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Newbie : 1st trial with Resmed S9 Auto
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SleepEZ Offline

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Posts: 37
Joined: Jul 2013

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed H5i
CPAP Pressure: Autoset (7 - 13)
CPAP Software: SleepyHead

Other Comments: Respironics Premium Chinstrap. Had to buy myself. My DME ignored prescription and many requests.

Sex: Male
Location: Des Plaines, IL

Post: #11
RE: Newbie : 1st trial with Resmed S9 Auto
I heartily second SuperSleeper's comments. Last night was my 5th on my S9 Autoset. My prescription was written as a set-CPAP at 11 CWP, but I really struggled for the first 4 nights. I don't see the doctor till about the third week of September, so couldn't imagine myself existing till then with the results I was getting.

So, after resisting the temptation for 4 days, last night I got into the Clinician's Menu and turned on the Autoset option. Set a range of 7 to 12, covering my prescription, then set a short ramp time, put on my mask, and went to sleep. The next thing I heard was the alarm this morning.

I can't believe how sleep quality improved and how much better I felt. Usually I don't mess with sleep data when I get up at 5 AM, but was really anxious to see my results. The device ranged between 7 and 9 (hit 9.5 once); and it stayed in the 7 to 8 range most of the night. My AHI went from 33.97 the night before to 5.77, with my Hypopnea Index at .26 and Apnea Index at .0. CAs went from 253 the night before to 40 last night. So, while my body needs to continue acclimating to the machine, I think CAs will soon be a non-issue.

Also, during the first 4 nights I had leak rates off the charts (peaking between 30-55), but had leak rates last night at nearly -0- all night except for just a few spikes that I suspect were related to changing position in bed. And I really don't think I mouth-breathed at all where I was blowing up a storm other nights.

All of the above to say that I feel my personal research ... and knowledge and taking the initiative to change the settings, even at this early stage in my treatment, are helping me to make huge advances rather than spend weeks of frustration waiting to see the doctor, only to wonder what changes he'd want to make in my settings. I haven't talked enough with him about technical settings to know his philosophy of treatment, but my guess is he's a bit "old school" and would want to stick to straight CPAP.

So, my recommendation would be to do lots of research and don't make hasty decisions or huge changes, but informed ones. And, stay tuned in to this forum. It has been an incredible help to me in the short time I've been a member. Smile

(08-14-2013 02:35 PM)SuperSleeper Wrote:  I second the "take control of your own therapy" idea. That's what Apnea Board exists for, really: Patient Empowerment. Coffee

Patients who take a more active role in their own therapy tend to have much better results overall. I wish all medical professionals would realize this, but unfortunately a few of them have a condescending attitude towards their patients. Don't let that stop you from taking an active role in your own therapy. Since you described yourself as a "certified geek", I suspect that you'll enjoy getting into the data that the ResScan or SleepyHead software provides.

That doesn't mean that we ignore the advice of the health care professionals - it only means that we educate ourselves as best we can to understand our condition and treatment options as much as possible to maximize effectiveness & comfort ......
08-14-2013 08:04 PM
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Tez62 Offline

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Posts: 837
Joined: Feb 2013

Machine: Resmed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: Resmed
CPAP Pressure: 5-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Melbourne, Australia

Post: #12
RE: Newbie : 1st trial with Resmed S9 Auto
(08-14-2013 05:22 PM)dodgyblue Wrote:  Well. . Still can't wear the mask past midnight. Been going to bed earlier at about 9.30pm to try and get used. I have downloaded the resscan software and retrieved info for the 1st night (usage of 4.5 hrs) and the ahi was 17.5... maybe that's why half the time I felt the machine was blowing enough air to puff my cheeks out. . Besides I found out she programmed the s9 to have min pressure of 6 and max of 20. I changed that to 5.4 and 10. So last night felt a lot better.. I still managed only 2.5 hours only but ahi was 4.5.

I've thing i want to ask is. . The minimum pressure shouldn't really be set too to the extent it feels like air is being forced into lungs doing normal breathing. I tend to take long deep breaths and long exhalations when sleeping and a few times while still awake it seemed to me the machine is trying to force me to breath faster. Is there a setting to affect that? The only thing I can think off is setting the min pressure lower.

Btw.. setting humidifier to off with the reservoir filled worked. No stuffy nose. Also setting the temp to 25C May have helped. Will have to download data tonight and see.

Thanks for comments so far

dodgyblue, it is a bit of trail and error, everyone is different, are you using the ramp feature? I would change it to 4 and set your ramp between 0 - 30minutes whatever you are comfortable with that way it doesn't start raising till it hits the minutes you select. I don't think you will find a lot of difference between 4 and 5.4 but give it a try for a few nights. You really need to try these things over a week or more because you have to adjust to them and that takes a few nights. Your AHI may also take a few days to come down but anything under 5 is good. You may want to look at your EPR settings in the future, not sure what yours is set at, this is also a comfort setting.
08-14-2013 08:14 PM
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dodgyblue Offline

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Posts: 9
Joined: Aug 2013

Machine: Resmed Autoset S9
Mask Type: Full face mask
Mask Make & Model: Resmed Quattro Air
Humidifier: Resmed H5i
CPAP Pressure: 6-20 APAP
CPAP Software: ResScan

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Sex: Male
Location:

Post: #13
RE: Newbie : 1st trial with Resmed S9 Auto
(08-14-2013 08:14 PM)Tez62 Wrote:  dodgyblue, it is a bit of trail and error, everyone is different, are you using the ramp feature? I would change it to 4 and set your ramp between 0 - 30minutes whatever you are comfortable with that way it doesn't start raising till it hits the minutes you select. I don't think you will find a lot of difference between 4 and 5.4 but give it a try for a few nights. You really need to try these things over a week or more because you have to adjust to them and that takes a few nights. Your AHI may also take a few days to come down but anything under 5 is good. You may want to look at your EPR settings in the future, not sure what yours is set at, this is also a comfort setting.

I have set the ramp feature. Starts off at 4 and over a 5 minute period. No issues with that. Haven't looked EPR at the moment will do that tonight. It may be set to off at the moment. As many have indicated, its a trial and error with settings at the moment to see what works for me. I think the lower min pressure really helps at the moment..so I will set it to 4. Haven't had time to download the data at the moment but thanks guys for all the good suggestions!
08-14-2013 08:55 PM
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Tez62 Offline

Monitors

Posts: 837
Joined: Feb 2013

Machine: Resmed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: Resmed
CPAP Pressure: 5-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Melbourne, Australia

Post: #14
RE: Newbie : 1st trial with Resmed S9 Auto
(08-14-2013 08:55 PM)dodgyblue Wrote:  
(08-14-2013 08:14 PM)Tez62 Wrote:  dodgyblue, it is a bit of trail and error, everyone is different, are you using the ramp feature? I would change it to 4 and set your ramp between 0 - 30minutes whatever you are comfortable with that way it doesn't start raising till it hits the minutes you select. I don't think you will find a lot of difference between 4 and 5.4 but give it a try for a few nights. You really need to try these things over a week or more because you have to adjust to them and that takes a few nights. Your AHI may also take a few days to come down but anything under 5 is good. You may want to look at your EPR settings in the future, not sure what yours is set at, this is also a comfort setting.

Just on the EPR I have mine set at 3, orignally it was at 0 and I couldn't breathe out and changed it each night till I got to 3, good luck with it.

I have set the ramp feature. Starts off at 4 and over a 5 minute period. No issues with that. Haven't looked EPR at the moment will do that tonight. It may be set to off at the moment. As many have indicated, its a trial and error with settings at the moment to see what works for me. I think the lower min pressure really helps at the moment..so I will set it to 4. Haven't had time to download the data at the moment but thanks guys for all the good suggestions!
08-14-2013 09:01 PM
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dodgyblue Offline

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Posts: 9
Joined: Aug 2013

Machine: Resmed Autoset S9
Mask Type: Full face mask
Mask Make & Model: Resmed Quattro Air
Humidifier: Resmed H5i
CPAP Pressure: 6-20 APAP
CPAP Software: ResScan

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Sex: Male
Location:

Post: #15
RE: Newbie : 1st trial with Resmed S9 Auto
Update. Day 4.. still can't sleep through the night (or maybe fall asleep) I feel like I'm dozing - half awake sort. Hopefully with more time, I will actually get into deep sleep and sleep through. Last night lasted all of about 4 hours before I took off the mask to get some uninterrupted sleep.

@Tez62. Thanks for the tip regarding EPR. I've set EPR to 2 and it feels so much more comfortable now. Now much air leaks anymore and not balloon cheeks whole of last night. I did set min pressure to 4 and max pressure to 15. According to the readings, the Max the autoset went up to was 9.8. And for the half awake/dozy 4 hours, the AHI was 1.3. Not sure how accurate.. really need to have a fall asleep and wake up in the morning event to say that therapy is working. I might really be half awake and not relaxed enough for an apnea event to occur.

One thing though.. even with a FF mask, I'm getting very dry lips and mouth. I know I mouth breath and I have set the humidifier to about 1.5 but I don't want to go higher as that causes my nose to go stuffy. Caught between a stuffy nose and a dry mouth. Any suggestions?
08-15-2013 04:10 PM
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RonWessels Offline

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Posts: 465
Joined: Jun 2013

Machine: REMstar Auto AFlex DS560TS
Mask Type: Nasal mask
Mask Make & Model: ComfortGel Blue
Humidifier: REMstar Heated Tube DS6T
CPAP Pressure: 11 - 20
CPAP Software: SleepyHead

Other Comments: CMS50F Pulse Oximeter

Sex: Male
Location: Ontario, Canada

Post: #16
RE: Newbie : 1st trial with Resmed S9 Auto
(08-15-2013 04:10 PM)dodgyblue Wrote:  Last night lasted all of about 4 hours before I took off the mask to get some uninterrupted sleep.

I will point out that you are training your subconscious that, if it is uncomfortable with the CPAP, you will eventually relent and remove it.

I hope that works for you. Personally, I went the other way and owned the fact that I had the choice between CPAP or death (and no, this is not an exaggeration, at least not for me). And yes, there were two weeks where I got zero (none, nada, spent essentially the whole night downstairs watching TV) sleep, followed the next day by 4 hours of sleep. I still dislike the feeling of warm humidified air on my nose (I need the humidification to prevent nasal dryness), but I can now ignore the annoyance and get to sleep.

Your choice.
08-15-2013 04:25 PM
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dodgyblue Offline

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Posts: 9
Joined: Aug 2013

Machine: Resmed Autoset S9
Mask Type: Full face mask
Mask Make & Model: Resmed Quattro Air
Humidifier: Resmed H5i
CPAP Pressure: 6-20 APAP
CPAP Software: ResScan

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Sex: Male
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Post: #17
RE: Newbie : 1st trial with Resmed S9 Auto
(08-15-2013 04:25 PM)RonWessels Wrote:  
(08-15-2013 04:10 PM)dodgyblue Wrote:  Last night lasted all of about 4 hours before I took off the mask to get some uninterrupted sleep.

I will point out that you are training your subconscious that, if it is uncomfortable with the CPAP, you will eventually relent and remove it.

I hope that works for you. Personally, I went the other way and owned the fact that I had the choice between CPAP or death (and no, this is not an exaggeration, at least not for me). And yes, there were two weeks where I got zero (none, nada, spent essentially the whole night downstairs watching TV) sleep, followed the next day by 4 hours of sleep. I still dislike the feeling of warm humidified air on my nose (I need the humidification to prevent nasal dryness), but I can now ignore the annoyance and get to sleep.

Your choice.

Unfortunately I need to work so I do need some sleep else it won't do for me to be sitting in meetings or at my desk. . Lol. Hopefully tonight I will be able to keep it on longer as tomorrow is Sat so will not be too worried about lack of sleep. How did you finally managed to fall asleep properly after that 2 weeks of being up? The 4 hour you mention is that with therapy?
08-15-2013 05:36 PM
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DreamDiver Offline

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Joined: Jul 2013

Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Quattro FX Full Face
Humidifier: ResMed S9 H5i
CPAP Pressure: 10.4 | 11.8
CPAP Software: ResScan SleepyHead EncoreBasic EncorePro

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Sex: Male
Location: Georgia

Post: #18
RE: Newbie : 1st trial with Resmed S9 Auto
(08-15-2013 05:36 PM)dodgyblue Wrote:  ...Unfortunately I need to work so I do need some sleep else it won't do for me to be sitting in meetings or at my desk. . Lol. Hopefully tonight I will be able to keep it on longer as tomorrow is Sat so will not be too worried about lack of sleep. How did you finally managed to fall asleep properly after that 2 weeks of being up? The 4 hour you mention is that with therapy?
Another alternative is to wear the mask and hose for a half hour while reading or watching TV before sleep or during the day when you have a moment to spare. (Like any of us have a spare moment, I know.) The concept is to train your subconscious to be comfortable with wearing the mask by allowing yourself to get comfortable wearing the mask during waking hours. Who cares what your AHI looks like while you're awake. The only thing that matters is getting yourself used to wearing it through your entire sleep session. It works for some. It might work for you.

dreamdiver.org
08-15-2013 07:31 PM
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dodgyblue Offline

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Machine: Resmed Autoset S9
Mask Type: Full face mask
Mask Make & Model: Resmed Quattro Air
Humidifier: Resmed H5i
CPAP Pressure: 6-20 APAP
CPAP Software: ResScan

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Post: #19
RE: Newbie : 1st trial with Resmed S9 Auto
The concept is to train your subconscious to be comfortable with wearing the mask by allowing yourself to get comfortable wearing the mask during waking hours. Who cares what your AHI looks like while you're awake. The only thing that matters is getting yourself used to wearing it through your entire sleep session. It works for some. It might work for you.
[/quote]

Agreed. That's why I have been wearing the mask for an hour or so awake before going to bed. Tonight I'm going to try for the whole night long. Smile
08-16-2013 12:36 AM
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RonWessels Offline

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Posts: 465
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Machine: REMstar Auto AFlex DS560TS
Mask Type: Nasal mask
Mask Make & Model: ComfortGel Blue
Humidifier: REMstar Heated Tube DS6T
CPAP Pressure: 11 - 20
CPAP Software: SleepyHead

Other Comments: CMS50F Pulse Oximeter

Sex: Male
Location: Ontario, Canada

Post: #20
RE: Newbie : 1st trial with Resmed S9 Auto
(08-15-2013 05:36 PM)dodgyblue Wrote:  How did you finally managed to fall asleep properly after that 2 weeks of being up? The 4 hour you mention is that with therapy?

Sorry, I may not have been clear. I stayed up completely for one evening, got 4 hours of sleep the next evening, then slept "normally" after that. Then, a week later, I again stayed up completely for one evening, got 4 hours of sleep the next evening, then slept "normally" after that.

The first time it happened was because I had selected an ill-fitting mask and had tightened the straps so tightly trying to control leaks that, while it felt "ok" with me awake sitting on the side of my bed, it was too claustrophobic for me to fall asleep with lying down with the lights off. The 4 hours of sleep happened the next night when, at 6 in the morning browsing the Internet looking for suggestions, I ran across an article (on this forum, as I recall) about how over-tightening your mask straps could cause this problem. I tried loosening the mask straps and just ignoring the resulting leakage and fell right asleep.

The next time it happened, I kept remembering and re-living in my mind the difficulty I had the first time, basically setting myself up for failure. Instead of ignoring my mild discomfort and going to sleep anyway, I kept focusing in on it, comparing it to when I first had my sleepless night, and convinced myself that I again couldn't do it. I also kept making excuses to myself: oh, my sinuses were not totally clear - I need to let them drain before I can put on my nasal mask or else I won't be able to breathe. And so on.

After the first time, I did switch to a properly fitting mask, which I have been using ever since. And the only time I let myself sleep without the CPAP machine was when I realized that I was having difficulty initially getting to sleep, but if I got up in the night to go to the washroom, getting _back_ to sleep wasn't an issue at all. Pre-CPAP, I would wake up every hour or so having to go to the washroom, so I thought I could go to sleep without the CPAP, and when I woke up and went to the washroom, I could continue the night _with_ the CPAP. As I recall, that was not as successful as I was hoping.

I have not had anything as bad since then, and for the past 6 weeks or so, have been having essentially no problems at all. As I mentioned, I still dislike the feeling of the warm humidified air, but now I simply ignore it and go to sleep. Nowadays, a "bad" night for me is when I actually have to get up _twice_ in the night to use the bathroom.
(This post was last modified: 08-16-2013 02:55 PM by RonWessels.)
08-16-2013 02:53 PM
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