or listen to music. The machine goes through its ramp cycle then the pressure builds to a high level. You start the ramp cycle again and go to sleep and you tolerate the delivered pressure though obviously, you don't know what it is.

My guess is that if the machine reached high/max pressure after you were asleep, you would be wakened by the APAP gale leakage. You don't mention this so I assume it doesn't happen. The machine is functioning correctly.

The pressure build happens when you are reading/listening to music - and you are awake.

I was watching a rugby match on TV yesterday afternoon - the one before those pesky Chiefs had us seriously worried again! - and the strangest thing happened. They didn't have a half time and the scores increased immaculately. I don't know how this happened because I definately did not fall asleep! Now, had I been wearing a mask and running APAP whilst I was definately not asleep then the pressure could not have risen to max due to an apnoea because I definately was not asleep. Had I fallen asleep, the pressure would have risen to max as the machine is designed to do. But this didn't happen because I was definately not asleep. I still haven't figured why they didn't bother with half time, let alone increase the scores without a penalty or a try.

I wonder, when you listen to music or read, are you on your back? chin on chest?

TF

[symmit]

starts at 4(ramp)... min is 4.....max is 20...

So your machine is set "wide open" - has your clinic reviewed your data at all yet? I suspect it needs narrowing down a little, how much will depend on what the data looks like.

[Chivalry]

thanks for the replys..
Tiger.. yeah i do get woken up in the night 2 or 3 times with the machine blowing like a gale and mask leaking badly ;0(
Although some times when i finaly wake in the morning the machine is plodding along at 8 or 9 and i cant even tell its still on.. i lean over and check..

I know probably my main problem is i have 2 masks from the hospital,, both of which i cant get to fit without leaks ;0(.... im hoping they will allow my to try others until i find one that suits me although im worried that they have to buy a new mask for me each time i try one and i dont like to think of all the wasted money on masks that dont fit ;0(

Symmit... nope i havent been back yet for my first appointment after i got my machine 3 weeks ago... i think im due back in about 5 weeks ;0(
unfortunaly.. althoughmy clinic is great for supplying me with a great machine and masks.. on the 2 times i have been in contact with them with problems the technition seemed either unwilling or unable to help... in fact they got quite`tetchy` when i went in to see about having my first mask replaced with something else, and when she put the new mask on me and turned the machine on,, and it didnt leak,,, she declared it a perfect fit...

It was only when i tried to explain the machine was only at ramp pressure (4) and i had to show her how to put it into a higher pressure mode to test the fit under pressure that the mask started leaking... she wasnt even aware that just turning the machine on only set it to 4 pressure ;0(

To add to this... she refused to believe my first mask leaked.. as my machine was showing a green smiley face.. and as such my mask couldent be leaking... ( i believe in the S9 as long as it leaks less than 21lpm, for less than 15 mins out of each hour... it counts as a good fit and shows the green face..... which is mad.. as mine leaks like crazy!

She seemed very put out when i tried to explain.. ;0( and when i suggested turning the max pressure down to 14 or 15 to try to combat the `runaway` circle of leak/more pressure/leak/more pressure... she outright said no as it would defeat the purpose of a auto machine..........

sorry.. big post an all thanks again for taking the time to help out..

[symmit]

Well - it's crazy to think that altering the min/max defeats the purpose of an auto - admittedly I've left the max at 20 but I'm not suffering runaway with it anyway, but increasing the minimum to reduce the apnoea events makes a lot of sense.

I'm sorry to hear that your tech seems a bit unsympathetic to your demands - I bet she doesn't have to sleep with a mask on and a machine blowing air up her nose every night.

I'm biased when I say this, but it's not actually rocket science, if your condition isn't exacerbated by anything else then (correct me if I'm wrong everyone) it's a matter of working towards a pressure setting that gets your AHI and ODI down to a reasonable amount and prevents the daytime tiredness, by going down the private / self treatment route we have the advantage of being in full control of our stats and settings, but the disadvantage of having to pay for our equipment and consumables.

If your machine is running at 8 or 9 in the morning when you wake then that might be a good place to set the minimum and you may find it then less likely to increase by huge amounts as you'll not be triggering the increase as often. Again, I'm not making this a recommendation but my tech and I went through upping the minimum by 1 every 2-3 days until reaching about 11, and have dropped it back since then to 9.

[Tigers Fan]

A narrower band will undoubtedly help the situation. Setting the max to a little above your 90/95% pressure is key to reducincg the gale and min to a pressure that prevents 'most' events.

TF