Runaway pressure S9 Autoset with H5i and Climate Line. Help?

[Burkebang]

Please take a look at the following video:

https://www.youtube.com/watch?v=d1t0o7sN0EI


Sorry for speaking Norwegian, all I say is that I'm performing a test, that I will not speak and breathe normally, then that my mask no longer keeps the seal, and that this is the same fault as the previous machine had.

This is the second machine I have that does the exact same thing, I got this one just two days ago. This sample worked normal for one night only. Only the machine was swapped, the humidifier, powersupply and climateline is the same. It will up the pressure all by it self even without the H5i attached, but it will not go all the way up then. It also howls and hoots a lot, as did the previous sample.

I'd be very grateful for any advice.

[kaiasgram]

Hi Burkebang, it appears the machine is ramping up from your set minimum pressure of 4 to your set maximum pressure of 15. Do you have the ramp feature turned on?

You said your mask is leaking -- is that because of the pressure going all the way to max, or are leaks helping to drive the pressure up?

Could you have a hole/leak in the hose that is driving pressure up?

I'm new at this, newer than you, so I'm sure others will be along to help.

[stubones99]

What is the High setting on the unit set to?

My Dr. set my unit after a sleep study and put a limit to 12 on the high side. I changed the ramp time to a minute or so, since it always seemed to ramp up as I was falling asleep and that caused leaks around the mask. I preferred to set it up at the "operating" pressure and get the mask situated with no leaks before falling asleep.

Is it set on CPAP or BiPAP mode?

I don't think they are truly "auto-set" devices since there were quite a few settings on the device.

ResMed S9 Series (S9 AutoSet, S9 Elite, S9 Escape Auto, S9 Escape, S9 VPAP S, S9 VPAP ST, S9 VPAP Auto & S9 VPAP Adapt): For Setup Instructions with pictures, click here. Plug in machine and turn the Push Dial until the device is showing the Home position (Home Icon illuminated). In Home position, press the Push Dial and the Setup Menu buttons down simultaneously for 3 seconds. The clinician menu will appear. Select parameter(s) you wish to modify with the Push Dial (push down to select, turn to modify). When done, select the Home choice again from the displayed menu, push down the Push Dial again and the adjustment is saved. from ApneaBoard.com http://www.apneaboard.com/adjust-cpap-p ... tup-manual

[kaiasgram]

His APAP pressures are 4 minimum, 15 maximum. So the pressure is staying within the set limits. Burkebang, prior to this problem where does your pressure line usually stay when you look at your SleepyHead reports?

[Slartybartfast]

Or is his APAP machine actually set in CPAP mode with a ramp from 4 to 15?

[LSAT]

Or is his APAP machine actually set in CPAP mode with a ramp from 4 to 15?

Interesting thought!

[kaiasgram]

Or is his APAP machine actually set in CPAP mode with a ramp from 4 to 15?

Good catch. A possibility. We need to know if he's done something with his settings, what the pressures were doing before, does anything correlate with the problem he's having, etc. Seems quite odd that two machines in a row are doing the same thing -- unless they are in fact set to do exactly what they're doing.

[Burkebang]

Thank you for replying to my call for help.

My machine is in Autoset mode, my prescribed pressurerange is 4-15. The Ramp feature is turned off in the servicemenu, it's also a pretty much useless feature when the prescribed pressurerange is 4-15.

When I use my backup Devilbiss IntelliPAP Autoadjust at the same preasure range, it normally stays between 5 and 7 the whole night, with short peaks up to 8-9, and sometimes, but rarely as high as 10-11.

This is the second S9 Autoset to get the excact same malfunction for me. I have checked the whole machine and hose for leaks and I cannot find any. As I see it, leaks would not be any reason for the machine to RAISE the pressure. The machine would simply just pump more air to compensate and maintain the correct pressure, as it does with the air leaking from the ventholes in the different masks. Am I right?
I adjust my mask so it's quite loose and comfortable, as it's normally not required to maintain the seal much above 10. So the mask leak you hear at the end has nothing to do with driving up the pressure, it's just that the headgear is not tightened up hard enough to withstand a pressure of 15.

Another bothersome thing is that the machine registered an AHI of 5,8 but I was awake and breathing normally the whole time. The other S9 that "failed" did similar things.
Two machines getting the excact same malfunction can lead me to believe that the fault is not in the machine itself, but in the stuff attached to it, so I was hoping that somebody else has stumbled over the same problem and knows whats wrong.

[BudSky]

Perhaps the power supply is defective and is tripping up the microcontrollers in the unit...
Some digital electronics are sensitive to ripple or noise on the power supply.

[billbolton]

Another bothersome thing is that the machine registered an AHI of 5,8 but I was awake and breathing normally the whole time.

With any "scoring" xPAP machine, anything that is scored while you are awake is totally meaningless, as the scoring is predicated on automous sleep breathing behvaiour.

If your typical variation is in 5 to 11 cms H20, why is the S9 set at 4 to 15 cms H20?

Cheers,

Bill

[archangle]

Please post SleepyHead graphs, including the statistics and daily views.

[Burkebang]

Perhaps the power supply is defective and is tripping up the microcontrollers in the unit...
Some digital electronics are sensitive to ripple or noise on the power supply.

That is definatly a possibility. I also notice minor flickering in the light inside the humidifier. Could this be a symptom of a bad powersupply? Could a minor fault in the heaterplate lead to ripple or noice that can mess with the main unit?

With any "scoring" xPAP machine, anything that is scored while you are awake is totally meaningless, as the scoring is predicated on automous sleep breathing behvaiour.

If your typical variation is in 5 to 11 cms H20, why is the S9 set at 4 to 15 cms H20?

I could not agree more, this definatly means that there is something very wrong with the machine.

In Norway, the public healthcare system pays for all our machines. To get rid of the need for titration studies, they give us all autotitrating CPAPS in stead. ALL Norwegian machines are set to a pressure range of 4-15 by default. My sleeptech said that this is fine for 99%, very few needs any changes to this, those that do, mostly requires BIPAPS or more advanced machines. The goal is to have people go to sleep at 4, that means most people are compliant without allmost any problems at all. The next goal is that when people sleep, their pressure requirements should always be decided by the machine and not limited by settings. This means that when I go out for a beer and my pressure requirement increases, it's no problem for the machine.

[BudSky]

Perhaps the power supply is defective and is tripping up the microcontrollers in the unit...
Some digital electronics are sensitive to ripple or noise on the power supply.

That is definatly a possibility. I also notice minor flickering in the light inside the humidifier. Could this be a symptom of a bad powersupply? Could a minor fault in the heaterplate lead to ripple or noice that can mess with the main unit?

I have the exact same CPAP and just checked the light in my humidifier, never noticed it flickering before, but- yes mine flickers slightly too when the machine is "blowing". When standing by the light is steady before it shuts off. The flicker is much slower than the 50 or 60 HZ AC into the power supply so I'm not sure of the cause.

[Slartybartfast]

In Norway, the public healthcare system pays for all our machines.

Don't remind us!

I had a coworker from a little town in Norway who worked with me for a few years while her husband was working in the harbor, learning how to make sails using a computer (which was sort of new, then). She spoke flawless English and about 4 other languages. And she was a good scientist. After a few years, her hubby had learned all he needed to. She was VERY pregnant, and they moved back to Norway. We received several letters with pictures from her in the ensuing years. She said they decided to return to Norway because the governmennt will pay her to stay home and raise children. Healthcare was free, so that's what they did. Not bad work.

Last picture I received was of Anna and her husband with three cute little blonde girls standing outside their tiny house in a tiny village nestled against the steep wall of an enormous fjord, as pretty as a postcard.

[Edit: And anything the machine does while you are awake is meaningless. While you are awake your breathing will be very irregular. Many events will be recorded and they may cause the machine to change pressure, but those events should be disregarded. That's one reason some people like to use the ramp. Set the ramp for example at a pressure of 6 for 45 minutes, which should allow you enough time to drop off to sleep. Then the machine will be assured of steady breathing to begin its work. ]

[Burkebang]

I understand your friends well for moving back home. I'm mostly very happy with the public healthcare system in Norway. It means everybody shares the cost and everybody gets the same quality of treatment, rich and poor. Everybody who gets diagnosed with sleep apnea gets an S9 Autoset.

I was told to engage the ramp function by the tech I'm "working" with. This helps a little, but the machine still raises the pressure from 4 to over 12 as soon as the ramp time is over. It takes forever to gradually lower the pressure, about 20 minutes, it seldom goes all the way down before another event pushes it up again. Without ramp, it still just maxes out the set max pressure from my normal breathing. I don't have astma or anything wrong with my lungs or airways.

I have been reading about the different APAP algorithms here:
http://www.apneaboard.com/forums/Thread ... y-Pressure
It might be that the Autoset algorithm is just a little bit TOO advanced and therefor not suitable for all people. My backup is a Devilbiss IntelliPAP Autoadjust and that algorithm works perfectly for me. It keeps the pressure as low as possible, responds quickly to any events and lowers the pressure back down after a short time. I was expecting the S9 to be even better, but if my machine is technically in order, I'm starting to believe that the algorithm is just not suitable for me. Compared to the IntelliPAP, I'll be "OD'ing" on unnecessary pressure.