ResMed S9 AutoSet Slim Tube w/ Mirage Quattro

[Tean94]

So I just picked up my equipment yesterday and I've noticed a few things.

My prescription was written for CPAP at 8cm only. My DME was perfectly fine with giving me the AutoSet, however, she would not program the APAP since I didn't have a prescription for it.

My sleep study showed:
6cm = 9.1 Min Duration, 2 Central Apneas, 2 Hypopneas, 0 Arousal, AHI = 26.4, RDI = 26.4, O2 Sat = 87
8cm = 85.1 Min Duration, 19.5 Min REM Duration, 0 Central Apneas, 2 Hypopneas, 9 Arousals, Arousal Index 6.5, AHI = 1.5, RDI = 2.2, O2 Sat = 91

Though the pressure at 8 seems almost too high. I swear I feel pressure in my ears and I have excessive gas (TMI I know), but it feels like the air is being forced into my stomach. Is this normal? Will I eventually get used to 8cm pressure?

I'm very tempted to go back to my Dr and ask him to write up a prescription for the APAP, so at least I won't have a leaf blower blasting me at full pressure all night long.

[LSAT]

8cm is relatively low...You should get used to it quickly. Here is a poll that was taken a while back.
viewtopic.php?f=1&t=58432&st=0&sk=t&sd= ... ssure+poll

[archangle]

Though the pressure at 8 seems almost too high. I swear I feel pressure in my ears and I have excessive gas (TMI I know), but it feels like the air is being forced into my stomach. Is this normal? Will I eventually get used to 8cm pressure?

Tough it out for a few weeks, if at all possible.

I'm at 12 minimum and I sometimes have to lift up the corner of my mask to convince myself the machine is blowing.

I do still have a gas problem. It beats having an apnea problem.

[sleepymike]

I started on CPAP about 2 months ago. I was on 8cm of pressure and I got used to it after a few weeks. The exhale pressure relief setting of 3 helped me some, on the autoset that is the EPR setting. I also used the ramp for a few weeks. I've reached the point where 8cm isn't much at all and I've learned how to avoid making my ears pop with the pressure. I don't use the ramp anymore and my EPR setting is 2 and I'm thinking about moving it to 1. So, it gets better. Give it some time.

Moving to an auto range setting won't likely lower your pressure. Mine went up to spending most of its time at 9.5 or 10.5 depending on the night with a peak reaching almost 11. Those are still fairly low numbers compared to what a lot of people need for effective treatment.

Mike

[Pugsy]

Though the pressure at 8 seems almost too high. I swear I feel pressure in my ears and I have excessive gas (TMI I know), but it feels like the air is being forced into my stomach. Is this normal? Will I eventually get used to 8cm pressure?

Yes, you will get used to it and in a short time that hurricane should feel like a gentle breeze.
There is no reason to be miserable though, especially with the gas (google aerophagia in the Wiki at the top of the page to find some hints to help). For some people the gas is more than gas...it can be extremely painful and make a person ill.
Again, no reason to be miserable.
Are you using EPR? If not, I suggest you turn it on and use it. It will lower your pressure on exhale and offer immediate relief. Settings 1, 2 and 3 each gives a per cm reduction in pressure during exhale.
If you are already using EPR but at a lower setting, increase it.
If you are already using EPR of 3...well that is the most you can get and if the other hints don't help enough and you are made ill by the aerophagia then talk to your doctor. There is another type of machine that offers greater relief.

No one should trade off killing the apneas for no sleep and being ill with aerophagia.
If the gas is minimal and just annoying...it might lessen with time. Might not. Up to you how much it disturbs your quality of life. I was lucky and only had it bad a couple of times but when I did...it was bad and I fully empathize with someone who has it bad and no one should have to endure it when there are options available for relief.

BTW EPR is considered a comfort feature and it is totally okay for you to adjust it or use it or turn it off or whatever.
For some people the reduction in pressure during exhale may let a few events sneak past the defenses. If it lets too many sneak past we just adjust the inhale pressure upwards a bit to offset that reduction. It doesn't happen to everyone though..so it isn't a given that everyone has to increase their pressure...but if they do..it is still easier and more comfortable than the gas.

[Tean94]

Though the pressure at 8 seems almost too high. I swear I feel pressure in my ears and I have excessive gas (TMI I know), but it feels like the air is being forced into my stomach. Is this normal? Will I eventually get used to 8cm pressure?

Yes, you will get used to it and in a short time that hurricane should feel like a gentle breeze.
There is no reason to be miserable though, especially with the gas (google aerophagia in the Wiki at the top of the page to find some hints to help). For some people the gas is more than gas...it can be extremely painful and make a person ill.
Again, no reason to be miserable.
Are you using EPR? If not, I suggest you turn it on and use it. It will lower your pressure on exhale and offer immediate relief. Settings 1, 2 and 3 each gives a per cm reduction in pressure during exhale.
If you are already using EPR but at a lower setting, increase it.
If you are already using EPR of 3...well that is the most you can get and if the other hints don't help enough and you are made ill by the aerophagia then talk to your doctor. There is another type of machine that offers greater relief.

No one should trade off killing the apneas for no sleep and being ill with aerophagia.
If the gas is minimal and just annoying...it might lessen with time. Might not. Up to you how much it disturbs your quality of life. I was lucky and only had it bad a couple of times but when I did...it was bad and I fully empathize with someone who has it bad and no one should have to endure it when there are options available for relief.

BTW EPR is considered a comfort feature and it is totally okay for you to adjust it or use it or turn it off or whatever.
For some people the reduction in pressure during exhale may let a few events sneak past the defenses. If it lets too many sneak past we just adjust the inhale pressure upwards a bit to offset that reduction. It doesn't happen to everyone though..so it isn't a given that everyone has to increase their pressure...but if they do..it is still easier and more comfortable than the gas.

Excellent information. Though I don't see a setting adjustment in the settings for EPR. How do you go in and adjust that setting?

[Pugsy]

Though I don't see a setting adjustment in the settings for EPR. How do you go in and adjust that setting?

This link has directions on how to get to the clincial setup menu so you can get your hands on the EPR settings.
http://www.apneaboard.com/resmed-s9-cpap-setup
This link you can request a pdf copy of the provider manual which also explains how to change EPR among other things.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

And here is a link to a video that might help.
http://www.cpaplibrary.com/machine-education

[Tean94]

Though I don't see a setting adjustment in the settings for EPR. How do you go in and adjust that setting?

This link has directions on how to get to the clincial setup menu so you can get your hands on the EPR settings.
http://www.apneaboard.com/resmed-s9-cpap-setup
This link you can request a pdf copy of the provider manual which also explains how to change EPR among other things.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

And here is a link to a video that might help.
http://www.cpaplibrary.com/machine-education

You have been a tremendous help!!! Thanks for the links! Now I know how to set EPR. Sweet!