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Clinician Setting on Older S9 Machine:
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DesertMax Offline

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Posts: 44
Joined: May 2016

Machine: ResMed S9 Vpap Auto
Mask Type: Full face mask
Mask Make & Model: ResMed Quatro Air Medium
Humidifier: ResMed H5i
CPAP Pressure: unsure
CPAP Software: Not using software

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Sex: Male
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Post: #61
RE: Clinician Setting on Older S9 Machine:
Or like this...
Ok system will not let me post jpg's over 500kb which makes my shots reeeeeeeeeeeeeeely tiny... I feel like I am working overtime at this and getting NOWHERE QUICKLY!!!


Attached File(s) Thumbnail(s)
   
(This post was last modified: 05-29-2016 01:00 PM by DesertMax.)
05-29-2016 12:58 PM
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DeepBreathing Offline
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Posts: 2,291
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: #62
RE: Clinician Setting on Older S9 Machine:
Max, the file you linked to Imgur was fine - good size and quite legible. It would also help if you could post a recent "daily" view so we can see some more detail.

My initial thought on the summary data you've presented is that you're changing your settings too frequently and your brain doesn't have time to acclimatise and stabilise its response to the new settings. Once you make a change don't touch it again for at least 5 days, preferably a week. Related to this is that we have to use the machine all night every night - which can be easier said than done. But if you're only using it a few hours each night then you won't be getting any sort of result.

Second thought is that you EPAPmin is too low, and should be up around the average.

Third, the number of clear airways is a concern. I don't recall if you had these at your initial sleep study or if they came later. It could mean that you need an ASV type machine. But let's work on the obstructive component first, eliminate those and see how the central apneas are going.

DeepBreathing
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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.
05-30-2016 07:52 PM
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DesertMax Offline

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Posts: 44
Joined: May 2016

Machine: ResMed S9 Vpap Auto
Mask Type: Full face mask
Mask Make & Model: ResMed Quatro Air Medium
Humidifier: ResMed H5i
CPAP Pressure: unsure
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #63
RE: Clinician Setting on Older S9 Machine:
Wow wow wow some good feedback... so valuable so grateful to you...

Ok I fiddle with it because I don't know what I am doing and spazzing out..
This is why I am here trying to make sense of it all.. I can be a very good student but is it not unusual to have been through 4 studies and 3 machines and still fumbling in the dark..? (literally!)

I will do as you suggest..

Q: "number of clear airways?" What does this mean?

I have a serious case of Complex SA so did have an ASV machine last but it was on a very mixed up and nasty greedy program I could not abide by and worse yet..
they didn't appear to know the **s from a popcorn machine let alone a breathing machine...

So this is what I want to know...? I should be in a "medical" environment to get the guidance I so desperately need but feel that here in Bend OR I have exhausted all possibility of that.. no credibility at all!
I am however going back to full time RVing in a month of so and can possibly get back on Medical in CA which I foolishly lost when I came up here in 2014.
Add to that the elevation here of 4K+ as well as terminal allergies and a serious one to Pine of all things.. (in Oregon???!!)

So things could get better.. Or... I will have a better quality of life in my RV and could just buy the ASV myself and learn how to set it up which would be my choice and which is what after all we are attempting to do here now anyhow!
05-30-2016 08:06 PM
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DeepBreathing Offline
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Moderators

Posts: 2,291
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: #64
RE: Clinician Setting on Older S9 Machine:
Quote:Q: "number of clear airways?" What does this mean?

Clear airway apneas are central apnea - where the brain doesn't tell the lungs to "breathe now". They are called clear airway apneas because your airway is not blocked or obstructed. They are also called central apneas because your central nervous system is not doing its job properly. (And this could be for a whole range of reasons). In your case the number of clear airway / central apnea is too high. This tallies with your comment that you have severe complex apnea, which is a combination of central and obstructive.

The correct treatment for complex sleep apnea is ASV. Without going all the way back through the last seven pages, I don't understand why you had an ASV but downgraded to the VPAP Auto. The great majority of members who have had intractable complex apnea problems have had great success with ASV. The machines are expensive and the insurance company will make you jump through hoops to get hold of one, but they are definitely the best treatment for central apnea and related conditions.

If you have the funds to purchase an ASV privately that might be the best way to go. The main manufacturers are Philips Respironics and Resmed. My personal preference is the Resmed, either the superseded S9 VPAP Adapt or the current Aircurve 10 ASV (or whatever it's called this week). The Resmed machines have limited setup options and rely on their software to optimise treatment. Very successfully in my case.

The Philips and Resmed machines have a very different "feel" and I always encourage people to try both if possible.

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.
05-30-2016 09:41 PM
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DesertMax Offline

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Posts: 44
Joined: May 2016

Machine: ResMed S9 Vpap Auto
Mask Type: Full face mask
Mask Make & Model: ResMed Quatro Air Medium
Humidifier: ResMed H5i
CPAP Pressure: unsure
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #65
RE: Clinician Setting on Older S9 Machine:
I appreciate your exceptional knowledge and concern.
I do know about Central of course but had not heard the term Clear.. Makes sense now..

Ok here is why I have the older machine: Bend Memorial Clinic (BMC) here in the Bend area of Oregon dispatched the last 2 machines to me. Both were set up wrong and nobody helped me get them to work. It was nothing short of uncanny and through my eyes.. very sad. In looking back over the paperwork, the doctors prescription for my last machine reads "BiPap S/T with settings of 15/1 cmH2O
and can't read his writing but it looked exactly like this...    

I lived in San Diego when I first became sick with Complex SA and they gave me the machine I have now.. S9 Auto. I use it because it is all I have. Why I gave back both machines? Both of them were actually making me sicker. The last one was blowing me up like a balloon until I got headaches and the "rate" or what I like to call cadence was way faster than my natural breathing rhythm. This made me light headed in what amounts to hyperventilating..
It was just wrong and I made repeated calls and sent repeated emails to Norco who is the outfit who dispensed the machine to me.. The entire support group was simply MIA! I now have filed a grievance against Pacific Source Insurance and BMC but don't expect much to come of it.. It's too cold for me here anyhow and as I mentioned, I am heading south soon and I will either begin the process yet once again or buy the machine I need and with your help, get the settings right for me..
I believe I can be helped but the sad truth is, I had no idea there was such a thing as "Clinicians Settings." Had I known this, I may be healthier today however as we all know, "doctor is the only one who can change the settings!"

Going back to full timing I will have the opportunity to save some cash so there is hope in that direction..
I did find a site called second wind cpap who sell slightly used machines and they appear to have what I need but what a shame it has to be this way..
Have you ever heard a story like this before..
05-30-2016 11:17 PM
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DesertMax Offline

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Posts: 44
Joined: May 2016

Machine: ResMed S9 Vpap Auto
Mask Type: Full face mask
Mask Make & Model: ResMed Quatro Air Medium
Humidifier: ResMed H5i
CPAP Pressure: unsure
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #66
RE: Clinician Setting on Older S9 Machine:
Hey DB, had another horrible night for May 30th 16.
I started out by lowering the epap I think it was that you suggested
and slept a few hours.. woke up with terrible dry mouth, head pounding and
spinning.. took a break and went back to bed afraid to use the dam thing..

To me, it feels like I sleep better these days without the machine.
I know that sounds reckless and removes the possibility for data but
don't know what else to do for now..

I am looking at next month getting to sea level and pretty sure that's going
to help... Here are the charts for last night.. I see the ClearAirway 23.01
again and only 3.04 Obstructive.. That at least is encouraging..
If I can just fix my brain@

           
(This post was last modified: 05-31-2016 02:01 PM by DesertMax.)
05-31-2016 01:58 PM
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DesertMax Offline

Preferred Members

Posts: 44
Joined: May 2016

Machine: ResMed S9 Vpap Auto
Mask Type: Full face mask
Mask Make & Model: ResMed Quatro Air Medium
Humidifier: ResMed H5i
CPAP Pressure: unsure
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #67
RE: Clinician Setting on Older S9 Machine:
This site is too complicated for me..
attaching files is mixed up and not understandable..
too dam many buttons all over the page..

Send it all back to the code basement and tell them to fix it..!!!
(This post was last modified: 05-31-2016 02:03 PM by DesertMax.)
05-31-2016 02:02 PM
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justMongo Offline

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Posts: 3,839
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

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Sex: Male
Location: Калифорния

Post: #68
RE: Clinician Setting on Older S9 Machine:
PS=9? where did you get that setting? You may be inducing pressure induced centrals with that wide split between IPAP and EPAP.

In my non-medical opinion, you end up with an EPAP that is too low to control obstructives; and with PS=9 added to EPAP, your IPAP is too high.
The large PS also results in CO2 washout that can result in CA.

(05-31-2016 02:02 PM)DesertMax Wrote:  This site is too complicated for me..
attaching files is mixed up and not understandable..
too dam many buttons all over the page..

Send it all back to the code basement and tell them to fix it..!!!

I believe you're smart enough to figure it out. It's just that your therapy is off; and it's difficult to think when you're feeling unwell.

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.
(This post was last modified: 05-31-2016 02:17 PM by justMongo.)
05-31-2016 02:14 PM
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DesertMax Offline

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Posts: 44
Joined: May 2016

Machine: ResMed S9 Vpap Auto
Mask Type: Full face mask
Mask Make & Model: ResMed Quatro Air Medium
Humidifier: ResMed H5i
CPAP Pressure: unsure
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #69
RE: Clinician Setting on Older S9 Machine:
Wow thanks.. that's a lot of corrections.. I'll try that tonight..
thank you soooooooooooooo much!!
05-31-2016 03:46 PM
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DesertMax Offline

Preferred Members

Posts: 44
Joined: May 2016

Machine: ResMed S9 Vpap Auto
Mask Type: Full face mask
Mask Make & Model: ResMed Quatro Air Medium
Humidifier: ResMed H5i
CPAP Pressure: unsure
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #70
RE: Clinician Setting on Older S9 Machine:
Oh forgot to ask?? Where do you think the PS should be? Any other settings I should change? thnx
05-31-2016 03:50 PM
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