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[CPAP] New S9 Autoset Setup
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zimlich Offline

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Machine: Respironics PR System One BiPap Auto SV Advanced
Mask Type: Nasal mask
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Humidifier: System One
CPAP Pressure: 8-20 ASV, 8 EPAP,PS 12
CPAP Software: Not using software

Other Comments: I use the Quattro FFM when necessary

Sex: Female
Location: Norfolk, VA

Post: #11
RE: New S9 Autoset Setup
Looks like it's all been said, aehjr. I would work around my current CPAP pressure. I did note one thing when I was trying to do a titration with an AUTO. The higher I set the IPAP, the higher my ahis would go and I ended up chasing my tail.
Good luck,
please keep us posted,
Mary
01-09-2013 08:11 AM
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archangle Offline
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Posts: 3,159
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #12
RE: New S9 Autoset Setup
Start with the same pressure as your old machine at least one night. If that works as well on the new machine as the old one, start adjusting the pressure.

Run 6 manual. Then do 6-7 auto, 6-8, etc. and see what happens.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
01-09-2013 05:38 PM
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vsheline Offline

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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: #13
RE: New S9 Autoset Setup
(01-09-2013 08:11 AM)zimlich Wrote:  I did note one thing when I was trying to do a titration with an AUTO. The higher I set the IPAP, the higher my ahis would go and I ended up chasing my tail.

Hi zimlich,

Maybe your obstructive sleep apneas were fixed by the higher pressure but your clear airway apneas were increasing as the pressure was raised. As you know, some of the newer data-capable machines (like the S9 Autoset) are able to classify apnea events as obstructive or central.

Shows the importance of being prescribed a machine which accurately classifies the types of apneas we are having (obstructive or central), so our therapy can be appropriately adjusted.

Even if we have a great machine, Docs really do not have time to study our daily results as much as is needed when we are having problems, so I think we need to monitor the data for ourselves (with the help of a supportive on-line community such as this forum), as you were doing by monitoring your AHI numbers, but apparently using a machine that didn't give you much other information to work with.

As the data the machines report gets better, and as on-line communities such as this forum become more knowledgable and capable, I think patients and eventually doctors will gradually understand that great benefit is possible when patients become active and put in the time needed to monitor their sleep therapy data themselves and make their doctors aware of any problems.

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: 01-10-2013 05:39 AM by vsheline.)
01-10-2013 05:31 AM
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SuperSleeper Offline

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Posts: 9,973
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Machine: PR System One REMstar Auto (DS560)
Mask Type: Nasal pillows
Mask Make & Model: ResMed Mirage Swift II
Humidifier: none
CPAP Pressure: 12.5 - 18.5 cmH20 (auto range)
CPAP Software: SleepyHead

Other Comments: Have diabetes Type II

Sex: Male
Location: Illinois, USA

Post: #14
RE: New S9 Autoset Setup
(01-09-2013 05:38 PM)archangle Wrote:  Start with the same pressure as your old machine at least one night. If that works as well on the new machine as the old one, start adjusting the pressure.

Run 6 manual. Then do 6-7 auto, 6-8, etc. and see what happens.

Hi Arch,

Interesting on these two approaches. I posted that (given the fact that the original titration was inconclusive as to the correct pressure) aehjr might start with a wide pressure range and work down to a more restrictive range, and you're suggesting that aehjr might start with a restricted range and work up to a more open range.... Thinking-about

I in no way have any solid opinion on either method, but if you get a chance, could you explain why you think starting off with a more restrictive range of pressures might be the better approach in this situation?

Thanks

SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

01-10-2013 05:26 PM
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aehjr Offline

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Posts: 92
Joined: Dec 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Mirage FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 6 - 12
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Colorado

Post: #15
RE: New S9 Autoset Setup
(01-08-2013 11:22 PM)Sleepster Wrote:  How long have you had your current CPAP? What pressure is it set at? What were the results of the sleep study you had when you were issued your current CPAP?

If you have simple OSA with no complications you would simply set your new autopap with a range somewhere around your prescribed pressure.

But it appears you do have complications. If I were you I'd contact your doctor and tell the office that you need the results of your sleep study. The doctor should be able to call you back and discuss the results. Keep calling them and asking that the doctor release the results of the sleep study to you. I would bug the hell out of them until they cooperate.
Sleepster,
Going on 5 years with the current CPAP. Setting is 6 cm. Original sleep study said I had about 8 AHI but my desaturation levels were of concern to my doc (down to 70% during the events). He told me never to sleep (nap or otherwise) without the CPAP and I haven't. The current CPAP has worked fine for a number of year; the increased fatigue levels only began about a year ago and have gotten worse.

The doc is either on travel or vacation and I have a business trip I can't get out of so the appointment scheduled is the best they and I could do.


Thank you again to everyone who took the time to respond. I received the machine today and plan to use it tonight. I'll keep you posted on the results.
(This post was last modified: 01-10-2013 10:26 PM by aehjr.)
01-10-2013 10:24 PM
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Sleepster Offline
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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: #16
RE: New S9 Autoset Setup
I would suggest then that you follow archangle's advice. Not to disagree with him, but I would be a bit more aggressive and start with it on the 6-8 range. Give it a few days and see what the AHI looks like. Also make sure your leaks are under control.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
01-10-2013 10:30 PM
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Sleepster Offline
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Moderators

Posts: 4,995
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: #17
RE: New S9 Autoset Setup
(01-10-2013 05:26 PM)SuperSleeper Wrote:  I in no way have any solid opinion on either method, but if you get a chance, could you explain why you think starting off with a more restrictive range of pressures might be the better approach in this situation?

My guess would be a concern that there are central apneas and that too high of a pressure might make them worse.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
01-10-2013 10:32 PM
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archangle Offline
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Posts: 3,159
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #18
RE: New S9 Autoset Setup
(01-10-2013 05:26 PM)SuperSleeper Wrote:  I in no way have any solid opinion on either method, but if you get a chance, could you explain why you think starting off with a more restrictive range of pressures might be the better approach in this situation?

It's sort of a scientific approach. New machine, same settings, be sure it works the same as before for one night, the way you'd expect. Then small adjustments observing the results.

If you limit the change to 1 cmH2O per night, it will only take a week or so before you've got a BIG pressure change, so it's not like you have to wait a long time.

If you make a bunch of changes or a big change all at once, it's a little harder to figure out what's going on, and to catch problems before they get bad.

Normally, I'd suggest even slower changes than that, but the OP seems to be anxious to do something. Hopefully, he can wait a few days to make big changes.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
01-11-2013 06:03 AM
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jgjones1972 Offline

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Posts: 516
Joined: Nov 2012

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro FX
Humidifier: ResMed H5i
CPAP Pressure: 18 - 20
CPAP Software: ResScan SleepyHead

Other Comments: CMS50I PulseOx

Sex: Male
Location: Ohio - USA

Post: #19
RE: New S9 Autoset Setup
This is just my opinion and I am not a doctor or scientist; but if it were me, I would be most concerned about correcting those O2 desaturation levels as quickly as possible. I could understand starting at current pressures and slowly making adjustments if the new machine were a fixed pressure machine; but, with an automatically titrating machine, why not allow it to do the titration? I'm led to believe this type of thing is pretty much what the AutoSet is designed to do - find the pressures needed for sufficient therapy, while minimizing excessive pressures and eliminating pressure increases due to CA events.

I understand that a machine can't be perfect and an AutoSet left on wide open probably won't deliver the most effective therapy possible; but it seems to me the best approach would be to get adequate therapy now and work over the next several weeks to refine it and make it great.

Once again, this is just my opinion...and I don't know all of the extenuating circumstances, but I base most of this opinion on the efficacy of the particular APAP, its ability to properly address CAs and my personal experience with its performance.
(This post was last modified: 01-11-2013 10:29 AM by jgjones1972.)
01-11-2013 10:26 AM
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aehjr Offline

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Posts: 92
Joined: Dec 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Mirage FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 6 - 12
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Colorado

Post: #20
RE: New S9 Autoset Setup
I really appreciate the input and assistance you all provided. I decided to take a more aggressive approach based on the following logic:
If my doctor had prescribed a home titration study, he'd have set the machine somewhere near "wide open" and let the machine do the titration. I used the new machine last night and while I recognize one night is not a trend, I think that this was a good approach.

Respironics data: 30-day average AHI of 7.0; 7-day average varied as described in original post.

S9 data (first night of use)
Machine settings: Autoset; Min pressure 4.0; Maximum pressure 12.0; EPR 3

Results (from Sleepyhead):
Median pressure - 7.66; 95% 10.86; max 11.80
Median leaks - 0; 95% leaks 7.2; max leaks 24. The two leak events were not coincident with the apnea events
AHI - 0.38
Hypopnea - 0.13
Apnea - 0
Obstructive - 0
Clear airway 0.25
The two clear airway apnea events were of 11 sec and 12 second duration
The hypopnea event lasted 29 seconds
01-11-2013 11:20 AM
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