How can I know if I have a malfunction machine

[derek70]

After 1 week with AHI<5 and AI<1 last night my AHI=9 and AI=3 without any explication.
Sometimes I feel the pressure is so comfortable that it's not my min APAP setting.
How can you guys know when your machine is malfunction?

[timbalionguy]

I doubt you have a problem with your machine. We all have bad nights. If you see this happening consistently, it most likely indicates a mask problem, etc. or a change in your breathing at night. It looks from your numbers that you are 'dialed in' pretty accurately, so you might want to check mask, etc.

Most machine problems manifest themselves as frank problems (inoperative, noisy, etc.) as opposed to slight changes in therapy effectiveness.

[archangle]

Sometimes I feel the pressure is so comfortable that it's not my min APAP setting.

For many users, it will feel like you're blowing into a hurricane the first few nights. Then after a week or two, you may feel like the machine isn't running because you don't feel the pressure. I find I have to occasionally lift up the edge of the mask and let air gush out to convince myself the machine is working.

If you feel the pressure is too low, look on the display and see what pressure the machine thinks it's blowing.

You can buy a manometer to measure pressure. You can actually make your own crude manometer by sticking the end of the hose into a bucket of water and seeing how far below the surface of the water you have to leave the hose before it starts blowing air bubbles out of the end. (Warning: water will tend to go everywhere. Don't ruin your machine or the furniture.)

A pressure of 10 means 10 cmH2O, which means the hose will start bubbling when it's less than 10 cm under the top of the water.

Don't worry too much about AHI changes for just one night unless it's a really big change or you have major discomfort or other symptoms.

[avi123]

DMEs check and clibrate CPAPs.

[derek70]

Thank you all guys.
You helped a newbie sleep this night less worried about a malfunction.
Keep on focusing on mask.

My machine have less than 200 hours.

[purple]

Leaks, Doc told me to forget about the machine malfunctioning and work on getting the leaks down a bit, which are not so easy to know about when we sleep. I can look at the data with software, not sure if the leaks are really showing, or the thing is just upping pressure because I need it.

Can you show us some data?

In my case, I discovered that at an AHI of 2.5, I did not feel so good. AHI of .2 I feel a lot more rested. A lot of my rest problems are now from pain, I have arthritis. Even a little pain, like that I can not identify which joint is hurting, can keep me from sleeping or sleeping deeply.

Anyway, if you can show us Data from your machine, then someone could offer a better opinion of what is happening.

[NightMonkey]

After 1 week with AHI<5 and AI<1 last night my AHI=9 and AI=3 without any explication.
Sometimes I feel the pressure is so comfortable that it's not my min APAP setting.
How can you guys know when your machine is malfunction?

You apparently are only looking at averages and not the detailed reports in the software.

IMO the averages are often close to useless. I would download the free ResMed software and look at what is going on minute by minute throughout the night.

As an example, you might see that most of your events occur in clusters and you may be able to do something about it. You can also see the leak line and the pressure line and know exactly what the pressure is doing throughout the night.

It is you therapy, your choice.

Official ResMed free software - http://www.resmed.com/int/assets/html/s ... ister.html

[derek70]

Sorry, I don't have the S8 expensive data cable to get data out of my Autoset II.

Here are some data I'm taking note every morning from machine LCD.

[Pugsy]

The S8 machines historically are known to tend to score Hyponeas more aggressively. This was discussed often a couple of years ago when the S8 was the top of the line. Some people went so far as to discount the Hyponea index by 50 %...I don't know that I would go that far but some people did.

You show a substantial increase in both the Apnea Index and the Hyponea Index the last 2 nights. Pretty much double. Why.. I don't know. I doubt anything is wrong with your machine. Can you think of anything different these last 2 nights? Noticed being awake during the night more? Tossing and turning more? Anything? Without seeing the actual detailed graphs we don't know if the bulk of that increase is from an ugly cluster that occurred when you might have been awake or not. The machine can't really distinguish between awake or asleep and some events might be falsely reported. Meaning you were awake or semi awake and your breathing is much more ragged and the machine got it wrong.
We see this even on the newer machines. When I lay in bed for that last 30 minutes in the morning just drifting in and out of sleep, I will often see a whole bunch of events being flagged and I know that I wasn't asleep.

I am not saying that this what you see here. Just saying it might be a possibility. Since you don't have the card reader to use the software you only have this to go on and sometimes we just can't see enough with these numbers to know what is going on. If the double AHI persists and doesn't go back down and you can't isolate any possible culprits then you might want to look at advising your doctor or if you are comfortable with changing some things yourself perhaps reducing EPR or a slight increase in minimum pressure to see if it helps. I wouldn't be changing things so soon based on 2 nights though...unless you want to fiddle with EPR a bit.

[HoseCrusher]

In looking at the S8 scoring, this study comes to mind.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2854701/

With 70 people doing a sleep study and titration, the titration results indicated an AHI of 4.2 for the PSG scoring and an AHI of 9.9 for the S8 scoring.

The AI for the PSG was 1.9 and for the S8 it was 2.4, so that indicates that the S8 scores similar to the PSG as far as AI goes.

But

When it comes to HI, there is a much greater difference. The PSG scored the HI as 2.3 while the S8 scored it as 7.5. Saying that the S8 is "aggressive" in scoring hypopneas is an understatement. The difference in this study was it scores over 3 times as many hypopneas when compared to the PSG scoring.

I use an S8. My instructions from my RT who is well versed in the various machines, and in whom I trust, was to take the S8 HI, divide it by 3, and add that to the AI to get a reasonable approximation to what the AHI should be.

Attempts at chasing the S8 hypopneas through pressure changes have historically proven to be fruitless, however your mileage may vary...