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Safety of the CPAP Machine

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Defuniak +0 points · 11 months ago Original Poster

I have Sleep Apnea and I have found that using the CPAP Machine has greatly helped my quality of life, however I am concerned about no battery backup when the electricity goes out. We are encouraged to make sure we have a tight seal. I recently woke during the night feeling like I was smothering. I took off the mask and was gasping for air when I realized the electrical power was out and no air was flowing through the machine. This was very scary ! I wonder why there are no safety regulations requiring battery backup for when the electrical power goes out.

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Sierra +0 points · 11 months ago Sleep Patron

I think the fortunate part is that we don't like to be short of air so we wake up. I think if you asked ResMed or others what the safety back us is they would point to the vent that all masks have. When we breath in all air comes from the CPAP. However when we breath out, all the air goes out the vent in the mask. It does not go back into the machine. If the power fails and the machine stops we can breath in through the vent in the mask, as well as breath out through the same vent. As you know it is not comfortable and you most likely will wake up. But, you will not suffocate.

If you want more reliability you could buy a 12 volt car battery and preferably a sealed AGM type. A group size 24 should do it, but a group 27 would be better. Then you need a DC to DC converter for the ResMed as it uses 24 volts not 12 volts. A Phillips machine uses 12 volts but you should use their adaptor for protection. Last you need a smart trickle charger large enough that the batter recharges during the day after each sleep. You can get these converters from ResMed and Phillips, or in a generic version from Amazon. But, it is a fair amount of hassle and expense to get set up. Both my wife and I use a setup like this in our trailer when we are camping off grid.

At the end of the day, I think most are ok with the fact that the mask has a vent built into it that will keep them from actually suffocating.

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Biguglygremlin +0 points · 11 months ago Sleep Enthusiast

Okay might be an overstatement Sierra,

Says me with a colossal headache.

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PutSleepApneatoBed +0 points · 11 months ago Sleep Commentator

I very much share the OP’s concern. I live in an area with an unreliable electrical grid, so I have gone to some effort to deal with this issue. The other source of my concern is that I can regularly desaturate below 60% which can be life threatening.

Here’s what I have done:

1) installed a whole house standby propane generator. It automatically kicks in less than 25 seconds after a power outage. Not inexpensive, but I love it, and given the unreliable grid, a popular addition to homes in my area. I seem to be able to endure Less than 25 seconds of a machine outage without problems, but be sure your machine is set to go on automatically.

2) purchased the manufacturer’s recommended batteries, usually used by campers, and I have several for each of us. You will also need matching inverters. A pigtail setup can help you seamlessly go from one battery to the next during the night. There are algorithms that can help you ascertain how many hours of service you can get from each battery and hence how many to purchase to provide coverage for a given number of nights.

Other possibilities are:

1) an alarm to alert you when the power goes out. It’s something you plug into an outlet. But it can be annoying if your power flickers off for only a second or two frequently—- and ours does.

2) an uninterruptible power source. You may already be using one of these on your computer set-up. It is essentially a battery that you insert in-line between the outlet and your CPAP machine. If the grid power flickers out, this will keep your machine running for a specified period, perhaps forty minutes or so. So, you won’t have to wake up to deal very brief outages. Given the generator, I haven’t felt it necessary to use one of these. But if the 25 second lag time on the generator kicking in troubles you, that’s a possible alternative.

3) Another solution might be roof top solar panels with whole house battery power storage. Beware, however. In many areas, you won’t get service from your rooftop solar when the grid is down, which, in this context, defeats the purpose.

Does anyone have any other solutions?

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Sierra +0 points · 11 months ago Sleep Patron

If one is going to get into one of the battery backup solutions, ResMed has a good document that shows how much each type of machine takes in the various configurations. If you use more pressure current draw will be higher. And a heated hose and humidifier take the most current. If you want to run on a battery for an extended time it is best to turn off the heated hose and humidifier. The other point is that voltage converters (12 volt to 24 volt) are more battery efficient than using inverters. These devices can be bought from ResMed or from non OEM suppliers on Amazon. I got the last converter for my wife's machine from Amazon and it seems to work well.

ResMed Battery Guide

We use these solutions when in our trailer, but don't worry about it when we are at home. Our electrical system is extremely reliable. The distribution system is all underground, and we live relatively near to a large hospital so it means our section of the grid has a high priority for reliability.

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Sierra +0 points · 11 months ago Sleep Patron

Here is an article about the issue of safety. The article basically concluded that there is no risk of suffocation if the power goes out while using a CPAP, because of the mask venting that is built in. They report on an incident in New Zealand where a person with apnea died while being without power as it had been disconnected. This is a red herring issue though as the person was no longer using a CPAP as they had no power. They were just trying to sleep with no CPAP at all.

Can I Die If The CPAP Power Goes Out?

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Biguglygremlin +0 points · 11 months ago Sleep Enthusiast

The references to the New Zealand case are totally irrelevant they don't prove anything either way.

That site has very little credibility in my opinion.

There is no simple answer to this issue and apparently no neutral authority.

There are too many variables to be making blanket statements.

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Sierra +0 points · 11 months ago Sleep Patron

I would suggest the FDA is the neutral authority and in fact approval is required by them before the CPAP can be marketed, at least in the US and Canada. FDA tests for safety and effectiveness.

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Biguglygremlin +0 points · 11 months ago Sleep Enthusiast

You are right that they are essentially neutral.

I don't know how they perform their job but I can't help but wonder how they test the medical conditions of the user including their level of competence and awareness or the nature of weather events in every location or the state of the electrical grid that supplies the premises or the function of the CPAP under diverse conditions and circumstances in combination with so many different settings and options then there are a multitude of masks and the variations of the end product when they are contracted out to different manufacturers and the varying aptitudes of the users in maintaining and adjusting those masks then put it all together and you have thousands of variables and that does not include the potential for users to adapt, tamper with, or compromise the functionality of the process.

I'd love to see the FDA factor in mouth taping.

In my view testing each component does not guarantee that the composite package is safe.

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PutSleepApneatoBed +0 points · 11 months ago Sleep Commentator

The problem is that sleeping with a mask on, and your machine off, due to lack of power is far worse than sleeping with no mask at all, because the mask, notwithstanding the exhalation ports, presents far more resistance to your breathing than using no mask at all. If, like me, you already desaturate to life threatening levels without PAP, a power outage while using a nonfunctioning mask/machine could be fatal.

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Sierra +0 points · 11 months ago Sleep Patron

Yes, it is more difficult to breathe comfortably with the mask on and the machine off. That is why we wake up. My wife had an unfortunate experience a few years back while we were using our trailer and camping off the grid. In the beginning I set her up with a 12 volt inverter to 110 AC running off the trailer battery. It worked ok, but the inverter fan would turn on during the night due to the current draw and wake us up. So for the next trip we "upgraded" by eliminating the inverter and going with a ResMed 12 volt DC to 24 volt converter. They are more efficient and have no fan so are quiet. With this arrangement the CPAP would shutdown several times during the night and my wife would wake up who in turn would wake me up. Not a good arrangement, but she did not die! I finally tracked the problem down to the S9 DC to DC converter not being able to take the full load of CPAP with humidifier, and heated hose. Two replacement converters acted exactly the same way. By this time I had an A10 machine with the DC to DC converter and it worked just fine even though the A10 and S9 units were rated at the same output. I finally concluded that the S9 units had a design problem from the factory and the overload setting was too low. She now has an A10 and uses an Amazon knock off converter and it is also just fine.

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Biguglygremlin +0 points · 11 months ago Sleep Enthusiast

I understand the argument that you use regarding vents Sierra and all of the masks I have used over the years have been survivable under normal cirumstances, except the one I am using currently. (Dreamwear Nasal)

I believe without a doubt that given the right circumstances it could be fatal. Yes it has 2 vents, primarily because in order to reduce complaints about noise and draft the vent at the nose is merely a token and when it's been all drooled over it is pretty much useless so that leaves an effective working vent on top of the head. Theoretically that should be enough to prevent asphyxiation but only if you can suck the air from that vent down through the air channels to the nostrils. Therin lies the issue.

If the mask is fitted enough to stay on, those air channels are already flattened, and the moment you try to suck air down with no pressure from the CPAP they suck closed. Still you reckon the user will wake or open their mouth or brush the mask off. I believe that is a dangerous assumption. It may work for you but there are times when I know it would not work for me. Times when I am just too sick and too unaware, too zoned out, times when I would be distressed and confused and most likely black out before I figured out what to do about it. At the moment when the machine shuts off or when the power fails I eventually wake up, totally distressed with a colossal headache, but I know that if I was really sick that would not be the case.

I'm stuck with the Resmed 10 at the moment and I consider it to be the least dependable machine I have. Currently it senses the resistance of those flattened hoses and just quietly slows down and, because they respond by further resisting the airflow, the CPAP simply stops blowing. It just sits there humming away waiting for an opportunity to start pumping more air. In the meantime I am loosening the mask to facilitate the useless machine, but in the process it now leaks air all over my face and ceases to work as a nasal pillow mask. The machine is happily pumping away at full bore and I am facing a hurricane but none of it getting where it should. All part of the fun right?

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Sierra +0 points · 11 months ago Sleep Patron

If the air flow to the mask gets blocked I would expect the ResMed to simply maintain the pressure it is set to in fixed CPAP mode, or go to the maximum set pressure if in Auto mode.

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Biguglygremlin +0 points · 11 months ago Sleep Enthusiast

It's definitely not in auto mode and yes it probably just putters quietly keeping the hose at 13 but none of the air gets down to the nose piece until I loosen the adjustments to the point where they no longer hold the mask to the nose.

I checked both vents last night. The lower one has no detectable airflow. The top one has about as much as you would expect from gently blowing through a straw.

Because of the length of the tubes back to the main vent and the impaired airflow the air must be rebreathed multiple times before it finally escapes.

Another issue with this Resmed 10 is that despite always checking that it shuts down when I remove the mask and being careful not to go near the machine or hose and mask as I leave the room I have come back to it many hours later to find the machine running and the humidifier dry and hot. It somehow starts itself and keeps running without any variation in feedback. Just now was the third time in the past few weeks.

I don't know how it starts, maybe the floppy silicone mask kinks or collapses on itself over time and triggers the machine but I think the reason it keeps going is because the mask, even without a wearer, provides so much backpressure that it confuses the machine.

The point is that there are too many variables and sometimes they conspire to form their own version of reality.

In my world it's rarely the obvious that gets you. It's the unexpected.

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Sierra +0 points · 11 months ago Sleep Patron

It sounds like that mask with the two tubes from the top of the head is not the right mask for you. I have considered buying one like that, but the tube arrangement scares me off.

Do you have the machine set to auto start and auto stop? Perhaps that is part of the issue with it starting. I do use the auto start feature, but I always manually shut the machine off in the morning. You may want to disable the auto start and stop, and just manually start and stop the machine.

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PutSleepApneatoBed +0 points · 11 months ago Sleep Commentator

Biguglygremlin: I concur in your view that the way your mask interfaces with the machine is the problem. Have you tried a variety of other style nasal masks?

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Biguglygremlin +0 points · 11 months ago Sleep Enthusiast

It's a brilliant design Sierra, if they made it with thicker or harder silicone or with an internal membrane to act like a spring and hold it open. That may well have been their original design but the product that found it's way to the shelves is so soft and comfortable that it's dangerous.

I hate spending money on CPAP gear PutSleepApneatoBed, and I hadn't planned to be down here long enough for it to matter but I do have some AirFit N20 Nasal CPAP masks in another state and they seem to be more practical.

I had forgotten that the auto start and auto stop were optional. I'll disable those right away then I'll see if it's worth ordering another mask for down here.

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Biguglygremlin +0 points · 11 months ago Sleep Enthusiast

I was browsing through my Skype conversations from a couple of months ago, when I was on my own, trying to prevent a series of burglaries, and I found this:

I'm cold and lost and cranky. I'm out of coffee and my toenails are hurting. Last night I kept waking myself to check on the cameras but it got harder to wake up and I got more and more confused until I couldn't understand what I was looking at then I panicked and forced myself awake only to realise that the CPAP had shut down and I was wearing the mask with the soft air tubes that suck shut when they are not inflated. I discovered that a blanket had fallen over the power supply and it was too hot to touch. It got so hot that the power lead plug going to the CPAP had gone all soft and floppy and fallen out."

It's just another example of obscure variables and combinations of factors that would be hard to anticipate and protect against with the current negligible safety protocols.

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