AutoSet Spirit advise wanted

Thomas · Post by **Thomas** » Mon Mar 21, 2005 4:51 pm

Hi, I'm new to the forum. Wish I knew about it a long time ago. I bought a Spirit about two weeks ago and need some advise. First a little background. Back in July I had a two week in home study with a Spirit machine and did not want to give it back. (I did anyway). At that time my pressure was changed to 10 on my cpap, which I've had for nearly five years. I was still having problems with feeling it was too much pressure at times and at other times not enough. After not being able to convince my insurance company that the new machine was medically necessary, I decided to buy one from cpap.com. The results from my two week study showed a range in pressure from a little over 8 to somewhere between 11 and 12, so I set the new machine between 8 and 15 for the first night. I have varied that setting somewhat over the last twelve nights. Using an ADAM Circuit nasal pillows my pressure results have varied between 10.4 and 15. My cold/flu congestion may have influenced that. So far most of the time, when I use the mask setting of Standard or Mirage, I feel I get too much pressure (measuring 14-15) and have bloating issues, which disturb my sleep. When I use the Ultra setting I don't have those problems and the pressure results are lower. The problem is that my AHI has varied between 7.7 and 41.2. When I feel like I'm sleeping better using the Ultra setting because of the lower pressure, I have mental alertness issues because of the hypopneas (I'm assuming). I tried an old ultra mirage mask and my breathing was considerably better and the AHI went down to around 8-10. But I was having to adjust the mask every time I moved, so I was sleepy during the day because of waking a lot during the night to adjust the mask (plus it itches). So I am either less sleepy with brain fog, or more sleepy with better mental alertness if I choose between these two masks. What I don't understand is that during the two week study last July, I was using the ADAM Circuit and it worked great, I felt I was breathing well and had no bloating issues, and my AHI averaged 5.5. So I'm having difficulty figuring how to best set the machine. It was set at 8 to 20 during the two week study . I asked the guy who set up the machine for the study and he said to set it to standard for the mask setting with the ADAM Circuit. Others have said to set it to Mirage. Tonight I am going to try the mirage setting again with the ADAM Circuit and set the pressure lower (8-13) to see if that resolves the bloating problems, in an attempt to get good sleep and mental alertness (low AHI) at the same time. If anyone has any further advise I would surely appreciate it. I would like to try a Swift or Activa, but currently have no insurance nor income, so I'll have to wait. Thanks

Tom

Mikesus · Post by **Mikesus** » Mon Mar 21, 2005 4:59 pm

Your AHI might be inaccurate because of the narrow tubing of the adams circuit. Anyone with experience with this type of mask chime it now!

But, the bigger question is, when it was 41, did you still feel rested? If you did, then I would suspect the reading is inaccurate.

If you felt like you did pre-cpap, then I would say that the AHI is prolly accurate and because of the higher pressure you might be causing centrals. You might want to try to lower the upper limit to 12 or 13 and see if that doesn't lower the AHI...

Thomas · Post by **Thomas** » Mon Mar 21, 2005 5:06 pm

I forgot to mention I am also using a DeVilbiss Heated Humidifier model 9200DI, which was also used during the test study.

Here are the pressures and corresponding AHI's.

12 - 7.7
12.4 - 7.1
14 - 12
14 - 10.9
11.4 - 25.5
10.6 - 37.5
15 - 27.3
10.8 - 26.6
11.6 - 8.1
11.2 - 10.2
10.4 - 41.2

Tom

chrisp · Post by **chrisp** » Mon Mar 21, 2005 5:07 pm

I had a Spirit. I rarely had a AHI under 15. Often 25. Didn't feel so good.
I used a Ultra mirage mask. Are you using the integrated heated humidifier ? I dont think the Spirit works well with its heated humidifier. Just my opinion. I also felt better and had better AHI when used Sudafed 24 hr. This machine seems sensitive to stuffy nose problems. I now use a PB420E. AHI of under 5. I feel much better.

Cheers,

Chris

Guest · Post by **Guest** » Tue Mar 22, 2005 8:30 am

Last night's pressure reading was 13 and AHI was 42.6, HI 42.2. The way I feel suggests the numbers are correct. Any more clues anybody?

Thanks

Tom

Guest · Post by **Guest** » Tue Mar 22, 2005 3:22 pm

For those who care to know,
I went to the sleep clinic this afternoon to try to figure this all out. They were baffled by the results as well. But they gave me an adapter pressure cord for the humidifier which I did not have, and are letting me borrow a swift mask to try out and a different size cushion for my ultra mirage. So for the next three weeks I get to test those two masks and the ADAM circuit again with the pressure cord attachment. They are very interested in seeing the results, as they want to find the answers as well. According to what they told me, the ADAM circuit is the only nasal pillows system that is supposed to work with the Spirit other than the swift. Here's hoping it all works out.

Tom