CPAP Resmed S9 breathing labored

[sjm1027]

Hello,
I have a problem and question. I have a Resmed S9, humidifier and heated hose with a Resmed FX nasal mask. I have been doing pretty good with it and about a month or 2 ago I noticed my breathing is labored. Setting never changed. Seems I have to work hard to get a comfortable breathing rhythm going. At times I can never get it right and from that labored breathing my nose gets blocked and all hell breaks loose. I flip off the mask and try to sleep without. I know I need the CPAP because I catch myself gasping for breath without the mask. Last night it woke me up like I was in a horror movie.
I have had 3 different sleep tests to make sure my setting are correct yet I feel they are not. Is there some setting to tweak the type of breathing or the way the S9 responds to breathing? Is anyone else experiencing anything like this? I would appreciate any help you have to offer.

Thanks,
Steve

[Pugsy]

So what settings are you using now?

[sjm1027]

Thanks for your time.

Auto set Mode
Max pressure - 7.6
Min pressure - 6.0
Max ramp - 5 min
Start pressure - 5.0
EPR - full time
EPR level - 3
Mask - nasal
Climate control - auto
Sleep quality - on
Smart start - on

Hope this was what you were looking for.
Steve

[grayghost4]

Are you using Sleepyhead to monitor your therapy?
if not you should download and post some info from it.

[Julie]

I don't know what they told you, but your settings are extremely low (4 being the default machine low), so no wonder you're working so hard! Raise your low setting to at least 7 and see how that goes over 1-2 nights, and let us know.

[sjm1027]

At one time my setting was 14.0 but that was 291 pounds ago. When I went back to my sleep study they told me I just barely needed it but I did need it. I think they said 6.0 or something like that. I could say this has been a nightmare but I don't sleep enough to even get icy REM sleep. Personally I think I should be around 9.5 or so. Is it dangerous to put the settings to 9.5 max and 7.0 min with Autoset mode on? Will Autoset know what you need?

Thanks
Steve

[Pugsy]

Is it dangerous to put the settings to 9.5 max and 7.0 min with Autoset mode on? Will Autoset know what you need?

The machine will pretty much go only to where it thinks it needs to go and if it doesn't see the need to go somewhere it won't go anywhere.
No real danger to using 7.0 to 9.5 as long as centrals are not present in large numbers and that happens only to a very small percentage of people and if you used 14 cm in the past without issues with centrals then it is highly unlikely that you would have a problem now.

If increasing the minimum pressure doesn't help....please see a doctor because perhaps something has change in regards to lung function and we wouldn't want to miss something that might need medical attention.

With EPR set to 3 that's a 3 cm drop during exhale but you aren't getting full benefit from it with the minimum being less than 7 because it can't drop below 4 cm.

[Julie]

Not dangerous unless you've had e.g. issues with many centrals in the past, but do raise the top pressure more than 9.5 as you could even leave it open to 20 - it's not going to matter much at the moment, though e.g. 15 would be a good place to put it, and see what's what in the future. And congrats on your weight loss!! Fantastic!

Btw, if you normally sleep on your back, try not doing it (with something behind you if necessary) and see how that goes - if all the weight loss has put you in the category of having only "positional" apnea, you might not even need a machine, especially not if you do sleep with a cervical collar and occasional oximeter check, though give yourself a few wks to be very sure of results.

[sjm1027]

I have Sleepy Head loaded. Not sure what I need to post to give you the data you are looking for?

[sjm1027]

Some sleepy head reading from my new settings Saturday nights typical settings to last nights New settings:

Saturday Typical for past year:

AHIGraph showing running AHI for the past hour 3.36
S9 AutoSetResMed S9 36005 22102159391
PAP Mode: APAP
Pressure: 340282346638528859811704183484516925440.0-6.0cmH2O
Date Sleep Wake Hours
2/7/15 22:31 02:23 03:52:18
Hypopnea 1.55
Obstructive Apnea 1.81
Unclassified Apnea 0.00

Event Breakdown

Statistics
Channel Min Med 95% Max
PressureTherapy Pressure (cmH2O)
W-Avg: 7.37 6.00 7.52 7.60 7.60
EPAPExpiratory Pressure (cmH2O)
W-Avg: 4.42 4.00 4.52 4.60 4.60
Minute Vent.Amount of air displaced per minute (L/min)
W-Avg: 5.70 2.00 5.88 9.00 15.38
Resp. RateRate of breaths per minute (Breaths/min)
W-Avg: 16.31 9.20 16.40 18.40 22.20
Flow Limit.Graph showing severity of flow limitations (Severety (0-1))
W-Avg: 0.04 0.00 0.00 0.18 0.50
Leak RateRate of detected mask leakage (L/min)
W-Avg: 3.33 0.00 0.00 15.60 31.20
SnoreGraph displaying snore volume (??)
W-Avg: 0.01 0.00 0.00 0.04 0.42
Insp. TimeTime taken to breathe in (Seconds)
W-Avg: 1.93 0.46 1.86 2.69 9.04
Exp. TimeTime taken to breathe out (Seconds)
W-Avg: 1.73 0.28 1.70 2.50 7.16
Tidal VolumeAmount of air displaced per breath (L/min)
W-Avg: 346.99 120.00 360.00 600.00 940.00

Time over leak redline 0.215%
Machine Settings

Pr. ReliefPressure Relief EPR x3
Session Information

On Date Start End Duration
CPAP Sessions
2/7/15 22:31 02:23 03h 52m 18sResMed:#1423366253 13938s


Sunday night, New Setting from suggestions on this thread. I did have a more comfortable nights sleep.

AHIGraph showing running AHI for the past hour 0.35
S9 AutoSetResMed S9 36005 22102159391
PAP Mode: APAP
Pressure: 340282346638528859811704183484516925440.0-7.0cmH2O
Date Sleep Wake Hours
2/8/15 22:10 03:57 05:47:08
Hypopnea 0.17
Obstructive Apnea 0.17
Unclassified Apnea 0.00

Event Breakdown

Statistics
Channel Min Med 95% Max
PressureTherapy Pressure (cmH2O)
W-Avg: 9.43 7.00 9.20 12.42 14.44
EPAPExpiratory Pressure (cmH2O)
W-Avg: 6.43 4.00 6.20 9.42 11.44
Minute Vent.Amount of air displaced per minute (L/min)
W-Avg: 5.48 1.38 5.62 8.12 14.88
Resp. RateRate of breaths per minute (Breaths/min)
W-Avg: 17.02 8.60 17.00 18.80 24.00
Flow Limit.Graph showing severity of flow limitations (Severety (0-1))
W-Avg: 0.01 0.00 0.00 0.08 0.63
Leak RateRate of detected mask leakage (L/min)
W-Avg: 7.02 0.00 4.80 22.80 33.60
SnoreGraph displaying snore volume (??)
W-Avg: 0.02 0.00 0.02 0.06 0.12
Insp. TimeTime taken to breathe in (Seconds)
W-Avg: 1.90 0.42 1.84 2.60 5.64
Exp. TimeTime taken to breathe out (Seconds)
W-Avg: 1.60 0.08 1.60 2.16 7.04
Tidal VolumeAmount of air displaced per breath (L/min)
W-Avg: 318.19 100.00 320.00 500.00 1060.00

Time over leak redline 3.524%
Machine Settings

Pr. ReliefPressure Relief EPR x3
Session Information

On Date Start End Duration
CPAP Sessions
2/8/15 22:10 03:57 05h 47m 08sResMed:#1423451445 20828s

I would be interested in what you all think.
Thanks for a better nights sleep

Steve

[Krelvin]

I have Sleepy Head loaded. Not sure what I need to post to give you the data you are looking for?

How to organize your charts
https://sleep.tnet.com/resources/sleepyhead/shorganize

How to take a screen shot
https://sleep.tnet.com/resources/sleepy ... screenshot

How to upload them to imgur so you can post them.
https://sleep.tnet.com/reference/tips/imgur

[sjm1027]

I have my screen shot from last night and would like some comments if you have a moment.

[url=http://imgur.com/pdLj0zp.png][img] ... .png[/img][/url]

[url=http://imgur.com/pdLj0zp.png][/url]

http://imgur.com/pdLj0zp.png

[SteveGold]

The EPR of 3 might be something to look at. Personally, I find EPR throws off my breathing rhythm and I sleep better with a steady pressure. Your pressure settings are close to mine and I gather pretty low in the scheme of things, so you may not be getting much benefit from EPR anyway.

[adin67]

I think the EPR =2 it would be better for you, and raise your max&min. pressure is a good idea.

[sjm1027]

I made the EPR change from 3 to 2 and have posted my results. I am trying to understand how to read this chart but all I can see is things are about the same or going in the wrong direction as I have has AHI of less than .79 in the past. I did feel less labored with EPR of 2. Do you think I should move it to 1 to see what happens?

Overall what do my results look like?

Thanks,
Steve