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[Equipment] i am in desperate need of help
#1
hi everyone, i have recently been diagnosed with obstructive sleep apnea and my doctor prescribed a resmed s9 autoset with humidifier. the problem is i live in a third world country where people know little about sleep apnea. i had to purchase the machine online and i now have it but i do not know anything about. when i turn it on the pressure is very high and i don't know if this is normal or not. i don't know if i am supposed to set a pressure or it automatically adjusts and if i do have to set the pressure then how and what do i set it to. in my country they don't conduct sleep studies so i don't know what pressure to set it to. i am really suffering from sleep apnea and i need help. can anyone please help me?[/size][/font]
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#2
(10-30-2012, 05:57 PM)steven jackson Wrote: hi everyone, i have recently been diagnosed with obstructive sleep apnea and my doctor prescribed a resmed s9 autoset with humidifier. the problem is i live in a third world country where people know little about sleep apnea. i had to purchase the machine online and i now have it but i do not know anything about. when i turn it on the pressure is very high and i don't know if this is normal or not. i don't know if i am supposed to set a pressure or it automatically adjusts and if i do have to set the pressure then how and what do i set it to. in my country they don't conduct sleep studies so i don't know what pressure to set it to. i am really suffering from sleep apnea and i need help. can anyone please help me?

Hi Steven,

Welcome to the Apnea Board. You have come to the right place for help. Having said that, sleep apnea is pretty complicated, plus no two individuals are the same. Figuring it all out will take you a long time, so the first thing you need is to muster your patience. Don't try to accomplish everything at once.

I would suggest you start with a few things:

1) Get a copy of your sleep study and the prescription from the doctor. There are facts in those documents which will make it easier for people here to make appropriate suggestions.

2) Get the Clinician manual (available via e-mail from this site) for your machine. This will enable you to change the settings yourself.

3) Spend some time reading Apnea Board. You will learn a lot in the process, and you will also discover you have questions that you haven't thought of yet.

Fortunately you have one of the best machines currently on the market. However, you may not yet have the best mask. Anyone here will tell you that getting the right mask for you is by far the hardest part of the whole process. I went through eight masks before I found one that worked, and I am not unusual. If your mask is giving you fits, don't worry. There are about a hundred on the market, so you have lots more to try.

I would also suggest you get some software so you can view the data that your machine is producing. I'm partial to SleepyHead, which is free, open source, and available for Windows, Mac and Linux computers.
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#3
I forgot to say Welcome
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#4
Hi steven,
WELCOME! to the forum.!
I echo what JJJ said.
Best of luck and keep checking back in and ask as many questions as you need to, and keep reading the posts on this board for lots of GREAT and HELPFUL information.
trish6hundred
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#5
What JJJ said.

Did your sleep study just where you slept or did they also hook you up to a CPAP (called titration and/or split study)? If all you did was sleep and get the diagnosis, then you've got some work to do.

Like JJJ said, get the clinician manual here:
http://www.apneaboard.com/adjust-cpap-pr...tup-manual

With that, you can access the inner set up where you can set the pressure ranges. If you did the split study and you know what they determined was the best pressure for you, then you want to set the autoset to a few points below and a few points above it. Say they said you did best with 8. Then you may want the minimum setting to be 6 and the upper to be 10. Use the machine, get used to it, and in at least 2 weeks, you can then use the data to determine if that is the best setting. It probably won't be but now you'll have a baseline. You want to wait that long before making changes because it takes that long for a trend to develop. One night or even two just is not enough.

If you did not have the split study or at least the titration, then the same will apply. The settings will depend on several things, mostly tolerance. I'd not go lower than 6 as lower than that may make you feel as if you are not getting enough air. You are, but it will feel like you aren't. Perhaps set the upper one for 20 (the max it can go). Wait two weeks then evaluate the data.

You can use Sleepyhead or ResScan to view the data, both found here:
http://www.apneaboard.com/forums/Forum-P...-and-Links
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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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#6
Steve, welcome to the club. I too was recently diaguise with sleep apnea and after 2 sleep test and 3 months, I just picked up my new Resmed APAP Autoset on this past Friday. It sounds like to me that you have not set your pressure yet, and therefore the unit just blows air up to 20 cm/H20. I agree with the rest of the members that finding the right mask is really a battle! I'm somewhat lucky that I'm a nose breather, yet it took me 6 masks before I found that one that worked for me! Don't lose faith and continue to push through. It has taken me 9 weeks to get to the point I'm at now, and that is about 5.6-6 hours of sleep a night, however the mask stays on for the entire night! I never thought that I would be able to state this!! When I tried out the S8 I changed my own pressure which was set by the doctor at 12 for a CPAP machine, then went to a APAP machine which started at 8 and went up to 20. Alhough I never get up above 14, I could not fall asleep. I had to go into the unit and change the setting to a starting point at 11 and capped at 15. From that point, to where I'm now, took almost 3 weeks..........but it did come around.

Now like a baby, the S9 AutoSet starts at 8 cm/H20 and hardly ever goes above 12.6 cm/h20. My leak rate is around 20-24 and my AHI is 1.2 or below. However I now wake up rested, and I'm not falling asleep at work any time after noon. Wow, never thought it would happen! Don't lose the faith and keep pushing through!!!!
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#7
Hi Steve & welcome to the forum

It seems you were thrown into battle with an tool that you know nothing about & no one to help.

I don't have a ResMed machine but there are plenty of people here who do & can help with settings to start you off on the right track.

If you have a Internet connection good enough to view youtube videos & search for "resmed s9 autoset" you can get a lot if info on setting your machine & pressure (auto set so you are not starting at the highest pressure)

But I think JJJ has given you a very good set of steps to follow & PaulaO2 has given a good description of how the forced air should feel.

I remember the first time as soon as it was turned on I felt like I was unable to breath & sets off a panic.
It really does feel very unnatural.

There is a Ramp feature on your machine that will help to start, it will start with the lowest pressure & clime up to the highest pressure but this needs to be setup.

PaulaO2 has given a starting point as far as pressure ranges because if your pressure setting is too high you will not be able to get to sleep at all.

The beginning of using CPAP is very hard to get used to & you will most likely feel worse then you did before CPAP but it does get better.

This forum could be your best help with sleep apnea so come back & read & ask for help

One thing that would help users of this forum is to update your profile like Mask Make & Model.
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#8
(10-30-2012, 05:57 PM)steven jackson Wrote: hi everyone, i have recently been diagnosed with obstructive sleep apnea [...] in my country they don't conduct sleep studies so i don't know what pressure to set it to.

If you didn't have a sleep study then how were you diagnosed with obstructive sleep apnea?

If I were you I would call whoever it was that diagnosed you and prescribed a CPAP machine for you. Ask them what the pressure is supposed to be set at. Tell them that the pressure seems too high for you.

They will probably tell you to use the ramp feature. This should be a button on the machine that you push. It lowers the pressure and then slowly ramps it up to the level set by your doctor. You can probably adjust the ramp time so that you can fall asleep before the pressure reaches too high of a level.

You can practice this while you're awake and doing something relaxing like reading, listening to music, or watching TV. It will help you acclimate yourself to the machine.

Besides obstructive sleep apnea there are other forms of sleep disordered breathing, such as central sleep apnea or mixed apnea. Treatment of these disorders requires a more sophisticated CPAP machine. Only a sleep study can determine which disorder you have.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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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#9
Steven,

First of all, welcome to the forum, I'm glad you found us. Sounds like you're in a bad situation. We're not doctors, but we can help.

You've already gotten recommendations to obtain the clinician manual and ResScan software. These are two critical tools to have to provide information so we can help you.

My recommendation:
1. Use the machine as much as possible, every night if you can. Some people will use it during the day to acclimate to the mask, feel, etc.

2. After one week of use, run a report in ResScan. The numbers we need to know:
- AHI (Apnea Hypopnea Index)
- Unintentional Leak Rate (lpm)
- 95% Pressure (may be report as 90%, not sure)

There's a lot more information (a lot) but we can start there.

3. Set the machine lower pressure to about 4 cmH2O below the 95% number, set the machine upper pressure to about 2 cmH2O above the 95% number (rough Rule of Thumb)

4. Use the machine for another week or two, go back to step 1 and repeat based on your actual performance.

These machines are often supplied in what we call "Wide Open" settings, meaning 4 cmH2O - 20 cmH2O. Many people find this wide a range uncomfortable and, worse, less effective for treatement than a narrower setting range based on your use.

As I mention, you're going to see a huge amount of data. Don't get too caught up in it until we get through the basics.

So, if you choose to, we can try to help. Again, almost all of us aren't doctors. I'd never try to say we can replace proper professional treatment. We can help and it sounds like you need it.

Keep us up to date.

Sleep-well



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#10
Hi Steven, welcome to a great place with plenty of experienced people who can assist you to get started. Very sorry to hear that they do not conduct Sleep Studies in your country so it is a bit more difficult to start you at a pressure when there isn't a starting point from a Sleep Study. However you will learn a lot here, even by just reading other posts! I hope the best for you and please reply so we know how you are making out with the information thus far.
Tim
Finger Lakes Region, NY
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