How Days > 4 is calculated

I've had my CPAP machine for a little over a month. It's been very helpful, and I've used it every day. But when the clinic checked the machine after my first month, it showed only 18 days at > 4 hours. To qualify for insurance coverage I need to be at minimum 21 days > 4 hours. There were two days during that period when the power went out during the night due to storms.

I often have very short nights. So after that checkup I have been looking at the clock when I go to bed and put the machine on, and making sure to keep it on for over 4 hours. That was a week ago, but my count of days > 4 is now down to 17.

Previously I had not been paying much attention to the "1 day" and "7 day" count, but in the last few days I've been watching those. Last night before starting, they showed 1 and 3 respectively. This morning, they showed 0 and 4. How can the 1-day count go *down* from 1 to 0, while the 7-day count goes *up* from 3 to 4?? (FWIW the 30-day count showed 17 for both days).

How exactly is the 4 hours calculated? It doesn't seem to be a simple count how much time I have it on and am using it. Does it exclude the Ramp Time? I have that set for 25 minutes. With a Ramp Time of 25 minutes, do I need to use it for 4:25 to qualify for the 4 hours?

Under what circumstances does it restart the count? If I take it off for 5 minutes to go to the bathroom, and leave it running during that time, does it start over at 0 hours for that night? What if I wake up and hit the Ramp button again? They have it set for 8 - 16 cm, which can be a lot of pressure when awake and it's toward the high end of that range, which makes it hard to get back to sleep. For Ramp Time it's set for 6 cm.

Thanks,

Greg

If you have been using it for a month and have not qualified, you must have some very short nights. By this time you should be using it much longer than 4 hours....even if there are leaks and other problems. I believe compliance requires 70% of the nights during a 30 day period to be over 4 hours..(21 nights).
What problems are you having that is keeping you from using the CPAP all night? I believe it's a simple count...after 24 hours the machine reports the number of hours used. Could you be crossing over different 30 day periods?

total hours per day is based on usage within a 24 hour period. Noon to noon per the machine's clock which I think is set internally to GMT time zone.
Also the final computation for total hours of use isn't change on the machine LCD screen until noon GMT time has passed. Perhaps you happened to check the 1 day calculation prior to the GMT noon and that might account for the 0 for 1 day over 4 hours data point.

You would be better off using software to see final hours of use.
Since SleepyHead is not yet compatible with the new Dream Station machines you would need to use Encore Pro. Send me a private message if you want to try it. Windows only software though...no Mac version available. So if you are using a DreamStation Respironics machine that is your only option.
Now if your machine is a PR System One machine you can use SleepyHead.
https://sleep.tnet.com/equipment
It would be really helpful if you could tell us exactly which model machine you are using. For Respironics the model number is on the bottom of the blower unit.

Ramp time does count for usage. Also if you were to turn the machine on and use it while reading or watching TV that time would also count.

Periods of large leak where the machine cannot sense that you are attached and breathing are NOT counted in the hours of use total. Using software it would report "no breathing detected".
So if you are experience large leaks that are prolonged that also might account for less than 4 hours if your total time used is short and close to the 4 hour mark.

It's a Respironics. For the model, I see this on the bottom:

REMStar Auto, DOM
REF: 560P

The top says this:

REMStar Auto A-Flex
System One

So does that mean I should try the "Sleepyhead" software at the link you provided?

My main computer is Windows. I have an old Mac too that doesn't get much use.


If it detects a large leak, does it restart the 4-hour count at 0?

When I wake up with the pressure up towards 16 cm, it's hard to not have a leak. It "farts" around the sides of the face mask, unless I tighten it so much it cuts off circulation. I've already made it much tighter than what the clinic set it at when they fitted me.

GMT is 4pm my time (Pacific time), so I'll check again after then.

Yes, you have a System One Auto CPAP machine and SleepyHead works great with it.

Total hours used is cumulative over a 24 hour period....so it doesn't "start over" if the usage recorded gets stopped for any reason.
Example...you could take 5 naps of 1 hour each and divided by an hour of the machine not being on...or blowing but you aren't attached...and total hours used will be 5 hours for that 24 hour period. It will qualify as a greater than 4 hour time frame.

Are you really experiencing so many "short" hour nights where you don't get 4 hours of sleep or machine use...or are you ever sleeping without the mask and machine on?
Are you guilty of ever not using the machine when you are sleeping.

Thanks, I'll try sleepyhead.

Sometimes when I wake up in the morning I find the mask lying beside me, apparently taken off in my sleep.

Is the "Therapy Hours" > "1 Day" for the current day, or is that also not updated until GMT? When I got up this morning it read 3:30. But now it reads 0:00.

Is it possible to check what time of day my machine is set to count as the beginning of a new day?

I just noticed that there is another "Days > 4" readout, under "Phone-In". That "Days > 4" is showing 23, not 17. Why would it be different? Which one should I be looking at?

GregL65 wrote:Is the "Therapy Hours" > "1 Day" for the current day, or is that also not updated until GMT? When I got up this morning it read 3:30. But now it reads 0:00.

The 1 day number also resets at Noon GMT time...That's why it now reads 0:00.
You are now on a new 24 hour cumulative "day".

The 3:30 hours that it was on...might be the total for 24 hours but it might also be just the second session if you happened to have more than one sleep session and if enough time passed between the sessions then it will only reflect the last session. This is why using the 1 day number for hours of use isn't always the total hours.
Example...go to bed at midnight and start the session...get up at 3 AM...that would be 3 hours for that 1 day period...say you stayed up until 6 AM...then went back to bed for another 2 hours and then checked the screen again might only show the most recent 2 hour session....so total time used is really 5 hours but the screen may show only the most recent 2 hours.
Also complicating the usage shown on the screen is the fact that where you are at Noon GMT time might have already happened which might break that 2 hour session apart.
I don't remember what Pacific time relates to GMT time.

GregL65 wrote:Is it possible to check what time of day my machine is set to count as the beginning of a new day?

All Respironics machines are set to noon GMT time as being the "start" of a new 24 hour period.
You would have to figure out what time you are at when the "noon" GMT happens to your machine.
I think you might be 8 hours behind...I am in Central time zone and I think I am 6 hours behind.
When it's Noon GMT on my machine I think that is 6 AM my time.
So if you are 8 hours behind GMT time that should make it 4 AM your time when GMT is noon on your machine.

Also complicating things is the fact that if you are actually using the machine when GMT time is hit...it doesn't break up that session but instead will lump those hours in the session it started with.

It get's really complicated when trying to go by just the 1 day number and you are not exceeding the 4 hour minimum or just barely making it because of the way multiple sessions might be calculated.

GregL65 wrote:I just noticed that there is another "Days > 4" readout, under "Phone-In". That "Days > 4" is showing 23, not 17. Why would it be different? Which one should I be looking at?

I have no idea why the difference. I prefer using software as it gives me an easy to see total of hours used on each day/night. Phone In data may be calculated differently...look in the manual to see if it is explained.
I don't have my provider manual handy at the moment.

I don't like using only the data on the LCD screen...too many "ifs" and "buts" to mess with.

If you are borderline on hours of use...just watch some TV or read a book while using it in the evening before bedtime.
But once that 24 hour period has rolled around you can't do anything about it.
Sleeping 3 hours one day and 8 hours the next day...still means 1 day with less than 4 hours.

I think the Phone in thing means total number of days with greater than 4 hours since you started and not necessarily during the last 30 days...I think ......unless your DME did an actual reset of the therapy hours.

I agree that after a month, 4 hours should be well below your real usage.
Set your goal to 6 or 7 hours, closer to what you really need.
Feel free to read, or watch TV with your cpap on.
Nobody knows you are not sleeping; and if you nod off, you are good to start sawing.

I installed Sleepyhead, but when I went to get the SD card from the machine, I found that it's no longer there. They must have forgotten to put it back in at my last appt.

Is it compatible with any generic SD card? Or are they special?


Greg

It is indeed compatible with any generic SD card.
Just buy one and stick it in the machine and whatever data is stored on the machine (and it's substantial) will be transferred to the SD card. Won't take long...just watch the LCD screen and when it is done you can pull the SD card and use it.