Problems with pressure relief/timing of breathin? S9 Autoset

[CAsleep]

So last night was my first night on my S9 Autoset, and the Phillips Respironics System One "Plus" CPAP with C-Flex is gone. Last night was my first time on an APAP machine (as opposed to CPAP), and first time using a Resmed machine vs. the PR1 machine.

Just to clarify, I switched because my old machine didn't record my AHI, leak rate, etc....and also, I'm still very sleepy during the day, so I figured change can't hurt.

I actually didn't like the new machine. I felt like with my old machine, I would exhale......then when I was ready to inhale, I could feel the air coming into my nose right at the beginning of the inhale. With this new machine, I feel that I start to try to inhale, but then like 1-2 seconds later (or maybe it's shorter, but this is my perception) the inhale air actually starts blowing in. THAT'S ANNOYING! It makes me feel like I'm not getting enough air or something.

It was almost like my old machine was reading my thoughts, and knew when I wanted the air blown in, and with this machine, it's a little delayed. Could it just be Resmed's "expiratory pressure relief"/"EPR" vs. PR1's version of pressure relief, called C-Flex? Or is this an issue of CPAP vs. APAP? Because I can try putting my machine in CPAP mode.

I am leaning towards the fact that it's differences in how the pressure reliefs work? What do you all think?

Also, when the inhalation pressure does kick in (or kick in "more" for the inhale), it doesn't seem smooth....it seems like it kicks in in a BURST (as opposed to what I was used to on my inhales on my PR1)....is that a complaint with the machine I'm now using? I am thinking that means I just need to turn the pressure relief down a little?

But then there is still the issue of the timing of when the inhale starts, being 1-2 seconds late......


Just to clarify, I'm grateful for my new machine, but I could only stay on it for a little bit, before I got annoyed and took the mask off. I'm wondering if I should just switch to the PR1's "data capable" machine, if the DME will even let me.

[CAsleep]

Also, tonight I am going to try the machine in CPAP mode to see if that solves the problem. Is it the fact that this is in APAP, so it's thinking too much, hence the delay?

Sorry so many questions....just sharing my line of thought. Any thoughts/comments are welcome.

[lbw]

I use the S9 elite in CPAP mode. Pressure at 12 EPR 2 sec Fast. You can adjust the EPR to fast or slow as well as adjust the seconds. At my settings I do not notice a time delay. It is actually very comfortable.
Good luck tonight

[jdm2857]

I think what you are detecting is the difference between the expiratory pressure relief algorithms. C-flex drops the pressure at the beginning of exhalation and increases it before the start of inhalation. EPR reduces the pressure for the entire exhalation period, increasing the pressure at the start of inspiration.

I would try reducing EPR or even turning it off. You also may find that after some time to adjust to it, EPR will work for you.

[kempo]

CA, you can go to options and scroll down to "EPR inhale" and change the setting from medium to fast but this only works in cpap mode not auto mode.

[Slartybartfast]

CA, you can go to options and scroll down to "EPR inhale" and change the setting from medium to fast but this only works in cpap mode not auto mode.

Where is that? I haven't seen that on the menus. Just EPR off, 1,2,or 3.

[Edit: Oh, I see you're using it in CPAP mode. I'm using it in APAP mode so don't have the EPR Inhale feature. Never mind.]

FWIW, I played around with all the EPR settings, and like the 3 setting best. I have awakened a few times thinking the machine wasn't running; couldn't detect it in my breathing, but found it was. It's as if it had synchronized its action to my breathing, or versa vice. Versa vice is probably more likely.

[CAsleep]

Thank you for the tips.

So....with APAP.....EPR is working, right? I just can't adjust the EPR? (OR, is EPR not even on, and if my bottom pressure is 6, is it just blowing 6 constantly?)

Sorry if that's a dumb question.

[jdm2857]

In AutoSet (APAP) mode, you can set the level of EPR to 1, 2, 3, or off. You just can't set the EPR Inhale parameter.

In AutoSet mode, the pressure starts out at your minimum pressure unless you are using the ramp function. With ramp, the pressure starts out at the specified ramp pressure and increases to your minimum pressure over the specified ramp time. Either way, once the minimum pressure is reached, the AutoSet algorithm takes over and increases (or decreases) your pressure in response to your breathing. The pressure will always stay between the minimum and maximum pressures, inclusive.

[CAsleep]

Thank you.