Trying to reset cpap back to autopap...may need instructions

[Seekinganswers]

His machine is a Resmed not an Escape ...does anyone know how to change those settings?

http://www.apneaboard.com/resmed-s9-cpap-setup
How to get into the clinical menu and change the settings...there's also a little video there that should help.

If you are wanting 14 cm after ramp time...cpap mode is the fixed pressure. apap mode is the auto adjusting pressure.
So if you are wanting 14 all night...cpap mode is what you want.

Well, you might know...the new card came today after he had to call the doctor and tell him he sent the wrong orders and changed his to cpap mode instead of apap mode. He can't tolerate it blowing at high rate constant. The doctor still ordered it wrong. Thanks to your instructions, he was able to quickly set it back to auto and to start at 5 and only ramp to 14 or 15 if he has events. He is settled down with his new setting and ready to go to SLEEP!! He said he was asleep and it woke him up blowing too hard. So, I'll report in the morning how it goes. Thank you so much for your instructions. I've saved that info just incase he needs to tweak it. Obviously the doctor doesn't give a rats behind that he is getting sicker by the day with no sleep!

[hyperlexis]

What about exercise? Your husband is in his early 40s and he's having all these problems? Low testosterone and whatnot? Is he overweight?

I would try two things -- 1.) both of you join a healthclub and start exercising together regularly. That may help on many levels. 2.) talk to a psychologist, together or individually. Something else may be going on and a psychologist and/or psychiatrist may prove helpful. I'd even wonder about an endocrinologist, if his thyroid is malfunctioning leaving him so lethargic.

Your answers may not actually lie at the end of an air hose or a scalpel.

[patrick_a]

What about exercise? Your husband is in his early 40s and he's having all these problems? Low testosterone and whatnot? Is he overweight?

I would try two things -- 1.) both of you join a healthclub and start exercising together regularly. That may help on many levels. 2.) talk to a psychologist, together or individually. Something else may be going on and a psychologist and/or psychiatrist may prove helpful. I'd even wonder about an endocrinologist, if his thyroid is malfunctioning leaving him so lethargic.

Your answers may not actually lie at the end of an air hose or a scalpel.

If you read her posts you would know he is not over-weight.

And, you should know better than suggesting to hitting the gym. Physical recovery from exercise mainly happens at night. Guess what happens when you cannot get any kind of quality sleep?

[Seekinganswers]

I have never heard of a ResMed S9 Auto 360...maybe AutoSet?? The only cpap item that I know with 360 in the name is the Opus 360 nasal pillow.
Let's proceed on that assumption for how. AutoSet and not Escape Auto.
Here's a link for the provider/clinical manual for the S9 Elite/AutoSet. It's a combination manual but the main difference is just addition of APAP mode available in the AutoSet menu choices. APAP is the auto adjusting pressure mode.
If his machine starts out at 4 cm pressure and increases pressure up to 12 to prevent the events...then that would be auto adjusting mode because you say it goes back down to 4 and waits till it needs to go up again.
If it were cpap mode then that 4 cm starting point would go up as a ramp feature within a set amount of time an stay at 12.

http://www.apneuvereniging.nl/forum/pdf ... manual.pdf
Look at the manual and make sure his machine looks like the one shown.
Figure out how to get into the Clinical setup menu area (instructions are in the manual) and go look for Sleep Quality setting. The factory default setting is for "Usage"...check to see if it is set to Usage or if it just says "On"...we want it to say "On". So if it is set to On...leave it alone. If set to Usage change it to "One"...this affects the data that is made available for review.

SleepyHead software will work with this machine. I think you will find it easier to use than ResMed's ResScan.
I have SleepyHead links in my signature. Be sure to read the User guide also.

A hint for installing SleepyHead. If your computer is Windows Vista or later operating system let's make a little change in the normal installation steps so that you can avoid a minor hassle later with the update you will need.

So download and unzip the Sleepyhead setup files from the link in my signature...Look for the latest build and it is marked as Beta build.

Once you have the setup files unzipped then instead of double clicking mouse to start the install I want you to right click the mouse over the setup files and from the little pop up menu choose "run as administrator" from the choices.
Then let SleepyHead do its install thing.

When doing the import or download from the SD card it will prompt you to navigate to where the SD card sits (the drive letter for the SD card slot) make sure you stop at the drive letter and don't go into the SD card itself to try to do the download. It won't work if you go into the SD card. There is a picture of this in the User Guide if you have questions.
The most common error made with SleepyHead download is that people try to go into the folder. That's too far.

I have my suspicions that the 4 cm minimum pressure is probably not able to do a good job if it has to go to 12...that's too far and takes too long. Besides that 4 cm pressure could very likely be part of the not being able to breathe problem. Most people will feel like they are suffocating with that low of a pressure. Even during my titration study night they started off with 5 cm and I could barely be comfortable with 5 cm. I felt like I was trying to breathe through a straw with a cheese cloth over the end of it.

So let's see if we can get some reports to review to see what is going on.
Also SleepyHead will tell use the exact model name if there is still some doubt.
The S9 models are fairly limited and easy to see. Model names are plainly shown on top of the round on/off button.
EPR (if the machine has it available) is shown just below the on/off button on the right.

So model choices for the S9 in the cpap/apap model line are these...that's all that is available. There is no 360 in any of the S9 names.
Escape
Escape Auto
Elite
AutoSet

Now in the bilevel model line we have models beginning with VPAP right above that round knob. I won't go into that unless you tell me you see VPAP somewhere by that round on/off knob.

Once you get the data downloaded/imported to SleepyHead then can you post the most recent night's detail data?
How to post images of reports is explained in this thread along with some examples.
viewtopic.php?f=1&t=81072&p=737779#p737779
Don't worry about all the graphs that is offered. Some we don't need to see right now.
The left side of the report has the AHI color coded bars for each category...we need to see that.
On the right side we only need to see the Events graph, the Flow Rate graph, the pressure graph and leak graph.
Go to the upper left in SH where it says File and click on File and then Preferences...in preferences click on graphs...remove the check mark from the AHI graph and the mask pressure graph. Those are unneeded and by turning them off the leak graph will move up into viewing area so that you only have to do one screen shot.

Sleep Quality in the S9 has to be set to On to get these graphs.

Pugsy, this info is amazing. I've had a lot going on of late and just found this. I have copied/pasted it into a word doc and am going to print off the manual for use tonight trying to reset his machine "again" He was able to set it last night to start at 5 and ramp to 7 and stay there..but what it isn't doing that he is trying to get it to do is start at any given number like 5, 6 or 7 (not sure where is good yet with that starting number) and stay there until he has an apnea, then ramp up to 12 or 14 and when he is breathing correctly again, go back down to the 5 6 or 7. What it is doing is starting at 5 and slowly ramping up to the top number and staying there. He set the top number to 7. He did sleep 5 hours with it but noticed he was having apneas toward the end of the 5 hours that were waking him up enough that he knew it was happening. So he's wondering if the 7 isn't a high enough number to ramp to...however when he had it set to ramp to 10 it was too high and blowing out around the mask (which is the one that covers his entire nose only and is the only mask that has given him a smiley face for a good fit) He seems comfy with that mask so we hope we can get settings right so he can continue using it. The original settings after his septoplasty & turbinate reduction was set at 4 and to ramp to 12. He slept good for 2 months at that setting until his allergies or whatever happened kicked in and his nose became stopped up (doc says nasal valve collapse) and that is when he just gave up and didn't try to use the machine, hence the horrible exhaustion came back quickly. So...bottom line...if we can get it set to only ramp up for apneas and then go back down to 5 or 6 rather than ramping up and remaining at the higher number constantly, I think we can whip this thing! Your knowledge is amazing and I only hope I can learn a fraction of what you know so that I can possibly help others. I work with a dear lady who's husband is going through the same thing and getting no help from his doctor/DME co. Unbelievable what we pay for in healthcare and insurance and have to find ways to practice our own medicine (and I work for brain surgeons!)
I will anxiously await your response. I still have to look through the rest of the posts and see what else you or others have posted that might answer some questions. I'm wondering if we might need to correspond by email or private message until we get this thing set right. i'm still so new at this forum it's a bit cumbersome to find where I left off and where new things are posted..

[Pugsy]

I am lost here. I don't know if you are doing straight cpap mode at 14 with or apap mode or cpap at 7 cm.
Or how long the ramp is and from what to where.
You talk about changing pressures being a problem and then you want to have the machine reduce the pressure for times when not as much pressure is needed.
Then you talk about starting at 5 cm ramp and going to 7 cm as top number...is that cpap mode?
If so if he normally needs 14 cm to deal with his sleep apnea then obviously 7 is not likely going to work.

Now he might be able to get by with less than 14 cm in cpap mode but we don't know how much less unless we see some reports. My own step sister spent 5 years at cpap 14 cm and using the new S9 AutoSet in APAP mode we discovered she rarely went above 11 cm.
She is good with changing pressures in apap mode but if she wasn't okay with that we could set her for 10 or 11 cm in cpap mode and she would still get great therapy. She doesn't need 14 cm.

Are you following his detailed reports at all? If not we are totally flying blind here.
We really need to see some recent reports to get a feel for what he is using and what the results are showing.

[Seekinganswers]

What about exercise? Your husband is in his early 40s and he's having all these problems? Low testosterone and whatnot? Is he overweight?

I would try two things -- 1.) both of you join a healthclub and start exercising together regularly. That may help on many levels. 2.) talk to a psychologist, together or individually. Something else may be going on and a psychologist and/or psychiatrist may prove helpful. I'd even wonder about an endocrinologist, if his thyroid is malfunctioning leaving him so lethargic.

Your answers may not actually lie at the end of an air hose or a scalpel.

No, he is not overweight. Very slim and trim. He doesn't have the "want to" to do much of anything but work and he forces himself to do that. He is self employed and his line of work is heavy construction type work. It's very hard to get up every morning feeling like you have been hit by a truck and even think about "exercising" or "joining a fitness club" but work is something he HAS to do.
Last year we did walk about 3 miles every evening but he wasn't in the condition he is now. The Low-T i'm sure is from the sleep deprivation as is the sluggish thyroid (he is on thyroid meds) and his pcp follows him for that along with the T-replacement. Yes, he is in his 40's but has talked to people he has known since childhood and they even remember him making "funny noises" in his sleep...this was back before you ever heard of sleep apnea. So I would guess that over a lifetime of this creeping up on him, it has finally taken it's toll. Until he is sleeping 8 hrs per night with good quality sleep, he isn't going to get better. We certainly are not looking for a surgical fix, quite the contrary. It's not that simple! Wish it were We are just hoping to get a good setting on his cpap machine and mask that he can tolerate so he can sleep uninterrupted for as many hours as he can. Since sleep is cumulative, I am sure it will take a year or more of consistent good quality sleep before he will be 80% better, but hoping he will feel improvement everyday until then.

[chunkyfrog]

Even a small amount of walking is likely to help.
If he gets a good pedometer, and tries to take a few extra steps whatever he is doing throughout the day,
the little bit of exercise will help build his endurance and ability to keep adding a little at a time.
A short stroll in the early evening, if done frequently, will make a significant difference.
and help him unwind before bed.
Long, brisk walks when you are not ready for them is a guarantee you will stop doing it.

[Seekinganswers]

I am lost here. I don't know if you are doing straight cpap mode at 14 with or apap mode or cpap at 7 cm.
Or how long the ramp is and from what to where.
You talk about changing pressures being a problem and then you want to have the machine reduce the pressure for times when not as much pressure is needed.
Then you talk about starting at 5 cm ramp and going to 7 cm as top number...is that cpap mode?
If so if he normally needs 14 cm to deal with his sleep apnea then obviously 7 is not likely going to work.

Now he might be able to get by with less than 14 cm in cpap mode but we don't know how much less unless we see some reports. My own step sister spent 5 years at cpap 14 cm and using the new S9 AutoSet in APAP mode we discovered she rarely went above 11 cm.
She is good with changing pressures in apap mode but if she wasn't okay with that we could set her for 10 or 11 cm in cpap mode and she would still get great therapy. She doesn't need 14 cm.

Are you following his detailed reports at all? If not we are totally flying blind here.
We really need to see some recent reports to get a feel for what he is using and what the results are showing.

Ok, let me see if I can explain a little clearer what has been going on in the past, what is now going on and what we NEED to have happen lol. He was on straight cpap when he first got a machine (it was a different older machine that a friend gave him because at the time, he didn't have insurance.) It was just a straight cpap set at 12 I believe. Then he started having problems with that machine because of his deviated septum. He went to a surgeon in a larger town about an hour away (we live in a very rural area) He had septoplasty and turbinate reduction surgery in August 2012. Surgeon said his nose was one of the top 5 worse cases he had ever did surgery on. But he believed the surgery was successful. After a month of nasal rinsing and after the pain subsided enough that he could stand his mask (nasal pillows back then) his nose was open pretty good on one side, but the other side was never really good, but he could breathe good enough to use the machine... and the surgeon got him his current machine (resmed autostart or whatever the one is that you have the pic of for the manual you gave me) It was not set as a cpap but rather apap or whatever it is called where it starts at a low number and stays there until he stops breathing, then it ramps up almost immediately to the higher number then as he begins breathing again, it would go back down to the 5...these were 5 & 12 at the time. He was able to use that through the months of october and november very successfully he thought...he actually started feeling pretty stinkin good. However, he began having some problems with his nose being stopped up, unable to get hardly any air through it. He went back to the surgeon who told him he had some "nasal valve collapse but that his turbinates were perfect...surgery was a success! He could drive a truck up in there! Hubby said well that's all good, but I can't breathe when I lay down and put my machine on because my nose closes up. The surgeon then replied, well, that's just the way your made! That doctor is the one who ordered the machine to ramp up to get him breathing, then it goes back down to make it easier for him to exhale. Does that make sense? So, he had another sleep study or titrate study ordered by the Neuro here in town to see if his setting were correct because he was still able to stop breathing and gasp for breath even with the full face mask (which is what he switched to because the nasal pillow one was uncomfortable sitting on his nose after surgery) So he thought maybe the top number of 12 was too low to get him breathing again. The study was done with a regular cpap machine with straight 12 or 14. The tech kept waking him up tightening his mask etc. Bad night which I posted about already...anyway...that doctor has now had to call the 3rd order in because he keeps having it set at straight cpap...starts at 7 and within 30 minutes it is at 14 and goes constant...never goes down for the exhale or regular breathing when he isn't having events. So..I just now got off the phone on a conference call with the DME provider & the doctor so they could explain what he was doing wrong in his order..I think they may have it right this time we will see. But in the meantime, we are going to follow the directions you sent to set it ourselves which he did last night and slept 5 hrs. However we were never able to get it out of cpap mode but we did get it set down lower so he could tolerate it better....at least for 5 hrs..that's better than he has ever used it since that initial two months. I sure hope this explains what were dealing with. We're new to all the lingo and may not be explaining so that you can understand...let me know and thank you for your tireless help, it is appreciated.

[zoocrewphoto]

We really need the data. Your descriptions leave us wondering what mode it is really in and what the settings really are. If you post the graphs, we can see exactly what the settings are and what the machine is doing. It would eliminate the confusion.

I don't understand why you keep asking for help, but you won't post any data or graphs. We end up asking more questions, and we can't help you without knowing what is going on. Explaining it doesn't help when the explanations have contradictions in them. For example, you describe both cpap and apap mode, but it can only do one at a time. Previously, we spent several days trying to determine what type of machine your husband has, and you wouldn't tell us what word was above the power button.

If you want us to help you, you need to post the graphs.

[Seekinganswers]

We really need the data. Your descriptions leave us wondering what mode it is really in and what the settings really are. If you post the graphs, we can see exactly what the settings are and what the machine is doing. It would eliminate the confusion.

I don't understand why you keep asking for help, but you won't post any data or graphs. We end up asking more questions, and we can't help you without knowing what is going on. Explaining it doesn't help when the explanations have contradictions in them. For example, you describe both cpap and apap mode, but it can only do one at a time. Previously, we spent several days trying to determine what type of machine your husband has, and you wouldn't tell us what word was above the power button.

If you want us to help you, you need to post the graphs.

I don't know for sure, but you seem upset with me? I don't HAVE any graphs to post. I do not know enough about these machines to be as specific as you folks do and it's not that I "wouldn't tell you" what kind of machine he has or what "word" was above the power button, I wasn't on here everyday and it may have seemed as though I was ignoring you and your questions. I understand it can only do one function at a time and frankly I do not know WHAT it is doing because it was set one way by one doctor and changed to the other function by another in error. I think we will get it set right next week when the new SD card arrives because I had a conference call between the DME company and the neurologist today and they explained to him how it needed to be set.

[zoocrewphoto]

We really need the data. Your descriptions leave us wondering what mode it is really in and what the settings really are. If you post the graphs, we can see exactly what the settings are and what the machine is doing. It would eliminate the confusion.

I don't understand why you keep asking for help, but you won't post any data or graphs. We end up asking more questions, and we can't help you without knowing what is going on. Explaining it doesn't help when the explanations have contradictions in them. For example, you describe both cpap and apap mode, but it can only do one at a time. Previously, we spent several days trying to determine what type of machine your husband has, and you wouldn't tell us what word was above the power button.

If you want us to help you, you need to post the graphs.

I don't know for sure, but you seem upset with me? I don't HAVE any graphs to post. I do not know enough about these machines to be as specific as you folks do and it's not that I "wouldn't tell you" what kind of machine he has or what "word" was above the power button, I wasn't on here everyday and it may have seemed as though I was ignoring you and your questions. I understand it can only do one function at a time and frankly I do not know WHAT it is doing because it was set one way by one doctor and changed to the other function by another in error. I think we will get it set right next week when the new SD card arrives because I had a conference call between the DME company and the neurologist today and they explained to him how it needed to be set.

Just frustrated. Back when we were trying to figure out what machine you had, you kept giving us odd names, numbers, and descriptions, and then you would not respond to posts asking what word was above the power button. You also haven't filled in the equipment on the profile. Back then, I was wondering if you were trolling as it just seemed odd that you would not tell us what machine you had, even though we kept asking. Since then, you have been given directions on how to get the software, get the data, and how to post the graphs. You just seem to skip over those and keep asking questions that we really do need the data to answer.

And lately, you keep telling us information that again doesn't make sense. You say the machine is in apap mode, but you are describing ramp and cpap mode. There is honestly no way we can help you if we don't know what mode the machine is in and what it is set to. And we can't trust your answers since your explanation contradicts itself. We NEED to see the data.

I'm sorry if I come across as grumpy, but I can't help but wonder if this topic is real or just a prank. If you are serious, PLEASE download the software and post some data/graphs for us. THEN we can figure out what is going on.


http://www.apneaboard.com/resmed-s9-cpap-setup
How to get into the clinical menu and change the settings...there's also a little video there that should help.

Sleepyhead link: http://sourceforge.net/projects/sleepyhead/files/


How to post images of reports is explained in this thread along with some examples.
viewtopic.php?f=1&t=81072&p=737779#p737779

[Seekinganswers]

We really need the data. Your descriptions leave us wondering what mode it is really in and what the settings really are. If you post the graphs, we can see exactly what the settings are and what the machine is doing. It would eliminate the confusion.

I don't understand why you keep asking for help, but you won't post any data or graphs. We end up asking more questions, and we can't help you without knowing what is going on. Explaining it doesn't help when the explanations have contradictions in them. For example, you describe both cpap and apap mode, but it can only do one at a time. Previously, we spent several days trying to determine what type of machine your husband has, and you wouldn't tell us what word was above the power button.

If you want us to help you, you need to post the graphs.

I don't know for sure, but you seem upset with me? I don't HAVE any graphs to post. I do not know enough about these machines to be as specific as you folks do and it's not that I "wouldn't tell you" what kind of machine he has or what "word" was above the power button, I wasn't on here everyday and it may have seemed as though I was ignoring you and your questions. I understand it can only do one function at a time and frankly I do not know WHAT it is doing because it was set one way by one doctor and changed to the other function by another in error. I think we will get it set right next week when the new SD card arrives because I had a conference call between the DME company and the neurologist today and they explained to him how it needed to be set.

Just frustrated. Back when we were trying to figure out what machine you had, you kept giving us odd names, numbers, and descriptions, and then you would not respond to posts asking what word was above the power button. You also haven't filled in the equipment on the profile. Back then, I was wondering if you were trolling as it just seemed odd that you would not tell us what machine you had, even though we kept asking. Since then, you have been given directions on how to get the software, get the data, and how to post the graphs. You just seem to skip over those and keep asking questions that we really do need the data to answer.

And lately, you keep telling us information that again doesn't make sense. You say the machine is in apap mode, but you are describing ramp and cpap mode. There is honestly no way we can help you if we don't know what mode the machine is in and what it is set to. And we can't trust your answers since your explanation contradicts itself. We NEED to see the data.

I'm sorry if I come across as grumpy, but I can't help but wonder if this topic is real or just a prank. If you are serious, PLEASE download the software and post some data/graphs for us. THEN we can figure out what is going on.

Really? A prank? I have nothing better to do with my time than look up a cpap forum and pour my heart out to you people trying to figure out how to help my husband and you say you think it's a prank? I don't have any data so...I have decided the additional stress is not worth it so I am not posting anymore questions and I will not be signing back on to this forum again.


http://www.apneaboard.com/resmed-s9-cpap-setup
How to get into the clinical menu and change the settings...there's also a little video there that should help.

Sleepyhead link: http://sourceforge.net/projects/sleepyhead/files/


How to post images of reports is explained in this thread along with some examples.
viewtopic.php?f=1&t=81072&p=737779#p737779

[Wulfman...]

Really? A prank? I have nothing better to do with my time than look up a cpap forum and pour my heart out to you people trying to figure out how to help my husband and you say you think it's a prank? I don't have any data so...I have decided the additional stress is not worth it so I am not posting anymore questions and I will not be signing back on to this forum again.

After reading this entire thread last night, I sort of came to a similar conclusion. (except maybe different wording)
You've wasted a month of everyone's time by not answering questions.....and giving "gobbledegook" (meaningless) answers in your posts. You haven't followed anybody's instructions or given any information for anybody to work with.

If any of the people who have tried to help this person feel like one of their legs may be longer than the other, I don't blame you. How frustrating!


Den

.

[zoocrewphoto]

Really? A prank? I have nothing better to do with my time than look up a cpap forum and pour my heart out to you people trying to figure out how to help my husband and you say you think it's a prank? I don't have any data so...I have decided the additional stress is not worth it so I am not posting anymore questions and I will not be signing back on to this forum again.

There are people who go to a forum and start posting stuff to see how long they can keep people responding. I normally wouldn't suspect somebody of being a prank, but I started to think so when you kept responding with odd descriptions of the machine, but no name, when the name was clearly on the front of the machine. You kept stating one brand name and then stating a feature only offered on a different brand. We knew something was wrong. And when we asked which word was on the front and gave you a list to choose from (several times), you ignored every post, and only finally answered after somebody posted photos. Why did you make us jump through so many hoops when we made it clear how important it was to know which machine you have?

I am sorry you feel that you need to leave. I kept posting in case you were really trying to get help and would actually answer the questions and post data. But for some reason, you refuse. I don't know why. But we can't help you. We keep trying to help you, but you won't help us help you.

You said you have a Resmed S9 Autoset, so you DO have data. And we have posted how to get the data and how to post the data. It's up to you. If you want help, get the data and post it. We can't tell what it is going on by our explanations, so we need the data.