[CPAP] Resmed S8-S9 upgrade failure, help apprecieted

[MartinJ59]

Hi
New to the forum, have been trying to find this info, sorry if it has been repeatedly asked and answered...

Problem is the curve for lowering pressure after a rise in pressure.

Have used Resmed S8 Autoset successfully for many years. As this was paid by myself and I asked my doctor could I please have a "free" one (Swedish health care permits one CPAP on free loan for anyone with severe apnea). I got my S9 autoset and a new mask. Got a RV/Motor home and want to keep one of the CPAP permanently in the RV.

Thought I was going mad for a few nights and went back for a mask change. Had severe leaks where I had to turn CPAP of to reduce pressure. Turns out that the next mask had the same problem.
Changed to S8 and it worked beautifully.

Back to the clinic. They tell med S9 has a "slower curve of settling back after stopping an apnea occurrence". So basically if I hit 17-18 (yes it is that bad), it takes some 30-40 minutes to reach 7 again.

Not possible to adjust. Now I believe the knowledge in this group may give me a more hopeful answer. I want to have a similar "curve" as in the S8.

Otherways a total waste of time and a worry that when my S8 finally goes dead, I will be in a very bad place. S8 obviously not produced any more as I was not able to change for that. And since I do some air travel the lighter weight of the S9 would be great.

Any thoughts and recommendations appreciated!

Martin

[Lazer1234]

Hej Martin, kul att se en svensk här. Jag tror du skullke behöva höja ditt min.tryck så inte cpap:en får en "gummisnoddeffekt".
När du får apner så börjar den höja trycket och fortsätter av bara farten för långt, kanske tillkommer läckage som yterligare spär på tryckhöjningen.
Du borde ladda ner SleepyHead för att se vad som händer under sömnen också, annars är det mest gissningar om vad som sker.
Ladda ner SleepyHead och stoppa i SD-kortet i datorn, ladda sen upp en skärmdump av en typisk natt så kommer du att få bra support här i forumet. Fråga på bara om det finns frågetecken.
Det är inga problem att ändra inställningar själv, oavsett vad din sömnklinik säger.
Ps. Anslut dig gärna till våran svenska FB-grupp, Sömn o Snarkgruppen.
/Lars-Erik

[MartinJ59]

Tack för tipsen!

A Swede responding :-). Will take his advice of monitoring my sleep and loading it to Sleepy Head.
Martin

[retired_guy]

Martin, what is your average pressure? The one you stay under 90% of the time?

I believe your problem can be solved by narrowing the range. You are at minimum 7 and maximum 18? That's a fairly large range. What can sometimes happen is due to a leak or some other event, the machine can slide to the high end of the range when normally it just needs to run much lower. So for instance if your 90% is something like 12, then you could set your minimum to 9 and your maximum to 15. That narrowing of the range may provide you with a solution to your issue.

[justMongo]

You cannot change the pressure retreat rate.
The S9 raises pressure aggressively to flow limitation and snoring.
As Lars-Erik said, get a look at the data with SH.
Perhaps raise the min pressure a bit to limit the snoring and flow limitation that results in increased pressure. Control the leaks.

Gruß aus Uelzen,

Mongo

[surferdude2]

Consider lowering the maximum possible pressure since it's sometimes better to suffer an apnea episode than to be awakened by a farting.squealing mask telling you that it can't handle some unrealistically high pressure. The S9's factory setting is 4 - 20 and it gave me fits with leaks until I reset it to my own preferences and a more realistic upper limit. I'm running 7 - 15 now and getting AHI's of 1.9 with no mask leakage nightmares. If any apnea events need a higher pressure than 15, I'll be happy to review that with the software but not in the middle of the night.

[MartinJ59]

Thank you everybody!
Some excellent advice. I will start with measuring what values I get with the S8, to get a basis for comparison. Then start the S9 without tweaking for a night or two. Then I will try both narrowing the "spread" and capping the maximum a bit and see what happens.

As with so many other situations, users are a competent source of knowledge! So now time for increasing my own knowledge. I may well be the sort of user that puts my head in the sand and just ignore my problems as long as the treatment works OK. But realizing these problems (and the lack of advice offered at the clinic) made me aware that I need to read up and learn more.

[trish6hundred]

Hi MartinJ59,
WELCOME! to the forum.!
Hang in there for more responses to your post and best of luck getting your S9 to work as well as your S8.

[justMongo]

Some excellent advice. I will start with measuring what values I get with the S8, to get a basis for comparison.

Do you have the proprietary card reader and data card for the S8.
They are difficult to find and obtain. Sleepyhead will not work with it either.... you would have to use ResScan and load the one driver for the card reader.

I had to get my reader from a source in Israel.

[archangle]

Welcome to Apneabord!

You should definitely get the SleepyHead program (or ResScan) and monitor your S9 machine yourself.

You seem to be assuming the S8 machine is right and the S8 machine is wrong. It's possible that the S9 is doing the "right" thing and the S8 is doing the wrong thing. The S9 has a more advanced algorithm. It may be that there is some sort of breathing problem that the S9 detects and tries to treat, that the s8 doesn't.

Just because the S9 generates a pressure that is more uncomfortable doesn't mean it's wrong and the S8 is "right."

I seem to remember that the S8 AutoSet algorithm was more cautious about increasing pressure above 10 cmH2O because ResMed was worried about causing central apnea. The S9 can distinguish central apnea from obstructive apnea, and will increase pressure above 10 if it's an obstructive apnea, but won't increase pressure if it's a central apnea.

However, sometimes an APAP machine will "run away" to the wrong pressure and you have to "tame" it by turning down the maximum pressure.

I strongly encourage you to not simply turn the max pressure down, though. The S9 AutoSet records a lot of data that will help determine if you really need the higher pressure it's blowing.

One solution may be to increase the minimum pressure. Adjusting the mask to work over a large pressure range is difficult. If you really do need 17 cmH2O, it may be better to start at a higher pressure than 7.

Good luck.