Why would Xpap register apneas while awake?

[red1]

What respiratory actions would cause the s9 Autoset to register apnea events while still awake? Can caughing, clearing chest, or a deep breath with the etc, with the mask on cause this?

I have bronchitis, so when I move to my side to sleep, gravity causes the flem to change position. THis creates a need to clear my chest for the first 10 minutes or so.

Rick

[cflame1]

The machines arent smart enough to figure out when you're asleep or when you're awake.

[Lizistired]

The machine won't score an apnea unless you stop breathing for at least 10 seconds. Coughing and such might show up in the snore graph.

[imagep]

The machines arent smart enough to figure out when you're asleep or when you're awake.

Thats what I suspect also. I'm very new to all of this and have only rented a machine as a diagnostic tool for a week. but I asked a lot of questions and I don't feel confident that the answers were correct. The lady at the medical store told me that the machine would not start increasing pressure until I was asleep. I asked her how it new that I was asleep, she said that "it has algorithims that tell it that you are sleeping". I really didn't buy that answer.

I was excited to get the machine home, but after wearing it my first night for 4 hours, it didn't seem like the presure ever increased. I took it back, they tried to convince me that it was working (claiming that I wouldn't know the presure was increasing because it only happened when I was sleeping), so I took it back home and tried another night. Again, I couldn't sleep because I have sleep apnea and the machine simply wasn't doing what is supposed to do. My wife monitored the machine for an hour and a half while I was trying to sleep and the pressure never changed so I know that it was not my imagination. So that morning I took the machine to work because I was going to try to exchange it again (they wouldn't let me exchange the machine the first time), I plugged it in at work without the mask on it and just let it run for a while. After about fifteen minutes it was up to 15 (I had never seen it higher than it's initial setting of 6). So I figured that it must have something to do with the fact that the tube and mask was not connected, so I tried it again with the tube and mask connected, and within two minutes it started titrating up and after about 15 minutes it was close to 15. So I thought that maybe it was titrating up because I wasn't wearing the mask, so I tried it again, this time I was wearing it (awake) and I had the same results, it was definately working. So I didn't take it back.

That night, it worked for about 4 hours, then I cut it off to go to the bathroom, cut it back on and it wouldn't titrate up again. So I took it back, demanded that they check the machine, and when the lady came back with the results she said "yes, it's working, see it went all the way up to 15". I took the papers from her hand and quickly noticed that it had only titrated up the previous day. the first two days it never went above it's initial setting. I pointed that out to the lady and explained that the machine was apparently "flaky" as sometimes it will work and sometimes it won't work. She basically told me that I was stupid and wanted to know why I couldn't understand that the machine will not titrate up unless I am asleep and she said that I must not have slept those first two nights. I put my hand on her shoulder and explained that I was not trying to be a pain in the rear, and that I was not angry with her, but that I wanted a different machine because I believed that machine not to be correctly functioning and unless I could try a different machine I would not be convienced that it was correctly functioning. She exchanged it and the new machine has worked exactly like I expected it to every day - thus, my origional theory, that the machine didn't work correctly has been vindicated.

Anyhow, my point is that the lady at the store didn't have a clue about what she was claiming. the machines DONT know when you are asleep or not. they are preset to titrate up at a certain time (like 2 minutes on my machine). Also, I am very skeptical about the reports. I really don't know that these things are capable of telling if you are coughing or snoring or laughing. I understand that they are programed to monitor the air pressure, and to interpret certain patterns as apneas or as this or that, but with only changes in air pressure to go by, I wouldn't think that they can be very reliable. when you look at those reports, they are more like the machines best guesses than factual information. If you have a typical breathing pattern, they are probably close, but I bet they are rarely perfect. If you have a weird breathing pattern, like if you talk in your sleep or have the hickups or burp a lot, I bet the results are terribly unrealiable.

[Lizistired]

imagep, I don't know what machine you have but the auto machines increase pressure in response to your airway closing. When you stop breathing, they check to see if the airway is open or closed by sending pulses of air. If the airway is open and you just aren't breathing, a central apnea, the pressure won't increase. Only the ramp feature increases pressure based on time. Hope that helps. Please go to the user control panel and edit your profile to add your equipment to your signature in TEXT so we know what you are using.

[archangle]

What respiratory actions would cause the s9 Autoset to register apnea events while still awake? Can caughing, clearing chest, or a deep breath with the etc, with the mask on cause this?

I have bronchitis, so when I move to my side to sleep, gravity causes the flem to change position. THis creates a need to clear my chest for the first 10 minutes or so.

Rick

In the normal person, breathing patterns are very automatic and regular during normal sleep. When awake, our conscious mind has some degree of control over our breathing. We may stop breathing for a few seconds when thinking hard, when swallowing, etc. This may cause a CPAP machine to "see" apneas when you're awake.

[archangle]

Thats what I suspect also. I'm very new to all of this and have only rented a machine as a diagnostic tool for a week. but I asked a lot of questions and I don't feel confident that the answers were correct...

The machine does not know whether you're awake or not, although a few machines do try to guess.

Machines that attempt to detect apneas measure the flow of air, not just the pressure. It generates a graph like an EKG for your heart, but it's airflow for your lungs. They can see that you breathe in air at 20 liters/minute, then breathe out at 20 l/m. They'll measure that you take a breath now, then another one 3 seconds later. If you go 15 seconds between two breaths, it may consider that an apnea. It looks at the shape of the graph. It looks at how your airflow changes from breath to breath. It "listens" for snoring. It applies some algorithms to determine whether you're having an apnea or not.

They are not usually fooled by swallowing, coughing, sneezing, laughing, etc. They generally won't record any apneas unless they last longer than 10 seconds. They do often falsely detect snoring, however, from bumping the hose, clearing your throat, etc.

If you are awake, you should not have any "real" apneas. Your throat just doesn't close off like that while you're awake. You may or may do some things like swallow or subconsciously hold your breath that will fool the machine. If you wear the machine and aren't asleep, it's "normal" not to see any apneas and not to have the auto pressure ramp up.

I don't know what machine you have or how it's set, so I'm missing some information. Does it say "Philips" or "ResMed" or something else. How about something like "Auto, AutoSet, Elite, Pro?"

Assuming it's an auto CPAP machine, here's how an Auto CPAP machine works.

The machine is set to, for instance, 6-15 auto pressure.

When you turn it on, it will blow air at 6 cmH2O pressure. It will monitor your breathing and watch for apneas, snoring, and other breathing problems. If it does not detect breathing problems, it will stay at 6 cm all night long. If it's a good machine, it will record the apneas and other breathing problems on a data card.

6 cm pressure may eliminate your apneas completely or reduce them to a low level. The machine will happily stay on 6 cm all night long. Just because it stays at 6 doesn't mean anything is wrong. Actually, that's the best situation. If you get adequate apnea relief at 6, that's great.

On top of this, some machines have a "ramp" function, where it will start at a low pressure, for instance 4, then gradually increase up to the "minimum" pressure such as 6. The idea is to make it easier for you to go to sleep.

[billbolton]

I understand that they are programed to monitor the air pressure, and to interpret certain patterns as apneas or as this or that, but with only changes in air pressure to go by, I wouldn't think that they can be very reliable. when you look at those reports, they are more like the machines best guesses than factual information.

If there is something here you are looking for an answer on, it is being totally lost

Cheers,

Bill

[billbolton]

THis creates a need to clear my chest for the first 10 minutes or so.

Your S9 will have a user setting for "ramp" time. If you set the ramp value to longer than the time it normally takes you to get into an autonomous sleep breathing state, your S9 will not score any respiratory events that occur before you fall asleep.

Cheers,

Bill