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[Pressure] S9 CPAP
#11
  • Sometimes, an auto machine will not find the "right" pressure. They may even "run away" to the max pressure. That's part of why they have a maximum and minimum pressure setting.

    Of course, you might need the higher pressure.



  • Some people get more central apnea as pressure increases. More pressure can make things worse.



  • If the pressure is climbing slowly, the sensors in the machine are probably working correctly. The problem is that there's not always a clear "right" choice, and the machine is not smart enough to find it. The machine also doesn't "learn" from experience. Other than the max and minimum pressure, it has to figure out the right pressure from the breathing patterns you've had in the last 10-15 minutes.

    Yet another reason why it's sometimes necessary to adjust the maximum and minimum pressures.
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.
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#12
Well, I said I would report, but last night was atypical, since somehow during the night , I left the mask off for several hours. I'll try again tonight. In the meantime, here's what I got:

I did drop the Ramp time to zero. The range is Min 5 max 14

Statistics for ~5 hrs recorded:
AHI o.o
Median Pressure 13.3
95 Percentile 13.9
Max 13.9

Leak-L/min
Median 0.0
95 Percentile 2.4
Max 126.0

No snoring

Other observations:

It took between 5 to 10 minutes from putting the mask on (I usually fall asleep quickly) to getting from 5 to 14 cmH2O where it stayed unless there was a leak
when the pressure dropped to 10 or 13 but went back up once the leak stopped. The mask usually leaks under my eyes. I sleep on the side.
As I mentioned earlier, this was atypical since the machine didn't register apneas or hypopneas. Still, the pressure was at max.

As one of you suggested, I did have the mask on for about 30 minutes while awake before getting up. The pressure line was steady at 5 cmH2O for that period.
That's about it. More tomorrow which will most likely paint a different picture.

Thanks for participating and sharing your experiences.

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#13
(02-15-2013, 01:33 PM)archangle Wrote:
  • Sometimes, an auto machine will not find the "right" pressure. They may even "run away" to the max pressure. That's part of why they have a maximum and minimum pressure setting.

    Of course, you might need the higher pressure.



  • Some people get more central apnea as pressure increases. More pressure can make things worse.



  • If the pressure is climbing slowly, the sensors in the machine are probably working correctly. The problem is that there's not always a clear "right" choice, and the machine is not smart enough to find it. The machine also doesn't "learn" from experience. Other than the max and minimum pressure, it has to figure out the right pressure from the breathing patterns you've had in the last 10-15 minutes.

    Yet another reason why it's sometimes necessary to adjust the maximum and minimum pressures.
Interesting to know, I'm still figuring out whether the machine is doing what it's supposed to do. I have 30 days of data and each day looks different with last night the oddest of them all as my post shows.


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#14
(02-15-2013, 03:21 AM)PaulaO2 Wrote: If your machine is going to the maximum you have set and then not moving the entire night, something is wrong with the machine. Or the pressure is too low. What is your AHI?

APAP's have been known to run away for some patients. They set themselves at too high of a pressure.
Sleepster
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#15
(02-15-2013, 11:05 PM)Sleepster Wrote: APAP's have been known to run away for some patients. They set themselves at too high of a pressure.
might feel that way, if minimum and maximum pressure set wide apart 4-16 and you need something like 13 to control your apnea

unlike its predecessor, the S9 Autoset does not "run away"
can detect central apnea, if central detected, no pressure increase
if obstructive apnea is detected, increase pressure but not to treat the one detected but rather to reduce the chance of further events occurring

if wanted some material to read, this might help explain the technical details
http://www.resmed.com/au/assets/document...-paper.pdf





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#16
(02-15-2013, 11:50 PM)zonk Wrote:
(02-15-2013, 11:05 PM)Sleepster Wrote: APAP's have been known to run away for some patients. They set themselves at too high of a pressure.
might feel that way, if minimum and maximum pressure set wide apart 4-16 and you need something like 13 to control your apnea

unlike its predecessor, the S9 Autoset does not "run away"
can detect central apnea, if central detected, no pressure increase
if obstructive apnea is detected, increase pressure but not to treat the one detected but rather to reduce the chance of further

I just downloaded the PDF file. Interesting and enlightening. No wonder they charge a $1000 for it. It's high tech and has a relatively small market.
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#17
(02-15-2013, 08:41 PM)SleepyTime Wrote: Statistics for ~5 hrs recorded:
AHI o.o
Median Pressure 13.3
95 Percentile 13.9
Max 13.9

Leak-L/min
Median 0.0
95 Percentile 2.4
Max 126.0

Hi SleepyTime, welcome to the forum!

Does look a lot like you may benefit from higher pressure setting, and/or from improving your sleep position with the goal of minimizing how high in pressure the machine needs to go to avoid Flow Limitation. May need less thick of a pillow, or more thick. Try adjusting the angle of your head/neck so that your throat/neck stays open and clear when completely relaxed.

(02-15-2013, 08:41 PM)SleepyTime Wrote: The mask usually leaks under my eyes. I sleep on the side.

I have obtained excellent success preventing leaks around the eyes by using the ResMed Gecko soft nasal pad. The Gecko also protects the bridge of the nose from getting hurt by the mask. Also, using the Gecko, I don't have to over-tighten the mask to eliminate leaks.

I hope you use the Mask Fit feature to adjust the mask so that your mask will not leak much if the pressure raises to maximum?

A key thing is to make sure the strap lengths are symmetrical, equal length on both top straps, and equal length on the two lower straps.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#18
(02-16-2013, 12:12 AM)SleepyTime Wrote: I just downloaded the PDF file. Interesting and enlightening. No wonder they charge a $1000 for it. It's high tech and has a relatively small market.

Based on how popular this board is, the market is larger than some of us would have imagined.
Bigwink
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#19
Every time I read a post, I learn something new. Soon, I should know what makes this thing tick even though the graphs look different every day. Today like every day the pressure climbed up to the max set

Pressure Setting min 5 max 14
Pressure Median 13.1
95th percentile 13.9
Max 13.9

Leak-L/min
Median o.o
95th percentile 34.8
Max 174.0 had the mask leaking while asleep. It's tight fitting when I'm in bed but...

AHI & AI Events/hr

Apnea index 0.2
AHI 1.5
Obstructive 0.1
Central 0.1
Hypopnea index 1.3

OSA showed a 32 above
CSA showed a 14 above
There was one event each >1 hour separated.
Hypopnea 8 events spread out over >3 hrs

Total time with mask, a Quatro FX full-face, was >6 hrs.?
I'll keep the pressure to see how it develops.
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#20
(02-16-2013, 04:49 AM)vsheline Wrote:
(02-15-2013, 08:41 PM)SleepyTime Wrote: Statistics for ~5 hrs recorded:
AHI o.o
Median Pressure 13.3
95 Percentile 13.9
Max 13.9

Leak-L/min
Median 0.0
95 Percentile 2.4
Max 126.0

Hi SleepyTime, welcome to the forum!

Does look a lot like you may benefit from higher pressure setting, and/or from improving your sleep position with the goal of minimizing how high in pressure the machine needs to go to avoid Flow Limitation. May need less thick of a pillow, or more thick. Try adjusting the angle of your head/neck so that your throat/neck stays open and clear when completely relaxed.

(02-15-2013, 08:41 PM)SleepyTime Wrote: The mask usually leaks under my eyes. I sleep on the side.

I have obtained excellent success preventing leaks around the eyes by using the ResMed Gecko soft nasal pad. The Gecko also protects the bridge of the nose from getting hurt by the mask. Also, using the Gecko, I don't have to over-tighten the mask to eliminate leaks.

I hope you use the Mask Fit feature to adjust the mask so that your mask will not leak much if the pressure raises to maximum?

A key thing is to make sure the strap lengths are symmetrical, equal length on both top straps, and equal length on the two lower straps.

Take care,
--- Vaughn

I have a full-face ResMed Quatro FX which doesn't bother the bridge of the nose since it doesn't go up that high. It comes in S M L. The medium is too small for me and the large goes up a little too high. I do have a tight seal, but while asleep I move and the mask shifts.
I have used the gel pad with other masks and saw no benefit using it then. I might just try it with this mask. Who knows...

As to sleep position, it's easier said than done. My body doesn't follow my orders too well. I have more success with my unruly dog:-)
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