Auto is slowly not working

[RN Ricky]

I have not been on the forum for a while. I am still having problems with the auto shut off.
I am still using the Zest nasal mask that I first started out with. It is the only mask that I have ever used. For almost a year everything worked fine.
Took the equipment to Apria and they "worked" on it. Stated there was not a problem with the auto feature. They made no suggestions. Made me feel like I did not know what I was talking about! Well I do thanks to the Forum Folk.
The problem is getting progressively worse ~ some nights it works fine then others not so much. I guess I had better learn how to push the button again, if I can find it in the middle of the night!
Does anyone know if Fisher-Paykel "improved" the Zest mask? That is the only thing left, that the mask does not interface with the machine.

[bap40]

Can't help you with the mask issue other than you trying something else. Our machines are like our kids. We take a kid to the doctor only for the doc to say all is well when we know it is not. Same thing with our machines. Maybe they just don't know what they are doing and can't figure it out. Maybe they don't want to go thru the trouble of sending it out to fix. Maybe they think you are nuts. Maybe you could take it elsewhere to have it check out like a 2nd opinion?
Welcome to the DME world.

[rested gal]

When the DME looked at the machine for you, if they didn't turn off "SmartStart" I'd turn that off . SmartStart is what makes the machine start up when you breathe into the mask, and turn itself off automatically if a person is not breathing into the mask.

If you turn off SmartStart, the machine should continue running even the mask is problematic. With SmartStart disabled, you'll have to push the "on" button to start your therapy each night instead of just breathing into the mask to get it started.

On page 13 of the Provider Manual of the ResMed S8 Autoset II:
SmartStart™
If you enable the SmartStart™ function, the patient’s device will start
automatically when they breathe into their mask, and will stop automatically
when they take the mask off. This means that the patient does not have to press
the Start/Stop key to begin or end treatment. See “Clinical Menu” on page 21.
for details about enabling SmartStart.

I didn't see anything on page 21 about "SmartStart." There was a mention of Smart Data, but not "SmartStart."
On page 26:
SmartStart* Enables or disables the SmartStart/Stop feature;
when enabled, the device will start automatically
when the patient breathes into the mask, and stop
automatically when the patient takes the mask off.

You can see where to enable/disable SmartStart in the Clinical - Settings menu on page 23:


While you're at it, have you checked your usual leak rate? If you happen to be mouthbreathing a lot while wearing a non-FullFace mask, perhaps a high leak rate was making the machine think no one was there at times...causing SmartStart (if enabled) to turn the machine off.

[Lizistired]

I use nasal pillows and the Smartstart will start the machine fine, but doesn't turn off if I take the mask off. I'm not sure how quickly it should respond.

[rested gal]

Perhaps SmartStart works differently in the S9 vs the S8. Dunno. The S8 manual for Ricky's machine was what I was looking in.

Does your S9 machine keep blowing full pressure after a few seconds of having taken your mask off, Liz?

Or does it keep blowing, but dropped down to a barely discernible pressure after a few seconds?

[rested gal]

Just now took a look in the Provider Manual for S9 Autoset and S9 Elite.

A description of how SmartStart works in the S9 is on page 21:

[Lizistired]

Hi Rested Gal,
Where did you get that supplier's manual?
When I take it off, it just keeps blowing full pressure. The information guide (troubleshooting chart) I got with it say it won't work on pressure less than 7, but I'm on 8, CPAP, no ramp. I thought maybe it was just cool down air, but I turned the knob to light the screen and it was still showing CPAP 8.0.

[rested gal]

Sent you a PM, Liz.

Are you sure "SmartStart" really is turned on in your machine? The PM will help you find out for sure about the status of "SmartStart" in yours.

If SmartStart is, in fact, enabled...then what you wrote here deepens the mystery:

When I take it off, it just keeps blowing full pressure. The information guide (troubleshooting chart) I got with it say it won't work on pressure less than 7, but I'm on 8, CPAP, no ramp. I thought maybe it was just cool down air, but I turned the knob to light the screen and it was still showing CPAP 8.0.

Wild guess... maybe if EPR is turned on (dropping the pressure below 8 each time you exhale)...maybe that has something to do with SmartStart's automatic-off-if-mask-is-removed being ignored, so to speak, by the machine. Maybe confuses it a little and makes it think the machine is operating at less than 7 cm H2O.

Since pressure displays " 8 " when you look at it... dunno.

Are you using your machine in straight CPAP mode, rather than auto mode? Although (still thinking aloud here) that shouldn't make a difference to "SmartStart."

If you're using it in auto mode, what is the minimum pressure in your range set at?

[Lizistired]

Yes, straight CPAP. I experimented with the APAP. It was more comfortable but took longer to get to the top of the range to clear events. If I remember tomorrow morning, I'll just take it off and see if it ever shuts down on it's own.
Thanks

[scbeaver]

In order for AutoStart to shut the machine off, the airflow must be greater than some minimum level to shut the machine off. I know that the Respronics M series will not shut off with small nasal pillows. I suspect that ResMed does the same. Try disconnecting the mask and see if it shuts off. There will be a short delay before the airflow drops to the cooling level.

Sleep Well

Steve