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[CPAP] New to CPAP and figuring out how to begin while waiting for consult/tests
#1
New to CPAP and figuring out how to begin while waiting for consult/tests
Hi all!

I have been waking up gasping for air for 3-5 years. Some nights it doesn't happen, some nights it's horrible, and recently I had my most terrifying episode of being keeled over on the bed trying to get my breathing back to normal for at least 3 minutes. Scared me so much that going to bed at night has been really difficult, as I am worried about it re-occurring.

A few years ago, I was given an at-home sleep study and the results were that I did not have sleep apnea or qualify for a CPAP. It was chalked up to anxiety and I took the appropriate measures to deal with my mental health. They said it was highly unlikely for being in my mid-30s, non smoker, not overweight, etc.

Now, after lab work showing my red blood cells are above normal (and ruling out blood disease), brain fog, and a consistent hypertension in the last few months, my doctor(s) are re-visiting the sleep apnea idea, especially after that latest episode (I'm now also on a 30 day heart monitor). I have a sleep doctor consult on the 19th, and then who knows when a test will be scheduled after that.

In the meantime, every day in between feels like wasted time of not taking action.

A family friend passed away years back and left me a ResMed S9 Autoset, from what I see on label. It is just the unit and the power cord. I am trying to figure out what else I need to use it until I am re-tested again or have more clarity.  Would it just be the mask and the tube from the mask to unit that I have to order online? Is heated tubing necessary or am I missing any other components besides those two things?

If anyone has recommendations for a safe way to start with settings, let me know. I don't know much about OSCAR but could learn if it is valuable. The recommendation I had from Reddit users were to do a min pressure of 4 and max of 12 with EPR of 3 and ramp off, and then increase the min pressure as needed. 

Also, is doing an at home test like Lofta a solid choice or should I do a pro sleep lab test? My health insurance isn't the best so I try to be conscious of costs. I am assuming a sleep lab is more thorough than an at-home test. My only concern would be an at-home test coming up negative again or on a night that I don't gasp, although not to say at some point I couldn't trust that if it was the result, but in the meantime most signs are pointing to sleep apnea.

Anyways, sorry for the handful of questions, would love to give this CPAP a go as I figure out things, any advice is appreciated.
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#2
RE: New to CPAP and figuring out how to begin while waiting for consult/tests
Welcome to the forum.
Try those settings, but with EPR = OFF. Why, because we want to see if you have sleep apnea and we do not want to assume we are treating it.
If no apnea shows we would suggest you set min= max at the lowest setting you can tolerate to see if that shows any apnea, then it makes sense to get into treating it.

if you feel you are sufficating/hard to breathe increase the Min to 6. It will not hurt you.

You do need a mask and hose. Heated hose is nice but not needed.

Post a screenshot from OSCAR here and we can see what is happening.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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.
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#3
RE: New to CPAP and figuring out how to begin while waiting for consult/tests
(10-14-2020, 01:53 AM)Pawther Wrote: . . .
A family friend passed away years back and left me a ResMed S9 Autoset, from what I see on label. It is just the unit and the power cord. I am trying to figure out what else I need to use it until I am re-tested again or have more clarity.  Would it just be the mask and the tube from the mask to unit that I have to order online? Is heated tubing necessary or am I missing any other components besides those two things?
Hi Pawther,
You'll need a mask and tubing.  The tubing can be purchased on Amazon or similar places, usually about $15.  A mask is a prescription item, and may be more difficult.  Try your PCP, as any doctor can write a prescription for CPAP equipment.  There are many online suppliers for masks, mask parts, etc.  See the supplier list in the black banner bar at the top of any page here.  I used Supplier #26 several years ago, as they had a great mask return policy. 

The last item needed will be an SD or SDHC card, any brand 2-32GB capacity (not higher), formatted as FAT32.  This will record the data for examination in OSCAR.

Good luck on your quest.
A.Becker
PAPing in NE Ohio, with a pack of Cairn terriers
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#4
RE: New to CPAP and figuring out how to begin while waiting for consult/tests
Thanks guys.

Darn, didn't know the mask portion would need an Rx, I'm guessing my PCP won't prescribe one in meantime since I have that sleep doctor consult on the 19th and he'll probably want to wait for results, but I will see what I can do.

As far as the unit, I am a COMPLETE newbie, so forgive me, but my understanding is this: I fill the humidifier part of the ResMed unit up, I connect the tube to the unit and mask to the tube. Turn on the ResMed and set the settings recommended to me, and just hit start and I am good to go? Regarding OSCAR, do I need to do anything manually on the ResMed settings to enable that, or does it just automatically work if there is an SD card in?
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#5
RE: New to CPAP and figuring out how to begin while waiting for consult/tests
When you put in the card the machine should light up and say something about preparing it for use. When it is done it is formatted and ready to go. 

Once you have put in the settings you don’t do anything but press the on button on top. I put on my mask and then turn on the machine.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
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#6
RE: New to CPAP and figuring out how to begin while waiting for consult/tests
(10-14-2020, 02:01 PM)Pawther Wrote: Thanks guys.

Darn, didn't know the mask portion would need an Rx, I'm guessing my PCP won't prescribe one in meantime since I have that sleep doctor consult on the 19th and he'll probably want to wait for results, but I will see what I can do.

As far as the unit, I am a COMPLETE newbie, so forgive me, but my understanding is this: I fill the humidifier part of the ResMed unit up, I connect the tube to the unit and mask to the tube. Turn on the ResMed and set the settings recommended to me, and just hit start and I am good to go? Regarding OSCAR, do I need to do anything manually on the ResMed settings to enable that, or does it just automatically work if there is an SD card in?

I think you are asking how to set the min/max pressure and other parameters of the S9. Try looking here:  https://www.apneaboard.com/resmed-s9-cpap-setup       Then some of these good hearted souls will give more detailed help once you get up and running.
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#7
RE: New to CPAP and figuring out how to begin while waiting for consult/tests
Hey all, to update, I was able to get a mask and have all the parts to run my CPAP in a test trial. I also had my sleep doctor consult today, who off record said it was probably a good move to try out the machine and see what the data says or how it makes me feel.

When I went into the settings for the ResMed S9, I noticed a bunch of stuff I was unclear on how to set for my trial. I'm assuming Max and Min pressure are for IPAP/EPAP? I am under VAuto mode, because under CPAP mode I didn't see a max anywhere so I am assuming VAuto mode is the one I should be on?

For VAuto mode it says:

Max IPAP: 12.0
Min EPAP: 4.0
PS: 6.0
Ti Max: 4.0
Ti Min: 0.1
Trigger: Very Low
Cycle: Med
Max Ramp: Off
Start EPAP (if max ramp enabled)
Mask: Nasal
Tube: Slimline

I set the last two based on the tube and mask I purchased. The others, I wasn't sure if they were set properly for a beginner and was wondering if anyone had any pointers. My intention is to try the CPAP out and then share the OSCAR data to see if it shows any valuable information to those who read it here. Thanks!
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#8
RE: New to CPAP and figuring out how to begin while waiting for consult/tests
I would think the PS of 6 will be more than your needs, and that Min EPAP would be too low. Maybe try 6 for the EPAP and 3 for PS. The Ti Min/Max, and the trigger and cycle should all be at defaults, unless you have a need that is discovered when used that suggests changing these timing settings.

I don't recall seeing on this thread that you've reset the PAP. It may be a good idea to reset and bring it to factory specs then edit the pressure settings. Otherwise you may be setting yourself up to have less than good settings to start with.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: New to CPAP and figuring out how to begin while waiting for consult/tests
Hey thanks. Total newbie question here, is it supposed to feel difficult to exhale or like you’re being suffocated a bit? I imagine that’s a common initial sensation that you grow used to, but curious if a certain setting helps with exhaling not feeling like it takes a bit of force to get out. I read EPR can help with that but actually don’t see EPR as a setting in VAuto mode as listed above.
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#10
RE: New to CPAP and figuring out how to begin while waiting for consult/tests
Ok, I'm not one of the pros and this may be incorrect, but if it is the same as mine (S10 VAUTO and I think it is).  PS is EPR in other machines.  It is also used a little bit different. The PS is ADDED to the EPAP to get the IPAP.  So the low number (EPAP) is the base starting pressure.  While the IPAP is how high it goes up to when you inhale.  The Max number is how high it can go if needed and probably never get that high.

So these are the numbers you had on your post.
Max IPAP: 12.0
Min EPAP: 4.0
PS: 6.0


So your bottom number is 10 and as you breath out it goes down to 4, and then goes back to 10 on the inhale, then back to 4 for the exhale.... and so on.  The 12 is as high as you have set your machine to go.  So if it need be it will raise the inhale number to 12 and the PS will bring it back to 6, it will stay there until the blockage is cleared and then go back to 10, 4..  That is the best I can explain it.  Like I said others here will explain it better than I did and clear up any falsehoods I put down.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
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