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First night: some good, some bad. Need help.
#1
Last night was my first time trying CPAP therapy and when I first did the mask test, I thought I am never going to be able to do this (pressure 4 - 12), but after some adjustments, I hope I can get there.

I did a test sitting up and felt the machine was inhaling/exhaling far too quickly for me and that I would hyperventilate if I kept at that pace. After awhile it got much better, but I was still out of sync. 

So I went to bed, humidity level at 3, and temp at 80. Ramp set to 35 minutes. Took off auto and set to constant 4.8 just to ease gently into this business. After an hour of lying there focusing on all the noises and my breathing, I realized it wasn't too bad, but my breathing was too slow for the rhythm of the machine and then I started to think, what if I start inhaling on the machine's pressure relief and take in too much co2 and suffocate, so that kept me awake. Bug-eyed My mask pamphlet is what started these thoughts:

Quote:Explanation of Warning: CPAP/Bi-Level systems are intended to be used with special masks with connectors which have vents holes to allow continuous flow of air out of the mask. When the CPAP/Bi-Level machine is turned on and functioning properly, new air from the CPAP/Bi-Level machine flushes the exhaled air out through the attached mask exhalation port. However, when the CPAP/Bi-Level machine is not operating, enough fresh air will not be provided through the mask, and exhaled air may be rebreathed. Rebreathing of exhaled air for longer than several minutes can in some circumstances lead to suffocations. At low CPAP pressures the flow through the exhalation port may be inadequate to clear all exhaled gas from the tubing. Some rebreathing may occur. Do not use the mask without the Non-Rebreathing Valve in place while using nose plugs. This valve ensures CO 2 rebreathing is kept to a minimum in the event of power failure.


So, after a couple more hours of getting used to breathing, I realized my mouth was dry. Bumped up humidity to 6 (highest level) and temp to 81. Raised pressure to 5.8. 

Several hours into this, I am getting sleepy, but notice every time I am about to fall asleep I start to make snore noise which makes me alert again. Normally my snoring doesn't prevent me from falling asleep, but it sure did last night. I think I eventually fell asleep for a little bit on my side, but woke again after 4:30 and decided that was enough for one night. 

I don't understand my results. When I check my info under sleep quality it reads:

Period: Last night
Usage: 0
Mask fit: Green smile
AHI:  --

but when I toggle to Sleep Report it reads:

Used Hrs: 5.5hrs
Pressure 5.8
Leak: 1L/min
AHI: 2.3
Total AI: 1.8
Central AI: 1.0

Keep in mind I was awake for the majority of the night, but why the discrepancy in data?

The other thing is after I shut off "treatment" my machine still kept making low clicking noises. I know it blows air for 30 to dry out tubes, but this continued even after several hours. Should I just unplug every morning? Thanks for all the help.
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#2
The best data is a lot of data.
Can you please download SleepyHead and upload your charts,

See my signature to see how.  Pay attention to the section on organization as some charts are not as important as others.
And please keep your uploads to 1 thread so we can see history.

Thanks
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#3
(03-25-2017, 03:19 PM)bonjour Wrote: The best data is a lot of data.
Can you please download SleepyHead and upload your charts,

See my signature to see how.  Pay attention to the section on organization as some charts are not as important as others.
And please keep your uploads to 1 thread so we can see history.

Thanks

I'm on a chromebook, so I can't download. Too bad the developer doesn't offer online. At least he could make some money from the ads. 

Hopefully someone familiar with the S9 can explain why my info is showing two different sets of data.
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#4
I don't understand why you can't download Sleepyhead to a Chromebook..

Isn't it just another brand of laptop?

I use a Lenovo ideapad 100s which is supposed to be in the same bracket as the Chromebook, I use Google Chrome as my web browser.. and I had no problem downloading Sleepyhead to the Lenovo from the Sleepyhead link at the top of this page.

I'm no help on what data is available on the display unit of an S9.. but my Dreamstation display only shows basic nightly info such as hours use/last 3 days hours/AHI for the night/AHI average for day-week-month/mask fit, and not much else.

You may find you were asleep more than you thought... I used to think I didn't sleep well, but with the use of a VivoFit activity watch and the app on my phone I found I actually slept more hours than I thought I had for some nights (though still not as good as I needed).

CPAP is a learning curve, and takes time to refine your specific personal adjustments.. don't expect results to be good right from the start, you will get there progressively. 

For me, I'm watching my 6 monthly averages on the Sleepyhead program, I feel it is a better guide of my overall status and progress.
And for my commercial driving licence compliance the motor licencing authority is only interested in my 12 monthly averages to stay compliant. 

If you can learn to sleep on your side it will greatly reduce your snoring, and if you spend as much of that time on your left side it will also help reduce any GORD/reflux issues you may have (snoring is not a problem for me, but I do suffer GORD fairly significantly.. and I trained myself to sleep on my side around the age of 10-12 years old, then as reflux became a problem I concentrated on sleeping more on my left side)

You will make progress, give it time... and work through it in small steps, make small adjustments and allow a week or so for them to take effect. 

Welcome to the journey that is sleep apnea.  Oh-jeez

Cheers,
Ock. (aka Steve)
Coffee
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#5
(03-25-2017, 08:06 PM)Ockrocket Wrote: I don't understand why you can't download Sleepyhead to a Chromebook..

Isn't it just another brand of laptop?

I use a Lenovo ideapad 100s which is supposed to be in the same bracket as the Chromebook, I use Google Chrome as my web browser.. and I had no problem downloading Sleepyhead to the Lenovo from the Sleepyhead link at the top of this page.

I'm no help on what data is available on the display unit of an S9.. but my Dreamstation display only shows basic nightly info such as hours use/last 3 days hours/AHI for the night/AHI average for day-week-month/mask fit, and not much else.

You may find you were asleep more than you thought... I used to think I didn't sleep well, but with the use of a VivoFit activity watch and the app on my phone I found I actually slept more hours than I thought I had for some nights (though still not as good as I needed).

CPAP is a learning curve, and takes time to refine your specific personal adjustments.. don't expect results to be good right from the start, you will get there progressively. 

For me, I'm watching my 6 monthly averages on the Sleepyhead program, I feel it is a better guide of my overall status and progress.
And for my commercial driving licence compliance the motor licencing authority is only interested in my 12 monthly averages to stay compliant. 

If you can learn to sleep on your side it will greatly reduce your snoring, and if you spend as much of that time on your left side it will also help reduce any GORD/reflux issues you may have (snoring is not a problem for me, but I do suffer GORD fairly significantly.. and I trained myself to sleep on my side around the age of 10-12 years old, then as reflux became a problem I concentrated on sleeping more on my left side)

You will make progress, give it time... and work through it in small steps, make small adjustments and allow a week or so for them to take effect. 

Welcome to the journey that is sleep apnea.  Oh-jeez

Cheers,
Ock. (aka Steve)
Coffee

Hi Ock.

Chromebook runs on a completely different operating system, so no go. I don't like downloading software anyway, and don't like that some virus protectors tag it as malware. Maybe it is fine, but I wish it was offered online. The developer could make more money that way if he ran ads on his page as well as just suggested donations. 

Anyway, I do try to sleep on my side, but eventually my shoulders hurt and I have to move to my back. Since you are online, let me ask, how often do you clean your water container for the humidifier? My manual says every dang day. It also says to remove tubes and hang them up to dry. Why not just blow air through them and keep them attached?
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#6
G'day Snorilla.

In addition to the excellent comments above,I'd like to throw in a couple of additional ideas...

It's very unlikely that anybody would suffocate by rebreathing air in the mask. I don't think the masks would pass the regulatory tests if that was the case. I think your supplier is exercising an overabundance of caution.

I don't really understand when you talk about the rhythm of the machine being out of synch. This can certainly be the case with ASVs and some types of bilevel machines, but the S9 Autoset provides a fairly constant flow of air. It has no "rhythm". You may be experiencing the effects of EPR (expiratory pressure relief) which lowers the pressure a little when it detects you exhaling, then reverts to therapeutic pressure when it senses you're inhaling. If you have the EPR at a high level (eg 3) try reducing it to see if that helps.

Quote: the machine was inhaling/exhaling far too quickly for me and that I would hyperventilate if I kept at that pace.
I suspect you actually were hyperventilating and the machine was trying to keep up with you, rather than the other way round.

The machine resets is daily data at noon, but still stores the summary data in internal memory. I suspect you looked at the screen in the afternoon, by which time the previous night's data would have been re-set.

If you can't run SleepyHead on your Chromebook, have a look for CrossOver for Android which allows you to run a Windows task which might accept SleepyHead. As for the online suggestion, this was discussed here a few weeks ago. I think it's unlikely that JediMark (author of SleepyHead) will be in a position to take on that task in the near future.
DeepBreathing
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www.ApneaBoard.com


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#7
(03-25-2017, 08:31 PM)DeepBreathing Wrote: G'day Snorilla.

In addition to the excellent comments above,I'd like to throw in a couple of additional ideas...

It's very unlikely that anybody would suffocate by rebreathing air in the mask. I don't think the masks would pass the regulatory tests if that was the case. I think your supplier is exercising an overabundance of caution.

I don't really understand when you talk about the rhythm of the machine being out of synch.  This can certainly be the case with ASVs and some types of bilevel machines, but the S9 Autoset provides a fairly constant flow of air. It has no "rhythm". You may be experiencing the effects of EPR (expiratory pressure relief) which lowers the pressure a little when it detects you exhaling, then reverts to therapeutic pressure when it senses you're inhaling.  If you have the EPR at a high level (eg 3) try reducing it to see if that helps.

Quote: the machine was inhaling/exhaling far too quickly for me and that I would hyperventilate if I kept at that pace.
I suspect you actually were hyperventilating and the machine was trying to keep up with you, rather than the other way round.

The machine resets is daily data at noon, but still stores the summary data in internal memory. I suspect you looked at the screen in the afternoon, by which time the previous night's data would have been re-set.

If you can't run SleepyHead on your Chromebook, have a look for CrossOver for Android which allows you to run a Windows task which might accept SleepyHead.  As for the online suggestion, this was discussed here a few weeks ago. I think it's unlikely that JediMark (author of SleepyHead) will be in a position to take on that task in the near future.

Yes, I did notice it did seem to slow down as the night went on, so I guess it is sensing to some extent. I will try to set the ESR to 2, but before I do that, I will run a test with a bag. I meant to do that today, but now am too tired to do so. I want to see if the bag goes up and down with ESR on. If it is constant then I guess that will show it does need to sense my exhale in order to let up the pressure. Maybe my lungs are too small and my exhale just isn't powerful enough or maybe as you say I was hyperventilating. Interesting stuff. 

Yes, I did wake up in the afternoon, so you solved that mystery! Thanks. Every little bit of info really is a big help. I think I can scrounge up an old PC laptop somewhere and eventually get around to sleepyhead.
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#8
(03-25-2017, 08:30 PM)Snorilla Wrote: Hi Ock.

Chromebook runs on a completely different operating system, so no go. I don't like downloading software anyway, and don't like that some virus protectors tag it as malware. Maybe it is fine, but I wish it was offered online. The developer could make more money that way if he ran ads on his page as well as just suggested donations. 

Anyway, I do try to sleep on my side, but eventually my shoulders hurt and I have to move to my back. Since you are online, let me ask, how often do you clean your water container for the humidifier? My manual says every dang day. It also says to remove tubes and hang them up to dry. Why not just blow air through them and keep them attached?

I still don't get the "offered online" part, if you can access this forum aren't you already "online" ?  

I have shoulder issues too, but also have a back issue, so I toss and turn from side to side all night long.... I feel your pain, so to speak.  Smile

Cleaning of my mask is maybe once every two to four weeks, the hose maybe every couple of months, and the humidifier tank whenever it starts to look discoloured by calcification or the water is looking cloudy. 
The cleaning of the tank would be dictated by your available water quality, and any possible respiratory health issues you may have. 

Cleaning the mask and hose would be similarly dictated, though mask cleaning would probably be the most often due to skin oils building up and causing it to not seal properly against your face. 

Everyone has a different opinion on cleaning regimes and methods, so it is really more a case of finding what works for you personally in that respect.
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#9
I think you are going to need the sleepyhead program to get decent advice, other than what seems to be a common suggestion, set the auto pressure 2cm under mean pressure and 2cm above 95% pressure.

I would google for the resmed s9 clinician manual, which will help you check and adjust your settings

As to running the program, there are many ways I can think of, ranging from as old PC on the verge on rubbish collection days to using a computer at a library. craigslist etc.
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#10
(03-26-2017, 08:14 AM)ajack Wrote: I think you are going to need the sleepyhead program to get decent advice, other than what seems to be a common suggestion, set the auto pressure 2cm under mean pressure and 2cm above 95% pressure.

I would google for the resmed s9 clinician manual, which will help you check and adjust your settings

As to running the program, there are many ways I can think of, ranging from as old PC on the verge on rubbish collection days to using a computer at a library. craigslist etc.

Link to CPAP manuals can be found at the top of this page.  Bigwink
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