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2nd night on new S9 w/ Sleepyhead daya and queries
#1
Hi all:

So I got my slightly used Resmed S9 as a replacement for my prior machine, and this was my second night. I downloaded Sleepyhead and read all the user guides (thank you RobySue) and I have a couple of comments and questions.

First night I woke up at 3AM or so and freaked out because I thought the machine wasn't working! Obviously it was. Boy is it quiet.

The first night obviously I had a mask problem. This mask is a Mirage Quattro that I hadn't used in a while. I was using a Phillips Amara with the gel insert but somehow during the night recently I ripped the insert (!) and I am waiting for replacements. But last night I made an adjustment to the Quattro which seems to have worked.

First night I forgot to reset the time on the machine (duh) also now fixed.

I'm curious about a few things.

First, how does it look overall?
Second, why is there so much activity at the beginning of the night? Is that normal? I do have the ramp time set to 20 minutes.
And third, why is the data showing two separate sessions on the first chart? Did I do something to the machine to cause that? Does removing the mask in the middle of the night trigger a new session?

Thanks everyone.



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#2
looks fairly good. the two charts are from different nights, and the data on each night is a different set of indicators.

general observation - it does not look like you are served by having the ramp set [and having it set to start so low]. I think the weird high/low back and forth flow rate is because of the low start pressure. many have noted a feeling of air starvation at 4 and suggest 6 most commonly as a minimum (I start at 5 and never felt starved at 4).

Your median pressure is 8 to 9.

If it were me, I would set my pressure from 8 to 13, my ramp to start at 6 and run 10 minutes.

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#3
There is normally some adjustment period for CPAP and you may want to delay making significant changes for a week or so until you have more data to make decisions. The leaks of the first night are pretty out of control, but the second night looks good. I also prefer the organization of your chart data for night 2 since it provides much more useful information.

A couple things to watch and consider. Your low ramp rate is not working for you. At 4.0 cm beginning ramp it is obvious you are making numerous recovery breaths and fighting the machine. Look at the flow rate chart during ramp it it's obvious you need to start ramp at a minimum of 6.0 pressure. I would make that change now. Secondly, you have either sleep stage or positional onset of OA at 22:45 hours, and your pressure is not sufficient to deal with it. Your median pressure is nearly 9.5, so with EPR at 3.0, this is 6.5/9.5 EPAP/IPAP. I think your minimum pressure of 6.0 is too low, (4.0/6.0) and the machine never stays there. I think you will eventually change minimum IPAP pressure to 8.0 (5.0/8.0 with EPR). This is still very low pressure and is below your current median. If you see this pattern continue, increase your minimum pressure to help avoid events. Similarly, if you see the clusters of OA continue, you will need a higher max IPAP to deal with that.

Great start! Good luck.
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#4
Hi denton,
Good luck to you with your new S9 AutoSet.
trish6hundred
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#5
Thanks everyone. I've made the changes you've suggested, pretty much.
I've changed the pressure to 8-13.
I've changed the ramp min to 6.
I've changed the ramp time from 20 minutes to 15. From experience, I can't get to sleep when the machine is running, so I need that time. Altho my prior experience was with a cheap machine. I'll watch this and if I can I will drop the ramp time to 10 minutes in a few days.
Also I felt pretty dry, so I'm upping the humidity from 3 to 4. The tank is hardly down any water.

Thanks again!

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#6
[quote='denton' pid='122775' dateline='1437336474']
Thanks everyone. I've made the changes you've suggested, pretty much.
I've changed the pressure to 8-13.
I've changed the ramp min to 6.
I've changed the ramp time from 20 minutes to 15. From experience, I can't get to sleep when the machine is running, so I need that time. Altho my prior experience was with a cheap machine. I'll watch this and if I can I will drop the ramp time to 10 minutes in a few days.
Also I felt pretty dry, so I'm upping the humidity from 3 to 4. The tank is hardly down any water.

Thanks again!
Hi Denton....I have turned my ramp off and like it alot better...I find the higher setting makes it easer to breath then having the ramp on. Good luck with your treatment...and latter you may want to try it with the ramp off.
It's exactly like that. . . . only totally different. . . . Sleep-well
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