New and Confused

[Sky Puncher]

Sky Puncher,
What you appear to have is an S9 Vpap S BiLevel.  This machine has a Cpap mode (straight pressure) and a BiLevel mode.  
This machine may be data capable, I’m thinking it is.  Can someone confirm?

Go ahead and download the free Sleepyhead software and once you use the machine, see if you can
use the SD card with the software.  

My suggestion is to set up in Cpap mode to start with a lower pressure, since we don’t know the severity of your sleep apnea.  

It may be harder to find the correct pressure for you, but not impossible.

You can order a Clinicians manual, see link at top of page.

Is there a big difference between certain machines that have an SD card slot? I've been working with computers since I was a pre-teen and I just assumed if it carried an SD card slot that the machine has the ability to gather data. Also, not sure if it helps but the machine came with a pamphlet with a SD card holder to have whatever is recorded onto the card be looked at by doctors so I don't know if that helps you or not.

Thanks for suggestion and I will of course be doing that. I saw the setting but didn't change it to CPAP but I will. And thanks for the info, if it's documentation that came with the machine then I probably have it but I'll check that link out when I have a spare moment. Oh, and I already have the Sleepyhead software downloaded and installed. I can't use the machine until I get my new mask, hose and filters in by Monday I believe. Once I do use the device will the readings be easy to understand or will there be a place I can put the data in to get a better idea of what I need to do?

I have one more question if all of you don't mind. Like I said before I'm not new to having Sleep Apnea but I am new to the medical side of it. Can stress have a great impact on how bad apnea can get during the night?

Thanks again and thanks everyone for making me feel welcome here.

[OpalRose]

Just be sure the SD card is in the machine while using it.  Also, lock the SD card when inserting in the computer.  

SleepyHead isn’t hard to understand, but there is a lot of data.  
Here is a link to the Beginners Guide to SH.  
http://www.apneaboard.com/wiki/index.php...SleepyHead

I’m hoping your machine works with the software, but we will find out.  

To answer your question:  Stress/anxiety can certainly have an impact, especially on sleep quality.
This would be something to talk to your doctor about.  Once your machine is set up correctly, and you are able to sleep, it should make a huge difference in how you feel.

Since there is no sleep test to go by, you could try to set the machine at a pressure of 8cm and see how that goes.  Once we can see some data, we’ll know more.

What mask did you order?  Just a note... masks can be the hardest part of this.  One size does not fit all, and with the many type of masks out there, you may need to try out a couple.

http://www.apneaboard.com/wiki/index.php...ask_Primer

[Sleeprider]

Skypuncher, I'm a bit late, but wanted to say you have an excellent machine.  If you want to eliminate all traces of odor, just get some regular Ozium at the auto parts store, spray a piece of paper towel or cotton ball lightly with the ozium, and put that cloth next to the machine intake and run it a few minutes. I have even cleared cigarette smoke with this technique. 

In order to properly self-titrate you are going to have to record the data and make some adjustments, but this is not hard to to do.  When a clinic titrates you for the correct pressure, they use the protocol below.  As you can see, starting with the first question, since you have not been on CPAP before, the recommended initial setting with your machine is IPAP 8.0 and EPAP 4.0 and turn Easy Breathe ON.  Also be sure to change the Essentials setting from ON to PLUS.  These should be your starting pressures.

Just follow the chart, increasing both EPAP and IPAP for obstructive events, then once OA is less than 2-3 per hour, adjust for hypopnea by increasing IPAP.  If central events occur we will bring EPAP and IPAP closer together (subtract from IPAP).  Download #Sleepyhead and follow the instructions in my signature to post the charts as an attachment.  You really got a winner of a machine. 

[mdhampton]

As a personal note, I'd only suggest EAP at pressures > 15.

[Sleeprider]

As a personal note, I'd only suggest EAP at pressures > 15.

What is EAP, and why only at pressure greater than 15?

[Sky Puncher]

Skypuncher, I'm a bit late, but wanted to say you have an excellent machine.  If you want to eliminate all traces of odor, just get some regular Ozium at the auto parts store, spray a piece of paper towel or cotton ball lightly with the ozium, and put that cloth next to the machine intake and run it a few minutes. I have even cleared cigarette smoke with this technique. 

In order to properly self-titrate you are going to have to record the data and make some adjustments, but this is not hard to to do.  When a clinic titrates you for the correct pressure, they use the protocol below.  As you can see, starting with the first question, since you have not been on CPAP before, the recommended initial setting with your machine is IPAP 8.0 and EPAP 4.0 and turn Easy Breathe ON.  Also be sure to change the Essentials setting from ON to PLUS.  These should be your starting pressures.

Just follow the chart, increasing both EPAP and IPAP for obstructive events, then once OA is less than 2-3 per hour, adjust for hypopnea by increasing IPAP.  If central events occur we will bring EPAP and IPAP closer together (subtract from IPAP).  Download sleepyhead and follow the instructions in my signature to post the charts as an attachment.  You really got a winner of a machine. 

Thanks. I bought a ton of the Ozium when I moved into my last apartment and thankfully have a few left over. That's one of those ideas that hit me with the thought of, why didn't I think of that, especially since I use the stuff all the time to get rid of annoying odors. Thanks again.

And thank you and everyone else that has given me some hope on doing this without a study. I know it'll be tough and I know it might not work but until then I'm going to keep learning and keep trying.

Thanks for the chart, I only understand about 5% of it but hopefully that'll be enough for right now.

As for the mask. It's just a replacement for the one that came with the device. It looks exactly the same and to be honest haven't really seen much difference between other masks online besides the full mask that cover both mouth and nose. I'll have more of an opinion when I try it out for the first week I'm sure.  That's about all I know about it. It's probably a cheap knock off or something as the product description didn't have a company name to the listing. Once I get it in the mail I'll update.

[DeepBreathing]

G'day again Sky Puncher. Looking at the posts above I can see some conflicting advice which depend on which mode you want to set the machine in. The VPAP S is a bi-level machine, which means it can set one pressure level for inhaling (IPAP) and a lower one for exhaling. This is S mode. Alternatively you can set it for a constant pressure - this is CPAP mode. However with CPAP mode the machine can lower the pressure as you exhale - this is called expiratory pressure relief (EPR). From the Resmed manual:

CPAP mode
A fixed pressure is delivered.

With optional Expiratory Pressure Relief (EPR)—
EPR can help ease any discomfort that your patient
experiences when breathing out during treatment.

S (Spontaneous) mode
You may set two treatment pressures-–one for inspiration
(IPAP) and one for expiration (EPAP). The VPAP senses
when the patient is inhaling and exhaling and supplies
the appropriate pressures accordingly. The difference
between IPAP and EPAP levels helps determine the tidal
volume.

With Easy-Breathe ™
You have the option to select the comfort feature Easy-
Breathe.

In the posts above, Opal Rose has assumed you will be using CPAP mode, and SleepRider has assumed you'll be using S mode. To some extent it doesn't matter which one you choose as they have a similar effect, but are not identical. In your shoes I'd be inclined to try S mode first as the relationship between EPAP and IPAP are more direcly controlled and you have more flexibility.

And at this stage you probably need to have a look at our glossary of acronyms and abbrevations. http://www.apneaboard.com/wiki/index.php?title=Acronyms

Is there a big difference between certain machines that have an SD card slot? I've been working with computers since I was a pre-teen and I just assumed if it carried an SD card slot that the machine has the ability to gather data. Also, not sure if it helps but the machine came with a pamphlet with a SD card holder to have whatever is recorded onto the card be looked at by doctors so I don't know if that helps you or not.

The difference is in the quantity and type of data that's collected. The "brick" types machines such as the S9 Escape record usage hours, but no usable data. You VPAP S will record a full suite of data including the hours used, how many apneas and hypopneas you experienced, snoring and a whole lot more. #SleepyHead will allow you to interrogate all this data.

Also be sure to change the Essentials setting from ON to PLUS.

Essentials is a means of preventing the patient from seeing all his data on the machine's screen. I'm pretty sure that Essentials doesn't apply to the S9 machines and was an innovation in the later A10 series. In the S9 series the equivalent function is given by "sleep quality" which can be set to "on" or "usage". It should be set to "on".

[Sky Puncher]

I'm a little glad for the conflicting advice since I've learned a great deal about the machine and how it works and don't feel so overwhelmed.

I've changed it back to S mode and have kept the default IPAP to 8.0 and EPAP to 4.0 with Easy-Breathe On. And I also made sure the Sleep Quality function is set to On. I was going to keep everything else to default unless advised differently.

Another quick question. My machine says 1/2 treatments when working. Does anyone know what that means? I assume the machine has the ability to have two separate treatment options and you can just pick the one you want but again that's just an assumption. 

Also, maybe I'm just not understanding. I keep seeing people ask me about my mask. Why is that so important? I get size should be a factor but does it really matter who makes it? And does it really matter if I don't select the right mask on my machine's options?

I'm glad I don't have a brick of a machine and that this one is fully capable of maybe helping me with my health.

I think this is going to be one interesting journey come this week. It sure would be nice to fix my 3-4 hours of sleep a night, which of course isn't that accurate since I'm not doing a whole lot of sleeping within those 3-4 hours. I'm not really all that sure I know what it feels like to wake up well rested, if I've felt it before it was too long ago for me to remember.

Again, thank you all for all the advice, conflicting or non-conflicting. I've learned a lot so far and I'm sure I'll continue learning as the days go on. You have no idea how completely lost and overwhelmed I felt when I first came to this board and how much weight has been lifted off me with each reply so thank you, thank you, thank you!

[Sleeprider]

I'm not sure what the 1/2 treatments display means, and will have to defer to someone with the S9 VPAP-S.

Masks come in different forms, from the minimalist nasal pillow to the large full face mask. In between are some nasal masks and hybrids. Finding a mask that is comfortable, fits well and meets your needs is actually one of the harder tasks in starting PAP therapy. If you want the lightest smallest and quietest mask available the Resmed Airfit P10 has no equal. I think the Mask Primer in my signature is a good read.

[OpalRose]

Yes, it can be overwhelming, so just take it one step at a time.

And don’t worry so much over which mode you start in.  That’s we we like to look at a screenshot of your data after a couple days use.  If something isn’t working, we can advise at that time to try a different setting.

I don’t know what 1/2 treatments mean, but I’m sure someone else will.

We only ask about what mask you ordered, because so many folk have fit problems which cause leaks.  With high leaks, your machine may not be able to detect Apnea events.  Not something to worry about right now.