Would like a few pointers...first full night on S9.

[spinifex]

It would be great if someone could give me a few pointer regarding my first full night's sleep.
Hopefully the 2 pics show enough data, so i can learn a bit more. S9 Autoset, ResScan 3.12

Thanks in advance

Jon

[jlk]

Only showing 5.5 hours of sleep but looks great for first night. At present I would work on leaks, they are fairly bad. Your machine is stopping the obstructive apnea quick, that is good. After 1 or 2 weeks, if you stay close to what you have here, I woulr raise the minimum to around 7, that is about the pressure the obstructive apnea occurred. I have raised my minimun to .2 above highest pressure obstructive events occurred during 1 weeks testing. At this point, I wouldn't worry about the centrals, there are not that many of them. The important part is how do you feel? There are many out here that would love to have your low ahi #. Great job. john

[spinifex]

Thank you for the reply, John

You have covered pretty well what i needed to know. At least it gives me an idea where to go and what to look for.
Still coming to terms with all the wording, but the more i read and see, the better i should get at understanding.

Thanks again

Jon

[adksleepygal]

Congrats fellow S9 travelor......you are way ahead of me using that software stuff - good for you. That is way above my pay grade
Just feeling this good will suffice for right now - I tend to be technologically challenged...

[robysue]

spinifex,

As jlk said, it looks like you had a pretty good night except for the leaks. Four events overnights, none of them particularly long, and only two of them relatively close together seems pretty good. Here's hoping that future nights look as good. How does the 5.5 hours of sleep/time in bed correspond to a typical night's length of sleep/time in bed?

It looks like your S9 is set to run wide open from 4 to 20 cm. That's a bit unusual unless your sleep doctor is wanting a week or so of auto-titration data. Did you have a titration study done in a sleep lab? If so, do you know what your titrated pressure was?

However, unlike jlk I'd be a bit reluctant to start increasing the minimum pressure unless the AHI starts to increase. But keep in mind that I'm one of those people who seems to be quite sensitive to even slightly too much pressure: My titrated pressure was 9cm and when my S9 was running as straight CPAP at 9cm I had some nasty problems with air getting forced into my stomach (aerophagia) and air getting forced into my eyes via my sinuses and tear ducts. It got bad enough where the PA in my sleep doctor's office ordered a week of auto-titration and then lowered my pressure to a range of 4--8. I think my upper limit may need to be raised (slightly) since the AHI's have crept up since then, but in my case I think it's going to be walking a very fine line between finding an upper limit that is high enough for the S9 to respond appropriately and low enough to not lead to the (for me intolerable) side effects of air in tummy and eyes.

So if you do decide to slowly increase your lower pressure limit, pay close attention to all of your body, not just the AHI. If your tummy and eyes can tolerate the additional constant pressure needed to reduce your AHI even further---great. If not, then you and your doctor will need to find a workable compromise for the pressure setting.

Good luck

[spinifex]

Congrats fellow S9 travelor......you are way ahead of me using that software stuff - good for you. That is way above my pay grade
Just feeling this good will suffice for right now - I tend to be technologically challenged...

Thanks young lady,

Figured some feed back would help me get a handle on the software side, so i get an idea what i'm looking at.
I'm sure i'll make mistakes trying to save the data, so trying to learn early may help.
Gets harder as one gets less youthful, or should that just be older, lol.

Thanks for replying, sleepygal.

[spinifex]

spinifex,

As jlk said, it looks like you had a pretty good night except for the leaks. Four events overnights, none of them particularly long, and only two of them relatively close together seems pretty good. Here's hoping that future nights look as good. How does the 5.5 hours of sleep/time in bed correspond to a typical night's length of sleep/time in bed?

Hi Robysue,

Typical nights sleep before cpap has been around 7 hrs, due to working long hours, whilst away from home. I work 2 weeks away and a week at home.
When home my sleep is nothing short of erratic as i don't have to get up early. I try and spend time with the better half and she is a night owl, lol.
Since she is an invalid, i do everything around the house, though no real rush to get it done. End result is intermittant sleep pattern.

It looks like your S9 is set to run wide open from 4 to 20 cm. That's a bit unusual unless your sleep doctor is wanting a week or so of auto-titration data. Did you have a titration study done in a sleep lab? If so, do you know what your titrated pressure was?

The sleep guy set it up for me and he knew i would not be back to see him for quite a while. No idea why the settings are the way they are.
I'm a total newb, so he could have done anything he wanted to, however i did a sleep test in hospital and they have all the results. Guess he based it on that info. Since then i have also done a home sleep test, so they have 2 lots of info to base settings on. No idea what my titrated pressure was.

However, unlike jlk I'd be a bit reluctant to start increasing the minimum pressure unless the AHI starts to increase. But keep in mind that I'm one of those people who seems to be quite sensitive to even slightly too much pressure: My titrated pressure was 9cm and when my S9 was running as straight CPAP at 9cm I had some nasty problems with air getting forced into my stomach (aerophagia) and air getting forced into my eyes via my sinuses and tear ducts. It got bad enough where the PA in my sleep doctor's office ordered a week of auto-titration and then lowered my pressure to a range of 4--8. I think my upper limit may need to be raised (slightly) since the AHI's have crept up since then, but in my case I think it's going to be walking a very fine line between finding an upper limit that is high enough for the S9 to respond appropriately and low enough to not lead to the (for me intolerable) side effects of air in tummy and eyes.

Sounds like you had a bad time of it, with air going places it wasn't meant to. Hope it is all ok now. I doubt i will touch the settings at this stage, unless i seriously need it and then only when i'm out in the desert working, miles away from civilisation. As i could be going anytime and a fair chance i'll be without internet, i needed some info to get by with.

So if you do decide to slowly increase your lower pressure limit, pay close attention to all of your body, not just the AHI. If your tummy and eyes can tolerate the additional constant pressure needed to reduce your AHI even further---great. If not, then you and your doctor will need to find a workable compromise for the pressure setting.

Good luck

To date, the S9 appears ok. It feels like there is some back pressure(?) when i breathe out. Perhaps the temp needs to be adjusted down a bit, from the 27C it is now.
He told me most people have it set on that number. See what happens when i'm away from home.

Thank you for the chat.

Regards

Jon

[jlk]

Jon, If your feeling backpressure, you need to turn on EPR, that will lower pressure on machine up to 3cm less with each exhalation. It will sense your breathing pattern and work with you, that is one of my favorite features of this unit. If you can print out some key pages of the clinicians manual or if you have a laptop that you can travel with, download it to a file that you can read up on when you are away from home without internet access. Again, you are doing great! john

[billbolton]

It would be great if someone could give me a few pointer regarding my first full night's sleep.

Yout appearto have the APAP range set to the default values (usually 4cm to 20cms).

As a starting point, you should adjust the APAP range down to cover couple of cms either side of the titrated pressure recommended by your sleep study, and see how that goes for you.

That may eliminate some apneas (as some occured at very low pressures), as well as assist you with at least some of your leaks.

Cheers,

Bill

[DoriC]

Spin, you really should get a copy of your sleep study results and your RX, they are part of your personal medical record and can tell you a lot . Having the settings wide open like that may cause you problems with runaway pressures and leaks, but if you knew your titration a good starting point might be 2 above, 2 below your titration pressure, ie,if your titration was 10cms a setting of 8-12 might get you some good results and you could tweak from there based on your data. Keep us posted.

[johnsx1]

I have also recently begun using the S9 with a less successful experience than yours. I just haven't been able to sleep with it on because the pressure was too high. I've already posted with a question about how to change the settings at home (getting software?), so I won't repeat it here. But I do want to ask about the advice from DoriC regarding a 2 cm spread on either side of the recommended pressure. My sleep doctor recommended I try fixed titration of 8cm, and go up to 12 cm if that is not enough. Would it be better to have auto titration in the range of 8-12? or to go for a wider range? Like spinifex I won't see the doctor again for quite a while so I'm sort of stuck with what he did with it, which I can't tolerate.... Thanks!

[robysue]

My sleep doctor recommended I try fixed titration of 8cm, and go up to 12 cm if that is not enough. Would it be better to have auto titration in the range of 8-12? or to go for a wider range? Like spinifex I won't see the doctor again for quite a while so I'm sort of stuck with what he did with it, which I can't tolerate.... Thanks!

If you can't tolerate what your sleep doctor has "stuck" you with, get on the phone and call his office and calmly and politely describe exactly what symptoms/side effects you are finding intolerable about the current set up. Request that the doctor or one of his PA's or nurses or RTs call you back to discuss what's going on since you find the current situation intolerable. Of all the things that I wish I'd done different during my first two weeks of therapy, it's waiting so long before calling the doctor's office. I should have listened to my hubby and called after Night 3 when a huge number of serious issues started instead of waiting another week or so before my husband took matters into his own hands and called the doctor's office for me.

[DoriC]

I was one of the lucky ones who found this forum before we got my husband's equipment(not data capable) and the pressure settings prescribed by the sleep doctor(almost wide open at 5-18cms), titration 13cms,so I already was somewhat educated and prepared to take control of my husband's therapy on my own with not a lot of input from him as the patient. I insisted on a data-capable auto and FF mask suggested here, purchased the software and with forum guidance and lots of questions, I gradually learned how to tweak in small increments and discovered along the way that he did not need Ramp, Flex disturbed his breathing rhythm so we turned it Off, he did not require humidification so we use it in passover and he did better on straight pressure of 12cms or very narrow auto range of 11-13cms. When we had our first (and last) followup visit with the specialist, at that point I already was experimenting with 11-15cms and was ready to do battle for changing the settings "without permission", but after he looked at the data he gave me a thumbs up and told me to keep up the good work and he''d see us in 6months. Of course software is essential to track any changes made and in my case, knowing the leak data was imperative as my husband was not aware of nor could he adjust his own mask leaks during the night. AHI data is not recorded correctly if leaks are not controlled adequately. We were fortunate that my husband just had OSA with no other complications. He does have other health problems not related to sleep apnea. In conclusion (didn't mean to go on so long), if your Dr says your titration is 8cms, you can follow his recommendation of straight pressure at 8cms for a few days and if that's uncomfortable for you, you might try auto starting 1cm lower at 7-11cms for a few days. Hopefully you'll have the software to monitor your daily data, otherwise you're flying blind and any advice would be questionable. Keep us posted.

[spinifex]

Thank you very much for the additional suggestions. It is very interesting to read what can be achieved, interpreting the software information.
I am running ResScan 3.12, so information is readily available. Just need more time and exposure to understand it all.
At this stage my work is taking me to parts unknown to me. I fly out tomorrow with a maximum weight allowance of 10kg, which means having to leave my notebook home.
I have sent an email to try and get extra weight allowance, but since it is a small, private plane i cannot just pay for extra weight.
Once i return from 2 weeks away, i will be home for 1 day to then fly to another minesite, where hopefully i can take my computer.
If no replies are forth coming, it is because of a) no computer, or b) no internet, due to working in isolated areas.

Thank you to all who replied with information and suggestions.

Regards

Jon