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Brand Newbie: Where to begin

Buying a ResMed S9/H5i off CraigsList today after suffering from horrendous snoring for many years. My wife has reverted to ear plugs because of the noise, and I usually wake up feeling very tired, foggy mind, etc.

Could not afford a sleep study, so I'm rolling my own, so to speak.

I'm hoping to get advice here on where to begin. What are the initial settings I should try? I think this machine is an "auto," so does that mean it will set itself?

Anything else to be aware of here?

Thanks very much for any advice/assistance you can offer.

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Welcome SnoreGalore,
How do you know you even have sleep apnea without a sleep study?
You will need to order the Clinical Manual for your particular machine. (Top of page)
It's hard to give advice without a sleep study, but since you already ordered the machine, and if it is an Auto, then we can help you.

No, the machine will not set itself, you will have to set a range of pressure. That is why a sleep study is so important.

Have you checked into an overnight home study? At least you would have something to go on.

To start, you will probably leave the machine wide open at a range of 4-20, and check your numbers for a few days.

Check back with us after you get your machine.
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G'day SG, welcome to Apnea Board.

Buying a used machine without a sleep study is a bit of a punt. There is a wide range of Resmed S9 machines out there with a whole spectrum of capabilities. So you need a machine which is data capable, so that you can use some software to see what's actually going on. If the machine has "Escape" in the name, escape from that transaction and try again - the Escape has no data capability and you'll be flying blind. If it has VPAP in the name, you might also want to reconsider - these tend to be specialist machines. Your best bet to start with is an Autoset. This is fully data capable, and can adjust to your needs, assuming you have simple sleep apnea.

To make use of the data, download and install SleepyHead software - there's a link at the top of each page on the forum. This will read your sleep data on a breath-by-breath basis and give you lots of charts and statistics to help manage your therapy.

To make the best use of your machine, once you know the exact model name (which will be printed on the machine itself near the on-off button) go to the link for CPAP setup manuals and request the clinician manual. This will help you set up the machine you your needs. Be sure to follow the download instructions exactly - there are hundreds of machines listed and you need to ensure you get the right manual.

I assume the machine you buy will be clean and in good condition - if there are any doubts on that front, walk away! In your position I'd look at changing out all the stuff which could contaminate the air you'll be breathing - filters, humidifier tank, humidifier gasket, hose and mask. In the States you'll need a prescription to buy a full mask, but your friendly local GP or dentist might oblige. Otherwise you can buy the bits separately (ie mask frame, cushion, headgear). You might be OK giving the humidifier tank a thorough clean, but I'd definitely change the rest. Note that the mask is the hardest part of starting out. There are a lot of different types and many of us go through a lot of masks until we find one which suits. If you don't have insurance this gets expensive! But if you mask is uncomfortable or leaks then everything else will be wasted.

Once you've got your machine, manuals, mask, hose etc, it's time to start breathing! Assuming you got the Autoset, I'd suggest the following settings to start off: Min pressure: 6; Max pressure: 20; Ramp: 10 minutes; Humidity: 3; Humidifier temperature: 27. Try it for a few nights, see how it goes and review in SleepyHead. Then come back here and give us an update - we'll be able to guide you from there.
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Thanks for your extremely helpful suggestions and advice. After considering what you've had to say, I'm going to order a home sleep test before buying a machine. I did not realize the intricacies involved in the process. Guess I'm just desperate to have a good night's sleep!

How would I go about finding the most cost effective home sleep study provider? Do you have any recommendations?

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It is good that you recognize you probably have a problem and want to fix it. But the approach of just buying a machine is kind of like saying, "Hey, I'm always thirsty and I pee a lot and I crave sugary snacks, so I think I will go down to the CVS and get me a couple vials of insulin and some syringes and start medicating myself for diabetes." That would seem silly, and very damned unwise. But you could do it as insulin is not a prescription drug.

It is one thing to be an established CPAP using patient that knows a little bit about what they need buying a replacement, primary, or backup machine on CL and quite another for somebody with little experience blindly buying a CPAP through unregulated channels hoping to self diagnose and self treat. It can probably be done, but it would take a LOT of homework, and I would not advocate it.

S9 is not a model of CPAP machine - it is a family of machines that look the same and share many features - but capabilities vary widely by model. Look at the pictures closely or call and ask - what does it say right above the power button? You would need to figure that out before thinking about buying anything. Try to avoid the ones that say "Escape" (non-data capable).

Having said that, CL can be a dangerous place for a newbie to buy a CPAP. There are a LOT of over priced units out there on CL. Most are VASTLY overpriced - machines that are worth maybe $75-100 are regularly advertised at $500 - $1000 - with the claim of a "terrific value" since the DME that originally sold them the unit told them that their invoice price was $2,500 (DME dollars are like dog years) and never shared that the insurance rate was really only $500. There are some heavily used ones that say "Just like new!" that may look good, but may be well into their service life. Before buying a used machine, you need to know how to check the total number of hours the blower has run to know what you are getting. And unless you are a smoker or live with a smoker, you would need to make sure any device comes from a non-smoking environment.

But this is all getting the cart before the horse. Have you at least discussed the possibility or likelihood of apnea with a medical professional?


PS - I see that there have been a couple of replies since I first started writing - and you responded that you were considering a home study. I think that is a good move.
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Hi SnoreGalore,
WELCOME! to the forum.!
It's more difficult without getting a sleep study done, so it's probably good to get started with a home study to give you a better idea of where your pressure should be.
Much success to you as you start your journey and hang in there for more answers to your questions.
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(05-11-2015, 05:22 PM)trish6hundred Wrote: Hi SnoreGalore,
WELCOME! to the forum.!
It's more difficult without getting a sleep study done, so it's probably good to get started with a home study to give you a better idea of where your pressure should be.
Much success to you as you start your journey and hang in there for more answers to your questions.

Many thanks for your thoughtful replies. Definitely going the home study route. How would I go about finding the most cost effective home sleep study provider? Do you have any recommendations?

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Snore, it would help if you listed where you are from. Suggestions depend on country, state, city, etc. Do you have any health insurance coverage? Others here can help you but we need to know the general part of the globe you live on.
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Thanks, TR. I'm in central Virginia. Big deductible insurance means this is out of pocket, thus, my inclination to find a "value" provider of the study.
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I know it's hard when you have high deductables, but you may want to touch base with your doctor. If you confide in your doctor and let him know of your situation, he or she can advise you.

Some sleep centers (with doctors perscription) will provide you with what you need for an overnight home study for a fraction of the cost.
Good luck,
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