New here - introduction

[JulieKalber]

Hi all,

I have been sitting here reading posts, at 5am in the morning (Australia time!) because I am having trouble sleeping. Having trouble sleeping due to excessive coughing, nasal congestion and dry throat. I spend my days as though I have chronic hay fever sniffling and sneezing. I have been on CPAP therapy for nearly three months now, this coughing thing has started in the last month or so.
When I had the sleep study (67 apneas in an hour, oxygen level 67%), I did not realise that I had been sucked in to a company sponsored by Phillips. I have been taken for a ride financially, with the only option to buy their machine (they thought....). After some pressure (pardon the pun) I got enough information out of them to be able to go ahead and buy the Resmed S9 (we did a lot of research online beforehand).
I have the software from the resmed site - it is version 3.14. I notice there is a choice of 3.7 on the equipment listing. Does this mean I can get a more updated version of the software somewhere?
I started on auto settings. Now I am trying it on manual settings and am not sure this is the way to go. Seems to me that if a machine can automatically work it out, then having it in manual mode is a waste. But I was told that trying both was the way to go. I understand that settings are a personal thing with many variables - I really have trouble with that, given I am a 'black and white' person. Fortunately, my husband is a patient man and already knows more about my settings than I ever will! My prescription is an 8
At this time I am trying to work out whether I need humidity, heat, auto or manual .....yes, pretty much confused and frustrated. Someone suggested to me that the coughing was caused by having humidity - I only had it set on 1 when I did try the humidity, but it is happening without it too. From what I am picking up, I may benefit from a heated hose?
Wow, it is time for me to get organised for work. Time flies when you are overwhelmed and trying to convey that in type!
Anyway, I am Julie from Australia and am looking forward to getting to know you all!

[chunkyfrog]

Welcome to our little group.

[teknomom]

Welcome, Julie! Those who know your machine will respond in more detail, but this is a great place to get information and support!

[msradar65]

Welcome Julie,

I use my machine in auto mode for humidity. I set the temp with the climate line hose and let it do its thing. It does take some time to find the perfect temp. But once you do all is well.

Right now I have a horrible cold. My S9 has been keeping me pretty comfy at night. I turned up the temp and added a room humidifier.

[Pugsy]

I have the software from the resmed site - it is version 3.14. I notice there is a choice of 3.7 on the equipment listing. Does this mean I can get a more updated version of the software somewhere?

Welcome to the forum.

Actually ResScan 3.16 is the latest version. Version 3.7 happens to be a much older version that used to be sold by cpap.com and that is why it is shown in the equipment drop down menu. ResScan can no longer be sold by companies like cpap.com so they are only offering a link for informational purposes since it used to be available. If something isn't sold (or was sold in the past) by cpap.com it won't show up as an option in the menu.

I read where version 3.7 might actually be 3.07 for numbering purposes. I don't know if that is true or not but 3.16 is the latest. Your 3.14 version is quite close and I don't think there are any differences that will impact your reports any. Just some minor bug fixes I think.

If you want 3.16 you can find information on it in UncleBob's signature line here. memberlist.php?mode=viewprofile&u=38643

Some of your nasal symptoms may be related to humidifier setting. Those symptoms can occur if someone either has too much moisture nor not enough moisture from the humidifier. Some people need more and some people need less. So you might try changing the setting one way or the other to see if it helps.
If symptoms occurred at a setting of 1 (low) and without humidifier...then perhaps you need more added moisture.

[Lizistired]

ResScan 3.7 should have been called 3.07, it's an older version so don't worry about it. The newest is 3.16 and that link can be found in UncleBob's signature, there should be a link in mine below.
If your titration said 8 cmh2o, I would try that for a week or so until you have time to get used to the machine, mask, hose and adjust the "comfort features", ie. Humidity, EPR and Ramp, to your liking. On CPAP, there is an additional setting for EPR that controls it's speed. Fast or Medium I think.
Then see what your data looks like and how you feel before you decide if you need adustments.

[Elle]

Hello and welcome. You came to the right place. There are many members well educated on sleep apnea here.

[idamtnboy]

I have the software from the resmed site - it is version 3.14. I notice there is a choice of 3.7 on the equipment listing. Does this mean I can get a more updated version of the software somewhere?

The equipment list links back to equipment currently, or previously, sold by the site sponsor. They used to sell Resscan s/w but that ended with version 3.7, hence the 3.7 choice. I don't know why they don't want to revise the equipment list choice to, at the very least, drop the reference to 3.7.

[JulieKalber]

Thank you very much for the welcomes and advice.
I think I will try the full mask tonight. I am so very tired, having had very little sleep over the last few nights with all that damn coughing.......

I am so glad to have found this group, that much I do know.

Julie

[Mary Z]

Maybe you could try it the way your doctor ordered the pressure and mode of operation while you fiddle with the humidity.

[Janknitz]

Having trouble sleeping due to excessive coughing, nasal congestion and dry throat. I spend my days as though I have chronic hay fever sniffling and sneezing. I have been on CPAP therapy for nearly three months now, this coughing thing has started in the last month or so.

It's unclear whether the coughing is related to your CPAP at all, particularly since it only started in the last month of three months of treatment. I'm not saying it's not caused by CPAP, but only that you should rule out any sinus issues, or even asthma/bronchitis before assuming it's the CPAP. Maybe a check in with your doctor is in order.

Once you have ruled out other causes of the cough, it MAY be the humidity, it may be mask leakage, it may be mouth leakage--you are using a nasal mask and complaining of a dry throat--very common when your mouth opens as you sleep and the pressurized air rushes out of your mouth instead of down your throat to keep your airway open. If that's the case, fiddling with the humidifier will make no difference whatsoever.

Since you have software and have been told how to download more up to date software, you can check the data to see what's going on. If the leak rates are excessive, then that may be an issue.

I started on auto settings. Now I am trying it on manual settings and am not sure this is the way to go. Seems to me that if a machine can automatically work it out, then having it in manual mode is a waste. But I was told that trying both was the way to go.

Well, here’s another clue to what may be going on. Auto can be very useful, but ONLY IF THE SETTINGS are optimal. From what you are saying “a machine can automatically work it out” I’m going to guess that you used the auto settings “wide open”—that is 4 -20, thinking that the machine would figure out the pressure you need at any given moment. Only it doesn’t work that way. The machine has a complex algorithm to determine if an apnea or hypopnea is the result of a smallish leak or an airway obstruction, or another issue (clear airway apneas). So it takes some time to work it out.

Often the machine will first LOWER the pressure, to see if it’s a small leak can seal itself off, and only if the event persists will it start to gradually increase the pressure. This can take several minutes, and if the machine starts too low and has too far to go to catch up with the apneas, it can overcompensate by going too high “chasing” the apneas. This may cause sleep disturbances and mask leaks. When an auto is set in a narrow and optimal range, it usually works better.

For starters, if your titrated pressure is 8, you may want to start the auto pressure no less than 2 cm below your titrated pressure and put the higher pressure about 3 cm above your titrated pressure. Then try it for several nights and adjust as necessary based both on your data and how you are feeling.

This is not an exact science, it’s not black and white, but there is some logic here. You are lucky to have a supportive spouse who complements your strengths and weaknesses. Together you CAN work this out.

Now, the hard part is that we advise changing only ONE thing at a time and spending a few nights with that change to see if it’s effective before making another change. You are going to have to look at your data and prioritize what change to make first. If leaks are an issue, start there—nothing else will be effective until leaks are under control. Try to separate out whether it’s a mask leak or an open mouth leak (or both!). Once leaks are taken care of, you can move to settings, like the humidifier (and yes, it’s OK to experiment with the humidifier completely off—passover mode, and then gradually increase the temp to see if that makes any difference), or the pressure.

[JulieKalber]

Mary, thanks for your response. Here in Australia, there are 'sleep clinics' that doctors refer to for sleep studies and subsequent diagnosis and machine set up. What I didn't realise that the sleep centre I went to was a "Phillips" sponsored clinic. They only promote Phillips products. A fellow apnea sufferer warned me about this, but only after I had had the sleep study with them. Once that happened, they provided (what they had indicated was a free service, but wasn't) three months trialling their machine. The 'clinician' saw me over those weeks and tried auto first, then manual settings without giving me any information.
It became obvious that she really was there to sell Phillips equipment (priced at an extortionate level, I might add) . She really had no idea about cpap therapy and it's issues - it was a "put on the mask and off you go, cured" mentality.
Meanwhile I researched a lot,asked questions and decided that the Resmed was the way to go. Once this clinician knew that I was aware that they had to give me my prescription, she reluctantly gave me my 'number'. Therefore, I have no backup from them, as the door was firmly shut once I didn't buy their machine.
This is why I am so thrilled that I found this site. I have spent a lot of time reading to fit all the pieces together, but this site is just wonderful! I ask the direct question and get such great responses. I have learned more reading here in the last few days, than I did during all those visits to the so called experts.

[JulieKalber]

Janknitz,

Thank you for such a comprehensive response!
I am feeling a lot better, having had a bit more sleep over the last couple of nights. I took your advice with one adjustment at a time and gave myself humidity the first night of 1. The coughing was less. Last night I raised it to 3.5 and had minimal coughing.
I know I have issues with leakage, but given my AHI is averaging less than 2 over the week, thought that maybe this made it ok. Having read a lot, I realise that it is not ok. I have ordered the mask liners as I think this will help with that problem and the discomfort that causes me to yank the mask off at times - not nearly as much as at first, so I must be orientating to it all. I am learning about fitting the mask properly too, practise makes perfect I guess.
I have also learned by reading the forum, that I had an incident of aerophagia. I woke up with severe pain and feeling nauseous one night - long story short, fainted at the toilet, cracked my head face and elbow - scarey stuff! Woke up inches from the toilet bowl, thinking I was seeing 'the light' Took me two days to feel back to normal, after that one.
I am so glad that I really had no idea how complex this all is, I think this gradual learning is a far better way to go for sanity's sake!

Thanks again for your support.