S9 goes from 5-15 in auto with in 10 min

[billbolton]

I am taking the machine in monday it is only 3 days old

Second time of asking - what is your titration pressure

[Justin 23]

This excact thing happens to me also. Take a look at my thread here and see if it is the same as in your case:
viewtopic.php?f=1&t=82998&st=0&sk=t&sd=a

I have now gotten to try 4 different machines and they have all done the same thing. Two of these machines have been tested extensivly by Resmed and found to be in perfect working order.

One thing I have found out is that the behaviour depends on the mask. My Resmed Mirage FX sends the machine to 15 in about 6 minutes. Using a Resmed Swift LT, the pressure stabilised at 8.3. With a Swift FX, the pressure stabilised at 9.5.
What mask do you use?

The behaviour is also dependant on how much water is in your humidifier chamber. The problem is worst with a full tank of water. Try to only fill your humidifier chamber half full of water and try again. Please let us know the result of such a test.

My conclusion is simply that the Autoset algorithm is SO hyper that the machine does not function properly as an APAP for some people, not for me and it seems not for you either. I also suspect that the humidifier is poorly designed, it's certainly very noicy and this may contribute to the problem.The solution is to get a Philips Respironics or Devilbiss machine in stead, they work very well as APAP's.

going in monday to have it checked out. I will let you know what happens I am going to try the hum at half full tomorrow. I tried it with a full face mask when it did this and with the nose pillows last night

[Justin 23]

I am taking the machine in monday it is only 3 days old

Second time of asking - what is your titration pressure

not sure what that is I will have to look at the sleep study I have hidden somewhere.

[Burkebang]

Second time of asking - what is your titration pressure

If his machine goes from 5-15, it's safe to assume that this is his prescribed pressure range. When an automaticically titrating machine is prescribed, there should be no reason for titration studies.

[zoocrewphoto]

We are trying to determine if he machine is actually set for 5-15, or if it set to 15 with a ramp of 15 minutes starting at 5. It sounds like that is what it is set to, which would explain what it is doing.

[archangle]

Archangle, I had problems viewing my data, but I have identified the problem. I had Sleepyhead set to ignore CPAP sessions shorter than 10 minutes. What I remember from the last data I looked at, there was no events flagged at all, so no reason to increase the pressure. I'm out of town on business, but I'll post the data when I get home tomorrow.

That short session thing fools a lot of people.

I'm talking about the flow limitation graph on S9 machines, not the flow limitations events that PRS1 machines do.

[Justin 23]

We are trying to determine if he machine is actually set for 5-15, or if it set to 15 with a ramp of 15 minutes starting at 5. It sounds like that is what it is set to, which would explain what it is doing.

I went in and changed it to 5-11

[Justin 23]

so last night I set the machine to 5-11 and put it on right before I went to sleep. It did its normal initial climb, but only went to 9.5 it went this high again at 4am which was a CA event. I think for some reason before I go to sleep and am breathing in it the machine wants to push more pressure and then come down when I go to sleep. however when it increase the pressure it does not show an event. shouldn't it show an event when it increase the pressure. the tech told me it would stay at 5 until it recorded 5 events and then the pressure would increase.

[ughwhatname]

When I am awake, my pressure stays at the minimum because the machine doesn't perceive I need any help, which is true. Once I fall asleep, it tries to keep up with my needs and I see ups and downs all night long on pressure. I'm new too, but your last sentence doesn't jive with what I think I understand about how the machine works. The purpose of the pressure is to avoid events, not start addressing events after you've had five.

so last night I set the machine to 5-11 and put it on right before I went to sleep. It did its normal initial climb, but only went to 9.5 it went this high again at 4am which was a CA event. I think for some reason before I go to sleep and am breathing in it the machine wants to push more pressure and then come down when I go to sleep. however when it increase the pressure it does not show an event. shouldn't it show an event when it increase the pressure. the tech told me it would stay at 5 until it recorded 5 events and then the pressure would increase.

[Pugsy]

however when it increase the pressure it does not show an event. shouldn't it show an event when it increase the pressure. the tech told me it would stay at 5 until it recorded 5 events and then the pressure would increase.

What the tech told you.....I have never read that. I would be rolling my eyes on that one.

Actually if the machine is doing its job you won't see an event followed by a pressure increase. The machine responds to snores and flow limitations in an effort to prevent the full grown apnea events from materializing. So if you see pressure increases and you don't see an apnea event being flagged it just means that the machine sensed something it didn't like and wanted to prevent any further potential collapses.
Once an obstructive event (hyponea or obstructive apnea) actually gets flagged because it has slipped through the defenses, the machines actually sits by and does nothing at all because it won't act like a ventilator and try to blow through the collapsed tissue and force the airway open. Once it senses that the airway is open again then it goes back into evaluation mode...evaluating the things that indicate a collapse of the airway is maybe in the works.
If you see a pressure increase near a flagged obstructive event...it is in response to some sort of flow limitation and not the actual event. Just a coincidence that they happen in a close proximity to each other. Most likely because the airway either doesn't completely open backup or maybe another collapse is starting to happen.

So ideally if the machine in APAP mode is doing its job...you will see a pressure line that goes up and down with minimal events ever being flagged. We shouldn't strive for 0.0 obstructive event reports IMHO. That's an unrealistic goal. Sometimes collapses of the airway just happen out of the blue with none of the usual warning signs that something it about to maybe happen.

If you see a pressure increase and no events getting flagged you can bet the machine has sensed something that it didn't like in the snores and flow limitations department. Those event precursors are actually what triggers the machine's response. It isn't the actual obstructive event that triggers an increase in pressure...the whole goal is prevention and not "fixing" a collapse with a burst of pressure. These machines don't have enough pressure available to act like a ventilator.
Now the ASV machines....yes, they do bursts of pressure but that is for a whole different problem related to central apneas and not obstructives. Our plain cpap/apap machines won't do that.

[Burkebang]

Archangle, I had problems viewing my data, but I have identified the problem. I had Sleepyhead set to ignore CPAP sessions shorter than 10 minutes. What I remember from the last data I looked at, there was no events flagged at all, so no reason to increase the pressure. I'm out of town on business, but I'll post the data when I get home tomorrow.

That short session thing fools a lot of people.

I'm talking about the flow limitation graph on S9 machines, not the flow limitations events that PRS1 machines do.

Here is the data from the test in the video I made. Shockingly it has not even recorded the pressures that was shown on the screen of the machine. There has to be something very wrong here.

[archangle]

If his machine goes from 5-15, it's safe to assume that this is his prescribed pressure range. When an automaticically titrating machine is prescribed, there should be no reason for titration studies.

Not necessarily true. In the US, most people have a titration study to determine what pressure to prescribe for a manual CPAP. Some are given an auto CPAP with a pressure range around the titrated pressure. Sometimes the titration study will determine that the persons pressure needs change during different sleep stages or positions and an auto CPAP is given for that reason.

An in-lab titration does have several potential advantages over APAP.

It would make some sense to use an APAP machine with a modem to basically do the titration at home, but here in the US, the medical mafia is hung up on the value of expensive and profitable in lab PSG titration, so they tend to insist on in lab titration and ignore the very valuable data the CPAP machines record.

[Justin 23]

so went to the place I got my CPAP to say the were pissed was an under statement when I told them I changed the settings from 15 to 11 on the auto function, because I could not get a hold of anyone in there office for 5 days. My actual CPAP # is only 9 on a fixed system.

[ughwhatname]

Were they able to explain what was happening with your machine? I mean, once the steam stopped pouring out their ears!

so went to the place I got my CPAP to say the were pissed was an under statement when I told them I changed the settings from 15 to 11 on the auto function, because I could not get a hold of anyone in there office for 5 days. My actual CPAP # is only 9 on a fixed system.

[Tino2You]

I've had my S9 Autoset since mid May. My pressure is set to 9-16. During the first few months, my pressure (during sleep) went from 9 to near 15 in an hour or so. It hovered at my max for most of the night. Eventually, and I am not 100% sure why, my pressure setting are still the same and most nights the max pressure the machine uses is in the 10 or less range. All I can deduce is that my leaks issues are resolved (average around 7mL) and my throat tissues are now accustomed to being held open.

-tino