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[Equipment] S9 AUTOSET SLOW TO RESPOND
#1
I assumed that an Autoset would progressively increase pressure during an Apnea to open the airways but my nearly new Machine does not increase pressure until after the apnea and breathing is resumed. This suggests to me that either the machine is faulty or I would be better using it in CPAP mode with a higher pressure setting to prevent the apnea in the first place. I used to use CPAP mode in S9 Escape using EPR 3 but it occurs to me that by the same token the lower pressure on expiration increases the the risk of onset of an apnea because it has less of a prophylactic effect. Feedback would be appreciated before I return the Resmed Machine under complaint. Incidentally, the S9 Escape would abruptly reduce noise and output (Detected by touch) but still show the correct pressure on the screen. Pointless to test it because when the machine is stopped and started again it is normal. Any similar problems?
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#2
is your pressure setting 13? if so, you are not using it in the auto set where there is a range of pressure and are using it in CPAP mode. I am sure you will get more ideas from other members. It probably would help if you could download SleepyHead and look at your data (or ResScan).
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#3
(12-12-2013, 04:52 AM)BILCO Wrote: I assumed that an Autoset would progressively increase pressure during an Apnea to open the airways but my nearly new Machine does not increase pressure until after the apnea and breathing is resumed.
the S9 autoset increase pressure if obstructive apnea detected (not if central apnea detected) does not try to treat the apnea that is detected (so not to cause pressure "run away" and lead to central apnea) but to prevent further obstructive events occurring. another line of defense, increase pressure in response to snoring and flow limitation which are indicator signs of obstructive apnea
having said that, the machine cannot perform miracles if the minimum pressure set too low nor to assume going to prevents all apnea events, AHI of 5 and below considered good result, of course the lower the better but AHI zero night after night is not possible, may be now and then
if wanted, you can also use the autoset in CPAP mode so deliver a constant pressure all night long (except ramp time)
the S9 escape even with an SD card is not going tells you any useful data other than how many hours using the machine each night



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#4
Billco, you might be jumping the gun a bit. Since it's free and very enlightening to see what your data tells you, I would encourage you to get Rescan or Sleepyhead and begin to learn how to interpret the data. You said the machine only increases the pressure after the event. How do you know? It seems to me that there is no way for any machine to anticipate an event, so it has to sense something happening and then react.

These machines are much more sophisticated than I imagined. From what you say, do I understand correctly that your machine is the Autoset model of the S9? I think what the Autoset is probably doing is reacting to an event, and then making changes to prevent further events, or keeping them from getting worse. That's the beauty of this machine.

There might actually be something wrong with your machine, but without looking at the data you really can't know what might be happening.
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#5
I am a new user too (less than a week) and I switched my S9 from CPAP to APAP the other night just to get a feel for all the different settings. On CPAP, my pressure was 12 with no EPR and my AHI was 0.8. However, it was taking me over an hour to get to sleep because I felt very agitated by the pressure on exhalation (I was experiencing mild anxiety/panic attacks because of it and would start gasping through my mouth) and I would wake up almost once per hour, get agitated again, and then try to fall asleep. Even though my AHI was low, I wasn't getting any sleep. I switched to APAP mode and my pressures have been fluctuating between 7 and 11, but I am falling asleep almost immediately and staying asleep all night. The downside is that my AHI is at 3.0 now, but I have almost no leakage. I think it's a good trade-off for me, as the agitation is gone, and I can sleep comfortably this way. Your mileage may vary.
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#6
what drgrimes said. Also, if you have it in straight CPAP mode, you are getting a set pressure for the duration of your sleep rather than a pressure range that is available with the auto set.
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#7
Hi BILCO,
WELCOME! to the forum.!
What everyone has said so far.
Hang in there for more responses to your post and best of luck to you.
trish6hundred
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#8
chezDan9

it is good that the auto set is helping your sleep quality, agitation, anxiety. And, an AHI of 3 is still within the preferred range. You are correct....the trade off is worth it for some of us. You said that you didn't have many leaks. Sometimes, events can occur during leaks and sometimes, depending on what the data shows, can be disregarded as an actual event. Hope this makes sense.
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#9
(12-12-2013, 05:54 AM)zonk Wrote:
(12-12-2013, 04:52 AM)BILCO Wrote: I assumed that an Autoset would progressively increase pressure during an Apnea to open the airways but my nearly new Machine does not increase pressure until after the apnea and breathing is resumed.
the S9 autoset increase pressure if obstructive apnea detected (not if central apnea detected) does not try to treat the apnea that is detected (so not to cause pressure "run away" and lead to central apnea) but to prevent further obstructive events occurring. another line of defense, increase pressure in response to snoring and flow limitation which are indicator signs of obstructive apnea
having said that, the machine cannot perform miracles if the minimum pressure set too low nor to assume going to prevents all apnea events, AHI of 5 and below considered good result, of course the lower the better but AHI zero night after night is not possible, may be now and then
if wanted, you can also use the autoset in CPAP mode so deliver a constant pressure all night long (except ramp time)
the S9 escape even with an SD card is not going tells you any useful data other than how many hours using the machine each night

(12-12-2013, 09:31 AM)chezdan9 Wrote: I am a new user too (less than a week) and I switched my S9 from CPAP to APAP the other night just to get a feel for all the different settings. On CPAP, my pressure was 12 with no EPR and my AHI was 0.8. However, it was taking me over an hour to get to sleep because I felt very agitated by the pressure on exhalation (I was experiencing mild anxiety/panic attacks because of it and would start gasping through my mouth) and I would wake up almost once per hour, get agitated again, and then try to fall asleep. Even though my AHI was low, I wasn't getting any sleep. I switched to APAP mode and my pressures have been fluctuating between 7 and 11, but I am falling asleep almost immediately and staying asleep all night. The downside is that my AHI is at 3.0 now, but I have almost no leakage. I think it's a good trade-off for me, as the agitation is gone, and I can sleep comfortably this way. Your mileage may vary.

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#10
Thanks for the feedback. I simulated an Apnea by closing my throat for over 10 seconds to see how quickly the machine responded and that is why I posted. It is interesting to hear comments about the Central Apnea which may be the answer to my misgivings about the machine. I do have the software by the way and try to analize sleep patterns and it is disappointing that the S9 Escape does not provide data and one of the reasons for me buying the Autoset. I have used a start pressure of 9 on the Autoset up to now but have increased it to 10 today to see how I get on. I have used this therapy for 10 years so am conscious of good and poor sleep quality which also affects my hypertension! Oxygen saturation levels generally over 96 Any comments welcomed about using EPR at 3 setting in CPAP mode would be appreciated. See my comments on the post.
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