S9 design flaw?

[frh]

My wife has a Resmed S9 and a Swift LT nasal mask with extra small pillows. Sometimes the mask makes her claustrophobic and she takes it off in her sleep. The SmartStart (auto on/off) feature of her ResMed S9 is turned on, but it will not turn off by itself. The noise eventually wakes her. After she turns it off she can't get back to sleep. It frustrates me because it makes her not want to use it. It also makes me wish I got her a Respironics machine instead of paying a lot of extra money for the S9.

Her machine is not broken unless mine is too. When I swapped masks, my S9 would not turn off with her extra small pillows. And her machine would turn off with my large size pillows.

I have been thinking about getting a tiny drill bit to open-up some of the holes in the front of her mask but am afraid I would screw it up. Does anyone have another solution?

[SleepingUgly]

I don't like the auto on/off feature, so I just turn my machine on and off manually. It is better that way for data purposes, I would think, as having a machine blowing for any length of time unattached to a person would register as a leak.

[Raj]

I'm fairly sure that is a design flaw with the S9's current firmware. Mine won't shut off automatically with the narrow FX tube, even with large pillows, but since I don't remove the mask while sleeping, shutting it off manually presents no problem for me. Your wife may need a mask she finds more confortable so that she can keep it on.

[Physician]

I'm fairly sure that is a design flaw with the S9's current firmware. Mine won't shut off automatically with the narrow FX tube, even with large pillows, but since I don't remove the mask while sleeping, shutting it off manually presents no problem for me. Your wife may need a mask she finds more confortable so that she can keep it on.

My S9 with SmartStart ON turns on immediately, and when taking off my Activa mask, the S9 shits off within one second.

HOWEVER, as I've posted six times before:

1. Instant on to the lower limit pressure should be available, and it is not in the S9. It takes ten seconds to get to the desired pressure. To help abate this issue and not feel smothered for the ten seconds, I have turned OFF SmartStart, turn the unit on manually, wait ten seconds, then put on the mask. ResMed needs to change this so that Instant ON to minimum pressure is available and user-selectable.


2. My EPR does not seem to work in any mode, including Full Time.



Try not attaching any mask or pillows to the unit, suck in and out on the hose end, then remove your mouth and see if the unit turns off. Or have SmartStart activated by using your pillows, but remove the pillows from the hose end and see if the unit shuts off.

[ozij]

I would be grateful for a machine that woke me when I took the mask off, since then, I would put the mask back on and try to sleep again. I don't think it's a good idea to keep on sleeping with the maks off, you seem to assume the machine should turn off and your wife would be better off if she could continue sleeping maskless.

I am not too concerned by the leak report on the screen - on the software charts a mask off leak is quite different from a major leak with your mask on -- and the charts are where you have the important info. A long peariod of leakage with the mask off accompanying no leaks when your mask is on means something quite different than many bad leaks when you're wearing the mask.

[frh]

SU, and others. I seem to have put myself in the rather uncomfortable position of talking about my wife's medical problems again. She has COPD and a bunch of other health issues. OSA is not very high on her list of priorities. It doesn't help that her (old school) pulmonologist is more concerned that she uses oxygen at night than her CPAP machine. And her GP doesn't know very much about OSA.

I am absolutely certain that if OSA is not the primary cause of her health problems, it is at least a huge contributing factor. Unfortunately, she is so fed-up with my obsession with getting my own numbers down, the mere mention of OSA makes her mad.

Having said that, she knows she has OSA and would like to be compliant. But wearing the mask causes agoraphobia http://en.wikipedia.org/wiki/Panic_attack#Agoraphobia (the fear of having a panic attack), which can bring on a panic attack http://en.wikipedia.org/wiki/Panic_attack. Fortunately, the knowledge of what is happening helps her work through it. For some reason, her Swift LT mask is easier for her to tolerate than her Swift FX. Everytime she tolerates it for 2 hours puts her 2 hours closer to being able to wear it all night. I am trying to make it as easy for her as I can without making an issue of it. The machine not shutting off when she takes off the mask in her sleep just gives her another reason not to put it on in the first place.

Unfortunately, using her CPAP machine the other night resulted in a trip to the ER and a diagnosis of Pleurisy http://en.wikipedia.org/wiki/Pleurisy, so she can't use it right now anyway. I would like to have the problem with it not shutting off fixed by the time her lungs stop hurting.

Raj, I have the luxury of two identical machines. Both machines shut off just fine with either my (large) or her (small) Swift FX mask. And both machines won't shut off with her extra small Swift LT mask. I have no idea what your pressure is, but I am also fortunate that my wife's pressure is about the same as mine. I understand the SmartStart feature might cause a little bit of data skew. But I much prefer the convenience of not having to fumble around for my glasses to see the machine. And I just want to make it easy for my wife to use her machine.

Physician, EPR works so well on my S9 that I did not think it was working until I tried using a Mirage Quattro mask. When I inhaled the seal would swell up like a ballon. When I exhaled, the swelling would go back down. It was so annoying, I finally turned EPR off with it. Right now with my swift FX it is set to 2, but I am thinking about turning it back off to see if it raises or lowers my AHI.

So we are back to the same question. Does anyone know of a solution for the problem of her machine not shutting off when she takes the mask off? Or should I risk ruining her mask by enlarging exhaust holes a few at a time until it starts shutting off like it should?

[tonytexas]

I was using Swift FX midium size and my S9 turns on within 1 second when I put on the mask and turns off within 2 seconds when the mask is removed.
However, I have recently switched my FX to a small size, since then, S9 will still turn on within 1 sec but it will no longer turn off automatically.

I think there is definitely a design flaw.

[frh]

tonytexas, I just checked and my wife's machine does not turn off with the small size Swift FX nasal pillow either.

[jdm2857]

The auto shutoff feature requires a bit of a balancing act.

If the shutoff flow threshold is too low, then the blower on a sleeper with a large leak. On the other hand, if the threshold is too high, it might not shut off when masks with very small openings are used.

I haven't heard about this problem with the S8, but maybe the S8 was shutting down on sleepers with large leaks, and ResMed moved the shutoff threshold. There are reports of people waking up and wondering why their machine had turned off.

[ozij]

I would not make any changes to the mask's flow vents.

[Wulfman]

My wife has a Resmed S9 and a Swift LT nasal mask with extra small pillows. Sometimes the mask makes her claustrophobic and she takes it off in her sleep. The SmartStart (auto on/off) feature of her ResMed S9 is turned on, but it will not turn off by itself. The noise eventually wakes her. After she turns it off she can't get back to sleep. It frustrates me because it makes her not want to use it. It also makes me wish I got her a Respironics machine instead of paying a lot of extra money for the S9.

Her machine is not broken unless mine is too. When I swapped masks, my S9 would not turn off with her extra small pillows. And her machine would turn off with my large size pillows.

I have been thinking about getting a tiny drill bit to open-up some of the holes in the front of her mask but am afraid I would screw it up. Does anyone have another solution?

Same situation was discussed in this recent thread:

viewtopic/t53804/Auto-OnOff-setting.html

Some (nasal) masks, like the Swift, don't have enough flow rate (apparently) to trigger the Auto-Off function and just keep blowing.
I don't know if I'd call it a machine "design flaw" or not as it seems to have happened on more brands and models in the past. If anything, maybe it's a mask design flaw.

The solutions are.......don't take the mask off when you're asleep and shut the machine off before taking the mask off when you're ready to get up (otherwise it screws up the leak data).


Den

[frh]

Sometimes the mask makes her claustrophobic and she takes it off in her sleep.

The solutions are.......don't take the mask off when you're asleep and shut the machine off before taking the mask off when you're ready to get up (otherwise it screws up the leak data).

Den

Thanks for the link Den. We are ready to go out the door for a little while, so I will have to wait till I get back to read it. I understand what you are saying, but unless I make that feature work for HER, she won't use it. I am still thinking about getting a tiny drill bit to open-up some of the holes in the front of her mask. But I am also still looking for another solution.

[jdm2857]

If you must modify the mask, I think that it would be wiser to add some additional vent holes near the originals instead of messing with the original ones. That way, if you want to undo the modification, you could just plug the new holes. Decreasing the size of enlarged holes a much more daunting task.

[Wulfman]

I think you need to investigate the "source" of the claustrophobia. Pressures too low or too much (heated) humidity, or a combination of both, can do that.
Maybe a different mask.......


Den

[Physician]

Physician, EPR works so well on my S9 that I did not think it was working until I tried using a Mirage Quattro mask. When I inhaled the seal would swell up like a ballon. When I exhaled, the swelling would go back down. It was so annoying, I finally turned EPR off with it. Right now with my swift FX it is set to 2, but I am thinking about turning it back off to see if it raises or lowers my AHI.

So we are back to the same question. Does anyone know of a solution for the problem of her machine not shutting off when she takes the mask off? Or should I risk ruining her mask by enlarging exhaust holes a few at a time until it starts shutting off like it should?

Damn you write well !!

My in-line condom inflation-deflation tests show NO CHANGE with or without EPR, so now I'm constructing a water meter level in line tester. I will also try Swift Nasal Pillows to see if the EPR is output device dependent.

Ideally, the EPR and auto shut off will work with any facial appliance.