Just got my first CPAP machine yesterday, a Resmed S8 Elite with heated humidifier. I had the heat setting set to "3" as recommended to start, but the water in the tank was at the full level and still cold when I woke up. Does anyone have any experience with this?
Also, I checked my efficacy data this morning and was disappointed to see that my overnight AHI was 18.8 (AI: 6.3, HI: 12.5) While I suppose that is an improvement from my sleep study (AHI of 34.9), I was really expecting better on CPAP. My pressure is set at 7 and I have the EPR setting on "3" (for a pressure of 4 on exhale). I used the Mirage Swift mask last night. The leak data was 0.12 L/s which I think was OK for the first night with a new mask. I slept a total of 5:12 hours. Any guidance an experienced S8 user can offer would be greatly appreciated!
Angela
First Night on CPAP w/ S8 Elite: Humidifier & AHI Questi
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Welcome and congratulations on joining the wonderful world of "hoseheads"!
I'm afraid I'm not experienced enough to address your numbers, but I have a Resmed S8 Compact with a heated humidifier, so perhaps I can help you there. You'll probably need to take the CPAP and the humidifier apart and then reassemble the two pieces to make certain that they really "click" together properly and ensure that the humidifer is connected to the CPAP's power supply. Once put back together, test it out by turning the humidity setting up to the maxx and, without the water container, see if the heating plate is doing what it's supposed to. If that doesn't work, you may have a faulty unit, but I'd play with it a few times and re-read the assembly directions before I called the DME.
Good luck!
Kurtchan
I'm afraid I'm not experienced enough to address your numbers, but I have a Resmed S8 Compact with a heated humidifier, so perhaps I can help you there. You'll probably need to take the CPAP and the humidifier apart and then reassemble the two pieces to make certain that they really "click" together properly and ensure that the humidifer is connected to the CPAP's power supply. Once put back together, test it out by turning the humidity setting up to the maxx and, without the water container, see if the heating plate is doing what it's supposed to. If that doesn't work, you may have a faulty unit, but I'd play with it a few times and re-read the assembly directions before I called the DME.
Good luck!
Kurtchan
"Life is not a dress rehearsal."
Angela,
Is the mask setting on your machine set to the proper setting?
You may be leaking air out your mouth during the night, which is counterproductive to your therapy. Make sure you tape your mouth or use Polident adhesive strips......then you'll have a better idea through a process of elimination. Or, try a full face mask.
I can't answer your question of the humidifier......don't have that machine setup.
Best wishes,
Den
Is the mask setting on your machine set to the proper setting?
You may be leaking air out your mouth during the night, which is counterproductive to your therapy. Make sure you tape your mouth or use Polident adhesive strips......then you'll have a better idea through a process of elimination. Or, try a full face mask.
I can't answer your question of the humidifier......don't have that machine setup.
Best wishes,
Den
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
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MandoJohnny
- Posts: 305
- Joined: Sun Apr 23, 2006 11:23 am
- Location: St Louis, Missouri
I have the same machine/mask you do and I had exactly the same problems. That humidifier doesn't really get warm until 5 (the knob pointing to the 3:00 position), which is where I have it. Just "crank it up!"
My AHI's were around 8 or so when I started, with a pressure setting of 10 and an EPR setting of 3. I called my sleep doc and he said he wanted my AHI's to always be below 4. He said to kick the pressure up to 11 and reduce the EPR to 2. That caused my AHI's to drop in half immediately. He has since advised me to turn the EPR off and now my AHIs are running like 2 to 3. He said EPR is a good tool for getting people used to CPAP and getting them compliant, but it can be counterproductive in some patients. I recommend consulting your sleep doc about raising your pressure and lowering your EPR.
It sounds like your mask situation is OK, but one thing I learned with the Swift is that the bigger nasal pillow set you can use, the better. I got fitted by an incompetent RT with the small set, even though I have an ample schnozz. I played around with the other sets and it was obvious that the medium fit better. Then I decided to try the large, just to see what would happen. It looked too big, but it was more comfortable and my leak stats are the same as with the medium. So consider trying the larger sets and see what happens. It may improve your experience.
My AHI's were around 8 or so when I started, with a pressure setting of 10 and an EPR setting of 3. I called my sleep doc and he said he wanted my AHI's to always be below 4. He said to kick the pressure up to 11 and reduce the EPR to 2. That caused my AHI's to drop in half immediately. He has since advised me to turn the EPR off and now my AHIs are running like 2 to 3. He said EPR is a good tool for getting people used to CPAP and getting them compliant, but it can be counterproductive in some patients. I recommend consulting your sleep doc about raising your pressure and lowering your EPR.
It sounds like your mask situation is OK, but one thing I learned with the Swift is that the bigger nasal pillow set you can use, the better. I got fitted by an incompetent RT with the small set, even though I have an ample schnozz. I played around with the other sets and it was obvious that the medium fit better. Then I decided to try the large, just to see what would happen. It looked too big, but it was more comfortable and my leak stats are the same as with the medium. So consider trying the larger sets and see what happens. It may improve your experience.
Thanks for all of the advice...
Thanks for the great replies....
Kurtchan - I checked to make sure the humidifier was assembled correctly, and it seems like it was. The RT did it the first time so it was good practice for me, thanks for the tip on clicking things together, I might not have realized that.
Den (Wulfman) - Mask setting is rights but hmmm, I didn't think about a mouth-leak. I'll try taping my mouth shut tonight, see if that changes the numbers. Thanks!
Kansas RT: Level 4 did the trick! Thanks!
MandoJohnny: Great information and advice. I will call my doctor today to see if she wants to change my pressure settings. I used the large Swift pillows last night instead of the medium but I'm not sure it made much difference. As the night went on, I found it so uncomfortable I switched to the Nasal Aire II in the middle of the night... which was much lighter and caused less pressure on my face, but it felt like it was strangling me around my neck! I dropped the EPR down to "2" last night but my AHI was 19.2 according to the machine this morning. Very frustrating. This is a lot harder than I thought it was going to be.
Wish me luck tonight.
Thanks again everyone.
Angela
Kurtchan - I checked to make sure the humidifier was assembled correctly, and it seems like it was. The RT did it the first time so it was good practice for me, thanks for the tip on clicking things together, I might not have realized that.
Den (Wulfman) - Mask setting is rights but hmmm, I didn't think about a mouth-leak. I'll try taping my mouth shut tonight, see if that changes the numbers. Thanks!
Kansas RT: Level 4 did the trick! Thanks!
MandoJohnny: Great information and advice. I will call my doctor today to see if she wants to change my pressure settings. I used the large Swift pillows last night instead of the medium but I'm not sure it made much difference. As the night went on, I found it so uncomfortable I switched to the Nasal Aire II in the middle of the night... which was much lighter and caused less pressure on my face, but it felt like it was strangling me around my neck! I dropped the EPR down to "2" last night but my AHI was 19.2 according to the machine this morning. Very frustrating. This is a lot harder than I thought it was going to be.
Wish me luck tonight.
Thanks again everyone.
Angela
Angela,
Glad things seem to be working better with the humidifier on a higher setting.
I'm all for customer service which is rare enough from the DME, but it is indeed good practice to take apart and re-connect all the pieces of the machine if it was done by the clinician on the first visit. Nothing like hands-on experience! It will also make it less of a hassle if you end up travelling with it. I found myself stumbling around a half-lit hotel room with pieces of the machine and mask strewn all over only days after I first started therapy. Not pretty!
Keep us posted as to your progress.
PS -- I used to live in Long Branch, NJ. Were we neighbors?
Glad things seem to be working better with the humidifier on a higher setting.
I'm all for customer service which is rare enough from the DME, but it is indeed good practice to take apart and re-connect all the pieces of the machine if it was done by the clinician on the first visit. Nothing like hands-on experience! It will also make it less of a hassle if you end up travelling with it. I found myself stumbling around a half-lit hotel room with pieces of the machine and mask strewn all over only days after I first started therapy. Not pretty!
Keep us posted as to your progress.
PS -- I used to live in Long Branch, NJ. Were we neighbors?
"Life is not a dress rehearsal."
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roadwarrior
- Posts: 146
- Joined: Wed May 17, 2006 11:54 am
- Location: Salt Lake City, Utah
- Contact:
My shotgun method worked
I have been reading plenty of commentaries of what has and has not worked for folks around here. I just got a new REMstar Auto with Cflex and heated humidifier Tuesday and have been using it since Tuesday night with a setting of Min-6 Max-12 pressure with the Cflex on 1 and humidifier on 2. I used the Swift for 2 nights. It was just "ok" from what I could describe. I didn't feel particularly wonderful but still a hell of a lot better than the night I spent without any machine.
So I decided to apply a different approach to the whole thing, starting with the pressure settings. I left the upper limit on 12, but instead of having the lower set on 6 I bumped it to 8. I was titrated at 9 for a CPAP based on a sleep study. This way I figured it would be closer to avoiding any fast onset Hypopneas just in case. I also then used my Activa mask WITH the chin strap leaving no stones unturned as far as potential of my chin dropping on me and allowing a mouth leak. I even used some saline spray prior to bed a few times to clear out my sinuses.
All of this and I can tell you I've slept like I haven't in too long to remember. I do know I had ONE awakening which I turned right over and went back to sleep. I had the longest dream I can remember in too long to remember, so surely I was getting some excellent REM cycle in my sleep as well. I noticed this moring there was a complete absence of drowsiness, and I was clear thinking as a bell. Did my treadmill workout and feel great.
Now I have to wonder which of the things I did made the MOST difference. I'm willing to bet upping the lower limit pressure was key. I will be trying the Swift tonight (without the chin strap) to really tempt fate and I'll let you all know how that setup works. If it does it almost certainly points at the pressure change as doing the trick. Unfortunately I have NO software and card reader as yet to see for sure what my stats are. Soon however........
So I decided to apply a different approach to the whole thing, starting with the pressure settings. I left the upper limit on 12, but instead of having the lower set on 6 I bumped it to 8. I was titrated at 9 for a CPAP based on a sleep study. This way I figured it would be closer to avoiding any fast onset Hypopneas just in case. I also then used my Activa mask WITH the chin strap leaving no stones unturned as far as potential of my chin dropping on me and allowing a mouth leak. I even used some saline spray prior to bed a few times to clear out my sinuses.
All of this and I can tell you I've slept like I haven't in too long to remember. I do know I had ONE awakening which I turned right over and went back to sleep. I had the longest dream I can remember in too long to remember, so surely I was getting some excellent REM cycle in my sleep as well. I noticed this moring there was a complete absence of drowsiness, and I was clear thinking as a bell. Did my treadmill workout and feel great.
Now I have to wonder which of the things I did made the MOST difference. I'm willing to bet upping the lower limit pressure was key. I will be trying the Swift tonight (without the chin strap) to really tempt fate and I'll let you all know how that setup works. If it does it almost certainly points at the pressure change as doing the trick. Unfortunately I have NO software and card reader as yet to see for sure what my stats are. Soon however........
Persistance is Omnipotent
Hi roadwarrior,
Glad to hear you slept well and feel good! There's hope for me, yet. When are you getting your cardreader? I would love to hear how your stats change with the pressure setting changes. I think a pressure change might be what I need, too, based on all of the posts here. I'm glad to hear it, I was feeling a little worried/disappointed thinking my therapy was not going to work, but I'm feeling hopeful again.
Thanks for adding your 2 cents. Keep me posted on how the Swift works for you.
Angela
Glad to hear you slept well and feel good! There's hope for me, yet. When are you getting your cardreader? I would love to hear how your stats change with the pressure setting changes. I think a pressure change might be what I need, too, based on all of the posts here. I'm glad to hear it, I was feeling a little worried/disappointed thinking my therapy was not going to work, but I'm feeling hopeful again.
Thanks for adding your 2 cents. Keep me posted on how the Swift works for you.
Angela
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SleeplessInVirginia
- Posts: 32
- Joined: Sun May 28, 2006 4:56 pm
Angela,
I have the exact same setup that you do, and when I first started a few weeks ago had many of the same questions. My humidifier didn't seem warm at all, but when I cranked it up it did get hot. Only problem was that I got a little bit of rainout at the higher settings so I now keep it at 3.
I also still some times get a higher AHI than I would like, but it seems to vary from night to night. The majority of mine are hypops though, and I think that happens frequently with the Resmed series. I don't have anywhere near as high as you do with 18, but some nights are higher than 5 which is what you want to keep your target number at or lower. My pressure is set at 10, and I still use the EPR but after reading your post I might try to decrease it. I find that when I use the ramp 4 is much too low, so I have my ramp set at 5 minutes so I can get the good stuff a lot quicker.
I've also found that alternating between masks helps with different sore spots. I started with the Swift, and now alternate with the Ultra Mirage II. I love both of them for different reasons.
Good luck with everything, I'm sure you'll figure out what your perfect settings are and you'll be on the road to clear thinking and feeling more rested very soon.
Take care!
I have the exact same setup that you do, and when I first started a few weeks ago had many of the same questions. My humidifier didn't seem warm at all, but when I cranked it up it did get hot. Only problem was that I got a little bit of rainout at the higher settings so I now keep it at 3.
I also still some times get a higher AHI than I would like, but it seems to vary from night to night. The majority of mine are hypops though, and I think that happens frequently with the Resmed series. I don't have anywhere near as high as you do with 18, but some nights are higher than 5 which is what you want to keep your target number at or lower. My pressure is set at 10, and I still use the EPR but after reading your post I might try to decrease it. I find that when I use the ramp 4 is much too low, so I have my ramp set at 5 minutes so I can get the good stuff a lot quicker.
I've also found that alternating between masks helps with different sore spots. I started with the Swift, and now alternate with the Ultra Mirage II. I love both of them for different reasons.
Good luck with everything, I'm sure you'll figure out what your perfect settings are and you'll be on the road to clear thinking and feeling more rested very soon.
Take care!
"Life is not measured by the number of breaths we take, but by the moments that take our breath away"
you are experiencing too many apneas (AI) with therapy.
Probabable causes could be:
1. Mask leaks, consult your leak data to that shown in the manual.
2. if the mask wasn't leaking, you may have been mouth breathing, signs would be dry mouth, high leak rate etc.
3. Pressure of 7.0cm is not high enough or EPR is set too high.
I would consult the mask leak data and if it was in Good range then I would increase the pressure from 7.0cm to 7.5cm. Your pressure is basically low, so I would turn down the EPR a notch, if your pressure was higher I could see using a higher EPR.
Since you are new at this, did you use the Ramp? I would check that and set it to a starting pressure of 5 or 6cm with a 30-minute timer. Then when you put on the mask hit the Ramp button, it will start the timer and keep the pressure down until you fall asleep.
If you made those changes you probably won't notice any difference in comfort.
How much water you use out of your humdifier all depends on the relative humidity where you live. I would think in NJ it would be very humid this time of the year, you may not even need the heater portion, just use it as passover mode (i.e. heat is on 1 or off). Winter time is where you'll want that heat.
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CPAPopedia Keywords Contained In This Post (Click For Definition): Ramp
Probabable causes could be:
1. Mask leaks, consult your leak data to that shown in the manual.
2. if the mask wasn't leaking, you may have been mouth breathing, signs would be dry mouth, high leak rate etc.
3. Pressure of 7.0cm is not high enough or EPR is set too high.
I would consult the mask leak data and if it was in Good range then I would increase the pressure from 7.0cm to 7.5cm. Your pressure is basically low, so I would turn down the EPR a notch, if your pressure was higher I could see using a higher EPR.
Since you are new at this, did you use the Ramp? I would check that and set it to a starting pressure of 5 or 6cm with a 30-minute timer. Then when you put on the mask hit the Ramp button, it will start the timer and keep the pressure down until you fall asleep.
If you made those changes you probably won't notice any difference in comfort.
How much water you use out of your humdifier all depends on the relative humidity where you live. I would think in NJ it would be very humid this time of the year, you may not even need the heater portion, just use it as passover mode (i.e. heat is on 1 or off). Winter time is where you'll want that heat.
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CPAPopedia Keywords Contained In This Post (Click For Definition): Ramp
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