Concerns about alarm snooze

I’ve had several occasions while sleeping where I’ve been low for a long period of time seemingly without getting enough alarms. I’ve read this part of the user manual multiple times and it’s still not clear to me how alarms and snoozing works. The manual indicates that pressing the ‘c’ (clear button) will snooze an alarm for the preset time. It seems to me that pressing any button actually initiates the snooze. I think what may be happening to me is this: the Dexcom vibrates and lights up telling me I’m low. Since it doesn’t bother to tell me how low my instinct is to press a button to actually see the number. My low alarm is set to 70 mg/dl so it might well say I’m currently 68. In my sleepy state I may well decide that 68 is just fine, do nothing to treat it, and go back to sleep. At this point I believe I’ve snoozed it for 30 minutes (can’t go less than that). If I string together 4 of these alarm/snooze cycles I’ve suddenly been low for two hours.


I believe this explains why, even though I've got all the alarms set to both vibrate and beep, that I almost never hear any beeps. The part about alarms going off every 5 minutes while you're high or low just doesn't happen for me because I always push a button immediately. I think about the only time I get beeps is when I'm driving and don't feel the initial vibration. Only then after five minutes does it vibrate and beep.

My preference would be to have it continue to yell at me every 5 minutes whether I'm low or high until I get things fixed. My high alert is 120 (can't go lower than that). I honestly can't imagine someone using the default high alert of 200 with a snooze time of 5 hours.

How do others deal with this?

I wish that there was an option to have them alarm more also. My problem is that I don’t hear them at night. Back in the August, I discovered a little software glitch that could also be part of your problem. I wrote about it on my blog, http://kellywpa.wordpress.com/2010/08/25/dexcom-software-glitch/.

I was having trouble with alarms periodically not going off and Dexcom wanted me to log everything for a couple days. I have my low alarm set as 70. As you know, the screen lights up and says low and has the 70. They also have 55 set as an alarm number and if you are below 55, the screen lights up and says low and has the 55 with it. Dexcom did not want me to respond to the alarms and I was supposed to write down what happened. I dropped below 70 and the screen lit up and vibrated to alert me. Before the 5 minutes was up, I dropped below 55 so had another vibrate because the 55 is considered a new series of alarms. Less than 5 minutes later, I was above 55 but below 70 so this created a new series of alarms yet again and it vibed a 3rd time instead of beeping at me. If I had kept going above & below 55, it would have kept vibing without giving me any beeps.

Depending on what your BS is hovering around, that could also be part of your problem at night. I frequently drop right below 70 then go back up to 71 and back down to 69 again.

I used to ignore alarms too. After some nasty lows, I trained myself to check the number and drag my butt out of bed and eat something. Have you considered putting the receiver where you can’t reach it from bed? Maybe if you are already out of bed when you see a 68 you will be more likely to treat it.

As an aside, because I am very hypoglycemic unaware, I have my low alarm set to 90. My CDE recommended it because of the delay between the sensor and a finger stick. She maintained that if my sensor indicated 90, I could actually be at 70.

I worry about the 5 foot range so I generally just keep it in the bed near the side that the transmitter is on. I’ve also tried using an amphipod running pouch to wear it around my waist to be sure to feel the vibrations. I definitely need to pay more attention to the alarms and snooze function and try to avoid sleeping through lows (or highs). I may even temporarily set the low alert to a higher value just to practice with it.



There are alarm clock applications for android and iPhones that require you to solve a math problem in order to snooze the alarm. Perhaps the Dexcom needs something like that.



I can’t claim to always be hypoglycemic aware but I think that I’m often low enough that my body is just used to it. Years ago, long before the concept of CGM, I played a little game with my meter. I’d write down my guess of my glucose level before actually testing and then record the meter value. My goal was to improve the accuracy of my guesses. This has enabled me to generally be aware of my levels. I can generally function down to about 45 mg/dl. A while back I even started a run at 49 (after having just eaten) but was down to 39 by the two mile mark and decided to quit at that point. It’s definitely nice to have the Dexcom while exercising.

Ok, something is clearly not right. Either the Dexcom is failing to alarm, I am capable of pressing buttons while asleep, or simply not waking up to the alarms. This morning I woke up on my own around 0330 and felt a little low. I grabbed the Dexcom and pushed a button to light it up and sure enough I was at 58 mg/dl. Once again my low alarm is set to 70 mg/dl with a 30 minute snooze time. Here’s the relevant section from the exported sensor data:



Sensor DisplayTime=“2010-10-20 00:36:01.840” InternalTime=“2010-10-20 04:34:34.010” Value="70"

Sensor DisplayTime=“2010-10-20 00:41:01.840” InternalTime=“2010-10-20 04:39:34.010” Value="69"

Sensor DisplayTime=“2010-10-20 00:46:01.840” InternalTime=“2010-10-20 04:44:34.010” Value="68"

Sensor DisplayTime=“2010-10-20 00:51:01.840” InternalTime=“2010-10-20 04:49:34.010” Value="67"

Sensor DisplayTime=“2010-10-20 00:56:01.840” InternalTime=“2010-10-20 04:54:34.010” Value="64"

Sensor DisplayTime=“2010-10-20 01:01:01.840” InternalTime=“2010-10-20 04:59:34.010” Value="62"

Sensor DisplayTime=“2010-10-20 01:06:01.840” InternalTime=“2010-10-20 05:04:34.010” Value="61"

Sensor DisplayTime=“2010-10-20 01:11:01.840” InternalTime=“2010-10-20 05:09:34.010” Value="62"

Sensor DisplayTime=“2010-10-20 01:16:01.840” InternalTime=“2010-10-20 05:14:34.010” Value="62"

Sensor DisplayTime=“2010-10-20 01:21:01.840” InternalTime=“2010-10-20 05:19:34.010” Value="62"

Sensor DisplayTime=“2010-10-20 01:26:01.840” InternalTime=“2010-10-20 05:24:34.010” Value="62"

Sensor DisplayTime=“2010-10-20 01:31:01.840” InternalTime=“2010-10-20 05:29:34.010” Value="61"

Sensor DisplayTime=“2010-10-20 01:36:01.840” InternalTime=“2010-10-20 05:34:34.010” Value="61"

Sensor DisplayTime=“2010-10-20 01:41:01.840” InternalTime=“2010-10-20 05:39:34.010” Value="60"

Sensor DisplayTime=“2010-10-20 01:46:01.840” InternalTime=“2010-10-20 05:44:34.010” Value="60"

Sensor DisplayTime=“2010-10-20 01:51:01.840” InternalTime=“2010-10-20 05:49:34.010” Value="60"

Sensor DisplayTime=“2010-10-20 01:56:00.840” InternalTime=“2010-10-20 05:54:33.010” Value="60"

Sensor DisplayTime=“2010-10-20 02:01:00.840” InternalTime=“2010-10-20 05:59:33.010” Value="60"

Sensor DisplayTime=“2010-10-20 02:06:00.840” InternalTime=“2010-10-20 06:04:33.010” Value="61"

Sensor DisplayTime=“2010-10-20 02:11:00.840” InternalTime=“2010-10-20 06:09:33.010” Value="61"

Sensor DisplayTime=“2010-10-20 02:16:00.840” InternalTime=“2010-10-20 06:14:33.010” Value="62"

Sensor DisplayTime=“2010-10-20 02:21:00.840” InternalTime=“2010-10-20 06:19:33.010” Value="62"

Sensor DisplayTime=“2010-10-20 02:26:00.840” InternalTime=“2010-10-20 06:24:33.010” Value="59"

Sensor DisplayTime=“2010-10-20 02:31:00.840” InternalTime=“2010-10-20 06:29:33.010” Value="57"

Sensor DisplayTime=“2010-10-20 02:36:00.840” InternalTime=“2010-10-20 06:34:33.010” Value="55"

Sensor DisplayTime=“2010-10-20 02:41:00.840” InternalTime=“2010-10-20 06:39:33.010” Value="54"

Sensor DisplayTime=“2010-10-20 02:46:00.840” InternalTime=“2010-10-20 06:44:33.010” Value="53"

Sensor DisplayTime=“2010-10-20 02:51:00.840” InternalTime=“2010-10-20 06:49:33.010” Value="53"

Sensor DisplayTime=“2010-10-20 02:56:00.840” InternalTime=“2010-10-20 06:54:33.010” Value="52"

Sensor DisplayTime=“2010-10-20 03:01:00.840” InternalTime=“2010-10-20 06:59:33.010” Value="52"

Sensor DisplayTime=“2010-10-20 03:06:00.840” InternalTime=“2010-10-20 07:04:33.010” Value="51"

Sensor DisplayTime=“2010-10-20 03:11:00.840” InternalTime=“2010-10-20 07:09:33.010” Value="53"

Sensor DisplayTime=“2010-10-20 03:16:00.840” InternalTime=“2010-10-20 07:14:33.010” Value="56"

Sensor DisplayTime=“2010-10-20 03:21:00.840” InternalTime=“2010-10-20 07:19:33.010” Value="57"

Sensor DisplayTime=“2010-10-20 03:26:00.840” InternalTime=“2010-10-20 07:24:33.010” Value="58"

Sensor DisplayTime=“2010-10-20 03:31:00.840” InternalTime=“2010-10-20 07:29:33.010” Value="59"

Sensor DisplayTime=“2010-10-20 03:36:00.840” InternalTime=“2010-10-20 07:34:33.010” Value="61"

Sensor DisplayTime=“2010-10-20 03:41:00.840” InternalTime=“2010-10-20 07:39:33.010” Value="62"

Sensor DisplayTime=“2010-10-20 03:46:00.840” InternalTime=“2010-10-20 07:44:33.010” Value="63"

Sensor DisplayTime=“2010-10-20 03:51:00.840” InternalTime=“2010-10-20 07:49:33.010” Value="65"

Sensor DisplayTime=“2010-10-20 03:56:00.840” InternalTime=“2010-10-20 07:54:33.010” Value="68"

Sensor DisplayTime=“2010-10-20 04:01:00.840” InternalTime=“2010-10-20 07:59:33.010” Value="72"

Sensor DisplayTime=“2010-10-20 04:06:00.840” InternalTime=“2010-10-20 08:04:33.010” Value="75"

Sensor DisplayTime=“2010-10-20 04:11:00.840” InternalTime=“2010-10-20 08:09:33.010” Value="76"



As you can see, I dropped below 70 at 12:36am and stayed below 70 until 4:01am. I was 55 or lower from 2:36am until 3:11am.



Assuming I wasn’t waking up or touching the Dexcom it presumably was alarming every 5 minutes for over 3 hours. If I had been pressing a button in my sleep with the 30 minute snooze it still would have gone off at least 7 such times. I don’t think that this is the same as Kelly’s glitch but it may be related.



Perhaps my next step is to lock the Dexcom in a clear plastic box to prevent me from pressing snooze without waking up or to somehow record/videotape the process for later analysis.

I found the alarms confusing at first also. Vibe then beep there’s a delay for the beep I think it’s 5 minutes.

I keep my Dex receiver on my nightstand. Most of the time it wakes me up. Doesn’t mean I can’t clear the alarm and go back to sleep though without fixing the low. I too am trying to train myself to respond appropriately and deal with the lows.

I haven’t tried this myself but I’ve heard of cases where people have put the receiver in a metal bowl or in a bowl with change and that is more likely to wake them up. One person on CWD used their kids karaoke machine to amplify the receiver volume. That was creative.

Diana

Diana