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CPAP Problems
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nmbugs Offline

Preferred Members

Posts: 25
Joined: Jan 2014

Machine: ResMed S-9 AutoSet
Mask Type: Full face mask
Mask Make & Model: ResMed quattro air
Humidifier: H5i
CPAP Pressure: 6-13
CPAP Software: SleepyHead

Other Comments: 3 L/min Oxygen 24/7

Sex: Female
Location:

Post: #1
CPAP Problems
I am having some real problems with my CPAP. First my provider gave me the wrong CPAP. My doctor ordered me an Escape S-9 because I have problems handling the pressures. I was given a Respironics System One which cannot adjust pressures but can ramp up over 45 minutes (as I am sure most of you probably already know :unsureSmile.

Anyways just a few nights after using the respironics (just got it 12-24) I started waking up with my low oxygen headaches. I guess I should mention I am on 24-7 oxygen for PAH. My husband had some work he could do at night so he monitored my oxygen saturations for 2 nights and it went in the 70s both nights. This I think, that caused my right leg to swell up (which happens when my oxygen levels go wacky) so the last two night I haven't used my machine.

This has been very frustrating because I felt like I got my best night sleep in years when I had my titration study. I was looking so forward to getting my machine but now it seems like it's only causing more problems. My cpap provider was supposed to order my correct machine, the day I picked up the wrong one but I found out yesterday they dropped that ball too so it's going to take another 2 weeks to get the right one (which is going to mess up my insurance report!!).

I guess I have a couple questions. First, should I try just taking my pressure down to 6 and don't let it ramp up to 13? I am thinking maybe I can tolerate a lower pressure. Also from what I am reading on these two machines there are huge differences. The model I have right now has no bells or whistles the respiratory therapist described as a pinto and said the one my doctor ordered is more like a camry. But then the office staff is telling me they are the same. Any thoughts on the two models?

I appreciate all your help!
Racquel

Photography: Macro | Super Macro | Misc photos | Facebook photos (mostly studio work here)

Since I have been sick and can't do much photography anymore Sad my creative outlet is now crochet (hats, cowls, stuffed animals). I will have my stuff posted here soon!!
01-04-2014 04:55 AM
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Tez62 Offline

Monitors

Posts: 837
Joined: Feb 2013

Machine: Resmed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: Resmed
CPAP Pressure: 5-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Melbourne, Australia

Post: #2
RE: CPAP Problems
Nmbugs, welcome, if your going with a Resmed you want the Autoset not the Escape. The Escape is the base model in the range, fixed pressure and not data capable. It sounds lik you want a Auto so you can adjust the high and low pressures and in the future you may want to look at the data. There is free software called Sleepyhead that you can download from here and you can take your therapy into your own hands.
01-04-2014 05:06 AM
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me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #3
RE: CPAP Problems
(01-04-2014 04:55 AM)nmbugs Wrote:  I am having some real problems with my CPAP. First my provider gave me the wrong CPAP. My doctor ordered me an Escape S-9 because I have problems handling the pressures. I was given a Respironics System One which cannot adjust pressures but can ramp up over 45 minutes (as I am sure most of you probably already know :unsureSmile.

Anyways just a few nights after using the respironics (just got it 12-24) I started waking up with my low oxygen headaches. I guess I should mention I am on 24-7 oxygen for PAH. My husband had some work he could do at night so he monitored my oxygen saturations for 2 nights and it went in the 70s both nights. This I think, that caused my right leg to swell up (which happens when my oxygen levels go wacky) so the last two night I haven't used my machine.

This has been very frustrating because I felt like I got my best night sleep in years when I had my titration study. I was looking so forward to getting my machine but now it seems like it's only causing more problems. My cpap provider was supposed to order my correct machine, the day I picked up the wrong one but I found out yesterday they dropped that ball too so it's going to take another 2 weeks to get the right one (which is going to mess up my insurance report!!).

I guess I have a couple questions. First, should I try just taking my pressure down to 6 and don't let it ramp up to 13? I am thinking maybe I can tolerate a lower pressure. Also from what I am reading on these two machines there are huge differences. The model I have right now has no bells or whistles the respiratory therapist described as a pinto and said the one my doctor ordered is more like a camry. But then the office staff is telling me they are the same. Any thoughts on the two models?

I appreciate all your help!
Racquel

Don't accept an Escape is about all I can suggest. If you are going with the Resmed then at the minimum take the S9 Elite which is a set pressure and better off taking the Resmed S9 Auto set where a pressure range can be set. If I were you and my leg is swelling up and my O2 is dropping in the 70's, I would be on the phone to my primary doc and report all of this. I am sure someone else will have more suggestions for you.
(This post was last modified: 01-04-2014 05:11 AM by me50.)
01-04-2014 05:10 AM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #4
RE: CPAP Problems
(01-04-2014 04:55 AM)nmbugs Wrote:  Any thoughts on the two models?
Hi Racquel, welcome aboard
I,m astonished your doctor ordered an S9 Escape, the Escape models don,t report other than how many hours using the machine each night, so you and the doctor will have no useful data to see how the therapy is working

Whats the model number of PR System One, model number printed on the label at the bottom of the machine (remove the water tank before checking). Model numbers below 450 or 460 are not data capable machines
01-04-2014 05:10 AM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #5
RE: CPAP Problems
Your user profile shows .. CPAP Pressure: 6-13, in that case the machine would be PR System One Auto , either model number 550 or 560 (60 series machine with the heated hose option)
PR System One Auto is superior to S9 Escape or Escape Auto (on par with Resmed S9 AutoSet)

Philips Respironics System One user instructions and how to obtain the clinical manual via email, the manual explain the ins and out of the machine
http://www.apneaboard.com/pr-system-one-...structions
01-04-2014 05:36 AM
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DeepBreathing Offline
Wiki Editor
Moderators

Posts: 2,296
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #6
RE: CPAP Problems
Hi nmbugs, welcome to the forum.

Both Respironics and Resmed (S9) are good brands with a wide range of machines available. However, within both brands there are less capable machines. The capabilities fall into two main areas - data and pressure.
  • Data capable machines keep a detailed record of your breathing, events and pressures on a breath-by-breath basis. This is valuable information for you and your doctor to monitor your progress and make necessary adjustments to your therapy.
  • The non-data capable machines only keep a record of the hours used, for "compliance" purposes. The S9 Escape is non-data capable. You should avoid getting this machine and insist on a data-capable one (Resmed or Respironics - they're both good brands).

The pressure capabilities are plain vanilla CPAP, autoset, bi level and ASV.
  • Plain vanilla means the pressure is set to a constant and remains at that pressure all night (except for the ramp up). This is adequate for many people.
  • An autoset machine allows you to set a minimum and maximum pressure, and the machine will vary between these as required to treat your apnea events. Generally an autoset is preferred as it is more comfortable for many people, running at a lower pressure unless there is an actual need to go higher. The autoset machine can also give you a night-by-night titration - you can see what pressures are actually required to treat your apnea and adjust the range accordingly.
  • Bilevel machines (Bipap or VPAP) are more complex, allowing different pressures to be set for inhale and exhale. These are more expensive and usually only prescribed if you can't achieve effective treatment on the CPAP or autoset.
  • Automatic servo ventilation ASV machines are very expensive and only prescribed if you have intractable central apnea or other breathing disorder like Cheyne-Stokes respiration

In your case, we don't actually know what sort of apnea you have (obstructive, central or mixed), nor how severe, nor what the prescribed pressures are. If you can share that information with us, we would be in a better position to make a recommendation. However, I do agree with Me50 - if you are experiencing leg swelling combined with very low saturations, you should be seeing your doctor ASAP! Don't wait for the machine to get sorted out.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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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.
01-04-2014 05:45 AM
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robysue Online
Wiki Editor
Advisory Members

Posts: 1,236
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #7
RE: CPAP Problems
nmbugs,

You need to clarify which System One you are using. There's a whole family of them, from the bare-bones System One SE to the top of the line System One Auto CPAP. Here's how to do that:

1) Take the humidifier tank out of the unit.

2) Turn the whole thing over so you're looking at the bottom.

3) Examine the bottom of the blower unit. There should be a tag with a model number. The important thing in the model number is the 3-digit number in the middle. It will most likely be one of the following numbers:

150, 151, 220, 221, 250, 251, 450, 451, 460, 461, 550, 551, or 560, 561

The important part is the first two digits, the third digit is not important.

If your machine has a model number >= 450, it is a machine that is superior to the S9 Escape, and you might as well keep this machine because it does do everything the S9 Escape does. If the model number is 220, 221, 250, or 251, it is equivalent to the S9 Escape. If the model is 150 or 151, then the machine has no Flex (exhalation relief) and is worse than the S9 Escape.

But as others have said, you don't want an S9 Escape anyway. You'd be better off with the S9 Elite or the S9 AutoSet.
01-04-2014 10:04 AM
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trish6hundred Offline

Advisory Members

Posts: 6,449
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: #8
RE: CPAP Problems
Hi nmbugs,
WELCOME! to the forum.!
What robysue and the others have said.
Best of luck to you in getting things sorted out.

trish6hundred
01-04-2014 01:55 PM
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nmbugs Offline

Preferred Members

Posts: 25
Joined: Jan 2014

Machine: ResMed S-9 AutoSet
Mask Type: Full face mask
Mask Make & Model: ResMed quattro air
Humidifier: H5i
CPAP Pressure: 6-13
CPAP Software: SleepyHead

Other Comments: 3 L/min Oxygen 24/7

Sex: Female
Location:

Post: #9
RE: CPAP Problems
Sorry for my delayed response and thank you for all the replies. It was the base model Respironics which only did ramp up. I contacted my doctor because I got even worse so he switched me to ResMed AutoSet. I just picked it up today so I will start my therapy tonight and see how it goes.

My history is may be a bit different than most since I have so many other problems going on like pulmonary arterial hypertension, pulmonary emboli, respiratory failure and tachy-brady syndrome which from my understanding can be attributed to untreated apnea, or at least cause it to worsen or something...this all new to me and I still don't understand most of it. I started getting sick last Jan (2013) and it has been going downhill rapidly ever since!

As for my sleep study my AHI was 25.6. I had to have the study done twice (both sleep and titration) because the first lab messed up and left my oxygen on and because of this only got an AHI of 4. Here is the strange thing. The first lab got a few centrals and a ton of RERAs but apparently medicare doesn't allow for reras anymore. When they did the titration I failed the cpap because I couldn't breathe out and it increased my centrals but reduced my RERAs. The second lab conducted the sleep study without oxygen BUT I didn't get any central or obstructives but got 144 Hypopneas. I desaturated to 69% without the oxygen that night.

I am not sure if I gave too much information now, I apologize in advance if I did Wink.

Hopefully all will go well tonight and I will wake up feeling like a human being tomorrow.

Photography: Macro | Super Macro | Misc photos | Facebook photos (mostly studio work here)

Since I have been sick and can't do much photography anymore Sad my creative outlet is now crochet (hats, cowls, stuffed animals). I will have my stuff posted here soon!!
01-10-2014 07:55 PM
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Surly Offline

Preferred Members-2

Posts: 62
Joined: Apr 2012

Machine: PRS1 60 Series REMstar Auto A-Flex
Mask Type: Nasal mask
Mask Make & Model: Resmed Swift FX Nano
Humidifier: PRS1 60 Series Heated Tubing
CPAP Pressure: 14.5 Opti Start - 18 (APAP)
CPAP Software: SleepyHead

Other Comments: Using latest unstable version of SleepyHead for Mac

Sex: Male
Location: Sydney, God's Country

Post: #10
RE: CPAP Problems
Hi Nmbugs,

Do you normally sleep with Oxigen? If so, some CPAP masks have a port for your O2 line, or alternatively, there's cheap connectors available to place between your CPAP mask and hose that enable continued O2 use while sleeping with your CPAP device.
(This post was last modified: 01-10-2014 09:11 PM by Surly.)
01-10-2014 09:08 PM
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