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#1
So I had my second sleep study and have quite a few health issues going on all at the same time. But as far as apnea related issues, what they concluded was that there was minor improvement on a low pressure and that raising the pressure made everything much worse. So my prescription was written for 5cm. In addition, it's already a known that I'm getting my tonsils out and possibly my upper palate worked on. I've only been with my CPAP about a week.

Getting it was a major hassle as only one DME in my area even managed to quote me the right price with insurance. And 4 of the 5 I visited only offered equipment without full data. However, the one I ended up choosing has been pretty awesome. Right off the bat they were handing me a S9 Elite, H5i, ClimateLine Hose and an AirFit P10. Sent me home at no cost on day 1. They lacked a bit in the settings, as they followed my doctor's prescription to the T, didn't turn on the data nor EPR, but I had already done my homework and made the additional changes myself.

7 Days in, I'm left with a few questions though. And yes, I totally understand that no one here is giving me medical advice, only informed opinions and all the responsibility is on me.

1.) My machine includes autoset, but it's set in CPAP mode. Being that higher pressures seemed to make my problems worse in my sleep study, rather than better, and having read a good few threads, I'm assuming that should probably be where I stay at? I'm tempted to turn the Autoset on and set it to min 4.0 and max 7.0 or something similar that is pretty low. Any opinions?

2.) I'm finding the AirFit P10 with large pillows to be pretty comfortable, but I really don't like the headband that much. I have long hair, it reaches halfway down my back, and the strap doesn't really work well with it. Not to mention, it just sort of sits at an odd angle and place. It's great that it's light and all, but I feel like maybe a behind the ears solution or something else might work better for me. I'm doing good on having almost no leaks and all that, I'm just looking for a solution that's more comfortable. Has anyone toyed with modifying it or using some other strap? Any suggestions?

3.) I've put my machine on a shelf on my nightstand with is enclosed on the back. The machine is almost exactly the same dimension horizontally as the shelf, and there's maybe 3 inches of space in the back. There's about an inch extra of vertical space when the humidifier is open. Any reason to think such an arrangement might cause a problem?

4.) I have pretty severe allergy issues and chronic sinusitis, which is part of what is going to cause me to have my tonsils out and possibly some sinus surgery. I asked the DME's rep if I should consider hypoallergenic filters and he said he thought it was often a waste of money and he also told me that he had so few patients using them they often didn't have them in stock. He said that the S9 filters were pretty nice. And being a pretty awesome guy, he said he would order them if I asked, but that I should be able to find them on the Internet for a much better price. Any insight on that? Are the hypoallergenic filters worth it or are the standard issue filters good enough? Really, any advice on filters appreciated.

5.) I've got the humidifier, I've got the hose. My natural body temperature runs high. My excitement level to find out what rainout is like first hand is less than zero. I'm already stuffed up plenty of the time, so adding to that isn't in the cards. Any advice on humidity and temp settings on my ClimateLine? DME said run the climateline 2 degrees above or below ambient. And said to work the humidity up from 3.0 until I no longer had congestion and irritation in the morning. But I've also got this nifty Auto setting sitting here. What's the preference, setting both the temperature and humidity manually? Humidity to auto and temp on manual? And last but not least, I noticed most people mentioning their temps on the ClimateLine were talking in the late 70s and early 80s. Is 70-74 really where I need to be?

6.) I turned on and messed around with the EPR. I know, I'm a wuss, 5cpm and I'm messing with EPR. I ended up sticking with it set on 1 with medium intervals. Any insight into the Fast interval or what the point would be to setting it to 2 or 3 with a pressure as low as mine?

7.) I saw at least one person with a solar setup. I might get around to do the same. I was wondering what really would provide a better efficiency, the DC adapter that ResMed offers,or a pure sine wave DC/AC inverter. I know there's likely only a few people with input there.

8.) I see quite a different versions of the S9 Elite mentioned. The bottom of mine, only says S9, as does the back. The top says Elite and EPR, but I also know for a fact it has Autoset. So what's the official word on what we call this thing here?

9.) How much data can the SD Card hold? I have it set to full data, and the card is a ResMed official 2GB card.

10.) Is there a good form letter anywhere for my doctor to use for flying with my CPAP?

11.) Do I actually need to empty out my humidifier resevoir every day? Even with it less than half full, I seem to have a lot of water left over. Any sort of range of how much water people generally go through? I hate to waste it.

12.) How much do people typically donate here? What's it cost to keep the place running and the people who run it in a happy place? How much money is approximately equal to love?

13.) Could we maybe add to the suppliers list/and or a section of comparisons on their policies and procedures? For me, looking at a pretty long list, which by numerical order gives subconscious precedence to some suppliers, I really had no clue what I was looking at. A little comparison chart with their return policies on equipment and masks, shipping policies, random notes. Maybe some of these suppliers are awesome at some random stuff and not others. I'd be happy to help put it together. It would just be a lot more useful to understand what the suppliers were like in a nice easy spot.

Lastly, thanks in advance for any answers you can provide.
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#2
G'day CKJ411, welcome to the forum.

I can't answer all your questions, but I'll have a go at a couple.

1, 8) What makes you think your machine has autoset? The Elite only does constant pressure according to Resmed's own site. Unless there's something new out, or you have a strange one-off, the model with Elite written on it is constant pressure and the one with Autoset written on it has variable (auto-setting) pressure. The model name is printed on top, near the power button.

2) I use a full face mask so I can't really comment on yours. The FFM uses a more comprehensive headgear which you may find better with long hair (that takes me back about 4 decades Smile )

3) Your setup sounds fine.

4) Sorry - don't know about the filters

5) I just set the climate control to auto and the temperature to 30. (Which would be about 80 - 85 in your strange American degrees). Never had a problem with rainout. This is probably something you need to try fr yourself and see how it goes. If you put it on auto, the machine takes into account the temperature and ambient humidity and adjusts the humidity through the hose to ensure rainout doesn't happen.

6) EPR is a personal comfort thing - there's no right answer. Try different settings and see what suits you.

7) Don't know

8) See 1)

9) Heaps! Mine has 27 Mb used out of 2 gig after 3 months. Resmed (for some stupid reason known only to themselves) erase the detailed flow data after 7 days, so you only get to keep the summary data. Most people here download to their computer at least once (and preferably twice) a week to make sure all their detailed data is saved.

10) Don't know - I've just taken mine as hand luggage with never a problem.

11) I just top mine up daily. On Saturdays I chuck out the water and give everything a good wash in warm soapy water followed by a very hot water rinse and air-dry.

12) I put in $25 but I think it's time to donate again. I don't know what this site costs to run, but from experience on another forum it is not cheap. The advertisements don't cover the full cost, and neither do the donations - I suspect the webmaster kicks in quite a lot of his own money.

13) Suppliers only get on the list by recommendation, so there is a basic level of assurance. I think what you're asking for would take a fair bit of management input.

Hope this has been of some help.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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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#3
Hi CKJ411 and Welcome to the forum. Welcome There is a ton of S9 users here that will be able to help you with your questions . Not a S9 user . I do know that the Resmed converter is more efficient then any inverter. If you do go the inverter way make sure it is a true sine wave inverter , Modified square wave inverters will mess up a S9 Humidifier and it won't like you any more. Blink This is one advantage PR have with being 12v DC operated (no converters needed ) just a dc cable . No you don't have to empty your humidifier tank everyday , you can just top off through the week then once a week dump it and clean the tank . Sounds like you shelve situation is fine you should have enough air movement around your machine , only thing I have noticed is when there is a hard surface near the air intake that it resonates the intake noise just glue a little bit of soft foam to the hard surface . seams to stop it. Sounds like your off to a good start . Cool
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#4
Hi CKJ411,
WELCOME! to the forum.!
I use the hypoallergenic filters.
I just add to the water that is left in my humidifier chamber and wash once a week. You'll get lots of opinions on that as you read the threads here on the board.
Hang in there for more answers to your questions and best of luck to you with your CPAP therapy.
trish6hundred
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#5
2.) I'm finding the AirFit P10 with large pillows to be pretty comfortable, but I really don't like the headband that much. I have long hair, it reaches halfway down my back, and the strap doesn't really work well with it. Not to mention, it just sort of sits at an odd angle and place. It's great that it's light and all, but I feel like maybe a behind the ears solution or something else might work better for me. I'm doing good on having almost no leaks and all that, I'm just looking for a solution that's more comfortable. Has anyone toyed with modifying it or using some other strap? Any suggestions?

Maybe try the Swift FX nasal pillows. Similar feel to the pillows of the P10 (but a little softer) with a much better headband. The downside of the Swift FX for me is that it doesn't use the diffuser on the vent as the P10 does - as a result, there is a pretty strong stream of air that comes out of the vent which will irritate anyone trying to sleep 6 to 8 inches from where your nose is pointed.

5.) I've got the humidifier, I've got the hose. My natural body temperature runs high. My excitement level to find out what rainout is like first hand is less than zero. I'm already stuffed up plenty of the time, so adding to that isn't in the cards. Any advice on humidity and temp settings on my ClimateLine? DME said run the climateline 2 degrees above or below ambient. And said to work the humidity up from 3.0 until I no longer had congestion and irritation in the morning. But I've also got this nifty Auto setting sitting here. What's the preference, setting both the temperature and humidity manually? Humidity to auto and temp on manual? And last but not least, I noticed most people mentioning their temps on the ClimateLine were talking in the late 70s and early 80s. Is 70-74 really where I need to be?

I set it to auto and set the temperature to around 80 and just leave it. During the winter, I use a whole container of water a night, while during the summer, a container lasts me 2 or 3 nights. I have no problems with rainout with the climateline set to auto (unless I over fill the water reservoir).

6.) I turned on and messed around with the EPR. I know, I'm a wuss, 5cpm and I'm messing with EPR. I ended up sticking with it set on 1 with medium intervals. Any insight into the Fast interval or what the point would be to setting it to 2 or 3 with a pressure as low as mine?

If you aren't having any trouble exhaling, just leave it where it is. If you have trouble exhaling, increase it. Don't worry about being a wuss - the setting is there for your comfort - do what feels comfortable.
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#6
By the way the difference between the EPR medium setting and the EPR fast setting is how quickly the machine moves from the exhalation pressure (4 in your case) to the inhalation pressure (5 in your case) when the machine notices you start to inhale. I haven't noticed any effect of the setting and I just leave it at medium.

By the way, based on what I have read, the lowest the machine will actually go in terms of providing pressure is 4 - so EPR 1, 2, and 3 should all have the same effect in your case.
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#7
(05-11-2014, 07:23 AM)CKJ411 Wrote: Getting it was a major hassle as only one DME in my area even managed to quote me the right price with insurance. And 4 of the 5 I visited only offered equipment without full data. However, the one I ended up choosing has been pretty awesome. Right off the bat they were handing me a S9 Elite, H5i, ClimateLine Hose and an AirFit P10. Sent me home at no cost on day 1. They lacked a bit in the settings, as they followed my doctor's prescription to the T, didn't turn on the data nor EPR, but I had already done my homework and made the additional changes myself.

7 Days in, I'm left with a few questions though. And yes, I totally understand that no one here is giving me medical advice, only informed opinions and all the responsibility is on me.

1.) My machine includes autoset, but it's set in CPAP mode. Being that higher pressures seemed to make my problems worse in my sleep study, rather than better, and having read a good few threads, I'm assuming that should probably be where I stay at? I'm tempted to turn the Autoset on and set it to min 4.0 and max 7.0 or something similar that is pretty low. Any opinions?
Is your machine an S9 Elite, which is a nice full efficacy data machine that only has fixed CPAP mode? Or is your machine an S9 AutoSet, which is a nice full efficacy machine that has both CPAP and APAP mode?

Quote:2.) I'm finding the AirFit P10 with large pillows to be pretty comfortable, but I really don't like the headband that much. I have long hair, it reaches halfway down my back, and the strap doesn't really work well with it. Not to mention, it just sort of sits at an odd angle and place. It's great that it's light and all, but I feel like maybe a behind the ears solution or something else might work better for me. I'm doing good on having almost no leaks and all that, I'm just looking for a solution that's more comfortable. Has anyone toyed with modifying it or using some other strap? Any suggestions?
The Bella Loops headgear for the Swift FX nasal pillows mask may be exactly what you want. But if you have attached ear lobes (like I do), you'll find the ear lobes get mighty sore after about 3 days. Even so, I love the Bella Loops when I'm dealing with sleeping on a hot, humid night and our air conditioning is not on.


Quote:4.) I have pretty severe allergy issues and chronic sinusitis, which is part of what is going to cause me to have my tonsils out and possibly some sinus surgery. I asked the DME's rep if I should consider hypoallergenic filters and he said he thought it was often a waste of money and he also told me that he had so few patients using them they often didn't have them in stock. He said that the S9 filters were pretty nice. And being a pretty awesome guy, he said he would order them if I asked, but that I should be able to find them on the Internet for a much better price. Any insight on that? Are the hypoallergenic filters worth it or are the standard issue filters good enough? Really, any advice on filters appreciated.
I'd insist on the hypoallergenic filters. I use the equivalent on my PR BiPAP and it makes a big difference during my main allergy seasons.

Quote:5.) I've got the humidifier, I've got the hose. My natural body temperature runs high. My excitement level to find out what rainout is like first hand is less than zero. I'm already stuffed up plenty of the time, so adding to that isn't in the cards. Any advice on humidity and temp settings on my ClimateLine? DME said run the climateline 2 degrees above or below ambient. And said to work the humidity up from 3.0 until I no longer had congestion and irritation in the morning. But I've also got this nifty Auto setting sitting here. What's the preference, setting both the temperature and humidity manually? Humidity to auto and temp on manual? And last but not least, I noticed most people mentioning their temps on the ClimateLine were talking in the late 70s and early 80s. Is 70-74 really where I need to be?
The Auto setting for the ClimateLine makes the humidifier and hose keep the relative humidity in the hose at 80%. Recall that as the temperature increases, the amount of water the air can hold goes up. In other words, air at 80degrees and 80% relative humidity contains more water than air at 70degrees and 80% relative humidity.

As for where you want to set the temperature on your ClimateLine: That's totally up to you and based on what feels best for your nose. Some people like a fairly high temp (and a greater amount of water in the air at 80% relative humidity.) Others dislike higher temps because for them it feels like they're sleeping in a swamp.

I've never used a heated hose and, quite frankly, I find the air in my unheated hose warms up plenty by simply blowing over the heated humidifier tank. I don't have any desire to have the air any hotter than it already is. Your mileage may vary, however.

Another thing to keep in mind about humidity: There's no one-size-fits all policy about what level of humidification is best. Some people find that 80% relative humidity makes the air too moist, and the extra humidity increases their congestion. Some people find that at 80% relative humidity the air is still too dry and the dry air increases their congestion. And some people find 80% relative humidity is the sweet spot for what their nose wants.


Quote:6.) I turned on and messed around with the EPR. I know, I'm a wuss, 5cpm and I'm messing with EPR. I ended up sticking with it set on 1 with medium intervals. Any insight into the Fast interval or what the point would be to setting it to 2 or 3 with a pressure as low as mine?
At a pressure setting of 5cm, EPR = 1, 2, and 3 are all going to do the exact same thing: They'll all reduce the pressure on exhalation to 4cm, the lowest pressure the machine will produce.

At pressures of 6cm or more, EPR = 2 will provide a 2cm drop in pressure at the beginning of the exhalation. At pressures of 7cm or more, EPR = 3 will provide a 3 cm drop in pressure at the beginning of the exhalation. But regardless of the EPR setting, the exhalation pressure will NEVER go below 4cm.


Quote:8.) I see quite a different versions of the S9 Elite mentioned. The bottom of mine, only says S9, as does the back. The top says Elite and EPR, but I also know for a fact it has Autoset. So what's the official word on what we call this thing here?
Please explain why you think a machine that clearly says "Elite" on the top is an AutoSet? My guess is that you really have an Elite if that's what the top of the machine says.

Quote:9.) How much data can the SD Card hold? I have it set to full data, and the card is a ResMed official 2GB card.
The S9 stores a year's worth of compliance and summary data on board in its internal memory, and it will write all the compliance data and summary data to the SD card when the card is inserted.

The S9 writes the daily detailed data and the daily high resolution data (the so-called Flow Rate data) directly to the SD card. If the SD card is NOT in the machine when it is running, that data will NOT be saved in the S9's on-board memory.

The S9 saves the last 7 days of high resolution data directly on the SD card. Once you have 7 days of high resolution data on the SD card, the oldest data is overwritten each night. In other words, the data for the night of Friday, August 1, 2014 replaces the data from Friday, July 25, 2014. Once the high resolution data is overwritten, there is no way to recover it unless you have made a backup of the data onto a computer.

The S9 saves the last 30 days of daily detailed data directly on the SD card. Once you have 30 days of daily detailed data on the SD card, the oldest data is overwritten each night. In other words, the data for the night of Friday, August 1, 2014 replaces the data from Tuesday, July 2, 2014. Once the daily detailed data is overwritten, there is no way to recover it unless you have made a backup of the data onto a computer.

The SD card will NEVER reach its full capacity: The total amount of data the S9 keeps around on the SD card is very small compared to the capacity of the card. But the S9 will overwrite the "aged" data even though there is plenty of room on the card.

The easiest way of backing up your SD card data on a regular basis is to probably use SleepyHead and make sure the "Create SD Card Backups during Import" box is checked in the SleepyHead preferences. You also need to remember to download the data at least once a week if you want all the Flow Rate data; if you don't care so much about the Flow Rate data, you need to import the data into SleepyHead at least once every 30 days.

You can also use ResScan to analyze the data from your machine, but ResScan will NOT create automatic backups of the files on the SD card itself.


Quote:11.) Do I actually need to empty out my humidifier resevoir every day? Even with it less than half full, I seem to have a lot of water left over. Any sort of range of how much water people generally go through? I hate to waste it.
Some people do dump the water every morning, clean the humidifier tub, and refill with new water each evening. But a lot of people are much less "fussy". Like many others, I routinely top off the humidifier tank as necessary and try to remember to dump it and clean it once a week or so.

As to how much water you'll use each night: That really depends on both the ambient conditions in your room and the settings for the heated hose and the heated humidifier. In general, if your bedroom air is humid, you'll use less water than if your bedroom air is dry. Likewise, if your hose temp is in the mid 80s you'll use more water than if your hose temp is in the low 70s.


Questions about SleepyHead?
See my Guide to SleepyHead
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#8
I see you are in Alabama. My situation with the humidifier is quite different from yours since I'm in Minnesota. In Feb. when I started using cpap, my humidifier ran out of water every night, and I used a gallon of it every 5 or 6 days, now, in the summer, I never use a full tank, but the amount of water I do use varies according to the fickle weather we've been having, but it's never more than a quarter of the tank... as a result, I dump it and rinse the humidifier then refill with what I think I will need according to the weather.
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#9
Quote:10.) Is there a good form letter anywhere for my doctor to use for flying with my CPAP?

I fly weekly and have never been asked for a letter. Thats both checked and carry on.
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#10
What can't_sleep said but only as carry-on for me. I do not check my CPAP.

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