S9 pressure issue?

[thecomputerguru]

OK, so after determining that my insurance only covers a new CPAP every 5 years, while satisfied with my M-Series machine, I was sick of rain out (house gets kept fairly cool at night) and while a tube wrap helped considerably I was sick of the extra weight it added that "pulled" the mask more.

Anywho, finally ordered (with my hard earned cash), received and used my new S9 Autoset last night. The first thing I did was set it to straight cpap mode at my prescribed pressure of 10 cm H2O. I noticed however that the once i put my mask on and turned the machine on, the pressure "hitting" my face didn't feel nearly as, how shall I say this, "gail force" wind like as my m-series at the same pressure setting 10 cm H2O. EPR was turned off (I never used C-flex) so this wasn't the issue. I thought the slimline tubing might be having an effect on how the pressure felt, so to test that theory out I hooked up the slimline tube to my M-series and ran it. For the most part the pressure felt like the same "gail force" that I've always felt and grown accustomed too, so that seemed to rule the tubing out.

Does anyone have any comment suggestions? Perhaps because I'm using the respironics comfort gel FFM and the machine is expecting something like the quattro? But that shouldn't matter as far as I know b/c the leak rate may report wrong but the machine should still pump the same pressure no matter what right? I mean 10 cm H2O is 10 cm H2O, no?

FYI- I ended up setting it to range from 11.6 to 14. I arrived at 11.6 (instead of 10) b/c as i was even just lying in bed at 1am still fiddling with the settings, as I lay my head to sleep I would close my eyes and not much time would pass (minute or two?) and I would notice via my pulse oximeter that I would drop from 95 to 93 usually down to 89 or 88 which seemed really odd to me since I was awake, it's not like I was trying not to breathe. So I looked at the screen and noticed 11.6 was what the unit would raise itself to when this occurred, so my thought process was that instead of leaving 10 as the minimum up it to 11.6 to eliminate lag time to get to a high enough pressure? the summary screen on the machine showed 12.4 as the pressure, and I assume thats the average pressure for the night? And if so, I'm still wondering why 10 doesn't "feel" like 10

I don't have the software so I can't check events at night like I did with my M series :-/. My AHI was 1.9 this morning that's all I know. And while I know I lot of people would love a number like that, I unfortunately am a person that need my AHI to be less than 1 typically to actually feel good in the morning.

Sorry several questions, concerns buried in this post. Any and all help is appreciated. Thanks!!

[kurth83]

I sent you the SW link in a PM.

I am a newbie so can't help much with the other questions.

Smells like a calibration issue however.
You might want to check that you have the correct hose type
selected in the setup menu.

[oscar98]

I'm no expert by any means but I thought I would throw this out there.
When I went from the ResMed S8 Escape to the S9 the pressure did feel like it was less forceful. So far I'm doing good according to my data (other then some leak related apnea).

Also, my husband has an Escape II and even it compared to my Escape felt different. I traded him machines because he had EPR and wasn't using it. He made me trade back because the pressure didn't feel as strong.

There was obvious variance in how each of these 3 machines felt but I have no idea if there was actual variance or not.

There are posts on here and you can google "how to make a homemade manometer". Then you can test it to see if it's right.

[jmelby]

Did you buy from a local DME? If so you could probably bring it in and have them check the pressure. I have never used Respironics machines myself, but I believe others have commented that the pressure feels different--softer on the S9 than other machines. Note that when you turn it on, it does not blast full pressure immediately--it takes a few seconds to ramp to your starting (or ramp starting) pressure. The other thing is to check your mask type setting in addition to the hose type.

[manas]

Which pulse oximeter do you use that shows the live display? Does it also save data that can also be downloaded into a computer?

On the S9 issue, I had set my pressure at 12.6-18 (prescription was 14-18) and with a nasal pillow (mainly Swift FX), and with pressure at 13.1-13.5 (pressure I see on the display when I wake up), it feels very soft and gentle. If I remove the mask, I can feel the pressure, so I think the reason the S9 feels gentle is because it's so quiet when the masks seal well. Or is it the other way around? Maybe it's both.

[Wulfman]

If you have a question about the output air pressure from the machine, you can always do a quick (and cheap) check of it by using the method discussed in this thread and the other links I've listed in this post:

viewtopic.php?f=1&t=49152&p=450105&hili ... er#p450105


Den

[thecomputerguru]

Thank you all for the info.

Did you buy from a local DME? If so you could probably bring it in and have them check the pressure.

No, I bought it online. I actually called local places, even places that wouldn't take my insurance but would take cash, and I even explained the possibility that I'd be willing to pay more if it meant local service. And you know what? Despite that, they never called back. I called one of them back 3 times and still no dice. Sometimes you have to wonder.

I have never used Respironics machines myself, but I believe others have commented that the pressure feels different--softer on the S9 than other machines. Note that when you turn it on, it does not blast full pressure immediately--it takes a few seconds to ramp to your starting (or ramp starting) pressure. The other thing is to check your mask type setting in addition to the hose type.

Yes, I did notice that even in straight CPAP mode it takes a few seconds and literally ramps the pressure from zero, versus my older m-series spins it's motor up and delivers the full pressure in a much shorter duration. I do suppose this could create a better seal like manas theorized. Still, with the same mask it still mystifies me how it could feel dramatically different (assuming no pressure relief settings turned on like EPR or C-flex).

Which pulse oximeter do you use that shows the live display? Does it also save data that can also be downloaded into a computer?.

I own two of them. The first is a Nonin GO 2 Achieve. It costs $99, runs on single AAA battery, does not record data and is used for spot checking. I also own the SPO-7500 which is $400 and is data capable. The software that comes with the 7500 is really nice, however for me personally the price was high and only after a month using it the USB data cable stopped working. It's not a standard USB cable as their is a serial to USB interface and whole circuit inside the cable itself, so it's not easily replaceable. I called SPO medical for a replacement, was supposed to be here in 7 to 10 business days and this is day 14 or so, but haven't had time to call and follow up. The 7500 fits really nicely and wears like a watch, but it is expensive and in my opinion the craftsmanship could be better for the price. http://www.go2nonin.com/GO2_Achieve_p/9570-a.htm and http://turnermedical.com/SPO_PulseOx_75 ... imeter.htm