S9 First night didn't go so well - darn!

I was actually excited to try the unit for the first time. It didn't go well. The ramp on the autoset is set at 4 to 11. The air flow seemed fine at it's highest, but when I laid down I didn't feel like I was getting sufficient air. I removed the mask afer only 1/2 hour.

Apparently, the Doctor has to order any pressure changes. So, I have a call in to the Doc and Rep so they can decide on a pressure change. The rep though changing the ramp from 8 to 20 and also has call into the Doc. I hate this "mumbo jumbo" and the dependence on the Doc & Rep.

Surely, there must be a way I can change the ramp and pressure on my S9 without involving the Doc & Rep each time? The rep said he might not be able to make the change until Monday. I still haven't heard from my doc. Apparently, the max pressure he S9 can deliver is 20. The rep said if I need more I may need to go to a different type of machine (a BiPap was mentioned).

If that's necessary which BiPap machine should I be requesting that has data capabilities? I'd sure hate to start that search process all over.

What mask are you using? If nasal pillows, try a larger pillow.

At this point since it sounds like you are new to XPAP, though you might have learned a lot on the forum, I would depend on the Doc and DME. If you need another machine the only way you'll get it is with a script from your Doc. If you've been using XPAP longer, my apologies, but you'll still need a doctor's order for a new machine. I doesn't seem like you've currently exhausted the capabilities of the S 9 you have yet.

Hi Wonka.... welcome to the forum. Yes, you can and should take charge of your own therapy. Being a pro-active and involved participant is empowering for your own good, because no one else is going to have the time or attention to detail as you will. Please do the following:

1. First, go up to User Control Panel, top left, and then Profile.... choose Edit Equipment on the left and then choose your gear from the pull down menus. Once done, choose to show it in TEXT not pictures. Now your equipment will show up in blue at the bottom of each post you write as mine does below.

2. Find Uncle_Bob on this forum and go to one of his posts.... one the left, under his avatar, you will see links for downloading the software for your machine and also the clinician's manual...this manual will show you how to change the settings on your machine yourself.

3. Do NOT tell your doctor or DME that you have the manual or software as they will get upset (at least 90% of them do), unless you think your doc will be supportive of this (mine is).

4. GET copies of your Rx and your sleep study reports. You are entitled to have these under the law.

Your ramp is set too wide, and, evidently, they want your pressure wide open too, if they are going to move it to 8-20. Do you know what pressure you were titrated at? If it is, for example, 12, you probably want your pressure range set at 8-14 or 15. Ramp, if you use it, would be best at 6 up to 8 over 15 mins. Most of us turn the ramp off after a few days or a week.... as you will adjust to the higher pressure by then and find the lower end of the ramp too hard to breathe with.

Best of luck to you! Keep us posted on your progress. Now, you have lots to learn so keep reading on here... and go up to the yellow lightbulb at the top and use the wiki to educate yourself!

[quote="Emilia"]Hi Wonka.... welcome to the forum. Yes, you can and should take charge of your own therapy. Being a pro-active and involved participant is empowering for your own good, because no one else is going to have the time or attention to detail as you will. Please do the following:

1. First, go up to User Control Panel, top left, and then Profile.... choose Edit Equipment on the left and then choose your gear from the pull down menus. Once done, choose to show it in TEXT not pictures. Now your equipment will show up in blue at the bottom of each post you write as mine does below.

Done, but there isn't a choice for Rescan 3.12

2. Find Uncle_Bob on this forum and go to one of his posts.... one the left, under his avatar, you will see links for downloading the software for your machine and also the clinician's manual...this manual will show you how to change the settings on your machine yourself.

Done

3. Do NOT tell your doctor or DME that you have the manual or software as they will get upset (at least 90% of them do), unless you think your doc will be supportive of this (mine is).

Don't plan to tell Doc

4. GET copies of your Rx and your sleep study reports. You are entitled to have these under the law.

I have them. How to interpret them is another issue.

Your ramp is set too wide, and, evidently, they want your pressure wide open too, if they are going to move it to 8-20. Do you know what pressure you were titrated at? If it is, for example, 12, you probably want your pressure range set at 8-14 or 15. Ramp, if you use it, would be best at 6 up to 8 over 15 mins. Most of us turn the ramp off after a few days or a week.... as you will adjust to the higher pressure by then and find the lower end of the ramp too hard to breathe with.

I'm not sure what "titrated" is, but I talked to my Dr Office today and they told me I "titrated" at 7. They recommended to the rep the ramp be set from 7-18, but agreed with the rep to set the ramp to 8-20 tomorrow afternoon.

I have the Clinical manual, but still cannot figure out how to adjusted the ramp, etc. myself. I can get to the Clinical setup, but that's about it. Can anyone else tell me how to do my own adjustments on the Resmed S9 Autoset. It seems awfully "silly" and "wasteful" that to adjust the levels I have to first call the Doc who has to call a prescription to the DME and then the DME has to come to my home to make the adjustment. Surely, it can be done by me at home. How is the question.

Emilia wrote:Yes, you can and should take charge of your own therapy.

Not after one night, that is just crazy! It is foolish to not at least try to follow the original prescription for a week or so before attempting to make unilateral changes to it.

Cheers,

Bill

I was told by both the Rep and Doc not to use it until it was adjusted. It'd be a tough week with the nasal mask if I can't breathe. We'll see what happens...I was ready to try and actually looking forward to the first night. I hope I'm not rushing things.

Wonka... your equipment isn't showing... did you Submit when you were done choosing your gear?
EDIT: Now showing! YAY!

I was titrated at 8 and my auto pressure range was Rx'd at 6-10. My data showed fairly good results the first few days, and I was still a bit higher on my AHI than I wanted to be mainly due to some mild snores. I increased my bottom number up to 6.5 and I was amazed at the difference in my results.... AHI fell and snores all but disappeared. So, I do advocate, for those who want to, to be pro-active from the start. Learning your machine's settings and how to change them will be empowering, but you should only be doing this if you have the software to monitor the changes' results.

I am sure someone will be along to help you understand your machine better.

Wonka:
You said your test was a failure; but this is not so:
You learned things that you did not know previously.
The more you try, the more you will learn. Follow the guidance of the wise ones here; and you will prevail.
This process takes a while--mostly ongoing.
Here's hoping you will sail through the hard part quickly.
Sleep well, newbie.

Adjusting the pressure is very simple.

Press the main dial once to have the display light up. Then press and hold the 'Setup Menu Button' (the little silver one beside the dial with the two little check marks) and at the same time press and hold down the dial for at least 3 seconds. Then you should be in the Clinical Setup menu.

Click the dial once more and you will be able to make changes in the Settings menu. Scroll to 'Min Pressure' setting, click again and you can use the dial to scroll to a different setting. Press the dial button once more and you are done. Use the dial to scroll down to 'Home' and press if you want but you don't really need to as it will eventually go back to the default screen. It's that easy.

Hope that helps.

One thing that you have to understand about using the Autoset is that it does give you room to change the settings a little bit. it is silly to not change the ramp yourself. The ramp will not affect your overall treatment it just helps you fall asleep. Also you can change the start ramp pressure in the clinical menu. Although i would stay in the general range of the doctors order expanding your range and increasing the min pressure will not harm you at all.

here is a video that we put together that will help you get to know your machine and how to change things. Good luck
http://www.sleepnation.tv/post/1521698704/episode6

Thanks, Dane Schapper

Thanks again...and again...I couldn't find the same setting change info in the manual, and I will watch the video.