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[CPAP] New S9 Autoset Setup
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PaulaO2 Offline
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Posts: 8,065
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #31
RE: New S9 Autoset Setup
Yay! So happy for you!

What was your pressure before?

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
01-19-2013 05:50 PM
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trish6hundred Offline

Advisory Members

Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #32
RE: New S9 Autoset Setup
CONGRATULATIONS!
Good to hear such a GREAT report.
CONTINUED SUCCESS.!

trish6hundred
01-19-2013 09:54 PM
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vsheline Offline

Advisory Members

Posts: 1,907
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: #33
RE: New S9 Autoset Setup
(01-19-2013 03:50 PM)aehjr Wrote:  Thought I'd provide an update after 9 days with the new machine.

AHI - Last 7 days 1.0; Last 30 days 0.93; highest was last night at 2.14
95% pressure is running around 8.7 with occasional bumps to the max of 12.

Hi aehjr,

Congrats on the improvements in how you are feeling and on your great AHI numbers.

If your pressure is occasionally maxing out at 12, I suggest using ResScan to save a .pdf report showing All Data for one (or for each) of the nights this has happened. The All Data report includes two sets of time plots of the data, allowing the report to show the whole night plus a zoomed-in view of any interesting portion, such as a 5 or 10 minute period around your longest apnea event or any period you would like to bring to the attention of the doctor.

You could print these out to show your doctor. I think your doctor will want to raise the upper pressure limit higher.

To keep my nightly 95% pressure as low as possible (to lessen AHI and lessen the likihood of big leaks) I wear a teeshirt with a tennis ball in a pocket added between my shoulder blades.

The high limit setting for my pressure is a couple cmH2O higher than my max pressure on nights when NOT wearing a tennis-ball-shirt, in case I fail to wear it.

Personally, I find I do better when the setting for minimum pressure is not a lot lower than my average 95% pressure.

Also, I use the ResMed Gecko Nasal Pad to completely eliminate leaks around the eyes, and to protect the bridge of my nose from getting hurt by my Full Face Mask. The somehat similar Nasal Soft CPAP Cushion from Respironics or Sleep Care Technologies is cheaper but is too thin to seal my leaks or protect my nose very well.

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: 01-19-2013 11:06 PM by vsheline.)
01-19-2013 10:49 PM
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aehjr Offline

Preferred Members-2

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: #34
RE: New S9 Autoset Setup
Paula - My previous set pressure was 6.0 cm/ H2O.

Vaughn - I'd like to try ResScan but don't have a working Windows computer right now. What I plan to do for my appointment is to print out the SleepyHead graphs for my "best and worst" nights and the summary data. I'll also bring the memory card in case the doctor has the capability to import the data. I appreciate the suggestion on the Gecko Nasal Pad. The bridge of my nose is never bothered but my face on the sides of my nose are frequently red and irritated.

Last night's AHI was 0.14 with only a single hypopnea event.
01-20-2013 10:51 AM
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aehjr Offline

Preferred Members-2

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: #35
RE: New S9 Autoset Setup
Update

I had my doctor's appointment and learned the results of my sleep study. He was not amused that I took matters into my own hands and did a self-titration with the AutoSet; I saw the frowny face big time. Wink
Then I showed him the SleepyHead printouts (overview, statistics and best and worst daily summary) and there wasn't much he could say other than the previous comments about "well the auto algorithms don't always work well." Apparently the sleep study showed that a fixed pressure of 10 would work well and there were no other issues of concern. Doctor indicated he wanted me to try fixed pressure for 30 days to see how it worked. He also asked me to bring in the SleepyHead printouts when I come in for my next appointment.
Then he asked, "do I need to send in an order for the new pressure? I'm guessing you know how to set your machine." I smiled and said, "I'll set it myself, thanks."

The fixed pressure is working about as well as the AutoSet was working. AHI average after six days at 10 cm fixed is 1.55; other than the first night on fixed pressure (AHI of 4.27), the average is running around 1.0. As long as the AHI numbers continue to be this good, I'll continue at the fixed pressure until my next appointment. As I mentioned in previous posts, I can also feel my energy level improving daily and the daytime sleepiness decreasing.

As many folks have commented previously, it is very much in your best interest to take an active role in your treatment. And it is also very much in your interest to have a machine that is efficacy data capable so you can monitor your own progress and have meaningful conversations with your doctor about your health care.
01-28-2013 05:26 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,065
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #36
RE: New S9 Autoset Setup
I'm glad you feel empowered! Good for you!

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
01-28-2013 05:57 PM
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Sleepster Offline
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Posts: 4,988
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: #37
RE: New S9 Autoset Setup
(01-28-2013 05:26 PM)aehjr Wrote:  He was not amused that I took matters into my own hands and did a self-titration with the AutoSet; I saw the frowny face big time.

So they titrated you at a pressure of 10 cm. Is that consistent with what the AutoSet determined?

Quote:Apparently the sleep study showed that a fixed pressure of 10 would work well and there were no other issues of concern.

You're fortunate. There could have been complications.

Quote:He also asked me to bring in the SleepyHead printouts when I come in for my next appointment.

That's encouraging. Sounds like he might be willing to acquire some new knowledge that he can use to help his other patients. I wish all doctors were like that.

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.
01-28-2013 09:40 PM
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aehjr Offline

Preferred Members-2

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: #38
RE: New S9 Autoset Setup
Sleepster - In response to your questions...

Yes, they titrated me at 10. That is in the ballpark for the AutoSet results; those were in the 8.5-11 range for 95% pressure and a highest max of 12 one night.

Yes, I was very fortunate that there were no complications for my sleep issues other than the need for the moderate increase in pressure.

I don't know if it is knowledge he is seeking or he just wants to be sure I'm using the fixed pressure setting vice the auto setting approach. Bigwink
In any event, since the results are similar, I'll do it his way for now. After my next appointment (and with a month of data), I may experiment with auto settings or just leave it alone as long as I keep feeling like I'm well-rested.
01-28-2013 10:34 PM
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Sleepster Offline
Wiki Editor
Moderators

Posts: 4,988
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: #39
RE: New S9 Autoset Setup
(01-28-2013 10:34 PM)aehjr Wrote:  After my next appointment (and with a month of data), I may experiment with auto settings or just leave it alone as long as I keep feeling like I'm well-rested.

Sounds like a good plan.

The only real claims I've heard from users here on Apnea Board about the advantages of their APAP is that it allows them to spend more time at lower pressures. The higher pressures are of course less comfortable, sot that's a major motivation.

Like me, your pressure is not really too high, but it is up there in the double digits.

If there are times, though, when a higher pressure is needed, such as when you roll over on your back, then you may get some benefit from your APAP over having a fixed pressure CPAP.

You'll be able to tell by looking carefully at the data if this is happening. If there are times when a higher pressure is needed, and you're not getting it because you're in CPAP mode, it would interfere with the quality of your sleep.

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.
02-01-2013 04:09 PM
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aehjr Offline

Preferred Members-2

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: #40
RE: New S9 Autoset Setup
I was curious to see if I could find some medical literature on the issue of CPAP over APAP so I did a Google search "advantages apap over fixed pressure cpap."

Here are the two quotes I found most interesting in the article (taken from SLEEP Journal, Vol 30, No. 2, 2007). I could not find anything more recent.

"The findings indicate no consistent difference in efficacy or preference for APAP over CPAP among patients with mild to moderate OSAS, and most patients expressed a preference for the device initially prescribed. Thus, the study finds no evidence to indicate that such patients would be better managed by APAP. However, posthoc analysis indicated that patients requiring higher fixed- pressure levels tended to prefer APAP, similar to the findings of another report, whereas those requiring lower fixed-pressure levels preferred CPAP. Both devices were equally effective in reducing the level of sleep-disordered breathing, snoring, and arousal frequency, in addition to subjective daytime sleepiness, and were similar in efficacy to previous reports in this regard."

and

"We followed our patients for 18 months after they completed the study to evaluate the long-term outcome, particularly in terms of side effects and compliance. The prevalence of mild side effects remained high, with more than 50% of patients stating that they had ongoing nasal symptoms and more than 25% reporting intermittent mask leak. Seventy-six percent of patients were continuing therapy after the initial study period, the majority of whom were on APAP (59% on APAP compared with 41% on CPAP). While these differences are not significant, they do suggest some trend toward better long-term compliance with APAP compared with CPAP, and the lack of significance may be a reflection of the relatively small number of subjects studied. However, the data do not support the routine prescription of APAP as initial therapy for mild to moderate OSAS, and the authors recommend that, at present, APAP therapy be reserved for use in patients who are having difficulty with standard CPAP, or in selected patients in whom there is objective evidence of APAP superiority, such as those re- quiring high fixed-pressure levels with CPAP.
In conclusion, the present data indicate that CPAP and APAP are equally effective in managing patients with mild to moderate OSAS, and patients have no consistent preference for either device."
02-03-2013 08:04 PM
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