CPAP HELP!!

[TiredLady16]

Hi Everyone! I am new to this forum and to CPAP therapy. I have been diagnosed with OSA and I use a Resmed Elite S8 H4i. I am only 28 years old and at a normal weight for my height. It has really made me depressed because I am so young and should have all the energy in the world at my age.

I don't have insurance right now because I was laid off so going back to the Dr. right now is not an option for me. I am having trouble keeping my mask on all night and being able to finally get back to a normal life where I'm not exhaused all the time. The air pressure that is coming from my machine is way too much. I feel like it is suffocating me and I have to open my mouth to let some of the air out. I just found a way to change the clinical setting, I have been set to a level 6. I was reading there is a EPR setting and I am interested in knowing a little more about what that does and what it is used for.

So, I'm asking for any tips or help anyone could provide, I would GREATLY appreciate it!! I would like to get some quality sleep and get back to normal

Thank you!!!!!
Tired Lady

[Lizistired]

Hi, Welcome to the forum.
Please FIRST, go to the user control panel and list your equipment in your signature in TEXT so we know what you are using.
Then tell us what your prescribed pressure is and what your machine settings are.
What was your AHI from you PSG's
You can get lots of help here but you have to give us some information first.

[TiredLady16]

Liz-- Thanks for your reply!

I have updated the equipment I use and have added it to my profile.
My prescribed pressure is a 6
EPR is on full time
EPR setting is a 3
I will have to find out my AHI and will post that on Monday when I can get copies of my report

Please let me know if you need any more information....as you can see, I"m awake again. I'm having a horrible time with my CPAP

[hades161]

Welcome to the Forum!

Sorry you cant sleep

The pressure of 6 is pretty low as 4 is the bottom of the unit. EPR also lowers the pressure for you when you exhale making it easier for you to breath out. He is a link to explain EPR from Resmed.

http://www.resmed.com/us/assets/html/de ... c=patients

What is EPR?

EPR™ (expiratory pressure relief) is an effective alternative to continuous positive airway pressure (CPAP) therapy. It features several options that enable you to reliably and predictably control patient therapy while delivering a higher level of patient comfort.

EPR is only available on our new S8™ devices.



How does EPR work?

When the patient exhales, the S8 device detects the beginning of exhalation and reduces motor speed to drop pressure.

The patient or clinician can choose one of three comfort levels to determine the degree by which pressure will drop.

Setting 1 = mild comfort (1 cm H20)
Setting 2 = medium comfort (2 cm H20)
Setting 3 = maximum comfort (3 cm H20)

As you can see an EPR of 3 means the unit you are using bottoms out when you exhale. A setting of 6 cm H20 with a breath relief or EPR of 3 means it will drop by 3 so if your setting is 6, it would drop to 4 as there is no 3cm H20.

I think your experiencing a lot of anxiety though because your body and mind are not use to using the gear yet. I takes time and practice for you to adjust to the treatment. Putting a hose on and having air blasted up your nose is not something you can really adjust to quickly. I recommend putting on your mask and turning on your machine and laying down for 30 minutes to an hour before your normal sleep time to help get your mind and body use to breathing with it on. By doing this you will learn that the mask is not attacking you nor trying to kill you and this is now normal for sleeping and this will carry over into your subconscious mind. I also find that it helps you learn how to keep the mask adjusted so it doesn't leak. One other tip is to read a book, listen to an audio book, watch TV, or work on the computer before bed it helps you to "not" think of the mask or your breathing by taking your mind off of it and focusing your mind on something else. If you do this for a week or two you should adjust and then when you put on the mask you wont even think about it and head right to sleep. Once adjusted don't worry about "practice" anymore.

Good luck and again Welcome to the Wondrous Adventure that is Hose Head Land

[Pugsy]

SleepyHead software is not compatible with ResMed S8 machines because those machines use a Smart card to collect data (similar in size to a credit card)..here https://www.cpap.com/productpage/resmed ... -card.html
which requires a smart card reader to use the software that will work (ResScan)
https://www.cpap.com/productpage/resmed ... tup-manual

The S8 machines have been discontinued for quite some time now. Unsure why you have been given an old technology machine. The new technology machine in your model is the S9 Elite and it uses a SD card to collect data and it can be used with SleepyHead and ResScan software.

If your set pressure is 6 cm...that is really fairly low and if you are using EPR that will drop the pressure even lower (4 cm is lowest) during exhale and this may be why you feel like yo are suffocating. Simply not enough air is moving. If using EPR..I would turn it off and see if that is more comfortable. EPR is a comfort feature only. When set pressure is 6 cm...using EPR even at 3 will reduce the pressure only to 4 cm.. EPR is a one cm reduction in pressure per setting. So EPR of 2 will reduce the pressure from 6 to 4 during exhale. EPR of 1 will reduce pressure from 6 cm to 5 on exhale. So you would have 6 on inhale and on exhale you would have less pressure using EPR.

If you aren't using EPR...6 cm of pressure is fairly low and again it may seem like you are suffocating because some people feel like not enough air is moving. So...either turn EPR on if you really feel like the 6 cm is a hurricane.. or if you feel like you are suffocating turn it off...or consider a small increase in the pressure if 6 cm is indeed suffocating.. big difference between suffocating and hurricane force winds. You need to figure out which is your problem.

Don't know where you live or why you were given an older technology machine but if you do want to use the software..that card reader is next to impossible to find (on EBay only for around $75) which makes using ResScan more difficult.
Or push your machine supplier to dispense the S9 Elite if that is an option.

[Lizistired]

As others have suggested, I would using the machine while awake, watching tv or something.
I would do this with the EPR off. I found it very disturbing. It felt like the machine was telling me when to breathe.
You may find that a constant 6 is more comfortable than the constant fluctuations.
Then if you need it, start with a setting of 1 and go up to what is comfortable.

[TiredLady16]

WOW!! Thank you all so much for your replies!! You guys gave me a wealth of information that neither my doctor or machine provider gave me. I have had this machine for about a year now and have been laid off and couldn't afford to go back to the doctors office for help. I have tried to use it on and off for the past year and it has literally almost killed me...lol. I am claustrophobic so as you can see, this has been a wonderful adventure in Hose Head Land this far !! I found the instructions online on getting into the clinical settings so I will try what you all have suggested. I feel more positive about trying the CPAP again, thanks to you guys!! So again, THANK YOU THANK YOU THANK YOU!!!!! I am soooo glad I found this forum!

Cheers to a better way of life!!

[hades161]

Most everyone here is glad to help in whatever way they can.

Keep us updated, continue to learn, and never be afraid to ask whatever questions you may have.

[Slinky]

For ease of access to and amount of data available via the LCD screen I LOVE my Resmed S8s. I was started out on a Resmed S8 Elite.

Press the Left and Right buttons and hold for 3-4 seconds. A new screen: Efficacy Data, will appear on the LCD. From then on in it is Left button to Enter, Right button to Exit, Up button to return to the previous screen and Down button to Proceed to the next screen. You can not accidentally or intentionally change your therapy settings from this access menu.

The Leak rate reported is the rate of leak at or below which you spent 95% of the night.

THE FIRST TIME you enter the Clinicians Menu have a pencil and paper handy and write down what appears in EACH and every screen BEFORE you attempt to make ANY changes. That way you KNOW what your therapy settings SHOULD be if the changes you end up making don't work out. Leave yourself "square one" to go back to if necessary.

CPAP data is not as accurate as in-lab PSG data gathered by a good sleep tech. On the other hand there is a LOT of value in the data TRENDS that CPAPs can provide that a one-night PSG just can not. So the two different data sources really compliment each other.

Try to restrict yourself to ONE therapy change at a time, and for ONE full week at a time. Make your next change on the basis of that one week of data.

Changing to a new mask is considered one therapy change. And don't forget when changing masks that you need to change the Mask Selection on your Elite as well.

[Kairosgrammy]

I'm not sure what you are feeling more than just being unused to cpap therapy. It does take some time. Things that might help is to ramp although with 4 being the lowest pressure, there isn't much ramping the machine can do up to 6.

You may be fighting the machine. Having air blow up your nose is a different feeling for sure. Opening your mouth is definitely not the thing to do. It will register on your machine as a leak and you are releasing the air that is essentially stinting your airway open which means that your apnea will be remain unresolved.

Try wearing your cpap when you are awake and have no intention of sleeping. You can practice keeping your mouth shut. Try reading or watching tv which will distract you a bit. Eventually, you should get used to the feel of air blowing up your nose and you will begin to feel a lot better.

Liz-- Thanks for your reply!

I have updated the equipment I use and have added it to my profile.
My prescribed pressure is a 6
EPR is on full time
EPR setting is a 3
I will have to find out my AHI and will post that on Monday when I can get copies of my report

Please let me know if you need any more information....as you can see, I"m awake again. I'm having a horrible time with my CPAP