First Night with S9, Promising but Problems

[paolo]

I had some problems with using my new S9.

1. When I first put the mask on, I'd get a strong thump everytime I exhaled. Pressure was more exhaling than inhaling. I think the valve at the elbow was closing. In time and with slower careful exhale the problem seemed to go away. Perhaps the machine adjusted, or my breathing. But I don't like the idea that a strong exhale in the middle of the night can have me breathing against increased pressure, or worse taking in CO2.

2. Bloating, and burping this morning. I think this may be related to the number 1. above.

3. I woke at 1:30 and the machine wasn't pushing any air at all and it was a hard to breath with the mask on. When I pushed the on/off button, it started up again, and seemed OK for the rest of the night. Has anyone had this problem?

I hope and trust these problems can be worked out because otherwise the S9 seems great. Very quiet, and very easy to breath when its working correctly.

Any help much appreciated.

Mitchell

[Nord]

Don't know much about your set-up... but sounds more like the thumping was part of your swallowing air. I have not experienced any thumping other than my own throat. Perhaps its related to the range of your AutoCPAP settings 4 - 20 ???
Maybe the EPR set up is different than it should be... and you can choose fast and med profile for exhalation as well....

I run my machine with the auto on/ off set to off... there are no surprises. I use the button for on and off.

Nord

[paolo]

Nord,

Thanks for your reply. I'm sure the "thumping" wasn't in me, but in the mask, a Quarttro. Felt that my breathing out was closing the valve which was increasing resistance to breath out substantially. When the thumping stopped even on the next exhale there was a huge difference. It was an all or nothing thing. Either thumping or not. No middle ground.

I'm going to try your suggestion of using manual on/off instead of auto.

Thanks for your help,

Mitchell

[gpk111]

Paolo,
In addition to telling the S9 what kind of mask you have, the S9 has an auto set up to adjust for different masks. I foregot where it is, but it's a mask sensor of some sort. I turned that off and it helped.

[Slinky]

I don't remember when I used the Quattro but most full face masks have a valve of some sort, and that causes the thumping. It should only happen 2-3 quick times in succession when you turn your S9 on.

After you've been sleeping and adjusting to the pressures during the night it is not at all unusual to wonder if the PAP is really working because your PAP is so quiet and you are so acclimated to breathing w/it. Many of us ended up putting our hand over the vent on the mask to feel the pressure just to be sure. Or, if not a full face mask, opening our mouth to feel and hear the rush of air.

Its not at all unusual for us to take our mask off during the night w/o remembering doing so. You could well have reached over and turned your PAP off w/o remembering doing so. But if in doubt, take it in to your DME provider and check it out there.

[Uncle_Bob]

The thumping is the Quattro mask, i had the same issue, it has to do with the angle of the elbow.

cpap.com has a warning and disclaimer about the elbow on the Quattro under the "Import Tips" tab for the Quattro mask.

[Guest]

Thanks everyone,

I so appreciate the help. I now feel very optimistic that with the S9 and the folks here, I'm going to make substantial improvements in how I feel. For me, that's feels like a big deal.

Without the forum the picture might be different. Not in a good way.

Best,

Mitchell

[jmelby]

The auto on/off is not designed to work with a full face mask--you must not have the right mask setting if that still worked. This is probably what caused the machine to shut off in the night--the higher exhaust rates on full face masks makes it harder for the machine to recognize when you take it off... the issue you encountered is a case in point as to why they disable the feature for full face masks.

[mdkohm]

Has this issue gotten any better for you paolo? Last night was my first night with the S9 (I've been using an S8 for the past 4+ years) and I also experienced similar issues to what you described in #1 of your original post. I felt that there was little or no air pressure, and I actually felt claustrophobic when I first started the machine. As I calmed my breathing things started to feel more like what I had been experiencing with the S8.

I'm thinking my problem is that the starting pressure for the "Ramp" feature is too low while wearing a full face mask. I haven't had time to see if the starting pressure is adjustable, if not I'll just turn the Ramp feature off.

Anyone able to validate my thinking? If not, I guess I'll know tonight.

[jmelby]

When you first turn on pressure, what does the reading on the LCD say? It certainly could be the ramp feature... unlike the S8 AutoSet II, the S9 AutoSet allows a lower ramp start than your low pressure setting--on the S8, it would just say at your minimum pressure for the ramp time. The starting ramp pressure can be changed in the clinical menu.

[mdkohm]

You're correct. My S8 Auto, started off at my lower pressure limit (7cm), while the S8 was set at a ramp pressure of 4cm. I adjusted the starting pressure on the S9 to 7cm - problem solved.

So far, my AHI has been improved considerably w/ the S9. I can't say that I feel a whole lot better yet as it's only been a week with the new machine. The skeptic in me wonders if the S9 is using a more forgiving algorithm for identifying events, or if the combination of the S9 and better titration is really making the huge difference in AHI (went from a range of AHI of 9 - 20 w/ S8 to AHI of under 2 with S9).

I hope it's the later.

[finchy]

If you cont to experience "swallowing of air" be sure to bring this to your Physicians attention. This is called Aerophagia and is not normal. This is known to happen more with people who have GERD.