I need your help...

I've been doing some reading here, and on the web in general seeking solutions to my troubles with PAP. I have had my machine for just around 3 months and was diagnosed with severe apnea.. I think my test results were in the 2 to 5 hundred range. Sleep doc said he had never seen it so high. Anyway along with COPD I was really doing badly, but since I have had my machine my life has changed!

My trouble is this, my pressures are 25/20 and as thus are so high I have a real problem keeping a seal. To mitigate leaks the headgear is pulled so tight I wake up in the night with pain in the back of my neck. My AHI is steadily in the sub zero range and I think if I could maybe ease up on the pressure a bit I might still have an acceptable AHI with less leaks. I don't know how to adjust my settings.

you adjust the pressure in the clinicians menu and there is a combination of buttons to push to gain access to it. I personally would check out some other things first as it sounds like the pressure is doing a great job.

Some thoughts: some leaks are caused by the silicon seal not being able to stick to the face, under pressure it slides to the outside and breaks the seal-bingo leak.
Increased strap pressure is not always the solution to stopping leaks:
The correct strap pressure, top and bottom strap do different things, I adjust my straps 1/8" at a time. They are very sensitive.
clean mask and face, if the silicon gasket can slip it will slip.
maybe a mask liner

It's a frustrating thing, but if you are having trouble with mask fit-fiddle with it, a lot.

Loosen the straps - the silicone membrane needs to inflate to be effective. If you're worried about leaks, try Padacheek(.com) liners - designed by a forum member and pretty useful. I am a bit concerned at your 'sub zero' AHI's... theoretically great, but not necessarily necessary... not if it's giving you problems. The numbers are not as important (within reason) as comfort and overall good symptom relief.

Have you looked at the "Taming the Quattro" instructions? Do a search here for it. As Julie said, the mask cushion needs to inflate before you put the mask on. The mask needs to "float on your face. You should never have the straps so tight... they hurt.

Sheriff

biggamoose wrote:I've been doing some reading here, and on the web in general seeking solutions to my troubles with PAP. I have had my machine for just around 3 months and was diagnosed with severe apnea.. I think my test results were in the 2 to 5 hundred range. Sleep doc said he had never seen it so high. Anyway along with COPD I was really doing badly, but since I have had my machine my life has changed!

My trouble is this, my pressures are 25/20 and as thus are so high I have a real problem keeping a seal. To mitigate leaks the headgear is pulled so tight I wake up in the night with pain in the back of my neck. My AHI is steadily in the sub zero range and I think if I could maybe ease up on the pressure a bit I might still have an acceptable AHI with less leaks. I don't know how to adjust my settings.

I think you have a numbers problem.....

How to adjust the pressures is explained in the clinical manual.
You can read about it here (how to get to the clinical setup area is the same on all S9 machines)
http://www.apneuvereniging.nl/forum/pdf ... manual.pdf
but I strongly suggest that you go here and get the manual for your machine since it is a special machine
http://www.apneaboard.com/adjust-cpap-p ... tup-manual
This is what you would need to request
ResMed S9 VPAP COPD Noninvasive Ventilator

Your COPD complicates things so in this situation I would encourage you to not go changing things willy nilly without medical backup. Talk to your DME and/or your doctor about what you want to do.

At your pressure needs keeping a good seal is going to be a challenge no matter what mask you use.
Have you tried a mask liner?
Is there anyway you can use something other than a full face mask because there's simply a lot of surface area that requires sealing with full face masks?
Something with less surface area might be less problematic.
If you can normally breathe through your nose just fine you might do well with a nasal interface mask.
High pressures don't mean that a person can't use a nasal interface mask.
Now if you are using a full face mask because of nasal congestion that can't be cleared up that's one thing but sometimes patients are told that "your pressure needs mean that you can only use a full face mask" and that's simply not true.

No need to search for the "taming of the quattro" thing...here's a link
https://maskarrayed.wordpress.com/tamin ... e-quattro/

If you have too much difficulty getting a silicone mask to fit, you could try a GEL mask.
Welcome to the forum.

While I would be hesitant to suggest altering effective therapy, I'm wondering if it has been tested to see if a bit lower pressure might also provide effective treatment. Some users resign themselves to tolerating a few innocuous events if the lower pressure means they can tolerate the treatment better. It can be a balancing act, and one best done slowly in small increments with close data monitoring. Having COPD may change things. I would want a knowledgeable doctor on board if possible.