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How to have the S9 Autoset to react faster?
#1
Hello, my first post.

I have diagnosed to suffer on mild apnea, but my main issue is that even one longer event with low blood oxygen level triggers migraine.
I have ResMed s9 Autoset with humidifier and Quattro mask, and have been tracking my progress with the ResScan software.

The therapy is working well and I have low AHI but I still get multiple apnea and hypoapnea events each night.

My problem is that sometimes the hypo event takes more than 30 sec before the autoset starts raising the pressure and these nights I wake up with migraine.

Is there a way to make the auto set react faster?

The pressure limits are min 6 and 15 max


Is there a way to adjust
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#2
Using software gives you a lot more info for making adjustments. You can download SleepyHead in the sticky threads and their is a guide also. Posting screen shots can help.
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#3
(07-08-2014, 06:43 AM)jty Wrote: Is there a way to make the auto set react faster?

The pressure limits are min 6 and 15 max

there is no way to change how the machine reacts to events.

what you can do is to look at your nightly reports, look at what pressure you're having events at, what pressures you stop having events at, and raise your minimum pressure to that area.

say if you typically have events at less than 9, then raise the min pressure to a little below that, or even to 9.

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#4
(07-08-2014, 06:43 AM)jty Wrote: The therapy is working well and I have low AHI but I still get multiple apnea and hypoapnea events each night.

My problem is that sometimes the hypo event takes more than 30 sec before the autoset starts raising the pressure and these nights I wake up with migraine.
The machine is NOT designed to increase the pressure during an event. This mimics part of AASM Clinical Guidelines for Manual Titration Sleep Studies. If two or more events happen close together the machine will increase the pressure after the second event is over. The Resmed S9 you are using also pretty aggressively increases the pressure in response to snoring and flow limitations.

Quote:Is there a way to make the auto set react faster?

The pressure limits are min 6 and 15 max
There's no way to increase the speed of the S9's reaction. (And it already has a reputation for being more aggressive in its pressure increases.)

You could try increasing the minimum pressure setting so that (1) fewer events get through to start with and (2) the machine has less far to go when it decides you need more pressure.

To illustrate: Let's suppose that your 95% pressure number is something like 10cm. In other words, your pressure is AT or BELOW 10cm for 95% of the night. This means that you sometimes need a pressure as high as 10cm to keep the apnea under control.

With a min pressure setting of 6cm the machine has to increase the pressure all the way to 10cm if a nasty cluster of events starts up. And even with its aggressive pressure increases, it's going to take the S9 about 4-5 minutes to increase the pressure from 6 to 10 cm.

With a min pressure setting of 8cm the machine only needs to provide a 2cm increase in pressure when a nasty cluster of events starts up. And the S9 can increase the pressure by 2cm in 1-2 minutes.

So with a min setting of 6cm and a need for 10cm, it can take the machine 4-5 minutes to fully respond. But with a min setting of 8cm and a need for 10cm, it only takes the machine 1-2 minutes to fully respond.

So the critical question is: What is your 95% pressure setting? If it's above 8cm, then increasing the min pressure may reduce the number of apneas/hypopneas that get through the PAP defenses and make it easier for the machine to respond to the ones that do get by.

Questions about SleepyHead?
See my Guide to SleepyHead
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#5
(07-08-2014, 06:43 AM)jty Wrote: Hello, my first post.

I have diagnosed to suffer on mild apnea, but my main issue is that even one longer event with low blood oxygen level triggers migraine.
I have ResMed s9 Autoset with humidifier and Quattro mask, and have been tracking my progress with the ResScan software.

The therapy is working well and I have low AHI but I still get multiple apnea and hypoapnea events each night.

My problem is that sometimes the hypo event takes more than 30 sec before the autoset starts raising the pressure and these nights I wake up with migraine.

Is there a way to make the auto set react faster?

The pressure limits are min 6 and 15 max


Is there a way to adjust

We actually could use a bit more information. First, as Robysue has suggested, depending on the 95% level for your pressure, it might be helpful to increase your low pressure a little. However, what events are you experiencing? OA's, Hypop's, CA's? If CA's then depending on what your overall AHI is doing, it might be appropriate to lower the high end a little. But we need to know what you're looking at. Including your leak numbers.
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#6
My wonder? In the above thinking, if the 95% rate is '10', why not set it to '11' - assuming it does not create any new issues like CAs and the like?

Otherwise, I do agree that raising the starting pressure to just below or just at the 95% pressure may be the answer in this one case.

*I* am not a DOCTOR or any type of Health Care Professional.  My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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#7
Hi, first, thanks a lot for the insightful responses. My pressure varies quite a bit, but typically the Max stays between 10 and 15. 95% varies between 8 (rarely) and 14. For the last month or so the 95% has been 9-12.

Mostly the leak is low (way less than 10L/min), 95% mostly 1-5. The catch is that I have to strap the mask very tight to prevent leaks but sometimes it just hurts too much and I loosen them up and cope with waking up multiple times with leaks.

Events are OA and CAs - I am mostly concerned about OA's lasting over 25 sec.

Edit: I seem not be able to post links so removing http://

Summary report:
1drv.ms/1jmHAGN

Details from last thursday:
1drv.ms/1oyFD7j
1drv.ms/1jmHQWf
1drv.ms/1jmHWx8
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#8
Your results look good jty, good job!

I'm more inclined to think your headaches/migraines are due to some other cause, probably the mask fitting.

If it's too tight that will create issues for you in sleep quality.

So try not to have it so tight. Using a mask liner can help with the leaks too. I'd rather see your leaks be a little worse and you be more comfortable.

If you can't make peace with the full face mask, you might consider a pillows mask such as my favorite, the Resmed P10. Yeah, yeah, I know,,,, can't breath through your nose --- all of that. Me too. That was my battle cry clear up until I actually did use them. Will never go back!
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#9
(07-08-2014, 03:47 PM)jty Wrote: The catch is that I have to strap the mask very tight to prevent leaks but sometimes it just hurts too much and I loosen them up and cope with waking up multiple times with leaks.
if you have to overtighten the straps to get better seal, more likely the mask is the wrong size/type, not fitting correctly, or cushion worn out
try another mask, don,t torture yourself
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#10
I get a few apneas from leaky masks. I use a full face mask. Remzzs, chin straps and Geckos all work to reduce leaks and lower the number of events.
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