How to adjust S9 settings for high altitude?

[SleepDaddy]

Fellow CPAPrs,
I have searched for a solid answer to this question before, but no luck. Can anyone give me opinion/guidance on how to adjust my S9 Autoset to operate at 9600 ft above sea level? I am going on a skiing trip to Breckinridge Colorado and since the S9 only auto adjusts to 8500 ft, want to know how to compensate. My current settings are 9 - 13. I would appreciate anyone who can shed some light on this issue.

Cheers,
Chris

[gschamel]

Fellow CPAPrs,
I have searched for a solid answer to this question before, but no luck. Can anyone give me opinion/guidance on how to adjust my S9 Autoset to operate at 9600 ft above sea level? I am going on a skiing trip to Breckinridge Colorado and since the S9 only auto adjusts to 8500 ft, want to know how to compensate. My current settings are 9 - 13. I would appreciate anyone who can shed some light on this issue.

Cheers,
Chris

I live at 9700 feet in Colorado and have used my Autoset in Denver ~5400 feet and Houston (Sea level) without making any adjustments. I use a 10-17 range and rarely go above 13.

Just go and enjoy yourself - they've been getting some good snow up there recently.

George

[SleepDaddy]

Thanks for the reply, although I have had a different experience. On my trip to Breckenridge last year, my nightly AHI increased from under 3 to well over 50 or 60. I assume the increase was due to the inability of the S9 Autoset to compensate for Breckenridge's 9600 ft altitude. According to the Resmed manual, the S9 only autoadjusts for up to 8500 ft. If anyone has any advice on how much I should increase the pressure (I am currently set at 9 -13) to compensate for the additional 1000 ft in altitude, that would be appreciated.

[RandyJ]

If you don't get any definitive replies on this from an expert, one option would be to simply increase your maximum to 20 (the highest setting offered on the S9). After the first night, you can check onscreen data to see what your 95% pressure number is; with that information you can see if you should increase the minimum as well.

Hopefully opening up the high end will let the S9 take you where you need to go.

[timbalionguy]

You may be getting nonlinear responses from your machine's internal pressure sensors at that altitude. Try boosting your lower and upper pressures by 2 cm and see what difference that makes. You might also, and an alternative, try lowering it 1 cm to start with and see if that helps. In any case, I think you will find the right setting within +/- 2 cm of the current setting.

[SleepDaddy]

Well my results for the first night at Breckenridge (9600 ft altitude) were an AHI of 57 with 42 for Centrals. My normal AHI at home is less than 3 with Centrals around 1. Since the number of Centrals appears to be the major issue, I am somewhat reluctant to increase the pressure for fear of causing even more Centrals. I felt pretty normal and didn't notice an undue number of awakenings that I was aware of, so am thinking that maybe there is something in the algorithms that is more sensitive to pressure changes at the higher altitude. I would be interested in hearing any theories as to what is going on.

Thanks,
Chris

[SleepDaddy]

I ran across the following bit of information on the Mayo Clinic website that may explain the increase in Central apneas I have been experiencing. Although I am only at 9600 ft not the 15,000 feet mentioned. One of the solutions suggested is to use oxygen, although I am not sure how to do that while also on a CPAP.

High-altitude periodic breathing. A Cheyne-Stokes breathing pattern may occur if you're acutely exposed to a high-enough altitude, such as an altitude greater than 15,000 feet (about 4,500 meters). The change in oxygen at this altitude is the reason for the alternating rapid breathing (hyperventilation) and underbreathing.

If anyone has any experience with a similar issue, I am interested in how best to treat this condition. I also am not sure what a Cheyne-Stokes breathing pattern is. Since I am not at home, I don't have access to my Rescan software to give me more details on what is occurring.

[HoseCrusher]

If you are going to be there for a few months, I would suggest that you try and figure everything out...

If you are only going to be there for a week or so, I would just go by how you feel and figure the machine is operating at the edge of its abilities and giving you some skewed data.

[chunkyfrog]

I would discuss the situation with a pulmo doc. It is possible you may need oxygen at the higher altitude.

[SleepDaddy]

Thanks for the replies. I did discuss this with my Sleep Doc, but he did not have any ideas other than to avoid high altitudes, which is not a good option. Since we travel to Breckenridge every year, I would like to find a way to address this problem. Is it possible to add oxygen to CPAP therapy? If so, can that be added to the S9 Autoset I am currently using, or does it require a different machine?

Thanks for the help,
Chris

[VikingGnome]

Oxygen can be easily added to your S9 but you'll need a doctor's prescription. If you get a pressurized tank of O2, the airlines won't let you fly. There are O2 concentraters that you can take on the plane but they are expensive and if it is just for a very occasional use, not worth it.

I wouldn't assume it is an oxygen problem. Do you feel light-headed and dizzy when you're skiing? If not, the air is not "too thin" for you during exercise. Do you get altitude sickness the first couple of days up there? A cheap pulse oximeter would be able to tell you if your oxygen level is getting low.

It is possible that the S9 sensors are measuring incorrectly and exaggerating your CAs.

[billbolton]

but he did not have any ideas other than to avoid high altitudes, which is not a good option. Since we travel to Breckenridge every year, I would like to find a way to address this problem.

Since you are not running your S9 at maximum settings you can adjust your top APAP setting up by several centimetres H20 and that will probably compensate for the higher altitude... you may need to ajdust the settings a few times until you find the right point to maintain your normal AHI score.

Is it possible to add oxygen to CPAP therapy?

Adding oxygen wont do anything useful for your particular issue.

Cheers,

Bill