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[Pressure] ResMed S9 max pressure of 20.0 possibly problematic
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welshmike Offline

Preferred Members

Posts: 31
Joined: Dec 2013

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: ResMed
Humidifier: none
CPAP Pressure: 4.0 to 10.0
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: Hampshire, UK

Post: #1
ResMed S9 max pressure of 20.0 possibly problematic
My backround:
I believe that the reasons I have had sleep apnoea are:
1. I have a severe overbite
2. I have broken my nose several times playing Rugby causing a deflected septum and have had two septoplasty operations.
3. I am a mouth breather and snored while asleep.
4. My natural sleeping position has been on my back.
A video I took of myself overnight while wearing my backpack, not using the APAP device and sleeping on my side showed that I breathed normally mostly through my nose and there were no snoring or snorting sounds.
I believe that the only cause for my sleep apnoea is the collapse of the soft tissues in my throat that occur only while I am sleeping on my back.
A bonus of being free from sleep apnoea is that my regular episodes of atrial fibrillation have stopped.


My current problem:
I have been having pain and bruising on the left side of my nose possibly due to the tightness of my Quattro Air mask even when wearing a Gecko Nasal Pad that I replace regularly with a new one.
I believe that I may be tightening the mask straps too much so that I do not get air leaks when the S9 detects apnoeas and pumps up the air pressure. Recently leaks only happen up to two or three times per night when I find myself sleeping partly on my back instead of sleeping on my side.
I wake up at those times and recollect that the S9 shows at those times that the air pressure has gone up from 4.0 to 20.0.

So I am suggesting that I reduce the maximum air pressure to 10.0 and also loosening my mask straps.
What opinions do members have about my suggestion please?

Death is not the greatest loss in life. The greatest loss is what dies inside us while we live.
http://en.wikipedia.org/wiki/Norman_Cousins
11-03-2014 08:19 AM
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me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #2
RE: ResMed S9 max pressure of 20.0 possibly problematic
my suggestions are to look at the software and see what your pressure is the majority of the night. I agree your pressure range is wide open and that could cause some issues. Post your pressure graphs for the night so we can see them. I wouldn't drop your pressure down to 10 right now. Show us your graphs so we can better help you. I would think raising your lower number a bit is an option but we can better help when we see your graphs of your pressure, AHI and leaks would help a lot.

you might consider changing to a nasal mask or nasal pillows and use a chin strap to help with mouth breathing. YOu can elevate your head to help when you sleep on your back.

Others will have more suggestions for you.
(This post was last modified: 11-03-2014 09:13 AM by me50.)
11-03-2014 09:12 AM
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justMongo Offline

Monitors

Posts: 3,840
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #3
RE: ResMed S9 max pressure of 20.0 possibly problematic
For most of use, sleeping on the back does worsen our apnea as gravity does add to airway collapse.

Make pressure changes in small increments and follow with your software. ( I would not jump down to 10)
4 cm-H2O is a little low for a starting pressure.
Rig yourself such that you cannot sleep on your back. One trick is a nightshirt with tennis balls sewn into the back.
(Or, for you ... perhaps a Rugby ball.)
Once you rig it so you cannot sleep on your back, you can decrement pressure every few days, by about 0.5 cm-H2O until you're comfortable; and your apnea events are still well controlled. I'd say 0.5 -- but I know the ResMed only dials in even increments.

Your autoset is in what user Retired_Guy calls Magpie Mode (4 and 20 blackbirds baked...); it's running "wide open."
Dialing it in (narrowing down the limits) generally better suits a person.

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.
11-03-2014 09:23 AM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #4
RE: ResMed S9 max pressure of 20.0 possibly problematic
Yes.. As our flyguy suggests dial it down from the top a bit and dial it up from the bottom a bit. What is your "normal" running pressure? For instance if it's 10, I'd shoot for a min of 8 and a max of 14. That'll help with the leaks and will allow you to loosen the straps a bit on your mask making your cute little nose a happy camper.
11-03-2014 12:26 PM
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Galactus Online

Advisory Members

Posts: 1,384
Joined: Jan 2014

Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #5
RE: ResMed S9 max pressure of 20.0 possibly problematic
Just to add to everything else, that machine has a mask fit option, that will adjust the pressure to the average setting and allow you to fit your mask at that pressure. That will make it so you don't have to over tighten at the low pressure just to compensate when there is high pressure. I don't have that machine, but I see that mask fit mentioned many times.

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
11-04-2014 01:35 PM
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