First Night w/ResMed S9 Auto Set - What do I do!?

[sarajane82]

I just received my ResMed S9 Auto Set and it was set at at a range of 4-20. Up till now I have only been using a regular (not auto) and I have been using at a setting of 7. How do I set my new machine to work as a non-auto machine and set it to a 7. I would ideally like to use it at the setting that my doctor originally intended and then look at the data and see if I need to use the Auto feature later. If I see that the data show I am doing well at 7, I will likely not use the Auto function right away.

But I can't seem to find anything in the literature that came with it that tells me how to set it or turn off the Auto function. Can anyone help?

[Pugsy]

Check Uncle_Bob's signature for the clinician manual and software. The manual will explain how to get to setup to change pressure
memberlist.php?mode=viewprofile&u=38643

How to use software tutorial
http://montfordhouse.com/cpap/resscan_tutorial/

Video about the machine
http://www.cpaplibrary.com/machines.html

[sarajane82]

I actually did just download the software and the clinician's manual. There are so many optional settings on there, so I am wondering if anyone could comment on what are the most important things that I should want to see- I know AHI is important...what else should I care about right off the bat?

[Pugsy]

Leak line...Stay as far below the red line as possible. ResMed leak report is all excess leak. They already subtract a vent rate. Leak and AHI for now.

Don't worry about trying to understand flow under the microscope..time for that later.

What optional stuff were you wondering about?

[archangle]

I like setting the minimum pressure to something that's comfortable to me, so I don't suffer through low air pressure at the start of the night. That leads to uncomfortable lack of air and can make it difficult to get the mask fit right. Mine stays at the minimum pressure I've set most of the night. I found I feel better if I set the minimum a little higher than what the machine will auto adjust up to.

I leave the top pressure at 20, because my machine does not tend to run away and go to a higher pressure. I figure if it ever decides to run away, that's a good indication it's time to check my results and see if something has changed.

If yours does run away, set the upper pressure, too.

[sarajane82]

Pugsy- exactly that kind of stuff!

So the auto function makes it to where if I put the minimum at 6 or something, and max 20, it will only go higher than 6 if the machine detects that you need it, right?

[archangle]

Pugsy- exactly that kind of stuff!

So the auto function makes it to where if I put the minimum at 6 or something, and max 20, it will only go higher than 6 if the machine detects that you need it, right?

In theory. Sometimes, various things "confuse" the machine into thinking you need more pressure when you may not really need it. I call this "runaway".

I don't think it's that common, but if runaway happens to you, you can set your maximum pressure to a lower level.

The risk is if you really do need a higher pressure and you limit the maximum pressure, you're not getting the correct therapy, so put some thought into it. Many people don't really like the pressure that they need for good therapy.

[sarajane82]

If I keep the maximum fairly low, and see that my AHI number is not good, can I fiddle with it then? Or should I just give it a try at 20 and hope the machine customizes itself to my needs?

[sarajane82]

So is it safe to keep it at 4-20 for the first few nights and see what my AHI number is before thinking about changing it? Maybe that's what I need - a variable rate-- i've just been at the same pressure for the whole time i have been using the CPAP but still feeling tired. maybe it's because i do need the auto adjusting rate.

[Lizistired]

So is it safe to keep it at 4-20 for the first few nights and see what my AHI number is before thinking about changing it? Maybe that's what I need - a variable rate-- i've just been at the same pressure for the whole time i have been using the CPAP but still feeling tired. maybe it's because i do need the auto adjusting rate.

Then I would just set it to 7-8, maybe 7-9 for tonight and not worry about it.
Did you have EPR (Exhale Relief) on your old machine? That makes it easier to exhale but if you haven't had it, you shouldn't need it.
For the pressure, press and hold the "double check mark" button and the knob for 3-5 seconds until the display changes. Then turn the knob thru the options and push it to highlight an option, then turn it find the selection that you want for that option. The video does a much better job of explaining that.

[Lizistired]

I wouldn't go 4-20 because you will suffocate at 4 and probably take the mask off if for some reason it goes over what you are used to.

[Pugsy]

So is it safe to keep it at 4-20 for the first few nights and see what my AHI number is before thinking about changing it? Maybe that's what I need - a variable rate-- i've just been at the same pressure for the whole time i have been using the CPAP but still feeling tired. maybe it's because i do need the auto adjusting rate.

Your RX is/was 7 cm? I would start with 6 cm minimum. I don't think you will like 4 cm not much air moving it will seem like. The minimum is the most critical. These machines increase pressure in small increments in response to event triggers and if minimum is too low the machine can't get to where it sometimes needs to be quick enough.. So we have to give is a head start of sorts.

Regarding the maximum. The machine won't go there if it doesn't think it needs to BUT sometimes if there is a large enough leak it will try to compensate for leak with an increase in pressure and the increase in pressure can feed the leak monster more.. So a nasty circle. Also sometimes a person finds that the pressure variations with APAP are disturbing to their sleep. I use APAP..10 min and 20 max..sometimes I do see 18 or 19 and not because of leaks.
The pressure variations have never bothered me but they might bother you.
You are brand new to all this and it is a huge learning curve.
You can use 20 max if you wish but to be honest while you are learning and adjusting and probably having leaks that might cause pressure increases I would suggest for a little while that you limit the maximum till you get a good handle on things. I would suggest 12 maximum for a few nights till you get a little more experience.
This is hard enough to adjust to without having wild variations in pressure the first night.

Now you might not be bothered and you might not have much of a leak so the choice is yours.
BTW when I first started cpap therapy with my own machine like you ... I used 7 min and 10 max because my RX was for 8 cm. I quickly saw I needed more pressure but I don't regret the tight range to start with..There is enough to get used to without sticking wide pressure variations into the mix.

[sarajane82]

Thanks everyone. As always, you've been very helpful. I think I will start with a tighter range because I do think I would be freaked out if it jumped way higher than I am used to on the first night with it. I'll let you know how it goes!!!

[Alshain]

Thanks everyone. As always, you've been very helpful. I think I will start with a tighter range because I do think I would be freaked out if it jumped way higher than I am used to on the first night with it. I'll let you know how it goes!!!

A larger range can also make your problems seemingly worse. If your pressure is jumping around because of what archangle calls 'runaway', it can wake you up. Although the treatment is still good and your O2 sats should level out, it still will leave you tired and your body will be less functional from sleep deprivation than it could be. This effect is worse for people still getting used to having pressure at all.

[sarajane82]

I set it to 6-10 and slept GREAT. AHI= 1.0 and mask fit= green smiley! Unfortunately still tires today but prolly cause the sleep was so good that I just want MORE!!!