Category Archives for "Sleep Apnea Blog"

Fisher & Paykel Icon 5.03 Error

503 Error code Fisher And PaykelOn Saturday night at 2am, I woke up to find my Fisher & Paykel Icon CPAP machine not working.  The display on my F&P Icon+ was showing a 5.03 error code and wouldn’t restart at all.

I jumped online straight away and did a quick search, nothing really about that error code.

I decided to see if unplugging the machine at the wall and making it restart entirely would get it back up and operating so that I could get some sleep and investigate more thoroughly in the morning.  That seemed to do the trick and when the machine powered up again I was able to press the button and the air started to flow.

But it wasn’t normal.

Before I even laid back down that I noticed the airflow didn’t sound right.  Normally when you look down into the Icon CPAP machine you can see the humidifier well lit up and the air flowing through causing the water to agitate a bit.  This time, while there was some air going through, the water was very still.

The CPAP Machine’s Air Pressure Was Faulty

I put the mask back on and hooked up to the hose and tried to go back to sleep.  Immediately I could tell something was wrong with the air pressure – it just wasn’t powerful enough.  As I laid there with the mask on I could hear the CPAP machine labouring to force air through the hose and my mask wasn’t really inflating correctly.

I managed to go back to sleep after a few minutes, but unfortunately, I woke up again at 4:19am with the machine really struggling – it was making an awful noise, so I turned it off.  I took the mask off and tried to go back to sleep naturally, but as I’ve come to discover, I actually find it odd sleeping without my CPAP mask now, so after about half an hour, I got up and out of bed at 4:45am.

For the first time since going on CPAP over three months ago, I felt tired Sunday afternoon.  I’d only gotten about 3 hours sleep and with the machine on the blink, it probably wasn’t even good sleep so I decided I’d try and have a nap that afternoon using the machine.

I went through the whole pre-flight regiment of filling the container and getting everything ready just like I was going to sleep at night.  The machine kicked in, sounded right and for the first time in three months, I had an afternoon nap.

But it was short-lived.

The nap lasted about an hour before it just didn’t sound right again and the air pressure was no good.

I woke up and sent an email to Fisher & Paykel Healthcare support to ask what the 5.03 error code on the Icon+ was and I also sent my supplier an email telling them about the trouble.

I managed to use it again on Sunday night and got about 6 hours sleep – the machine struggled at times.

Fisher&Paykel Icon+ Motor

By 9:30am on Monday I’d had responses from both my supplier and Fisher & Paykel.

The Fisher & Paykel support rep told me that the 5.03 error code on the Icon+ meant that there was a motor issue and that I should take it right away to my supplier to be assessed.  My supplier told me that they’d do a straight replacement on the spot for me whenever I could bring it in.

It was a very painless process – I literally went to the supplier’s office and they setup a brand new Icon+ for me, took a data dump off the old device and twenty minutes later I was back home in the car.

One thing that we looked at was the data from the last week which has been very sporadic with my AHI fluctuating wildly, night to night and my leaks having increased by 50%.  My supplier told me that he felt that the motor had probably been playing up for a week causing the air pressure to be irregular.  It’ll be interesting to see if those numbers come down now with the new machine.

I’d also like to add that this is the third time I’ve had reason to contact Fisher & Paykel support and each time, they have contacted me within 24 hours of my email and most importantly, they’ve replied with sensible, coherent answers to my questions.  I’m very happy with them!

Have you ever had a mechanical fault with your CPAP machine?  I’d really like to hear what happened with your machine and what was the outcome?  Please leave a message below and tell me about your experience.

CPAP Mask and Having a Cold

Using CPAP Mask With ColdI think I must have jinxed myself when I posted about my low AHI score the other day.  Within 24 hours I was coming down with cold and flu like symptoms – just generally feeling rotten.

There was however, a bit of morbid curiosity wondering how my sleep apnea treatment with CPAP would work if I had a cold.

Would I be able to sleep with the mask on?

Would a runny nose during the night create difficulties with having to remove the mask to wipe or blow my nose?

What would the impact on my AHI be?

I had a ton of thoughts racing through my head about my sleep would be impacted by the onset of this cold.

Well, the reality of it was quite interesting…

Did The CPAP Mask Actually Help My Cold Symptoms?

First of all, the cold turned out to be fairly minor.  It never really turned into anything really severe, a bit of nasal congestion, sore throat and some phlegm in the throat.  I actually attribute this faster recovery to my CPAP machine in some respects – I feel that the forced air helped keep my sinuses and nasal passages more clear, but also I just slept better and my body recovered properly.

Secondly, related to the first point I suppose, but my nose never really got runny so the whole dirty nose into the full face mask thing I was dreading never really became a problem.  For a head cold and sore throat, my nose was surprisingly clear!

Finally, I do think my sore throat and the phlegm has been wreaking a bit of havoc on my sleep numbers.  I’ll start by saying that my AHI for the last 7 days is 8.9 and it has averaged in excess of 12 for the last four days – last night was 13.4!

There are also some other interesting statistics that are worth looking at that help round out the story:

  • My leaks are way up from an average of 35 to 58
  • The 90th percentile pressure was 18!  Normally it is 13.
  • SensAwake kicked in just 6 times, which is normal for me

Here’s my hypothesis… My breathing is being interrupted and having problems because of the sore and swollen throat.  I know I’ve mentioned phlegm a couple times, but it really is just stuck at the back of my throat and even when I’m awake it is causing my breathing to rattle a bit.

I think the machine is seeing this as a reduced flow of air, is hiking the pressure to compensate and because of the stuff going on with my throat, the flow isn’t improving.  With that happening the pressure is staying really high and that sustained high pressure is causing an increase in leaks.

I noticed it last night when I woke up in the middle of the night because of the air leaking into the corner of my eye – the pressure was unlike anything I’d ever noticed before with my Simplus mask.  As I adjusted the mask a bit, it started making “fart noise” and squealing sounds.  I ended up just tightening the straps really tightly and falling back to sleep.

It will be interesting to see if my numbers go back to normal over the next couple days as my condition improves.  The upside of the whole thing is, despite the cold, I slept really well and with minimal disruption.

I’d really like to read about your experiences with your CPAP Mask and having a cold or flu, so please leave your comments below!

My Lowest AHI Score

Low AHI ScoreI mentioned the other day that I had to replace my Simplus mask because the headgear was having some issues and the silicon seal was a bit floppy.

I thought this would be a good time to update everyone on how it is performing so far because I passed a bit of a milestone – I had the lowest AHI score that I’ve ever had since starting CPAP nearly three months ago!

My AHI average for the last 7 days is 5.1 which is the lowest week I’ve ever had for a seven day period and last night I had an AHI of 2.9.  My average should even be lower because two nights ago for some reason my AHI jumped up to 9.0 which was the highest it had been since about the second week of my CPAP experience – first week I was averaging between 11 and 13 as I learned to adjust the mask, we were playing with the starting pressure, etc.

A Random AHI Increase

The AHI of 9.0 the other night doesn’t really bother me because I think it is just a random AHI increase and having looked at the data in the past when these occurred it was more “flow limitations” than even apneas or hypopneas.

More importantly than the AHI scores though is the fact that I just feel good when I get up and start my day.  Last night I went to bed really late, woke up at 6:45am naturally as usual and I feel really good despite only getting 5.3 hours sleep.  Ultimately, that’s what the whole CPAP machine and the mask are meant to do, improve my sleep so that I feel better.

On an aside, one thing I’m thinking I’m going to do is buy a second set of headgear and rotate my usage a bit.  I like my mask really tight and I think what might be happening is that the straps and stuff on the headgear are stretching as I use it over time.  My thought process is that we can wash one of the headgear and let it dry out for a week, then swap it back in and wash the other, letting it dry for a week.  It may shrink back in to shape.  Just a theory at the moment.

Adjusting The CPAP Straps

One thing I’ve also noticed is that I’m not adjusting the straps all the time anymore.  I set the straps on this mask up the first night I used it about ten days ago, played around with them for ten or fifteen minutes while I started going to sleep and haven’t touched them since.  Everything just seems to fit nicely.

Overall, the progress with my CPAP therapy is going really well.  I still feel good, my comfort levels with the mask are great and now the stats seem to be backing that up.



CPAP Mask Replacement

Problems With CPAP MaskI’ve had a few things not quite right with my sleep apnea CPAP therapy the last few weeks.

First, my AHI has crept up from an average of about six to close to eight – about a 30 percent hike.

Second, my Fisher & Paykel Simplus mask seemed to be leaking more than it normally did no matter how much I tightened it.

Finally, the header on the Simplus started to have some material issues.

With all of that going on, I took a trip to my CPAP equipment provider to discuss the situation with the mask and see if we could find some kind of solution or remedy.

The Simplus mask that I was using was only about six weeks old, so it wasn’t like I’d been using it for a year or so which made the whole situation even odder.  Over the last week of using it, I started noticing that the silicone seal had become a bit looser and “gummier”.  The looseness was also exactly where I was getting leaks.  What seemed to be happening is the air pressure on the seal was causing it to blow out when pressure would increase while I slept and was having events.  My theory was, these little leaks were causing me to wake up slightly and adjust my mask in a half-conscious state and exacerbating the number of hypopnea and apnea events I was having, thus explaining the increased AHI.

The headgear issue was a bit more troubling, not from a CPAP therapy perspective, but purely from the quality of the product I’d bought.  The mask tightens by ways of six velcro straps: two on top of the head, two on the forehead and two on the side by your cheeks and under the ears.  The straps on the cheeks started having real problems.  The Velcro adheres directly to the material of the headgear, but what started happening was the actual material started peeling away from the foam structure underneath.  The obvious problem here is that the straps are longer secure, they float around as the material peels away from the underlying structure of the headgear.  I wish I had taken pictures, but I forgot.

The Problems With My CPAP Mask

My CPAP equipment provider said she’d never seen anything like the problem with the headgear before and it was something she was going to keep an eye on.  She pointed out something I’d not noticed, a slight discolouration of the fabric where it was peeling away.  I thought perhaps it was sweat or something, but it was on the outside, not the underside where it came in contact with my skin.  I told her that it looked like the industrial glue that they use to adhere the material to the underlying foam structure of the headgear may have liquified and broken down causing the material to come away.

The issue with the silicone was also something she’d not seen in such a new mask.  She really had no explanation for that one.

My provider then immediately called the Fisher & Paykel sales rep they use, explained the problem and the sales rep immediately told her to do a full warranty replacement of the entire mask and headgear.

I’ve now used the CPAP mask replacement for a few nights and I’ve noticed straight away that the headgear is “stiffer”.  My original CPAP mask was right out of the package as well, but the headgear was loose and malleable.  I don’t really have an explanation, but the new mask’s headgear just seems to be better constructed, we’ll have to see how long it lasts.

Have you ever had your CPAP mask or headgear fail or deteriorate within a few weeks of using it?  I’d like to hear about your experiences, so please feel free to post a comment below.

Shaving and CPAP Masks

Beards and CPAP MasksI really like my Fisher & Paykel Simplus CPAP mask because it is very comfortable and I get consistently good results with it.  In an earlier post, I talked about a bout of CPAP mask rash that I’d gotten because of some skin care products that didn’t like the silicon of the Simplus mask.  The other small irritant I’ve started to notice with my mask is the whiskers on my face when I don’t shave for a few days.

I’m the first to admit that I can be a bit slack about shaving.  I don’t like doing it.  It really is that simple.  My skin is pretty good, I’m not one of those guys who suffers from bad razor burn or anything like that, I just dislike shaving.

I’m also pretty lucky that I’m not constantly dealing with customers or clients in my line of work, so if I haven’t shaved for two or three days, nobody really cares.

Unfortunately, I sometimes let that stretch out to four or five days and that’s where the problems begin with my CPAP mask.

Beards And CPAP Masks Don’t Get Along

The first thing I notice is that my face gets itchier in the night and I find myself half awake poking my fingers inside the mask scratching my chin or my top lip.  That breaks my seal, causes leaks and just generally makes things annoying.

Unlike many people, I don’t really have a problem with tightening my Simplus mask up really snug.  Waking up with indent marks from the straps on my cheeks isn’t a big issue for me, so when the leaks start from me jostling the mask, I just tighten it up.

The second problem is a bit more of an issue and that’s the heat.  All of that extra fur on my face makes it quite a bit hotter under the mask, so I sweat around my mouth a bit which tickles and causes me to scratch more.  This perpetuates the whole itching and leakage issue even more.  Cue the tightening of straps.

The last issue is just that whiskers cause the mask to slip and move around more.  That leads to more leaks and more nocturnal irritation… And cue the tightening of straps.

Like I said, the tight straps don’t bother me but they do wake up my wife sometimes and they disrupt my sleep and that’s more annoying than shaving.

I have no idea how men with full blown beards tolerate wearing full face CPAP masks.  To my more facially hirsute CPAP brothers, I salute you!

I think the simple answer is, in my battle to stay atop my sleep apnea, I’m just going to have to shave more… Or hope my face becomes desensitized, either way works for me.


Why Did My AHI Score Go Up?

Checking Your AHI scoreI’ve been on CPAP therapy now for over two months and as I’ve mentioned elsewhere, my AHI Score went from the mid-70s during my sleep study to somewhere in the five to seven range while using my CPAP machine.  For the second time though in the last month I’ve had a really strange anomaly – my AHI score jumped up to over 13. The first time it happened my score went from 6.4 to 15.3 in one night and I was a little bit concerned.  Was I going to be tired that day?  Is this the new normal for me now? Then the other night, I came home from work and checked my Icon+ CPAP Machine and it showed that the previous night’s AHI was 13.1.  I checked the leak numbers and my SensAwake figure and nothing seemed amiss.  I just rolled the shoulders and carried on. The most important thing that I’ve discovered with trying to overcome my obstructive sleep apnea is to focus on how I feel rather than the statistics.  When I first went got my CPAP machine I would worry about the results every single day, hoping that my “numbers were good”.  The truth of the matter is, I felt great, I wasn’t tired, no more inadvertent naps or falling asleep in front of the TV at 7:30 at night.

Checking Your Sleep Data

One of the idiosyncrasies of my Icon+ machine is that it doesn’t write or update your data on the USB stick until noon each day.  That makes some sense when you think about it because Fisher and Paykel are trying to ensure that if you have multiple sleep sessions during a 24 hour period, they capture the entire day and are able to calculate the figures for the full 24 hour period.  On the other hand, that means I can’t check my sleep data before I go to work or when I first wake up in the morning. And you know what?  I actually like that.  I really think that if I had the ability to roll over in the morning and bring up my AHI numbers on the display, I’d be thinking about it all day and I think it would have some kind of impact on the way I felt that day.  Without knowing the numbers, I just get on with it and check when I get home from work. I suppose I still haven’t answered the question about why the numbers on a couple of occasions suddenly spike up?  Well, I have a pet theory about this.

The SensAwake Feature

I think the spike is down to the “auto” algorithms in the machine.  The SensAwake features and the auto-titration elements of the CPAP machine adjust the flow of air based on “feedback” from your breathing patterns.  My feeling is that maybe I’m just sleeping more lightly or something and am having more hypopneas rather than apneas and therefore the numbers might be elevated.  This potentially could wreak havoc on the machine’s algorithms which try and make the airflow comfortable by making small adjustments rather than massive increases in titration when you start having events. I’m going to look at the data a bit more closely this week.  The good folks at Fisher & Paykel don’t make their InfoSmart software available directly to patients, so I’m not able to see the detailed sleep data easily.  I’ll probably spend an hour this week looking at the open source, SleepyHead software and see what that can tell me.  Hopefully, some more detailed data will either confirm my theory or give me more insights.  Either way, I’m not too concerned about it because like I said, I feel so much better now that my odd AHI scores are just a curiosity piece for me more than anything else.


CPAP Mask Rash

Rash From CPAP MaskI’ve had the strangest problem.  I was just in the bathroom washing my hands at work and I noticed that I have a big red rash on my face where my Simplus full face mask sits while I sleep!

I’m not sure when or how it appeared, it certainly wasn’t there when I left the house this morning, but it’s there now.  I’ve been struck by CPAP mask rash.

I think I know what happened.

Shaving and CPAP Masks

Last night before bed I decided to shave.  I find that when I have cleanly shaven skin my mask gets a better seal and my AHI is reduced slightly.  Also, I must admit, it saves me time in the morning during my mad rush to get ready for work and get out the door.  One subtle difference in my shaving routine last night though, I used a new skin care product –  an after shave gel to cool my skin.

Clearly, the silicon of the Ssimplus mask has some kind of reaction with the after shave and irritated my skin while I slept.  The rash doesn’t hurt really, my skin is a bit more tingly than normal and a little itchy now that I think about it, but it’s not burning or anything like that.

The bigger problem, of course, is that I look a bit silly with this red rash ring around my mouth.  Nobody has commented yet and I’m about two hours away from finishing work for the day, I’ve got one telephone conference and a half hour meeting to get through without being completely embarrassed!

Obviously, the lesson learned from this episode is that I need to make sure that I don’t use any skin care products on my face before I use my mask and go to bed.  My wife is going to give my CPAP mask a really good scrub today to make sure there’s no residue on it and exacerbate the problem while I’m sleeping tonight.

Hopefully, this silly looking irritation goes away overnight, I’d hate to wake up in the morning with it again.  Has anyone else had a similar problem?

Realizing My Sleep Apnea Was A Problem

Avoiding Sleep Apnea TreatmentWhen I look back on the days before I was diagnosed with sleep apnea, one thing that amazes me now is that I knew that I had the condition well before I was diagnosed or actually did anything about it. Looking back, I had gone online, done some research about sleep apnea, I knew that my snoring was outrageously loud and I had even made the leap of connecting my constant fatigue to the sleep problems. Even with that amount of understanding and knowledge, I just never really “felt” it was a serious issue.

Like many people, I just figured that I’d eventually start to lose some weight and the whole problem would alleviate itself. Presto! Just like magic.

Even reading about all of the serious side physical effects and the potential for death didn’t jar me into the realization that I should probably do something about the problem. In hindsight, I find it unbelievable that heart damage and high blood pressure wasn’t enough to motivate me to do something about seeking out treatment.

The thing that finally made me actually do something and to seek treatment was an increase in my private health insurance cost – how stupid is that?

I went to the doctor’s got the referral for a sleep study and being honest, even at this point, there was part of me that thought that the tests were going to come up empty and there was going to be nothing wrong. That’s almost delusional, right?

My Apnea-Hypopnea Index Score

The tipping point for me came when I went to see my doctor after the sleep study and we went through the results. My Apnea-Hypopnea Index (AHI) score was 73.1. He explained in layman’s terms that effectively I wasn’t breathing or my sleep was being disrupted over 70 times per hour! Not only that, my brain wave activity during my sleep showed that I was never really entering REM sleep for any length of time and that I was probably never having Level 3 REM Sleep let alone Level 4 which completely explained why I never woke up feeling refreshed.

Essentially, I was chronically sleep deprived and it was placing a severe strain on my body. In retrospect, I think it is safe to say that this severe sleep apnea probably started five or six years ago, so I’ve been suffering sleep deprivation for half a decade! I didn’t have a sleep debt, I was pretty much sleep bankrupt.

I came away from that consultation knowing I had a problem that I had to deal with. Maybe it was the numbers, maybe it was the graphs or even the doctor’s serious tone when he was describing the seriousness of my condition, I’m not exactly sure, but it finally resonated with me.

Being Tested For Sleep Apnea

Then came the second sleep study where they put me on a CPAP Machine and monitored the results of my sleep. They hooked me up to the computer, slapped a Fisher & Paykel Simplus Full Face Mask on me and I fell off to sleep. A couple times through the night I struggled with the mask and they had to come in and re-adjust it for me and about a half an hour before I was due to wake up I literally pulled the mask off in my sleep, but they felt they had enough good data, I had gotten about five hours sleep with the mask and they were happy.

With just those five hours sleep and waking up at 5:45am, I was a different person. I was showered, dressed and eating my hospital breakfast at 6:30am. I was checked out and in a taxi home by 7am. In fact, I didn’t even go home, I went to my local coffee shop – I felt like a million dollars, I was refreshed!

That day was pivotal for me. I walked in the front door by 8:30am and my family and I went out for breakfast like we always did on Saturdays. Except I was in the car wide awake and talking a hundred miles an hour. I had clarity of thought and was coming up with new ideas for things. Halfway to breakfast, a mere ten minutes in the car and my wife said I was a completely different person. The whole day was like that – I wasn’t tired at all, no little cat naps, no struggling to stay awake driving… I didn’t even fall asleep watching TV that night!

I knew then that obstructive sleep apnea was a MASSIVE problem for me and that I absolutely needed to get treatment. In just five hours of good sleep, I could see the difference and I didn’t want to go back. I now feel like a new man, and can only wonder why I didn’t do it sooner.

What about you, do you have a similar story to mine, or did you get treatment straight away when you knew what the problem was? Or maybe you’re tossing up whether to go to a doctor to get a diagnosis?

Please go below and leave your thoughts or a comment.