Stumped (updated with new sleepy head data)

Pugsy wrote:It's easy to turn smart start off...I don't know if your DME has made it available in the patient menu but for sure you can do it in the clinical setup menu area.
http://www.apneaboard.com/resmed-s9-cpap-setup
It's in the "Options" menu right under Sleep Quality.
You will have to manually push the button to start and stop the machine but unless you have machine beyond arms length it really isn't that big of a deal to start and stop manually.
With Smart Start off...if there is a massive leak the machine will still continue to blow...all this does is at least prevent the machine from turning itself off...if it is a big leak that is causing it to turn off.

Thanks will do that tonight hopefully when I post the sleepy head data someone can help me understand the info and maybe we can determine if it is a leak.

When you look at the SleepyHead reports...look closely at the detailed data graphs for the times the machine turned itself off. It will show up as a break in therapy line that is easy to spot. Then look at the leak line at the time of the break in therapy line. It takes a pretty big leak to cause the machine to think no human is attached...I don't know for sure how much though. 30 to 35 L/min leak won't though...that I am fairly sure of.

If the broken part is on the lid itself, not on the humidifier, they're $20 plus shipping at cpap.com. https://www.cpap.com/productpage/resmed ... p-lid.html

Be sure the latch is actually broken. It's a little strange looking and you could mistake it for broken even if it isn't. Of course, yours may be obviously broken. Also check that the silicone rubber gasket inside the lid is in good shape and seated properly.

Don't forget you can remove the humidifier entirely.

Has it happened when you were awake? I've seen mine cut off when I had a large leak. Once it quits, I usually wake up. It then restarts once the leak goes away and it sees my breathing again.

You can also turn off the smartstart function in the clinical setup menu. This turns off the autostop function. Unfortunately, it also turns off the autostart function. I ended up turning mine off because the accidental stops in the middle of the night bothered me. Unfortunately, this means if it does stop for some reason, it won't automatically turn itself back on.

You could also try something like a velcro strap to hold the lid in place. Just don't tighten it enough to crack something.

sleepwiggler wrote:

Pugsy wrote:Thanks will do that tonight hopefully when I post the sleepy head data someone can help me understand the info and maybe we can determine if it is a leak.

If you want to, post a copy of your SD card and I'll look at it.

Be sure to lock your SD card before putting it into your PC, especially if you have Windows 8 or 10, or Mac.

archangle wrote:If the broken part is on the lid itself, not on the humidifier, they're $20 plus shipping at cpap.com. https://www.cpap.com/productpage/resmed ... p-lid.html

Be sure the latch is actually broken. It's a little strange looking and you could mistake it for broken even if it isn't. Of course, yours may be obviously broken. Also check that the silicone rubber gasket inside the lid is in good shape and seated properly.

Don't forget you can remove the humidifier entirely.

Has it happened when you were awake? I've seen mine cut off when I had a large leak. Once it quits, I usually wake up. It then restarts once the leak goes away and it sees my breathing again.

You can also turn off the smartstart function in the clinical setup menu. This turns off the autostop function. Unfortunately, it also turns off the autostart function. I ended up turning mine off because the accidental stops in the middle of the night bothered me. Unfortunately, this means if it does stop for some reason, it won't automatically turn itself back on.

You could also try something like a velcro strap to hold the lid in place. Just don't tighten it enough to crack something.

sleepwiggler wrote:

Pugsy wrote:Thanks will do that tonight hopefully when I post the sleepy head data someone can help me understand the info and maybe we can determine if it is a leak.

If you want to, post a copy of your SD card and I'll look at it.

Be sure to lock your SD card before putting it into your PC, especially if you have Windows 8 or 10, or Mac.

It is the black section that the top is attached to so not possible to just replace the top. Also I have never had it cut off before until last week.

sleepwiggler wrote:

Yeah, you gotta fix that leak. If smartstart is on, that may be why your machine is cutting off. You still gotta fix that, though.

Try some sort of strap around your humidifier to hold the lid closed.

With a leak that bad you should be able to hear it. However, it's possible that you have a leak around your mask instead of the humidifier.

Look on the overview screen of SleepyHead to see if your leak rate has increased recently.

here is last nights data. First I did turn off the auto start/stop, second I did use a Velcro strap on the humidifier top, third after I turned the machine on I checked the machine for leaks none found, and finally I checked the mask and disconnected the elbow and plugged it so I could make sure the hose was not leaking. I did some readjusting on my mask to fit just right not too tight not too lose but last was a toss and turn night for me. Also at some point the mask did start bad from the elbow so I pushed it back in I am not sure if I actually messed with the elbow or in my tossing the tab got pushed.

Also my leak rate has fluctuated over the past year my previous mask just was not right for me and I finally decided to change to a full face.

The normal vent rate (intended leak rate) for your mask at 15 cmH2O is 45L/m and the max leak shown on the SH graphic exceeds 120 L/m (unintentional leak rate) so that, at times, the total leak rate exceeds 150 L/m. The ResMed S9 can't cope with a total leak rate that high and the detection of apneic events is impaired. It is likely that, from time to time, the machine just concludes that you aren't there and, with SmartStart turned on, shuts itself off.

It appears that in this most recent SH graphic with SmartStart off, there are no instances of the machine just stopping. Is that true?

So, your goal is it determine the source of the leak - for which the main candidate is the humidifier and its broken latch. If you can't feel the leaking air using your hand, try holding a lighted candle next to the edge of the humidifier lid and see if the flame is disturbed. There should be no change in the flame at all and any flicker will indicate a leak.

Pending replacement, tying the lid down with Velcro doesn't seem to be working. Try masking tape which will provide an air-tight seal and see if there is any change. The lid in a normal configuration is firmly held with down pressure that the Velcro may not be providing. If the inner seal is not installed correctly, then the leak may be internal to the humidifier. As was suggested before, check the placement of any inner seals in the unit to make sure they are firmly in place with no bulges or wrinkles.

Because the leak rate changes throughout the night, I don't think it is the humidifier. However, the humidifier could be eliminated by disconnecting it and connecting either a standard or slim line hose directly to the S9 (a climate line hose won't work). Be sure to set the hose type accordingly if changing type.

I think most probably the jaw is dropping out of the mask or the mask is otherwise leaking a great deal due to the changes in facial structure with sleep and/or position. Notice the leaks do not really start until sometime into the night - either with sleep onset or change of position.

Using a chin strap may help to verify and/or eliminate jaw drop. (yes, even with a full face mask)

I am also suspicious of the "elbow" you mention. The connection of fittings could change with position, though I think it unlikely if they are seated correctly and not damaged. Make sure the "elbow" is properly seated.

You could try the "mask fit" feature (Set Up button) of the S9 to help identify leaks by donning the mask and wiggling all connections to see if a "Frown Face" develops.

JDS74 wrote:The normal vent rate (intended leak rate) for your mask at 15 cmH2O is 45L/m and the max leak shown on the SH graphic exceeds 120 L/m (unintentional leak rate) so that, at times, the total leak rate exceeds 150 L/m. The ResMed S9 can't cope with a total leak rate that high and the detection of apneic events is impaired. It is likely that, from time to time, the machine just concludes that you aren't there and, with SmartStart turned on, shuts itself off.

It appears that in this most recent SH graphic with SmartStart off, there are no instances of the machine just stopping. Is that true?

So, your goal is it determine the source of the leak - for which the main candidate is the humidifier and its broken latch. If you can't feel the leaking air using your hand, try holding a lighted candle next to the edge of the humidifier lid and see if the flame is disturbed. There should be no change in the flame at all and any flicker will indicate a leak.

Pending replacement, tying the lid down with Velcro doesn't seem to be working. Try masking tape which will provide an air-tight seal and see if there is any change. The lid in a normal configuration is firmly held with down pressure that the Velcro may not be providing. If the inner seal is not installed correctly, then the leak may be internal to the humidifier. As was suggested before, check the placement of any inner seals in the unit to make sure they are firmly in place with no bulges or wrinkles.

Correct this is the first with smart stop off.

Jay Aitchsee wrote:Because the leak rate changes throughout the night, I don't think it is the humidifier. However, the humidifier could be eliminated by disconnecting it and connecting either a standard or slim line hose directly to the S9 (a climate line hose won't work). Be sure to set the hose type accordingly if changing type.

I think most probably the jaw is dropping out of the mask or the mask is otherwise leaking a great deal due to the changes in facial structure with sleep and/or position. Notice the leaks do not really start until sometime into the night - either with sleep onset or change of position.

Using a chin strap may help to verify and/or eliminate jaw drop. (yes, even with a full face mask)

I am also suspicious of the "elbow" you mention. The connection of fittings could change with position, though I think it unlikely if they are seated correctly and not damaged. Make sure the "elbow" is properly seated.

You could try the "mask fit" feature (Set Up button) of the S9 to help identify leaks by donning the mask and wiggling all connections to see if a "Frown Face" develops.

The elbow was secure but the tabs for the elbow are sensitive and I do have a tendency to do crazy stuff in my sleep so I could have tried to remove it who know but I do know that one side came loose and was blowing air like crazy.

I just discovered the mask fit section. Even when my pap shows a good night and good mask fit I still have large leaks and ups and down. I will post of graph of the overview sometime today

Since you are in troubleshooting mode, may I suggest that you just remove the humidifier and then look at the data. You just move the locking mechanism on the bottom and they pull apart - don't force anything. Then you plug the hose into where the humidifier usually connects.

That will eliminate the problem with the humidifier lid and let you see if you are getting a good mask seal and/or are mouth breathing. Depending on your location and nasal system, you may or may not even need the humidifier at this time of year. If you do OK without the humidifier on your test night then you can just leave it off until you get your new one.

sleepwiggler wrote:The elbow was secure but the tabs for the elbow are sensitive and I do have a tendency to do crazy stuff in my sleep so I could have tried to remove it who know but I do know that one side came loose and was blowing air like crazy.

Certainly, depressing one tab enough could allow the elbow to become partially unseated and produce the results you are seeing. The tabs of my F10 don't appear to be too "sensitive", but I can see how pressure from something (finger, etc.) could do it.
Still, I would disconnect the humidifier tonight just to eliminate it as a possible source, but I'm betting on the mask facial fit or connections.

Jay Aitchsee wrote:

sleepwiggler wrote:The elbow was secure but the tabs for the elbow are sensitive and I do have a tendency to do crazy stuff in my sleep so I could have tried to remove it who know but I do know that one side came loose and was blowing air like crazy.

Certainly, depressing one tab enough could allow the elbow to become partially unseated and produce the results you are seeing. The tabs of my F10 don't appear to be too "sensitive", but I can see how pressure from something (finger, etc.) could do it.
Still, I would disconnect the humidifier tonight just to eliminate it as a possible source, but I'm betting on the mask facial fit or connections.

I would disconnect the humidifier but all have is a climate control hose. I had another hose but we cannot find it. So I will be ordering one.

sleepwiggler wrote:I would disconnect the humidifier but all have is a climate control hose. I had another hose but we cannot find it. So I will be ordering one.

Check to see if the Climate Control hose will fit and work with the blower outlet even though there will be no electrical connections. On Respironics systems, the hose will fit even though the electrical connections are ignored.