DIY - Equip Arrived Settings Where DoI Start?

[jameslv-nv]

FINALLY all my equipment has arrived.

Ok, some info for those who've helped and may have forgot because it seems like forever ago I started this journey.

Was diagnosed with OSA about 8 years ago. I did NOT get the results for various reasons. The tech who administered the test said..you've got it bad..a clear case.

So here I am.. got my ACPAP RS9 and full face.

I"m sure i've got moderate to severe. When I sleep in even an upright chair on my back..i'll wake up gasping for air at a minimum of 4 to 5 times in less than an hour. I always sleep on my side or stomach but now my arms are killing me..they ache all the time.

So... I've not gotten results or settings from a DME or doctor. I had to use cash as I have NO insurance for my equipment and supplies.

I'm needing some expert assistance on where I should start with my machine, what settings to begin with as I have no real clue where I should dial my machine in and really how to begin. I have watched several tutorials on my machine so I know HOW to un it...just not where to set it for starters.

Your help, patience and assistance will be most greatly appreciated!

Happy Easter Weekend

Jim

[jmelby]

For software and clinical manual, see Uncle Bob's signature in this thread:
viewtopic/t52732/ResScan-310-gt-314.html

Seeing as you are doing this yourself, the software will be really necessary to determine your ideal pressure or range. You'll probably want to start out with a fairly wide pressure range and narrow that over time once you know where the machine settles in to treat you. I'm not saying what you should do, but I was unable to be titrated in the sleep lab, and so my doctor started me on an APAP with a range of 7 - 15. I have since narrowed that to 9 - 13 because that is the range where I always end up on auto. Keep the fine people here on the forum informed and what your AHI and pressure ranges are and there will be plenty of help for you to determine your ideal settings.

[Emilia]

jmelby gives you good advice. I am sure rested gal will help you a great deal as she is a DIY veteran and a treasure trove of great advice and knowhow. Keep checking back as those with your machine and mask will chime in to advise you.... Best of luck!

[Otter]

Hi James,

As you know I'm no expert, but two weeks ago I was where you are now. Mark has a useful stat somewhere on secondwindcpap.com. 80% of cpap users are titrated somewhere between 6 and 14 cm h20. You could use that as a starting point. Keep in mind that's for straight CPAP with no exhaliation relief. With EPR set to 3, you might have to increase both pressures 3cm h20.

What I did was to set EPR to 3, min to 6 and max to 12. Then I put the mask on and laid down for a while. I bumped the minimum pressure up over several times until I felt like I could breathe, I think that was 8. I tried EPR 2 and didn't like it, so i went back to 3.

When I finally got the mask adjusted well enough that I could almost fall asleep, I woke struggling for breath, so I bumped the min up some more. And I kept doing that until I was able to fall asleep. IIRC, that got me to 10.4, but of course you'll be different, and you may not be so conveniently conscious of your apnea.

Later I woke up struggling for breath again and looked at the display. Pressure was at 12, and I was feeling much more comfortable with the mask, so i moved the max up.

The next night, or maybe the third night, I set the upper end to 18. I'd held off doing this at first not because i was afraid the S9 would cause my head to explode, but because I was concerned that it might blow the mask off my face.

After reviewing a few nights data, I arrived at 11.6 - 16.4 with EPR at 3. 11.6 seems to keep me out of trouble most of the time, and 16.4 is just above the highest 95th percentile I had. When I'm actually asleep, AHI is under 2, with almost no centrals.

You'll probably see some centrals right at the start of each session and perhaps about where you wake up. The former are just you holding your breath while you fuss with the mask, hose, and settings, the latter are common when people transition out of sleep. I'm still not sleeping more than two hours at a time with this contraption, and I when I'm settled in I breathe in a distinctive pattern that I can see on the traces (three fast, deep inhalations, three slow shallow, three more fast and deep). This allows me to eliminate most of this waking noise, though of course it still shows up on the averages. When I'm awake, I sometimes get an AHI over 20 for a short session, but all that means is that I don't breathe evenly when I'm tinkering with the mask straps and whatnot. You'll probably be awake a lot at first, so look at the traces in ResScan or EDF Browser instead of just accepting the averages. You can ignore centrals where you wake up, but if you have an obstructive event there, your OSA probably woke you up.

Again you'll be different, but I hope this helps.

Software:
http://www.resmed.com/int/assets/html/s ... c=patients

or if you don't want to register:
http://storage.resmed.com/software/ress ... n_3.13.exe

Clinician's manual
http://tinyurl.com/24x73ws

[roster]

For software and clinical manual, see Uncle Bob's signature in this thread:
viewtopic/t52732/ResScan-310-gt-314.html

Seeing as you are doing this yourself, the software will be really necessary to determine your ideal pressure or range. You'll probably want to start out with a fairly wide pressure range and narrow that over time once you know where the machine settles in to treat you. I'm not saying what you should do, but I was unable to be titrated in the sleep lab, and so my doctor started me on an APAP with a range of 7 - 15. I have since narrowed that to 9 - 13 because that is the range where I always end up on auto. Keep the fine people here on the forum informed and what your AHI and pressure ranges are and there will be plenty of help for you to determine your ideal settings.

jmelby, Perfect.

Don't start until you have the software loaded. You should look at the daily details report immediately after your first night.

[Lizistired]

Here's a link to the tutorial for the ResScan software. It will save you lots of time.

http://montfordhouse.com/cpap/resscan_tutorial/

[Guest]

Much appreciate your response and the resource link.

Will keep you posted on my progress.

Thank you!

For software and clinical manual, see Uncle Bob's signature in this thread:


Seeing as you are doing this yourself, the software will be really necessary to determine your ideal pressure or range. You'll probably want to start out with a fairly wide pressure range and narrow that over time once you know where the machine settles in to treat you. I'm not saying what you should do, but I was unable to be titrated in the sleep lab, and so my doctor started me on an APAP with a range of 7 - 15. I have since narrowed that to 9 - 13 because that is the range where I always end up on auto. Keep the fine people here on the forum informed and what your AHI and pressure ranges are and there will be plenty of help for you to determine your ideal settings.

[jameslv-nv]

I've read some of her post I believe..will look more in depth. Thanks for your encouragement.

jmelby gives you good advice. I am sure rested gal will help you a great deal as she is a DIY veteran and a treasure trove of great advice and knowhow. Keep checking back as those with your machine and mask will chime in to advise you.... Best of luck!

[jameslv-nv]

Oh yes Otter. I remember seeing your post about secondwindpap several weeks back. I was too late to the party and the real discounted slightly used machines were gone by the time I grabbed my ccard. LOL

I did get my machine from them but had to go bit higher priced but I have it now..and that's what matters.

Seems you're certainly understanding the info and what to try. I hope you get things ironed out and rest comfortably yourself very soon. Sounds like your very close.

Hi James,

As you know I'm no expert, but two weeks ago I was where you are now. Mark has a useful stat somewhere on secondwindcpap.com. 80% of cpap users are titrated somewhere between 6 and 14 cm h20. You could use that as a starting point. Keep in mind that's for straight CPAP with no exhaliation relief. With EPR set to 3, you might have to increase both pressures 3cm h20.

What I did was to set EPR to 3, min to 6 and max to 12. Then I put the mask on and laid down for a while. I bumped the minimum pressure up over several times until I felt like I could breathe, I think that was 8. I tried EPR 2 and didn't like it, so i went back to 3.

When I finally got the mask adjusted well enough that I could almost fall asleep, I woke struggling for breath, so I bumped the min up some more. And I kept doing that until I was able to fall asleep. IIRC, that got me to 10.4, but of course you'll be different, and you may not be so conveniently conscious of your apnea.

Later I woke up struggling for breath again and looked at the display. Pressure was at 12, and I was feeling much more comfortable with the mask, so i moved the max up.

The next night, or maybe the third night, I set the upper end to 18. I'd held off doing this at first not because i was afraid the S9 would cause my head to explode, but because I was concerned that it might blow the mask off my face.

After reviewing a few nights data, I arrived at 11.6 - 16.4 with EPR at 3. 11.6 seems to keep me out of trouble most of the time, and 16.4 is just above the highest 95th percentile I had. When I'm actually asleep, AHI is under 2, with almost no centrals.

You'll probably see some centrals right at the start of each session and perhaps about where you wake up. The former are just you holding your breath while you fuss with the mask, hose, and settings, the latter are common when people transition out of sleep. I'm still not sleeping more than two hours at a time with this contraption, and I when I'm settled in I breathe in a distinctive pattern that I can see on the traces (three fast, deep inhalations, three slow shallow, three more fast and deep). This allows me to eliminate most of this waking noise, though of course it still shows up on the averages. When I'm awake, I sometimes get an AHI over 20 for a short session, but all that means is that I don't breathe evenly when I'm tinkering with the mask straps and whatnot. You'll probably be awake a lot at first, so look at the traces in ResScan or EDF Browser instead of just accepting the averages. You can ignore centrals where you wake up, but if you have an obstructive event there, your OSA probably woke you up.

Again you'll be different, but I hope this helps.

Software:
http://www.resmed.com/int/assets/html/s ... c=patients

or if you don't want to register:
http://storage.resmed.com/software/ress ... n_3.13.exe

Clinician's manual
http://tinyurl.com/24x73ws

[jameslv-nv]

excellent thank you! I book marked and will watch that in detail tomorrow.

Here's a link to the tutorial for the ResScan software. It will save you lots of time.

http://montfordhouse.com/cpap/resscan_tutorial/

[jameslv-nv]

I'm going to download the software and get things set up tonight.

Unfortunately due to the sever high winds we've had in Las Vegas the past few days, along with my apnea issues, I can't think to clearly right now.

Very unfocussed so I"m going to get things ready tonight, software and watch a couple tutorials, then I"ll set up machine and mask tomorrow.

My mask just came today but I can tell it's at least the proper fit and I did the right thing by not even trying the large. Medium seems like it's gonna be fine.

Wishing you all a good nights sleep and hopefully tomorrow, God willing, I'll enjoy a great nights sleep IF I"m one of the very lucky few who get it right off the bat. I don't have my hopes high as from what I've read here this is a sprint not a race!

Thanks again for all your helpful post and for taking time to share your wisdom.

[Otter]

I did get my machine from them but had to go bit higher priced but I have it now..and that's what matters.

Ah, so you got the open box one? That's not such a bad thing.

Seems you're certainly understanding the info and what to try. I hope you get things ironed out and rest comfortably yourself very soon. Sounds like your very close.

Thanks. I'm getting there. I call Mark up every week or two to pick his brain, and he seems to honestly welcome the questions. I'm sure he'll be glad to help you too.

Good luck.

[Otter]

Very unfocussed so I"m going to get things ready tonight, software and watch a couple tutorials, then I"ll set up machine and mask tomorrow.

One thing I've learned is not to put off fussing with the equipment until bedtime if it's something I can do when I'm still somewhat awake.

My mask just came today but I can tell it's at least the proper fit and I did the right thing by not even trying the large. Medium seems like it's gonna be fine.

For me, the big secret to the QFX was to make sure the upper strap is on top of my head, just slightly behind center, and the lower strap is down below the base of my skull. When I was adjusting the straps the first few days, it was easy to let them wander up and forward, and this made getting a good seal impossible. On me, the QFX pushes fairly hard where it crosses my cheekbones, but hardly at all on the bridge of my nose. When I can't get a seal without having the mask dig into my nose, that means I've got the headgear too far forward. If after a day or two you find the mask doesn't work right anymore, or the headgear seems to have gotten too large, you might check where those two straps are.

[jameslv-nv]

Will see how it goes tonight. I've been adjusting and testing the settings today and after a couple of hours of not falling asleep I'm tired and ready for a real nap. LOL

I was close and felt mysef a couple of times but my mind would not allow it as I was really just trying it on for comfort and to test my air leaks.

Finally settled on starting with low of 8 and high of 12 for now. 14 seemed to make the unhappy face, leak detector, come on in a few positions but might not have had it tight enough.

Anyway..tonight will be my first official night. I'm not going to nap and figure I should be good and tired tonight.

Guess I should RESET the sleep info from my testing today or does that matter?

Thanks again for all your help!

[Otter]

Finally settled on starting with low of 8 and high of 12 for now. 14 seemed to make the unhappy face, leak detector, come on in a few positions but might not have had it tight enough.

Because there's some elasticity in the headgear, and the mask seal is an inflatable cushion, I think the the ideal fitting at one pressure is likely to leak at another. If you don't know that you need to go to 14, I wouldn't bother fussing with that yet.

Guess I should RESET the sleep info from my testing today or does that matter?

If you don't, you'll have all the data from when you were awake in your stats. And as you don't have to satisfy an insurance company, there's no downside to deleting what clearly isn't a sleep session.

If you can't sleep with the mask on at first, try putting the mask on and not sleeping. That will at least give your body a chance to get used to the mask and the pressure. Once yo'uve got enough pressure to prevent sleep onset OAs and your lizard brain has figured out that nothing bad is happening, you'll probably fall asleep.

Dream well!