"Mask Alert" feature - worth using?

mister_hose · Post by **mister_hose** » Thu Aug 17, 2006 8:47 am

Before I start, for those of you who don't know what "mask alert" is, it's a feature of some xPAP machines that's supposed to (I haven't tried it yet) awaken you with an alert tone whenever it senses that your mask is off, or that it has a serious leak the machine can't compensate for. You're supposed to fix the situation, which kills the tone, which lets you sleep again. Okay, on to my question:

I've been on CPAP for about a month, and although I've been waking up with the mask off (after taking it off in my sleep), the frequency of that is lessening. However, when it still does happen, the effects are serious enough for me to consider enabling my machine's (REMstar Pro M-Series) "mask alert" option.

Specifically, I get arthritis-like, movement-initiated pain in one of my hands (I make a fist, I get bad pain). This only lasts maybe 2 hours after waking, but I've got to wonder what long-term effects this will have if repeated. I'm assuming it's due to O2 desat. There are also other bad effects (I wake with both hands numb; they recover after a few minutes), but they're not quite as worrisome. None of these effects occur when I wake with the mask properly on, so I'm assuming they're O2 desat-related.

My basic question boils down to: is "mask alert" worth using? Is the tradeoff worth it? Is the benefit, the guarantee of NEVER again dangerously sleeping without treatment, worth the downside of being awakened more often (whenever the mask isn't on, or properly on)?

Is the total and permanent elimination of most or all O2 desats, and the elimination of both their immediate and longer-term negative effects on the body, worth the increase in awakenings and thus sleep fragmentation? The short-term negative effects are just an annoyance (briefly numb/painful hands), but the long-term effect list includes things that can make you assume room temperature (heart disease, type 2 diabetes, stroke, etc.)

Nobody seems to discuss "mask alert" here, and my DME brushed it off as something nobody uses because of the potential frequent awakenings... the DME rep reflexively turned it off in about a half-second while going through the setup menu, not even giving it a second thought. So I get the impression nobody uses it.

Being awakened on a regular basis to fix the mask would be annoying, but the benefits may be worth the annoyance. Instinctively, I'm guessing they probably are. Opinions?

Thanks guys!

Patrick A · Post by **Patrick A** » Thu Aug 17, 2006 9:32 am

mister_hose

In my opinion it's a feature that someone who designed your cpap machine included in the machine. And it's probably something that could quit possibly save your life. Being as I am told that some Sleep Apnea conditions can killyou.

I would use it if it's available on your unit.
I am not flaming you or your question
I also find that if I take my mask off during the night that I wake up from the noise of the air hissing from the machine

Also when I do take my mask off and start snoring I get an elbow in the side from "She who must be obeyed"

Goofproof · Post by **Goofproof** » Thu Aug 17, 2006 10:51 am

I think the cost of running the unit is the same, the idea it to use it while you sleep. not using it isn't going to help you. The night before last I had rolled over and the hose slipped off the mask, I woke up in a fog, and found breathing to be hard but I though it was just my nose stuffed up.

Then the machine went off, I felt the mask and the hose wasn't there, it was under the pillow. It was a lot easier to breath after I hook the hose back on. Jim

ladytonya · Post by **ladytonya** » Thu Aug 17, 2006 11:22 am

I've been wondering the same thing. I have a ResMed S8 and the DME automatically left the mask alarm off. I am using the mask leak detection that is built in to the S8 when I first put my mask on at night but I am not using the alarm. I take my mask off at some point during the night and never wake up. With previous masks I have used, I have taken the mask off and turned the flow generator off in my sleep. Now with the Hybrid, I am finding that I just take the mask off. I wake up in the morning and the machine is still running. I'm hoping it's just a learning curve and I'll eventually be able to keep it on all night, but in the meantime I might just try the alarm and see if it works. Although, I should probably wait until Friday night because I sleep like a rock. I sometimes wonder if a nuclear explosion would wake me up. My alarm sure doesn't so I'm wondering if the mask alarm would. I would hate to have it going off and not waking me up but waking my husband up instead. He would not be happy if I do that on a night when we have to get up and got to work the next day!

Knightfall · Post by **Knightfall** » Thu Aug 17, 2006 2:16 pm

[quote="ladytonya"] I would hate to have it going off and not waking me up but waking my husband up instead. He would not be happy if I do that on a night when we have to get up and got to work the next day!

tooly125 · Post by **tooly125** » Thu Aug 17, 2006 4:37 pm

mister_hose

Here are your choices,

Wake up a few times a night when the mask alert is sounding to fix your mask and go back to sleep.

or

Wake up potentially hundreds of times a night because your body is trying to tell you that you need to breath and that your o2 levels are getting dangerously low. Of course you will not wake up enough to remember any of this happening.

I strongly suggest you enable your alert
Hopefully the alert will be loud enough to wake you.
Keep in mind that as you get more used to cpap the taking off the mask thing will get less frequent.

wabmorgan · Post by **wabmorgan** » Thu Aug 17, 2006 11:16 pm

When I first got CPAP, the DME supplied the unit with the feature turned off.

Since, I have gotten rid of the DME, purchased my own AutoCPAP. One of the first things I did when I got the new AutoCPAP was to turn ON the mask off alert!!!!!!!!!!

Just seems like a good idea to have this turned ON!!!

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Snoredog · Post by **Snoredog** » Thu Aug 17, 2006 11:33 pm

enabling the Alert feature is nice if you suspect you are mouth breathing.

mouth breathing shows up to the machine just like a mask leak. with the Alert feature disabled should you develop a large mask leak the machine will shut off without you even knowing. You may go 30 minutes before you awaken then it may start back up if an arousal causes you to move where the leak is stopped.

It takes a Remstar 1.5 minutes to shut off. First 45-seconds to detect the large leak and trigger the alarm, then the alarm sounds for 45-seconds where the machine then shuts off.

Same happens if you are mouth breathing, the alarm will sound, you hear it, stop the leak the alarm is silenced and reset. The arousal from the alarm is not enough to awaken you fully so you fall back asleep like nothing happened.

I leave the Alert enabled on all of my machines. I trip it like once a month, but it is better just seeing 1.5minutes of leak than 2 hours.

Julie · Post by **Julie** » Fri Aug 18, 2006 4:54 am

Hi, a little tangent here for you - have you considered asking your MD to refer you for a wrist splint (made for people with carpal tunnel problems) that you can wear at night? They can be very effective in holding your wrist and hand in a 'neutral' (non-aggravating) position and alleviating tingling.

mister_hose · Post by **mister_hose** » Fri Aug 18, 2006 7:57 am

I "mouth breathe" the entire night, but then again with my full-face mask, that's never a problem. =) Oh, and I already have wrist splints for my carpal tunnel, but thanks for the suggestion anyway!

I tried the mask alert, it was worthless. The "alert" beep is so quiet that I can barely hear it while AWAKE and LISTENING FOR it. It's the exact same feeble, barely-audible beep as the "I'm ready" beep the unit makes once at startup. It has zero chance of ever waking me up, even partially.

Anybody know if there's any way to turn this sucker's volume up? As it is, it's completely useless. I run a HEPA air cleaner on low and an A/C unit all night, but even if it were a dead silent room, I doubt that faint beep would ever awaken me anyway.

I'm pretty disappointed about this... I think I need the feature...

Offerocker · Post by **Offerocker** » Fri Aug 18, 2006 8:57 am

wabmorgan wrote:When I first got CPAP, the DME supplied the unit with the feature turned off.

Since, I have gotten rid of the DME, purchased my own AutoCPAP. One of the first things I did when I got the new AutoCPAP was to turn ON the mask off alert!!!!!!!!!!

Just seems like a good idea to have this turned ON!!!

I had the exact same experience! I keep the alarm feature ON, as I want to know when there's a problem.

cybergt · Post by **cybergt** » Fri Aug 18, 2006 12:34 pm

I found the same issue with my ResMed S8 Elite. The Alarm is too faint for me to wake up (I guess I am a deep sleeper). I wish they had different loudness settings for this feature.

I have also noticed that I tend to take the mask off an hour into my sleep. Then, I wake up around 4AM and put the mask back on, leaving it on for the rest of the morning. Not sure why I tend to take it off in my sleep? Has anyone else experienced the same problem???

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christinequilts · Post by **christinequilts** » Fri Aug 18, 2006 1:17 pm

I used at one point on my Synchrony BiPAP ST, except its called patient disconect alarm because BiPAPs are used for other types of breathing problems not related to sleep. I never had problems with taking my mask off at night- my problem was I went through a period were I would forget to hook back if I got to use the restroom or something since I never take my mask once I put it on for the night. In my defense, I have some other medical problems & have 2 other things I'm hooked at night. I usually managed to get both of them hooked up before falling back asleep, often times with my xPAP hose still in my hand. I used the alarm for a few months, more to help retrain myself, and I haven't had any problems with not rehooking up in a couple years now. I think it should be something that can be patient controlled and not part of the clinical controls, because there are times you may need it on & other times were you don't- like if you're staying somewhere or are sharing room or such.

Someone was mentioning their alarm wasn't loud enough to hear, if I remember corectly, my Synchrony has an option to make the alarms either louder or queiter in the clinical controls. I don't know if any of the CPAPs have that option or not, since my machine has a lot of extra alarms that most don't, including power failure/interuptions.

Wulfman · Post by **Wulfman** » Fri Aug 18, 2006 1:22 pm

Another one of those things I either never tried or did and shut it off.
Don't need anything else trying to wake me up during the night.

Den

mister_hose · Post by **mister_hose** » Tue Aug 22, 2006 8:12 am

Wulfman wrote:Another one of those things I either never tried or did and shut it off.
Don't need anything else trying to wake me up during the night.

Yes, I used to think that way too, until I started waking up without the mask and feeling like crap. Doing the "self-programming" trick (ordering myself to look at the clock before removing the mask and not to remove it if it's before X:XX AM) helped reduce the frequency, but it still happens. I feel terrible when it does, and I'm doubtless hurting myself because my case is over double the diagnosing minimum for "severe" OSA (untreated AHI=71, low 02 sat 74%).

So, I *want* to be awakened if the mask is off. But the alert beep is completely pathetic. I don't mean merely indequate, I mean it's so quiet that it's comical. It makes me wonder what morons actually selected that sound level for a feature that's supposed to reliably wake someone. Pretty hard to imagine.

Anyone have any ideas? Does anyone make a stick-on thing with a tiny mike and a speaker that listens for things like faint beeps and amplifies and replays them a lot louder?

I'm tempted to call Respironics and ask them what they were thinking when they did this....

Anyone have any ideas? I don't want to keep feeling like crap and messing myself up physically every night or two....

"Mask Alert" feature - worth using?

"Mask Alert" feature - worth using?

Mask alert

Alarm feature

Machine