Help! Again.....

[JDC]

I live on a remote island. Northern Canada. I bought my own machine after renting one from a sleep clinic that determined that I needed one. But, because they could not 'assist' me with any kind of regularity, I got the machine without 'counselling'. My rented machine was set at 12 (whatever that means) so I set the Resmed for 12. I set the ramp-up for 20 minutes, the temp for 78 degrees and I understood the machine would 'adjust' to my needs as they came up during the sleep. I've been at it one year and still feel tired. Not rested. But it may just be puffy eyes........hard to tell.
My Resmed card filled up. I am no longer getting readouts. But the last ones showed low apneas. Varying leaks problems but I have worked on that without needing data feedback. I seem to recall that I would occasionally 'max out' the 'setting' and peak at a 16 or something but mostly I was 12 or under. Again.........whatever that means.
But maybe I set it wrong? Maybe I should be higher? Maybe lower? Or does it even matter with an automatic?
I confess to thinking the 'sleep experts' were just 'salespeople' and since I couldn't get in to see them nor be in touch, I was just as happy to go it alone. It is the way of life out here. But, after a year, I could use a little support. I have even forgotten how to make adjustments to the machine.

[Lizistired]

The Resmed card doesn't "fill up". It overwrites the data on it. Are you getting onscreen data?
I assume you have the ResScan software. Did you download the Clinician's Manual for your machine?
It sounds like you need to start there. Find out what your settings are and look at your data. Tell us what you find.

[archangle]

Of course, there are risks to trying to treat apnea without the aid of a competent DME and doctor.

You can Google "S9 AutoSet Clinician Manual" and find the PDF file.

What do you mean by "I'm not getting readouts?" Are you using PC software or just looking at the display on the S9?

If you haven't already done so, turn the machine off and unplug it for half an hour or so to be sure it's been reset.

It's possible that you've accidentally flipped the little write protect switch on the SD memory card. Or that the little piece fell out. Look for a little tab on the side. It's usually white, and there is usually a little arrow and the word "lock." It should not be in the "lock" position.

You can also try getting a new SD card. I believe any generic 2GB SD memory card will work.

[Bobby269]

You stated that the machine is set to 12. It appears that you have the machine in Cpap mode. If I understand you correctly. You can set the machine to
autoset and then can choose a low setting and a higher setting and it will operate automatically. Look at this link for the clinical manuel download under
Uncle_Bob signature. It also includes a newer version of ResScan. memberlist.php?mode=viewprofile&u=38643.

I only use Cpap mode So hopefully someone will be along soon to offer advice on using Apap.

[squid13]

Here's a link for the video about the S9 http://www.cpaplibrary.com/machines.html

[JDC]

The card won't 'read'. But I can get onscreen data from the machine, such as it is. It is not as indicative as the card readout was. Still, I'll go about trying to get that back on track. I spent the last week experimenting and ended up strapping a damp facecloth over my eyes and trying that. Eyes were twice as puffy! So maybe the problem is too much moisture rather than too little. I am gonna try reducing the temp setting on the hose.

Before the card crapped out on me, I was 'apneaing' about 5 times on a regular basis. But I was leaking up a storm. And it was the leaking that was waking me. And, I thought, causing puffy eyes. But I have now reduced the leaks (I can just tell) but the eyes are just as puffy if not more so. And it doesn't seem as if I can get rid of leaks even if I can reduce them somewhat. I am a generally ugly guy but my nose and mouth are normal. I don't weigh 400 pounds or anything. I am generally just a normal (ugly) guy. Nothing should make the leaks so bad. They seem to happen because I sleep on my side (can't sleep on my back) and so when my face moves around a bit, the face mask pulls the pillows a bit and 'swooooosh' a leak.

I am thinking of taping them in place with duct tape!

[nanwilson]

JDC
This is what I have found out............went to my eye doc for my yearly check up and he told me the air blowing into my eyes was drying them out and my tear ducts were overcompensating for the dryness by adding more fluid, thus puffy and leaky eyes. Gave me a trial bottle of GenTeal gel drops. It works......at bedtime I put 2 drops in each eye and the puffiness has gone away. For the first week I used it about 3 times a day, after that only at bedtime. I can now skip a few nights here and there, but if I skip too many, the puffiness comes back.
Bottle says...GenTeal Gel Drops, lubricant drops, DIN #02286351, cost me $10 at Superstore, and lasts months. There are several diffeant types of GenTeal and I blew it once by buying the wrong one such a deal at $8...NOT.
Hope his helps you out.
Cheers
Nan

[moresleep]

Have you tried other masks? (I had to go through a lot, before I found ones that worked for me.) How often do you change the mask? If you use a mask too long, leaks get worse, often a lot worse. You must get leaks under control for Cpap therapy to work. With a properly adjusted nasal pillows mask, you just should not have serious leak issues. If mouth leaking is a problem, you have to find a solution, such as a chin strap, FFM, or even taping (I tape--only thing that would work for me).

For me, the minimum amount of humidity necessary is the best in terms of least stuffiness--more definitely made things worse. Similarly, with Cpap pressure, the least effective pressure in terms of obstructive events is often best, in terms of keeping leaks and central events from happening.

You need to get a data card that works, so that you can see what is happening. Post results here and there are people who can help you interpret them.

[JDC]

A bit repetitive. Sorry. Two HELP ME! posts.

I use a medium pillow. Swift. I tried large. They slipped more. I did not try small. I am average sized. I have an average nose........... I am pretty sure i am 'medium'. I have two 'medium sets'. I change now and then. Not often. No. Not a mouth breather. No, the little white tag is in the right place. One day it worked. The next it did not. Today, Adobe Acrobat leapt in and said 'Can't read'. I didn't even know Adobe was involved? Anyway, the card won't read but the machine still reports and last night it reported that I did well. Low aps. Good everything. Smiley green face on the pillows. But the eyes have it. They look like marshmallows. I look like a thyroid patient! This is disturbing and aggravating. Seems to be getting worse. The temperature in the hose was at 80. I am dropping down for a night to 74. Making a big jump to get a definite difference to notice. I think I'd like to reduce the humidity..........

[robysue]

A bit repetitive. Sorry. Two HELP ME! posts.

I use a medium pillow. Swift. I tried large. They slipped more. I did not try small. I am average sized. I have an average nose........... I am pretty sure i am 'medium'. I have two 'medium sets'. I change now and then. Not often. No. Not a mouth breather. No, the little white tag is in the right place. One day it worked. The next it did not.

Pardon me for asking the obvious: Have you tried simply replacing the card with a new one? The S9 uses a standard SD card (not an SDHC card). They use to be really easy to come by; now you have to pay attention because the SDHC cards have just about replace the SD cards. Still, it's worth ordering an SD card (since you're on that remote island in northern Canada).

Today, Adobe Acrobat leapt in and said 'Can't read'. I didn't even know Adobe was involved?

This makes no sense to me. Adobe would only be trying to read something on the card if a pdf file of some sort had been saved to the card. Ah ha! Two ideas come to mind:

1) Any chance you might have written a file to the card by mistake sometime?

2) Any chance your computer has a virus that's contaminating the card?

The second one happened to me when I was using an S9 a year ago. If I downloaded the data on Computer 1 and put the card back in the machine, everything was hunky-dory. If I downloaded the data on Computer 2 and put the card back in the S9, the S9 balked and told me it couldn't read the card and gave me an option to wipe the card and reformat it. I did this several times before hubby discovered the virus infecting Computer 2.

So my advice?

First, run some anti-virus scans to see if the computer is infected. If it is, clean the viruses.

Second, completely reformat the card on the clean computer.

Third, insert into the machine and see if the card now works.

Smiley green face on the pillows. But the eyes have it. They look like marshmallows. I look like a thyroid patient! This is disturbing and aggravating. Seems to be getting worse.

Mr. Green Smiley Face shows up as long as your 70% unintentional leak rate is below 24 L/min. Mr. Red Frowny Face doesn't show up until your 70% leak rate is AT or ABOVE 24 L/min.

To put it another way, you have to have unintentional leaks AT or ABOVE 24 L/min for an average of 18 minutes out of every hour of usage. For example, if you use the machine for 7 hours, Mr. Red Frowny Face shows up only if you are leaking AT or ABOVE 24 L/min for a grand total of 7*18 = 126 minutes = 2.1 hours (2:06 in Hours:minutes) during the night. That's a lot of leaking that's required for Mr. Red Frowny Face to show up: In a seven hour night, 100 minutes of leaks above 24 L/min still allows Mr. Green Smiley Face to show up, but that's plenty of leaking to do a real number on the eyes.

And then some folks' eyes are simply more bothered by leaks, even small leaks. And maybe you are one of them. It's quite possible that you've got a tiny, tiny leak that's blowing right into the eyes all night long. It's also possible that the intentional exhaust flow from the mask is bouncing of the covers and back into the eyes and bothering them. Heck, there's even a possibility that air is getting into your eyes from air being blown through the tear ducts.

To try to figure out what kind of air leaks are getting into the eyes, you may need to lie down with the mask on while awake. Really feel around trying to find very small drafts. Also try pressing your finger against the inner corner of the eye. That helps seal off the tear duct. By pressing and releasing it, you might be able to determine if it feels as though air is getting into the eye via the tear duct.

The temperature in the hose was at 80. I am dropping down for a night to 74. Making a big jump to get a definite difference to notice. I think I'd like to reduce the humidity..........

I never used a ClimateLine hose. You might want to reread the owners manual for the hose just to make sure you understand how that the temp setting affects the humidity. According to the ClimateLine's Information Guide, when the Climateline hose is used in Climate Control Auto mode (where the user sets ONLY an air temp for the hose), the S9's humidifier and ClimateLine hose are supposed to keep the air in the hose at a constant 80% relative humidity. (That's pretty warm and damp in my opinion.) Turning the temp down will make the air cooler, but the relative humidity will still stay at 80%. (The absolute humidity---i.e. the total amount of water in the air----will decrease because cooler air cannot hold as much water vapor as warmer air does. Relative humidity is relative to the maximum amount of water vapor the air can hold. Rainout happens when the relative humidity of the air in the tube hits 100%)

To reduce the relative humidity as well as the absolute humidity, it appears you will need to go into the Climate Control Manual mode. This will allow you to chose the air temp and the humidifier setting (from 0 to 6) independently of each other.

[JDC]

Great answers, Robysue. Thanks. How does one get to the 1- to - 6 climate setting? I got there once. Can't figure out how to do it now. I asked for a new card and the mail order supplier sent me something different so I got frustrated. But I just wrote again and asked for a new SD card. We'll see. I cleaned it off and was gonna download the new software but I can't find that either. God, I am feeling stupid but I am just hoping it is because I am not sleeping well.

Yeah, Green smiley face is not as indicative as the readout was. But at least it was green this time. It has been red a lot.

Thanks again for going through all that. Much appreciated.

[robysue]

Great answers, Robysue. Thanks. How does one get to the 1- to - 6 climate setting?

It's been a long time since I had my S9. My guess is to first look under the patient setup menu. If the RT who set the machine up didn't lock you out, you should be able to change the Climate Control setting from AUTO to MANUAL. Once the Climate Control is set to MANUAL, you will be stepped through choosing a temp and a humidity setting. Without the ClimateLine hose, every time you turn the S9 on you get put immediately into the Humidity Setting menu so that you can adjust the humidity level if you wan to.

If the patient SET UP menu doesn't allow you to change the Climate Control from AUTO to MANUAL, you'll have to get into the Clinical Menu to turn Climate Control to PATIENT. That will then let you choose between AUTO and MANUAL without needing to get into the clinical settings.

Yeah, Green smiley face is not as indicative as the readout was. But at least it was green this time. It has been red a lot.

If you've been seeing a lot of Mr. Red Frowny Face, no wonder the eyes are suffering. Any chance the mask cushion needs to be replaced?

[Newbie Woman]

Is there a chance that your puffy eyes result from another cause? Nothing to do with CPAP?

[Elle]

I agree with you on the puffy eyes making you think you are tired. Mine have been puffy lately (I am pretty sure my mask cushion needs replaced and have ordered it) and I do feel like lying down and closing my eyes. I do sleep well and know I have had enough because I feel rested when I first wake up but then notice the puffy eyes and it begins.

I read recently that a rapid heart rate from coffee or chocolate can make us panic...mind reacting to body state.

I had more leaks when using a pillow mask than I get with a nasal mask. I also feel the nasal mask is more comfortable for side sleeping if you have the right one.

I hope you find the solution. This is certainly the place. There are so many people willing to help and most with great knowledge.

[JDC]

I suppose it could be the pillows but I don't think so. I managed to get the software and the card working (don't ask how.......I just kept fiddling with it and all of a sudden I could 'read it' again.). Anyway my numbers are great! Virtually no aps. Even the pressure has dropped some. Leaks under ten. I should be doin' great......and....I kinda think I am because my body isn't tired - just my eyes. So, with that news I am pretty sure it is a humidity thing. Gotta play with that. Gotta 'get in behind the curtain'.

I never had a rep. Don't even know what DME stands for. I live remote. On an island. No roads,. No electricity (except what I make from solar and gensets). So I got tested and then just bought a Cpap unit and got a one-time lesson and been at it ever since. No complaints tho. That's the way it is out here. Figure it out on your own (OK, a little help from my friends - you) or it just doesn't get done. But I feel as if I am 95% there.

Any hints on the humidity? Temp setting?