questions & tired with new ASV machine

[new-to-BiPAP]

First off, let me say that I have a new machine (ASV) and have only been using a week. I feel sleep deprived so that might be why I am having trouble understanding the data. Last night, for example, my AHI was nice and low (0.12), however I am absolutely exhausted. I used the machine for about 8 hours and slept for another hour after that cuz I was too tired to get up. I seem to be waking up with mask leaks. The DME is supposed to get back to me for a mask fitting. I had 30 mostly small mask leaks. 49 flow limitations spread out over the night which tend to wake me up according to my sleep study. My EPAP is 6, IPAP is 9-21 PS 3/15. I don't remember what these numbers mean and if I read the definitions of EPAP and IPAP I forgot in a few seconds. Having some problems with focus and memory here which I'm assuming is from bad sleep. I haven't figured out how to attach my graphs. I'll see if I can do that later on in the day if I can wake up some. I have a data download at the dr's office in a month or so with a sleep tech. I guess, because my AHI is not too bad, I'm not sure what to look at to see what is causing my problem. I know I could wait a month till the data download but at this point I feel so tired that I cannot see myself using this every night until then. Plus, I like to look at the data myself cuz I think it is interesting. I just don't understand it. My Vt seems low 300-400 W-avg per night. I don't even know which squiggly lines to look at and which to take off because too many make my eyes glaze over.IT seems like I get a spike of my flow rate, tidal volume, minute vent & insp time all at the same time (sometimes in line with a flow limitation & or mask leak and sometimes without a flow limitation or mask leak. Could these be awakenings? I hate that this is making me sleep worse.

I tried a BiPAP and VPAP years ago but they made me exhausted and gave me central apneas so I am now on the ASV. I so want to give up but feel I haven't given it enuf time. How long does it take to get everything working properly?

[STL Mark]

Stick with the machine each night. Some take more than a week to feel better. Avoid naps without the machine. Some find that even though the majority of the night is with the machine if the last hour(s) are without they wake up feeling exhausted. So if your too tired to get out of bed, keep the mask on...

Which machine do you have? The Respironics DS960 is the latest model from that firm. The Resmed S9 VPAP Adapt is their current model. Some DME firms will buy out of date inventory to give to their patients because they can get it for a lower cost and their reimbursement is the same. Return here often and keep us posted on your progress.

[new-to-BiPAP]

Mine is the s9 resmed vpap machine. I have the humidifier and a resmed full face mask. But the mask is leaking, especially when it increases pressures and wakes me up so I am going back in to the DME to get fitted for a mask. They said I mouth breathe with the pressures so I will need a full face mask.

Yesterday I got dehydrated and felt ill most of the day so I did not sleep with it last night and I feel better. Yesterday was the first day i took a nap but because I didn't know I was going to fall asleep I didn't use the machine. Is it normal to feel more tired when you start using the machine? Also, can the you get dehydrated by using the machine even with the humidifier? I can't increase the humidifier (currently set at 68 degrees) because it feels stuffy, plus it makes my nose stuffy if I increase it even a degree. I feel like I have been sleeping worse with the machine than without. Hoping that some of that is the mask leaks waking me up.

[Pugsy]

Yes, it is normal to feel perhaps more tired when using the machine.
Especially sometimes the ASV machines. It can take a lot more adjustment for the body to get used to the way the machine responds even if everything regarding the therapy is perfectly ideal.
ASV users often complain that the machine wakes them often when it changes pressures and anything that wakes us up often (that includes your leaky mask) will end up making us have much less quality sleep and we feel it the next day.

Do you have your software up and running so that you can at least evaluate the therapy on paper?

While some ASV users feel a marked improvement pretty much right from the start of therapy, from what I have read it can take ASV users longer to get adjusted to the way the machine is trying to fix their problem. Longer than for the plain cpap/apap machine users because of the adjustments need and time for the body to learn that the way the machine wants you to breathe is for your own good.

So if you are waking often for any reason that alone will impact how you feel the next day even if your therapy is perfectly acceptable on paper.
So evaluate the therapy and also your sleep quality.

[robysue]

First off, let me say that I have a new machine (ASV) and have only been using a week.
<much deleted>
My EPAP is 6, IPAP is 9-21 PS 3/15.
<much deleted>
I tried a BiPAP and VPAP years ago but they made me exhausted and gave me central apneas so I am now on the ASV. I so want to give up but feel I haven't given it enuf time. How long does it take to get everything working properly?

and

Mine is the s9 resmed vpap machine. I have the humidifier and a resmed full face mask.

Can you please clarify what machine you have?

Is it a plain Resmed S9 VPAP Auto (aka BiLevel) machine: https://www.cpap.com/productpage/S9-VPA ... chine.html ?

Or is it the Resmed S9 VPAP Adapt-SV (aka ASV): http://www.resmed.com/us/products/s9_vp ... c=patients ?

I'm assuming it's the S9 VPAP Adapt-SV.

But the mask is leaking, especially when it increases pressures and wakes me up so I am going back in to the DME to get fitted for a mask. They said I mouth breathe with the pressures so I will need a full face mask.

Mask leaks with ASVs seem to be a tough, but common problem. It's those high IPAP pressures. You might want to do some searching for posts by JohnBFisher since he uses an ASV if I recall.

Is it normal to feel more tired when you start using the machine?

Yes, this is not uncommon.

Also, can the you get dehydrated by using the machine even with the humidifier?

Possibly.

I can't increase the humidifier (currently set at 68 degrees) because it feels stuffy, plus it makes my nose stuffy if I increase it even a degree.

Sounds like you're running on the default ClimateControl setting which allows you to choose the temp for your ClimateLine hose and then the machine decides how much humidity to add. There is a way to change that setting to some kind of manual setting that allows you to control the temp and the humidity level separately, but I believe the instructions on how to do that are in the Clinical manual. I haven't owned an S9 in several years and I never did have a ClimateLine hose, so the particulars about how to switch off the automatic ClimateControl for the manual version is not something I learned how to do.

[new-to-BiPAP]

First off, let me say that I have a new machine (ASV) and have only been using a week.
<much deleted>
My EPAP is 6, IPAP is 9-21 PS 3/15.
<much deleted>
I tried a BiPAP and VPAP years ago but they made me exhausted and gave me central apneas so I am now on the ASV. I so want to give up but feel I haven't given it enuf time. How long does it take to get everything working properly?

and

Mine is the s9 resmed vpap machine. I have the humidifier and a resmed full face mask.

Can you please clarify what machine you have?

Is it a plain Resmed S9 VPAP Auto (aka BiLevel) machine: https://www.cpap.com/productpage/S9-VPA ... chine.html ?

Or is it the Resmed S9 VPAP Adapt-SV (aka ASV): http://www.resmed.com/us/products/s9_vp ... c=patients ?

I'm assuming it's the S9 VPAP Adapt-SV.

Yes, it is the It is the Red Med VPAP Adapt S9 series w/ H5i heated humidifier.

But the mask is leaking, especially when it increases pressures and wakes me up so I am going back in to the DME to get fitted for a mask. They said I mouth breathe with the pressures so I will need a full face mask.

Mask leaks with ASVs seem to be a tough, but common problem. It's those high IPAP pressures. You might want to do some searching for posts by JohnBFisher since he uses an ASV if I recall.

Thanks, I'll check for the other posts your recommended.

Is it normal to feel more tired when you start using the machine?

Yes, this is not uncommon.

Glad to know, I'll keep plugging away at wearing it...

Also, can the you get dehydrated by using the machine even with the humidifier?

Possibly.

I can't increase the humidifier (currently set at 68 degrees) because it feels stuffy, plus it makes my nose stuffy if I increase it even a degree.

Sounds like you're running on the default ClimateControl setting which allows you to choose the temp for your ClimateLine hose and then the machine decides how much humidity to add. There is a way to change that setting to some kind of manual setting that allows you to control the temp and the humidity level separately, but I believe the instructions on how to do that are in the Clinical manual. I haven't owned an S9 in several years and I never did have a ClimateLine hose, so the particulars about how to switch off the automatic ClimateControl for the manual version is not something I learned how to do.

I didn't realize there was another way to change it. I'll ask the DME if I can do it manually. It shows it manually until I attach the climate hose. I have an old regular hose from back in 2008 that I could try and attach to play around with the settings. Not sure if it will let me but I can try.

Thanks for the help!

[Pugsy]

The CLimateLine can be set up so that temperature and humidity controls are separate settings.

According the the manual I have it just says turn "ClimateLine" to Off.
I don't have my S9 to check it but that sounds a bit weird. I thought I changed something to "Patient" and not "Automatic" but I have slept since then so my memory may not be accurate and I can't find my cheat sheet with the instructions on how I did it.

I think this video explains it though.
http://www.cpaplibrary.com/machines.html

While this manual is for the cpap/apap machine S9 and not the VPAPs...the menu choices for humidity delivery are the same for all models.
http://www.apneuvereniging.nl/forum/pdf ... manual.pdf

[NateS]

One trick I used to get accustomed to my S9 VPAP Adapt ASV was to start out each night, after lying down with the machine on and mask in place, by deliberately taking some long, very deep breaths in and out. I wanted lots of air intake, with no sensation of inadequate air supply, for about the first 3 long, deep breaths.

I got the sensation that I was instructing the machine and, whether it was my imagination or for real, I would then get the sense that the machine was taking instructions from my lungs and that my body and brain was in control of the machine. Maybe it was the other way around, but I nevertheless then felt more secure and relaxed, feeling the machine was tuning its algorithms to take care of my needs. It might have been for real or it might have been a psychological trick, but it worked.

After I did that, I relaxed and trusted the machine to know what I wanted and needed, and often fell asleep within fifteen to thirty minutes.

Best wishes, Nate

[new-to-BiPAP]

One trick I used to get accustomed to my S9 VPAP Adapt ASV was to start out each night, after lying down with the machine on and mask in place, by deliberately taking some long, very deep breaths in and out. I wanted lots of air intake, with no sensation of inadequate air supply, for about the first 3 long, deep breaths.

I got the sensation that I was instructing the machine and, whether it was my imagination or for real, I would then get the sense that the machine was taking instructions from my lungs and that my body and brain was in control of the machine. Maybe it was the other way around, but I nevertheless then felt more secure and relaxed, feeling the machine was tuning its algorithms to take care of my needs. It might have been for real or it might have been a psychological trick, but it worked.

After I did that, I relaxed and trusted the machine to know what I wanted and needed, and often fell asleep within fifteen to thirty minutes.

Best wishes, Nate

Thanks for the suggestion. I will definitely try that!

The CLimateLine can be set up so that temperature and humidity controls are separate settings.

According the the manual I have it just says turn "ClimateLine" to Off.
I don't have my S9 to check it but that sounds a bit weird. I thought I changed something to "Patient" and not "Automatic" but I have slept since then so my memory may not be accurate and I can't find my cheat sheet with the instructions on how I did it.

I think this video explains it though.
http://www.cpaplibrary.com/machines.html

While this manual is for the cpap/apap machine S9 and not the VPAPs...the menu choices for humidity delivery are the same for all models.
http://www.apneuvereniging.nl/forum/pdf ... manual.pdf

Thanks for the links. I listened to part of the video link and now know how to get to the clinical menu, Yay! I might use that to fiddle around with the hose/ humidifier settings if I can ever get my mask to fit properly. Thanks so much!