ResMed S9 and AHI 0.0 - Look Bob no hands!

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
User avatar
dave21
Posts: 720
Joined: Tue Mar 09, 2010 1:05 am
Location: United Kingdom

ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by dave21 » Sun Mar 14, 2010 12:59 am

Hi Everyone,

Well after a months worth of being on the S9 and reducing my AHI's from and average of 4.5 to 0.3 consistently which is amazing, I had my first night last night with an AHI of 0.0. That's no Apnea's and no Hypopnea's! Look Bob, no hands! I knew it wouldn't be long before I saw this (just a little longer than I expected).

The s9 is a truly amazing machine, and I'm going to see if I can sustain this. I've been making small tweaks to the machine over the past week and it's starting to look like it's paying off.

Image
Image
Image

_________________
Machine
Additional Comments: Running AirSense 10 AutoSet CPAP, previously S9 AutoSet and S8 AutoSet Spirit
Image

User avatar
GaryG
Posts: 537
Joined: Thu Jul 23, 2009 5:55 am
Location: CT

Re: ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by GaryG » Sun Mar 14, 2010 5:46 am

Well, the devil's advocate in me thinks, maybe the machine is not detecting the apneas. Seriously, this is great, and makes folks like me who have the S8 wonder whether we should run out and get the S9.... (But alas, my insurance provides a machine every 3 years, so I've got a bit of a wait....) Anyway, this is wonderful news. And I bet you're excited and can't wait to go to sleep to see how it goes tonight!

User avatar
DreamDiver
Posts: 3082
Joined: Thu Oct 04, 2007 11:19 am

Re: ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by DreamDiver » Sun Mar 14, 2010 7:07 am

Congratulations, dave21. Excellent.

_________________
Mask: ResMed AirFit™ F20 Mask with Headgear + 2 Replacement Cushions
Additional Comments: Pressure: APAP 10.4 | 11.8 | Also Quattro FX FF, Simplus FF

User avatar
KatieW
Posts: 1672
Joined: Sun Sep 27, 2009 11:07 am
Location: southern AZ

Re: ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by KatieW » Sun Mar 14, 2010 10:04 am

Excellent Dave!

_________________
Mask: Pico Nasal CPAP Mask with Headgear
Additional Comments: Resmed AirCurve 10 ASV and Humidifier, Oscar for Mac
KatieW

User avatar
Uncle_Bob
Posts: 2777
Joined: Tue Feb 24, 2009 12:10 pm
Location: Arizona

Re: ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by Uncle_Bob » Sun Mar 14, 2010 10:28 am

Thats great Dave

Now try for a zero AHI AND a flat leak line

User avatar
dave21
Posts: 720
Joined: Tue Mar 09, 2010 1:05 am
Location: United Kingdom

Re: ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by dave21 » Sun Mar 14, 2010 10:50 am

Can't wait for tonight, I'm really hoping it's not going to be a one-off but time will tell

_________________
Machine
Additional Comments: Running AirSense 10 AutoSet CPAP, previously S9 AutoSet and S8 AutoSet Spirit
Image

chairman
Posts: 3
Joined: Sat Mar 06, 2010 3:17 pm
Location: Florida
Contact:

Re: ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by chairman » Sun Mar 14, 2010 8:49 pm

I would be grateful if I can receive the Clinicians manual for the S9. Using S9 for 1 week so far. Sleep study had me at AHI w/o CPAP @ 28.3.
S9 for last night "0.3" Hard to believe it's accurate!

User avatar
KatieW
Posts: 1672
Joined: Sun Sep 27, 2009 11:07 am
Location: southern AZ

Re: ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by KatieW » Sun Mar 14, 2010 8:51 pm

chairman wrote:I would be grateful if I can receive the Clinicians manual for the S9. Using S9 for 1 week so far. Sleep study had me at AHI w/o CPAP @ 28.3.
S9 for last night "0.3" Hard to believe it's accurate!
Many of us would like the Clinical Guide. As far as I know, it's not available...yet.

_________________
Mask: Pico Nasal CPAP Mask with Headgear
Additional Comments: Resmed AirCurve 10 ASV and Humidifier, Oscar for Mac
KatieW

User avatar
dave21
Posts: 720
Joined: Tue Mar 09, 2010 1:05 am
Location: United Kingdom

Re: ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by dave21 » Tue Mar 16, 2010 12:28 am

Here's an update on my last two nights after making various tweaks. I've finally stepped off the bridge and I'm walking on water

1st night AHI = 0.0
2nd night AHI = 0.2 (two hypopneas)
3rd night AHI = 0.0

I think I may have finally cracked it

Here's the graphs from 2010-MAR-14
Image

Here's the graphs from 2010-MAR-15
Image

Last nights stats are a little shorter (6.27 hours sleep) due to being called out this morning by our IT department as we are implementing disaster recovery due to the heavy winds/floods on the east coast.

_________________
Machine
Additional Comments: Running AirSense 10 AutoSet CPAP, previously S9 AutoSet and S8 AutoSet Spirit
Image

User avatar
KatieW
Posts: 1672
Joined: Sun Sep 27, 2009 11:07 am
Location: southern AZ

Re: ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by KatieW » Tue Mar 16, 2010 8:25 am

Dave, I am pleased for you.

Would you be willing to post your other detailed graphs. I'm trying to learn how to best use the information in the graphs, and am wondering if there is anything interesting in, for example, the pressure graph--which I assume will vary during the night, or the Flow Limitation--which I assume will be pretty steady. Just trying to confirm my understanding.

_________________
Mask: Pico Nasal CPAP Mask with Headgear
Additional Comments: Resmed AirCurve 10 ASV and Humidifier, Oscar for Mac
KatieW

User avatar
dave21
Posts: 720
Joined: Tue Mar 09, 2010 1:05 am
Location: United Kingdom

Re: ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by dave21 » Tue Mar 16, 2010 10:19 am

Sure, here you go, here's for 15-MAR where the AHI was 0.0. It's a big image and some of the images might be cut off to the right (if so right click on the image and click OPEN) to see the full image - depends on your screen resolution.

Image

_________________
Machine
Additional Comments: Running AirSense 10 AutoSet CPAP, previously S9 AutoSet and S8 AutoSet Spirit
Image

User avatar
Uncle_Bob
Posts: 2777
Joined: Tue Feb 24, 2009 12:10 pm
Location: Arizona

Re: ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by Uncle_Bob » Tue Mar 16, 2010 12:40 pm

Thats good Dave. I've had 2 nights of AHI 0.0 but now i've noticed an AHI of anywhere from 0.1 to 1 of just centrals. And i just don't know how to deal with the little buggers.

User avatar
dave21
Posts: 720
Joined: Tue Mar 09, 2010 1:05 am
Location: United Kingdom

Re: ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by dave21 » Tue Mar 16, 2010 1:55 pm

Are you still running in Auto mode?

If you can give me your RAMP, MIN and MAX pressure settings, what your EPR is and also some images of EVENTS, PRESSURE and FLOW around the Apneas along with what your average pressure is across the night when you're not having Centrals I might be able to lend a hand.

If you'd rather PM me off forum you can.

Most of mine are Obstructive although I do have 1 or 2 Centrals a night, but since tweaking my settings and lowering the AHI to 0.0 I've not been seeing any Centrals either. Not sure if it would help your Centrals but I could offer some suggestions if you're willing to try something.

It's really nice to awake and press the INFO button and glance at the AHI figure and to have to squint three times to finally see AHI 0.0 I can't claim an every day of 0.0 but I'm seeing 7/10 days at 0.0 now. Some drift up slightly to 0.1 or 0.2 but mostly staying under 0.3 if they do drift up >0.0.

_________________
Machine
Additional Comments: Running AirSense 10 AutoSet CPAP, previously S9 AutoSet and S8 AutoSet Spirit
Image

User avatar
Uncle_Bob
Posts: 2777
Joined: Tue Feb 24, 2009 12:10 pm
Location: Arizona

Re: ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by Uncle_Bob » Tue Mar 16, 2010 2:28 pm

dave21 wrote:Are you still running in Auto mode?

If you can give me your RAMP, MIN and MAX pressure settings, what your EPR is and also some images of EVENTS, PRESSURE and FLOW around the Apneas along with what your average pressure is across the night when you're not having Centrals I might be able to lend a hand.

If you'd rather PM me off forum you can.

Most of mine are Obstructive although I do have 1 or 2 Centrals a night, but since tweaking my settings and lowering the AHI to 0.0 I've not been seeing any Centrals either. Not sure if it would help your Centrals but I could offer some suggestions if you're willing to try something.

It's really nice to awake and press the INFO button and glance at the AHI figure and to have to squint three times to finally see AHI 0.0 I can't claim an every day of 0.0 but I'm seeing 7/10 days at 0.0 now. Some drift up slightly to 0.1 or 0.2 but mostly staying under 0.3 if they do drift up >0.0.
Dave

I'm Ok posting here so we can all learn and share My centrals are pretty evenly spaced over the entire night as i remember. for some reason 90% of them are 10 secs with some going to 14-5.

I was titrated at 7cm so i run 7 - 15cm with EPR of 3.

I found the screen thats telling me the AHI and centrals. I have not figured out away of finding the HIs and AIs yet and my software is still not working so i'm limited right now My average pressure for a night can range anywhere from 7.0 to 8.6. My told told me to be careful raising pressure as that can induce centrals.

Given that I'm getting AHIs of <2 and that I feel pretty damn good, I'm open to the fact that this is as good as its going to get numbers wise. But I'm still prepared to do some playing around to see if anything helps, mainly because i consider centrals scary but i might have a big one and just die in my sleep

User avatar
dave21
Posts: 720
Joined: Tue Mar 09, 2010 1:05 am
Location: United Kingdom

Re: ResMed S9 and AHI 0.0 - Look Bob no hands!

Post by dave21 » Tue Mar 16, 2010 3:12 pm

Uncle_Bob wrote:I'm Ok posting here so we can all learn and share My centrals are pretty evenly spaced over the entire night as i remember. for some reason 90% of them are 10 secs with some going to 14-5.

I was titrated at 7cm so i run 7 - 15cm with EPR of 3.

I found the screen thats telling me the AHI and centrals. I have not figured out away of finding the HIs and AIs yet and my software is still not working so i'm limited right now My average pressure for a night can range anywhere from 7.0 to 8.6. My told told me to be careful raising pressure as that can induce centrals.
Without seeing the images from ResScan it's shooting in the dark but looking back at some of your older images I saw the pressure rising quite rapidly when you were hitting into a Central although the graph scale wasn't showing single unit increments so it was difficult to tell if it had increased by 2cm or 4cm. I would say if you can get these working, if you see the pressure increasing around the Central then it might be worth while upping the min and setting 7 as the Ramp and maybe have the minimum set at 8 or 9 or whatever it's increased to. It's entirely up to you if you want to try it or not. I know in Complex Sleep Apnea with a mix of Obstructive and Centrals that applying more pressure although it will reduce the Obstructive will increase the Centrals and that you would have to be careful of.
Uncle_Bob wrote:I have not figured out away of finding the HIs and AIs yet and my software is still not working so i'm limited right now
This is different to your problem but one thing I noticed today is that Flow is disappearing off of a lot of my graphs, when I looked back I only now have the last 8 days of Flow data in ResScan. Also the graphs don't appear if there's no data or ResScan thinks there's no data avaialble, e.g. if you don't have any AHI's for the night then it won't show Events. Reading the Clinician manual I see it says it will only keep Detailed stats for 7 days. The way I read it was that it would only keep it on the machine, but when I import the stats every day I'm importing all the stats again and overwriting and I think some of my detailed stats are getting overwritten. I'm wondering if ResMed are doing this to ensure they retain the space on the card.

For your problem have you tried to create a new patient record and then open it and import the SD card into that by clicking the Download Data? I'm wondering whether something has been screwed up in your patient profile and the data is on the SD card.

If that doesn't work and you have access to another computer that you can install ResScan on I would try it on there just to make sure it's not the installation that's corrupted. If it's pointing at the SD card then maybe a format of the SD card or changing the SD card for a night and see if that makes a difference. I'm wondering whether the SD card config files are corrupted on the machine and that it's not retaining or writing the detailed data correctly.
Uncle_Bob wrote:Given that I'm getting AHIs of <2 and that I feel pretty damn good, I'm open to the fact that this is as good as its going to get numbers wise. But I'm still prepared to do some playing around to see if anything helps, mainly because i consider centrals scary but i might have a big one and just die in my sleep
AHI's are still pretty good, I would be happy with them but you and I both know we're always trying to get them little blighters down to a better figure. I tried 2-3 years ago to get my AHI's down and in the end had to settle at 4.5, but lately with the S9 and getting access to the data I'm finding better ways to reduce my Obstructive AHI's.

_________________
Machine
Additional Comments: Running AirSense 10 AutoSet CPAP, previously S9 AutoSet and S8 AutoSet Spirit
Image