spontaneous change from CPAP to Auto mode???

I was looking at my latest SleepyHead report when I saw this:



I got my S9 AutoSet machine on 8/2/2013. It was configured in CPAP mode at 11 cmH2O. According to SleepyHead, that changed on 10/5/2013; suddenly it was in Auto (AutoPAP) mode, with the same maximum pressure, but a much lower (6.48) minimum pressure. The next couple of nights it was still in Auto mode, and the minimum pressure was 6.52; the night after that, still in Auto mode, but the minimum and maximum pressures were the same, 11.00. Since then, it's been in Auto mode every night. The minimum pressure has changed every night, ranging from 6.48 to 6.70. Last night, the minimum pressure was 11.00 again.

The S9 has a "phone home" wireless module for reporting compliance data. I guessed that had been used to change the machine's mode.

My durable medical equipment (DME) provider is stumped. My respiratory therapist is flabberghasted, thinking that's not possible, and asking me to turn the S9 on and see if it says CPAP, which it does. "Oh, that means it's in CPAP mode; so does having the same min and max pressures." (On the other hand, when I said I'd pulled data off the card and viewed it, the respiratory therapist said, "You can do that???")

The respiratory therapist is stopping by the house tomorrow. I'll make a copy of my card, demonstrate SleepyHead, and peer into the machine.

Until then: Has anyone ever heard of anything like this?

In this kind of case, it is worth looking at the data in ResScan as well as SleepyHead just to make sure that the problem is not some genuinely oddball and rarely found bug in SH.

It's been a very long time since I used an S9 AutoSet. Does the machine tell you the pressure it's blowing at when it's on? If so, what does machine's LCD say the pressure is when you first turn it on and start breathing through the mask?

The other really odd-ball thing is that the "min pressure setting" is all over the place: Most nights its being reported as being between roughly 6.5 and 6.8, but on two of the nights, the min pressure suddenly jumps up to 11cm.

Any chance there's been a power surge or some other even that could have left the electronics messed up?

A power surge or some anomalous event is a good guess...have you tried unplugging it from the wall, leaving it for a few minutes, and plugging it back in? Rebooting it may cause it to recover it's wits again, but be sure that you go over the settings to check that it is in CPAP mode and the pressure is set at 11. Don't know if you use a ramp, but I'd even turn that off if you do for the moment.

Also, can you disconnect the "phone home" feature so that it can't phone anyone, and vice-versa?

Then start it up and see what happens...you don't even have to wait for night time to try it, you can do this any time, of course *smile*.

Of course, it could be broken...but I'd try the reboot path first.

On the PR System One, this report shows changes in settings in the machine. I assume that this information is contained in one of the files it writes to the SD card. On my machine, this report showed every change since I got the machine together with the number of days at each setting.

If the S9 keeps the same type of record, then this report shows the settings changing every day.
I would suspect the remote access is the culprit. Perhaps a bad user ID being used to set somone else's machine and the tech thinking they are correcting 'bad' behaviour of that other patient.

Just a thought.

Review your actual detailed reports both in SleepyHead and ResScan to see what the pressure graphs are really doing.

The Statistics page in SleepyHead is bug ridden...Mark knows it and is working on it. I have never seen that bug though.
So verify the pressures used and shown via ResScan detailed graphs (do you have it and know how to use ResScan) and with Sleepyhead's detailed graphs.

What SleepyHead version are you using and the build date? That information is found in the Help section under "About SleepyHead".

This is showing a change each day..weird. My first suspect is SleepyHead Statistics bug rearing its ugly head.

Yes, definitely try looking at your data with ResScan if this could be a Sleepyhead problem. I've not seen problems with Sleepyhead, only been using it for a couple of months now, but Pugsy has much longer history with it. It seems to be pretty civilized and pretty good at the moment, but ResScan is the made for ResMed hardware by ResMed software, and I also have seen few problems with it. I'm sure that ResScan has problems as well, but they would be different problems than Sleepyhead, and again, I haven't run into them when I use it.

Last time I had inexplicable problems it was the SD card gone bad, but I've been using the S9 going on 2 years now, so it's a little older than yours.

Good luck with this one.

I unplugged my S9 for a few hours before bedtime last night. It doesn't appear to have made any difference. (Shore Spouse remembered we had a power outage a while back, and wondered if that was related. I find it unlikely the S9 would have forgotten CPAP/Auto mode but remembered the pressure of 11.00. To answer the likely next question: Yes, my S9 is on a surge protector.)

Pugsy wrote:Review your actual detailed reports both in SleepyHead and ResScan to see what the pressure graphs are really doing.

Thanks, Pugsy, very good idea. The statistics for last night claim my S9 was in Auto mode with no pressure relief (SleepyHead claims the original pressure relief setting was EPR x2, which seems more reasonable), minimum pressure 6.42, maximum pressure 11.00. The daily details show both Mask Pressure and Pressure varying from about 9 to about 11.

I don't have ResScan. (No PMs, please. If I need it, I have a very strong personal preference to get it through my doctor or DME. That's just me.)

The Statistics page in SleepyHead is bug ridden...Mark knows it and is working on it. I have never seen that bug though.
So verify the pressures used and shown via ResScan detailed graphs (do you have it and know how to use ResScan) and with Sleepyhead's detailed graphs.

What SleepyHead version are you using and the build date? That information is found in the Help section under "About SleepyHead".

v0.9.3-0 (beta) Build Date: May 18 2013 21:42:27 "No updates were found for your platform."

This is showing a change each day..weird. My first suspect is SleepyHead Statistics bug rearing its ugly head.

I'm shocked, shocked to find that software has bugs.

Shore Snorer,

Have you confirmed what the machine's settings are by looking at the machine's LCD? In other words, according to the LCD, does the S9 think it's in CPAP mode or APAP mode? And what does the S9's LCD say the EPR level is set to?

Shore Snorer wrote:

Pugsy wrote:Review your actual detailed reports both in SleepyHead and ResScan to see what the pressure graphs are really doing.

Thanks, Pugsy, very good idea. The statistics for last night claim my S9 was in Auto mode with no pressure relief (SleepyHead claims the original pressure relief setting was EPR x2, which seems more reasonable), minimum pressure 6.42, maximum pressure 11.00. The daily details show both Mask Pressure and Pressure varying from about 9 to about 11.

So there's a glitch in the Statistics page if it reports the min pressure as 6.42, but the daily data says the min pressure is around 9cm. But we knew that the Stats page is buggy already.

If your machine is actually set to straight CPAP mode with a pressure of 11cm and EPR = 2, then the mask pressure graph should have a "wave pattern" that goes up to 11cm every time you inhale and down to 9cm every time you exhale. However, the pressure graph in the daily details should show very little variation---much less than 2cm unless you are also using the ramp feature. In other words, if your machine is running in straight CPAP mode, the pressure graph should resemble an almost flat, somewhat "fuzzy" horizontal line at 11cm. If you are using SH on a Mac, there will also be a second line in the pressure graph that will be an almost flat, somewhat "fuzzy" horizontal line at 9cm since the Mac version of SH treats the EPR pressure as if it were an EPAP in a bilevel machine. (I don't know if the PC version of SH does this or not.)

Does what you are seeing in the daily detail pressure and mask pressure graphs look like what I've described in the previous paragraph? If so, then the detailed data in SH appears to be showing up correctly for the settings you thought you were using. If what you're seeing in the pressure and mask pressure graphs does NOT look like what I've described, can you post what those graphs do look like so we can continue to try to troubleshoot with you?

I don't have ResScan. (No PMs, please. If I need it, I have a very strong personal preference to get it through my doctor or DME. That's just me.)

The only way you'll be able to sort out for sure that what you're dealing with are SleepyHead bugs instead of a S9 machine possessed by a gremlin who magically changes the settings each night at random is to look at the same data in ResScan. Since you don't want to download ResScan on your own, you should ask the doctor or the DME about it. Chances are, however, neither of them will be forthcoming with helping you obtain a copy of ResScan. So if you cannot obtain ResScan through the DME or doc and you don't want to download it from links provided in a PM, then you need to have the DME or doc's office download both the summary data AND the detailed data in their copy of ResScan and make a copy of the report for you. Once you have the ResScan report in your possession, you will be able to compare it to the SH report.

I got just the same problem as you, just one little difference.
I just started using CPAP, and for initial days, used a rental auto set for testing. I downloaded the data everyday to Sleepyhead with no problems.
Then I bought my own auto set, but sleepyhead said it was adjusted for CPAP mode.
I'm a physician myself, so I adjust my CPAP configuration, and I'm sure it's adjusted for Autoset.
Reading data with ResScan, I confirmed that all configurations were right, but sleepyhead still reads it as CPAP mode. I tried to reinstall, but nothing works.
I guess it's a bug.

I had a similar problem in January/Feb. Sleepyhead showed my pressure/EPR/Mode changing from day to day. At one point it showed my Max pressure at 176. I replaced the SD card and everything stabilized. (strange)

Beta version + freaky numbers = grain of salt
--just sayin' Mark is awesome; but only God is perfect.