HELP A CPAP NOOB: CPAP Problems + Settings (s9 Autoset)

Hey Guys,

New to the forums and this is my first post so go easy

So like many of you guys out there, I was diagnosed with sleep apnea and after many many months and multiple sleep tests I managed to get my hands on a CPAP machine. The main reason I didn't get the machine earlier was for financial reasons (they are quite expensive here in Australia). I managed to find the s9 Autoset 2nd hand and bought it and because of this reason when I bought the machine it was not set to my specifications. My prescription is as follows:

Requires the following set up :
CPAP pressure requirement : 12 cm of water pressure
APAP pressure range : 5-15 cm of water pressure
Mask type and size : Mirage ACTiva LT – Large Wide
Humidifier : yes


I've personally set my machine to these specification in the special menu
Mode: Autoset
Max Pressure: 15.0
Min: 5.0
Max Ramp: 20 Minute
Start Pressure: 5.0
EPR: Full Time
EPR Level: 3


I've been trying to get some more information to help my sleep anpea but I feel like the sleep clinic really is not much help because I did not purchase one of their machines.

I've found that I only average about 2-3 hours of sleep with my machine for which I've had for about 2 weeks(I take it off without even realising it while I sleep)I've had this same problem when I originally hired my machine (which had settings specified for me) BUT it has been slowing increasing since when I first started (Early on I could only land 1.5hours a night with the machine). It really feels like I'm even more tired when I use the machine then when I don't use it.

Sorry about the long read, my questions for all you informed cpap users out there is:
1) Are my settings that I personally set correct? If not would you be able to tell me what I need to put in
2) Do you have any tips that could help me ease into the machine? I've read stories aobut other users who straight away get 7-8 hours using the machine when they first get it
3) EPR helps a HUGE amount when I'm trying to get to sleep, but do I need it fulltime or is it affecting how my treatment is going

Thanks for reading guys and I appreciate any help

It would help if you mention something about the data from the small amount of time you sleep: AI, HI, leak.

So now since you didn't I will make some "guesses".

With the settings you are using, you could be having just as many apneas and hypopneas with the machine as without.

If you need a pressure of 12 cm, then 5 cm is likely too low. The machine will raise pressure when you start having breathing problems, but it may take a long time to get to the required pressure of 12. During this time you could be having many apneas. This will affect the length of sleep in a negative way.

You might get better results by changing the pressure range to 10 - 15 cm.

Let us know what your data shows.

Some people also do better with a straight CPAP setting than on an APAP range. It's a bit of trial and error sometimes to see which works best for you, but the software or at least the info from the LCD screen is essential. Leaks, mouth breathing, or too low pressure could all be making you feel worse rather than better. So pls share the numbers.

Many people practice using the machine during the day to get used to it. That way you get used to the pressure and can fiddle with the mask and pressure settings while you're awake rather than bone dead tired at bedtime. Wear it while for example watching tv or reading.
You may be taking of the mask unconsciously due to leaks, or a poor fit, or not enough air from the cpap, or simply just not being used to the whole thing. daytime practice will help!

Welcome the forum!

hey guys thanks for the quick replies,

How abouts do i go about getting this data? And where is this AI,Hi, Leaks etc on the lcd screen?

You are probably waking because your starting pressure is very low and you have ramp turned on which means it's may really be starting at 4 cm,and then the pressure can increase a great deal--that increase pressure can "blow out" your mask and cause you to be uncomfortable so that you wake up or pull off the mask. You might sleep better if there is less difference between the bottom number and the top number. The usual recommendation is 2 -3 cm below and above the titrated pressure of 12, which is why Roster suggested 10 to 15.

You might start at 9 to 14 because 10 may feel like too much at first (you can always try and find out). If you can try this without ramping, you will have less difference between where you start off the night and where you end up. That may make you more comfortable and able to sleep, providing you can comfortably get to sleep at 9 cm to start with (I do, and to me it feels quite good). Keep the EPR for now, it is making you more comfortable. Later, IF it is affecting your AHI, you can consider decreasing or eliminating the EPR, but right now the benefits outweigh the potential problems.

Meanwhile get access to your data so you can see what's happening to your AHI and leak rates. Ask about (here) for the software so you can print your graphs and we can really help you optimize your treatment.

I experienced the same thing--I woke frequently at first and it took a while until I could sleep through the night. Good to hear it's gradually getting longer.

Hi

The cost of equipment in Aust is certainly expensive by comparison to the USA.

On the S9 you press the button on the top right of the screen to show the AHI and basic statistics. Getting the REScan software and an SD card reader will allow you to get a detailed look at the data downloaded onto a computer. A Clinician Manual can be downloaded to give you detailed info on setup: do a search on this site for posts on the manual and a link to the software and someone will help.

The basic setup appears to be correct. I suggest that you consider do not changing the setup greatly until you see the basic data results. I found it hard to get used to higher pressures initially so I used a lower pressure limit initially and gradually adjusted the lower limit up as I felt more comfortable with the pressure, ie a week or more at each ajustment of 0.5 upwards. The suggestion from many here seems to be one or two below your titrated level to two above for the min and max levels on the APAP. I found that difficult initially. The S9 adjusts pressure reasonably quickly as required so a wide spread may not be too much of a problem initially. I cannot handle it without EPR on max.

W

CPAP pressure requirement : 12 cm of water pressure

If that's what your prescription says and that's what they found to be effective in your sleep study, then that's where you need to set your machine. You need to TRY that pressure for a period of time to see how well it works. Sleeping with a single pressure typically produces better sleep........and right now, you need lots of good sleep.

In APAP mode, your machine is set with a too wide-open pressure range and the pressure changes are messing with your sleep.

Just because you HAVE an APAP doesn't mean you have to run it in that mode.


Den

Wulfman wrote:

CPAP pressure requirement : 12 cm of water pressure

If that's what your prescription says and that's what they found to be effective in your sleep study, then that's where you need to set your machine. You need to TRY that pressure for a period of time to see how well it works. Sleeping with a single pressure typically produces better sleep........and right now, you need lots of good sleep.

In APAP mode, your machine is set with a too wide-open pressure range and the pressure changes are messing with your sleep.

Just because you HAVE an APAP doesn't mean you have to run it in that mode.


Den

Wulfman I've taken your advice and given it a shot on CPAP mode. I set it up for 12 pressure starting at 6 .

I managed to get a whoppign 3.6 hours of sleep! (personal best)
Im gonna give this mode a go for a week and see how i feel, I will report back soon on those numbers you guys asked for when i can manage to find out how to get to them

YOO hoo, fellow s niner!
check your PM

khem26 wrote:Wulfman I've taken your advice and given it a shot on CPAP mode. I set it up for 12 pressure starting at 6 .

I managed to get a whoppign 3.6 hours of sleep! (personal best)
Im gonna give this mode a go for a week and see how i feel, I will report back soon on those numbers you guys asked for when i can manage to find out how to get to them

Glad to hear that. It's not unusual in the beginning of therapy to get LESS hours of sleep than what you were used to......but the "quality" of those hours of sleep will typically be better. As you get used to it, you'll get more. Try to get at least four hours per night (average) if your insurance and DME are monitoring your usage/compliance.

Hang in there.


Den