Newbie with S9 going back for follow up with Doc

Hi guys,

New to this site and thanks to my wife's cousin Joyce (who highly suggested this site) and help for others here I'm on my way to recovery from apnea

It was suggested that I purchase the S8 but the DME (which I'm not very keen on....located in an industrial park and not very helpful at all) ordered the S9 as it was a newer and supposedly better machine. I've not anything to compare it with but I'm feeling a bit better so I believe it is working for me. I started with a nasal mask but developed a blister on the bridge of my nose. I traded it out for pillows.

I had a sleep study with no titration follow up. The doc said he felt I wouldn't need it as the auto machines are very effective. I'm going back for a follow up doctor visit and was told to bring my card. I'm not sure what to expect out of it so maybe someone can give me some advice.

My machine was initially locked and thanks to Joyce and this site I was able to get into the menus. The doctor has me on a pressure range of 5-15. I felt like I couldn't breathe well as I tried to go to sleep so I turned changed it to 6-15. I feel a difference but don't know if I should turn it up even higher.

Here are my readings for a week (actually have used it for 16 days so far:

Pressure 10
Leak 3.6 (lately with the pillows I have a leak reading of 0)
AHI 5.1
Total AI 4.5
Central AI 3.8

I understand I need to get the reading lower to really begin to feel better....but I'm not sure how to go about that yet. I realize there is a systematic approach to it but I still feel like I'm a bit lost with all of the CPAP stuff.

I guess my question would be, can I adjust my pressure settings to lower my numbers without going through the software route? I'm also wondering if the doctor will make an adjustment after looking at the reading....and wondering if I'll catch it for changing the settings :{

Thanks,

Bob

How long ago did you change it to 6?

You might catch it from your doc... or you might not. Depends on the doc.

Eh, what's he gonna do? Slap your paddies? So you are going to be a patient who insists on taking an active role in your own healthcare and CPAP therapy. What's he gonna do? Fire you? Like he's the only sleep doctor in the state? Be diplomatic and tactful but you needed that little bit extra pressure on the low end.

How long did you wait before you changed the lower pressure from 5 to 6? How long have you been using it w/6 as the lower pressure? How long before rdoctor appointment?

Hi guys,

Thanks for the replies.

I'm really not worried about the doc, but anticipating some flack as the machine was Rx-ed "locked". I think being a self-motivated pro-active patient would be a positive thing if there is a resource of intelligent and tried information on hand (CPAPtalk.com). For instance, I was advised that the EPR level might need tweaking if I'm feeling like I can't breathe properly. When I got into the menu on the S9 both EPR settings were turned off. Now it is on "full" and at level "3".

Slinky, to answer your questions: I have been on CPAP for 16 days. I only changed it from 5 to 6 a couple days ago, so 14 days into it. My doctor appointment is this Wednesday.

BTW, my equipment is: Res Med S9, Res Med H5i, and Res Med Swift LT pillow mask.

Thanks,

Bob

Okay, you got in 2 weeks at "his" settings. Give yourself a week at the 6 lower setting. See what your data says at the end of the week. Based on your results at the end of the week you might even want to raise the lower pressure to 7.

Hi Bob and welcome to the board.

bob007 wrote:When I got into the menu on the S9 both EPR settings were turned off. Now it is on "full" and at level "3".

You might want to think about either turning EPR down (to level 1 or 2, or off) or...
think about raising the minimum pressure on your autopap some more if you want to keep EPR at 3.

Although the topic I'm linking to below started out about C-Flex in a Respironics machine, I also went into my opinion about EPR used by ResMed machines:

Cflex 1-3 Levels - topic started by jucs
January 2, 2010
viewtopic.php?p=436272#p436272

Hi rested gal,

Thanks for the welcome and the advise. I went back in and changed the EPR to "Off" on both settings. That's how it came originally and now that I have the pressure up at 6 I'll see how it goes tonight.

Bob

Wow, what a difference. I turned my EPR off last night, kept the pressure at 6-15 and my numbers dropped:

Pressure 9.4
Leaks 0
AHI 3.2
Total AI 1.3
Central AI 1.3

I felt I got the best night sleep for a looonnnggg time. And I'm adjusting to wearing the mask and felt quite comfortable last night.

I'm anticipating my numbers will come down even further as I move forward.

Thanks for the feed back.

Bob

Don't get too excited if the numbers go up a bit. I've encountered what I call "first night effect" from time to time where my data wasn't quite as good over a week's time or so as it was that first night. That's why I always caution that you stay at ONE CHANGE for ONE WEEK before making any other ONE change whether that change is a therapy setting or a mask change. On the other hand, there have been a very few occasions when my data improved over a week or so over the initial first night's data after a change.

Folks,

I'm new to the CPAP/APAP world; I've been surviving on a NightGuard for 3 years but those days are over. I have the S9 with the 5Hi and an Opus nasal pillow. The first 2 nights were quite difficult and uncomfortable. Last night i rigged up a loop to hold the tube over my head and that worked better. Excpet at some point the pillows got lose where the connect to the mask and I had to do a hard wake up to get the *#^#$%@*&$ thing back together. I could only doze after that.

The thing is, as tired as I am from not sleeping, I actaully feel a bit better with the little sleep I get with the Resmed. I think that's telling me the machine will help once I ge thte comfort issues worked out. I hope...

But my question: how do you folks read the data off the s9 SD card. Is there software available? I've seen Resscan mentioned, but I can't find anyplace on the intenet where I can but it or get it. Other than that, how else can I read the data?

Thanks for any help!

Thanks Slinky....

I'll keep that in mind. ALl I know is that today is the best I've felt for the past 6 months. I really only began to feel extreme fatigue last November but have been waking up feeling tired for years. My cardiologist expected sleep apnea.

BTW, I have been treated for high blood pressure and heart palpitations since 2007 and in Sept 2008 I had a bout with atrial fibrillation, which I'm on meds for and has been under control. My cardiologist prescribed a sleep study a little over a month ago and I go back to her tomorrow for a follow up since being on CPAP.

Bob

Ahhhh, enjoy this day. And have MANY more as good and even better. PAP therapy can do wonders for us once we get past any acclimation hurdles.

bob007 wrote:Wow, what a difference. I turned my EPR off last night, kept the pressure at 6-15 and my numbers dropped:

Pressure 9.4
Leaks 0
AHI 3.2
Total AI 1.3
Central AI 1.3

I felt I got the best night sleep for a looonnnggg time. And I'm adjusting to wearing the mask and felt quite comfortable last night.

I'm anticipating my numbers will come down even further as I move forward.

Thanks for the feed back.

Bob

You are having central apneas which have to do with the nervous system and not because your airway is closed. By increasing the pressure, you can actually make the central apneas worse and worsen your condition. Talk to your doctor about this.

karl9000 wrote:Is there software available? I've seen Resscan mentioned, but I can't find anyplace on the intenet where I can but it or get it. Other than that, how else can I read the data?

If you log before you post you are likely to get a helpful pm.

golfguy,

My centrals were in the high 4 to low 5 numbers previous to turning up my pressure to 6. I'm experiencing a marked lowering of AH, Total AI and Central AI since then. Not sure how your comment relates to the information I provided. I understand the relationship between raising the pressure and potential increase of centrals....but that doesn't seem to be the result so far though I will keep it in mind for the future. It will be interesting to see what my doc says tomorrow at the follow up....in terms of any adjustments.

Bob