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Resmed s9 & Ripping mask off during sleep
#1
Resmed s9 & Ripping mask off during sleep
I'll admit I should have come here sooner.
I have a resmed s9 and that's all I really know. It's my first cpap machine and I've had it just about a year.
I did the typical. I got my machine, set it up and wore it for every night for a short while.
my problem? Within 1-3 hours, I will find myself ripping my mask off. Often, I don't remember doing it. Up until recently, I thought it was the mask do I just gave up. We were in the middle of moving and I travel a lot for work so I failed at connecting with lincare. Fast forward 6 months, I got a new mask that is lovely and settled in last night for a good night's sleep. Only to last 1.8 hours. Only this time, I know why I ripped mask off. It was blowing air so hard that I could NOT breathe .
I remember having this problem earlier in the year and mentioning it to lincare in my one attempt to contact him. He blew it off....l
Any ideas?
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#2
RE: Resmed s9
yes

You really need to sort it out with them and not avoid/run away from the issue.

Moving around is no excuse either.

I live in Australia and when I moved to Toronto Canada I looked up the nearest supplier to get parts and advice.

It took me a full 6 months before I slept through the night without tearing the mask off and that was in the 90's with an old fixed pressure machine and old style masks before the pillows and easybreathe technology were invented.

So woman up and make it happen.

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#3
RE: Resmed s9
G'day Melissaruth, welcome to the forum.

The first thing you should know is that everybody experiences de-masking at some stage, so you're not alone. However, if it's still happening regularly after a year, then there is a problem.

Can you tell us a few things about your setup, to help us make some constructive suggestions? First, what type of S9 do you have? There will be a name printed near the on/off button - it may be Escape, Elite, Autoset or VPAP. What type of mask do you have? The basic types are nasal (just covers your nose), full face (mouth and nose) or pillows (two squidgy things that press into your nostrils)? When you wake up, does the screen on you machine show a green smiley face or a red frowny face? This is a measure of how consistently good or bad your leaks are.

Do you know what pressure your machine is set at? If you don't know, your DME should be able to tell you. Alternatively, you can find out for yourself by going to the clinical menu. Do as follows:

1. Press and hold the Setup button and the push-dial together for about 3 seconds. This will get you into the clinician menu. At this stage, don't make any changes, you're just seeking information.

2. You should be in the Settings screen, and one of the settings will be pressure, or perhaps minimum and maximum pressure. This is what we need to know.

3. Turn the push dial until you get to <<Home>> then click on it. This will get you back to the normal operation setting.

Once we know these details, the members here will be able to give some advice as to what's going wroing and how to overcome it.

Good luck.
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#4
RE: Resmed s9
Thanks for your help! I admit I was overwhelmed with life in general and unable to focus on this issue but now I can so that's why I'm here Smile I won't give up now as I know I need it and I need to accept that.

Here are a few of the answers to the questions asked:
I have the S9 Autoset.
As of yesterday, I'm now wearing the Resmed Quattro Air. It's a full face mask.
I looked today (thank you apneaboard.com for showing me) at the stats and that says 31L/min for the leak?
Mask Fit shows a happy face?
Max Pressure is 20.0 and Min pressure is 4.0.
Start Pressure is 4.0.
Max Ramp is 30 min.
EPR is set to Off
It is set to AutoSet mode
SmartStart is set for Off
Climate Ctrl is set to Auto

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#5
RE: Resmed s9
OK, the Autoset is an excellent machine - probably as good as you can get for obstructive apnea. The Quattro Air is a good mask (I use one myself) but masks are the most personal part of the therapy and perhaps the most crucial. If the mask isn't comfortable and/or leaks, then everything else is wasted. You've said the mask is comfortable, so we're half way there. The 31 L/min would be the 90% leak rate - in other words you were at or below 31 for 90% of the time. The target leak is below 24 L/min. The fact that the machine is showing a smiley face means that you were at or below 24 for 70% of the time - as a rule of thumb this is acceptable, but we should be targeting smaller leaks for shorter periods.

From what you said, I assume you're not on the best of terms with your DME? Do you have a sleep doc that you trust? If so, then what I suggest next should be done only after consultation with the doc. And it's quite likely they'll tell you that making your own adjustments is illegal - it isn't!

The maximum and minimum pressures are set at the highest and lowest that the machine can deliver. This is the factory default setting, but your therapist should have worked with you to narrow the range. It's possible the wide pressure range is a large part of the problems you're experiencing. It also means that because the starting pressure is set at 4 the ramp isn't doing anything but wasting half an hour of your therapy time. For the time being, let's set the ramp to zero, as it isn't achieving anything. You might want to increase it later if your starting pressure goes up, though that's a bit of a debate (a lot of more experienced users don't use the ramp at all).

I suggest you turn the EPR to 3. This will cause the machine to reduce its pressure when it senses you're trying to exhale. That might be sufficient to overcome the feeling of not being able to breathe against the machine. Again, once you become more comfortable, you might like to experiment with the EPR settings to see which is most comfortable for you.

At this stage we need to get some hard data about what's going on in detail. Go to the Sleepyhead link at the top of this page and download a copy of the Sleepyhead software. Get this installed on your computer and use it to read the data off the SD card from your machine. Take some screen shots of the daily summary (the big pie chart and associated numbers) and the graphs (especially events, pressure, flow and leaks). Sleepyhead is really quite easy to use, and there are some excellent instructions in the thread at the top of the main forum.

One very important thing I forgot to request previously was your AHI score. The target is below 5. AHI stands for apnea - hypopnea index and is a measure of the average number of breathing interruptions you get per hour.
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#6
RE: Resmed s9
Hi melissaruth,
WELCOME! to the forum.!
It sounds like you have had a rough time of things but now that you have come here, you can get the help and support you need, so feel free to ask as many questions to help you better understand all things CPAP..
I want to encourage you to stick with CPAP therapy. Once you get things fine tuned, hopefully,you will find that your sleeping will be greatly improved.
The mask is the hardest part of this therapy but, just keep at it, patience is required.
Hang in there for more suggestions and I wish you much success as you fine tune and continue your CPAP therapy.
trish6hundred
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#7
RE: Resmed s9
Thanks!
Well...there IS a story here.
I don't remember my score but I'll find it.
I had an in home study and the prescription was sent by my personal doctor I had been seeing for 4 months in Upstate NY to Lincare in my home town in Washington state where my official residence was since the NY Lincare wouldn't provide a machine to me as I was not a NY resident.
The WA office set me up in January but my paperwork and billing didn't get set up completely until March when I was on my way to Houston for a 3 month temporary housing until the family could be moved in July. The machine was tried a few more times in that time but with the same issues, I put it away hoping to re-visit it once we got settled in our home.
so to sum up, I don't have a DME and lincare is less than helpful....
I'll re-read your information today and will make those changes as recommended. ANYTHING is better than ripping it off 2 hours later every night and waking up feeling guilty.
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#8
RE: Resmed s9
(12-17-2014, 09:18 AM)DeepBreathing Wrote: I suggest you turn the EPR to 3. This will cause the machine to reduce its pressure when it senses you're trying to exhale. That might be sufficient to overcome the feeling of not being able to breathe against the machine.

This

When I briefly tried my S9 AutoSet at the DME, I commented that it was much harder to exhale than during the sleep study. They set the EPR to 3 and it's been there ever since.

Personally, I'd go nuts with a full face mask. I went from a Philips Respironics Wisp nasal mask to ResMed AirFit P10 nasal pillows after several people here raved about them. I've jumped on the fanboy bandwagon. I think I'd get huge claustrophobia with a full face mask.
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#9
RE: Resmed s9
IBI 25
AHI 11
Epworth 10
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#10
RE: Resmed s9
Quick question - I have the SD card locked right now...how do I put it into my windows 8.1 machine and make changes to it without risking the card integrity?
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