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Advice needed for new user
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Sleepster Offline
Wiki Editor
Moderators

Posts: 4,994
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #11
RE: Advice needed for new user
(07-27-2014 10:37 PM)doublestack1 Wrote:  Tried it for a short time and sent it back to the service company.

Why? What do you remember about it that made you do that?

The reason I ask is because there are bi-level machines that make CPAP therapy easier to tolerate. They lower the pressure when you exhale so it feels more natural.

The S9 Autoset that you ordered will lower the pressure on exhale by up to approximately 3 cm H2O. But a bi-level machine can lower it even further.

For example I have a S9 VPAP Auto. I start the night at a pressure of 10, but when I exhale it drops by 4.2. As the night goes on the pressure auto adjusts so it may go higher than 10, but when I exhale it still drops the pressure by 4.2.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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07-27-2014 10:45 PM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #12
RE: Advice needed for new user
(07-27-2014 10:37 PM)doublestack1 Wrote:  During my sleep study 7+ years ago they never hooked me up to a CPAP. Just sent data (brain sensors, etc) to my doctor who then prescribed the CPAP. Tried it for a short time and sent it back to the service company.
...
Will report back in a week. Machine should arrive Tuesday. Return from a business trip Wednesday night. Will try to set it up and wear Wed, Thurs, Fri and Sat nights. Will let you know Sunday afternoon

Hi doublestack1,

If you try the machine on its default settings (Min Pressure 4 and Max Pressure 20), it is not unlikely that you may be uncomfortable with such a low minimum pressure.

The first few days or weeks it will seem like you are having to work too hard to exhale, of course, because we are breathing against pressure. But if it also feels like you are needing to work a little too hard to inhale, I would suggest increasing the Min Pressure to 5 or 6 or 7 as soon as you like.

And if the higher Min Pressure does not seem to have made it any easier to inhale an adequate amount of air, I would suggest raising EPR by however much the Min Pressure was raised. The cycling back and forth between the lower exhale pressure versus the higher inhale pressure can take a little getting used to, but it actually makes it easier to get enough air, after we become used to it a little.

I also suggest starting with EPR enabled "Full Time" and set to 1. EPR is commonly considered a comfort feature, which the user is free to adjust for best comfort. (Enabled Full Time means all night, not just during the Ramp period.)

Also, it would probably be very helpful to watch TV or read for a few hours the first few days and maybe not even attempt to wear the mask at night (depending on how well things went when watching TV or whatever).

The idea here is it may take a while to ease yourself into becoming comfortable and able to sleep during the therapy.

If swallowing air becomes a painful problem or if dizziness or hearing problems or visual problems occur because the pressure is adjusting itself higher than is comfortable, it may be more important at first to limit the Max Pressure setting to something which is more bearable, and as we adapt to therapy usually everything gets easier and the pressure limits can be gradually re-adjusted based on what we see using SleepyHead or ResScan to look at the data which the machine has recorded for us.

Most people have somewhat of a hard time at first. Also, most often, several masks will need to be tried for a week or so each, before one or two are found which work reasonably well for us. (If buying supplies on line, some suppliers offer mask satisfaction insurance which would allow us to return the mask for a refund if it does not work well for us, but the 30-day time to return it may start when the mask is purchased or shipped rather than when it is received, and the mask may need to be received back at the supplier before the trial period is over, so be sure to read the fine print to understand the requirements.)

The most important thing is not to give up. It gradually gets easier as we become accustomed to the therapy.

Take care,
-- Vaughn

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. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 07-28-2014 01:36 AM by vsheline.)
07-28-2014 12:47 AM
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doublestack1 Offline

Members

Posts: 4
Joined: Jul 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: ResMed FX
Humidifier: H51
CPAP Pressure: 6.63 avg (1 week)
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: New York

Post: #13
RE: Advice needed for new user
Update:

Have good to excellent results since my first night with the S9. So far I have had four nights without tossing and turning or snoring. Last night was the only night where I didn't have 8 hours. For some reason I woke with 6.5 hours (based on the Sleepyhead software) even though it was a very long exhausting day. Another interesting fact is my AHI was significantly lower last night.
One thing I noticed that is consistent across all nights so far is my leak rate increases dramatically around 3:30 am.

Feeling better and tolerating the nasal pillow mask.
08-03-2014 08:23 AM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #14
RE: Advice needed for new user
Good job working the therapy this time around Double. I know you've had a bit of a struggle in the past.

Perhaps around 3:30 or so you are changing positions? Or just sinking into a deeper sleep can cause your muscle things to relax a little more which could change things. Or maybe it's that miserable cat jumping on your face in the middle of the night.

But the main thing is it's working for you! Good job.
(This post was last modified: 08-03-2014 11:03 AM by retired_guy.)
08-03-2014 11:02 AM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #15
RE: Advice needed for new user
Hi doublestack1, that's great news.

By the way, at the top of all forum pages is a link "My Profile" to update our profile (the info which displays next to all our posts).

Rather than having two overnight studies, one to diagnose that you (still) have sleep apnea and another to titrate your optimal pressure, you can ask for a combined or Split Night study which does both.

I think the sleep lab will insist on using their own equipment, not your machine, during the titration portion.

I would take my own mask to the sleep study, as a backup in case the sleep lab doesn't have a mask that is comfortable and works well for me.

If you are now using EPR and like it, then I would suggest searching for a sleep lab which is in your insurance company's provider network which uses ResMed equipment, and asking that your preferred amount of EPR be used during the titration portion of your overnight study.

I think it is more common for labs to use Respironics equipment, which can use "Flex" as a form of exhalation pressure relief. But after I had been using an AutoSet with EPR for a while and later had a titration using Respironics equipment, I found Flex to be very annoying because the pressure relief would end too early, way before I was finished exhaling.

Take care,
--- Vaughn

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. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 08-03-2014 12:40 PM by vsheline.)
08-03-2014 12:35 PM
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