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How to have the S9 Autoset to react faster?
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robysue Online
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Machine: PR Dreamstation BiPAP Auto
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Other Comments: Papping since September 2010

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Location: Buffalo, NY

Post: #11
RE: How to have the S9 Autoset to react faster?
(07-08-2014 03:30 PM)Peter_C Wrote:  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?
Because over titration can lead to comfort problems as well as increasing the probability of central apneas.

It's just not true that "more pressure" is always better.

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07-08-2014 06:55 PM
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robysue Online
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Posts: 1,245
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #12
RE: How to have the S9 Autoset to react faster?
First, I can't see the posted data.

Next you write:

(07-08-2014 03:47 PM)jty Wrote:  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.
A starting pressure of something in the neighborhood of 8-9 will probably be better than a starting pressure of 6.

Quote: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.
If the mask hurts, it's the wrong mask.

Seriously, if you have to tighten the mask to the point of pain, there's something wrong with the mask choice. And mask pain could be part of what's triggering the migraines rather than the stray H or OA getting by the PAP defenses.

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07-08-2014 06:59 PM
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zonk Offline

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Machine: A10 AutoSet
Mask Type: Nasal mask
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Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #13
RE: How to have the S9 Autoset to react faster?
(07-08-2014 03:30 PM)Peter_C Wrote:  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?
95th percentile 10 does not mean pressure was 10 all night long, mean pressure was at or below 10 for 95% of the night
how long was at 10, cannot tell without seeing the detailed data graphs

i think, you need at least 3 months worth of data to make any sense of the data. in the past my 95th was about 18, now on average sit on 11
things take time just like good bottle wine, improves over time
07-08-2014 07:48 PM
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trish6hundred Offline

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Machine: Resmed S9 AutoSet for Her
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CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

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Post: #14
RE: How to have the S9 Autoset to react faster?
Hi jty, WELCOME! to the forum.!
Hang in there for more responses to your post and best of luck to you.

trish6hundred
07-08-2014 08:06 PM
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diamaunt Offline

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Machine: S9 VPAP Auto 36006
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Location: texas

Post: #15
RE: How to have the S9 Autoset to react faster?
(07-08-2014 06:55 PM)robysue Wrote:  It's just not true that "more pressure" is always better.

what? you mean I shouldn't have set mine on 25 and left it there?

I'M JUST KIDDING!!!
07-08-2014 08:24 PM
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archangle Offline
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Post: #16
How to have the S9 Autoset to react faster?
(07-08-2014 06:55 PM)robysue Wrote:  
(07-08-2014 03:30 PM)Peter_C Wrote:  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?
Because over titration can lead to comfort problems as well as increasing the probability of central apneas.

It's just not true that "more pressure" is always better.

I agree with robysue. However, a higher pressure is sometimes worth trying. I'm convinced I feel better with my minimum pressure set a bit higher than the AHI numbers would suggest. I'm guessing that I get some distress from a partially compressed airway even if it doesn't trigger actual apneas. I guess this could also be some form of UARS or RERA's.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
07-08-2014 11:40 PM
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Sleepster Offline
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Post: #17
RE: How to have the S9 Autoset to react faster?
(07-08-2014 11:40 PM)archangle Wrote:  I'm guessing that I get some distress from a partially compressed airway even if it doesn't trigger actual apneas. I guess this could also be some form of UARS or RERA's.

Of course you have UARS (aka Flow Limitation). You have to have that to have hypopneas and apneas. It's not like your airway goes from fully open to fully closed. On the way it's first restricted enough to cause flow limitation and then hypopnea, even if they don't last long enough to score.

If the airway stops collapsing before it becomes restricted enough to become a hypopnea and stays there you've got flow limitation. It should show up on the flow limitation graph, you can see it in the waveform, and the fact that it triggers a rise in pressure makes it easier to find on the waveform.

How much distress this causes in terms of desat and arousal (RERA) is just about impossible to determine without sleep lab equipment. An oximeter might help.

The only way to have the S9 Autoset react faster to these events is if the pressure is already reasonably high when they occur. Then they are stiopped faster and are also less likely to occur.

All this has to be weighed against any issues such as aerophagia or centrals that might be caused by the higher pressure.

Stepping up to the S9 VPAP Auto might be worth a try, too.

Sleepster
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07-09-2014 12:31 AM
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jty Offline

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Post: #18
RE: How to have the S9 Autoset to react faster?
People, thank you for your insightful responses. I learned more about my specific condition here than visiting a specialist who did not bother to look into the details.

(07-08-2014 06:59 PM)robysue Wrote:  First, I can't see the posted data.
I apologize, the Forum did not let me add links to the images.
Attached the summary report, it takes up all my allowed attachment space.

The detail reports should be visible by copy pasting the links below to the web browser:
1drv.ms/1oyFD7j
1drv.ms/1jmHQWf
1drv.ms/1jmHWx8


Attached File(s) Thumbnail(s)
   
07-09-2014 01:01 AM
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jty Offline

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Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Quattro FX M
Humidifier: H5i
CPAP Pressure: 6-15
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Location: Finland

Post: #19
RE: How to have the S9 Autoset to react faster?
(07-08-2014 03:57 PM)retired_guy Wrote:  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!

(07-08-2014 04:21 PM)zonk Wrote:  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

(07-08-2014 04:53 PM)Lukie Wrote:  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.

Thanks guys for the suggestions, I am working on my nasal issues to be able to use the nasal pillows with the chin strap. Looking forward for that to help
07-09-2014 01:06 AM
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robysue Online
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Machine: PR Dreamstation BiPAP Auto
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Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #20
RE: How to have the S9 Autoset to react faster?
jty,

Could you zoom in on that cluster of events that took place between about 1:45 and 2:15 in the figure at

https://onedrive.live.com/?cid=67F09A01B...Fta_CI&v=3

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07-09-2014 10:33 AM
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