setting up old machine for wife

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Jack Burton
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setting up old machine for wife

Post by Jack Burton » Wed Mar 07, 2018 2:43 pm

My wife just got a prescription for a cpap machine and mask today.

The RX only mentions 6 cm h20.
I want to set up my old cpap machine for her so that she can get used to cpap before going back to the lab for the titration.
RX also mentions no ramp.
so I think I should set the machine(resmed s9 autoset) to min 6 and max 20 with no ramp.
The thing I am not sure what to do with is EPR.
What should EPR be set to when the RX does not specifiy?

The plan is to get her a new s9 and the nasal pillows of her choosing after the titration.
Is my overall plan sound?

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RicaLynn
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Re: setting up old machine for wife

Post by RicaLynn » Wed Mar 07, 2018 3:27 pm

Since the "old" machine is an S9, you may not need to get one through insurance (unless it's no cost to you). If her prescription says 6cm that's a great starting point, as you said, 6-20 for a few days to collect data and see how she tolerates it.

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Julie
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Re: setting up old machine for wife

Post by Julie » Wed Mar 07, 2018 3:31 pm

EPR is optional and she may well not need it at all. It's exhalation pressure relief for people who find exhaling to be a problem... pressure too strong... and unless she complains, I wouldn't set it up at all.

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Re: setting up old machine for wife

Post by D.H. » Wed Mar 07, 2018 3:33 pm

From what I read, 6 cmH2O is your prescription, not hers. You may as well start with your prescription, in the absence of other knowledge.

If she still snores (or reports “not enough air”), try raising it until she doesn’t (gradually). If she reports that the pressure bothers her, try reducing it and/or engaging the ramp.

If she reports trouble exhaling, try raising the EPR (also gradually). If she reports that the fluctuations bother her, try reducing (or totally turning off) the EPR.

Note that this is what happens in titration, except that those doing this are expert and that they do it based on much better instrumentation.

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Jack Burton
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Re: setting up old machine for wife

Post by Jack Burton » Wed Mar 07, 2018 4:41 pm

the rx=6 is my wife's prescription
will leave the epr off
my current machine and the old machine are s9 autosets.
If possible I intend to get her a new s9 autoset for her.

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Cpapian
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Re: setting up old machine for wife

Post by Cpapian » Thu Mar 08, 2018 10:12 am

Isn't the S9 an old machine? Why not get the newest model?

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Re: setting up old machine for wife

Post by palerider » Thu Mar 08, 2018 1:34 pm

Cpapian wrote:
Thu Mar 08, 2018 10:12 am
Isn't the S9 an old machine? Why not get the newest model?
Why not? there's very little *functional* difference in the s9 and air10, unless his wife wants to use the 'autoset for her' mode.

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Jack Burton
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Re: setting up old machine for wife

Post by Jack Burton » Thu Mar 08, 2018 3:54 pm

Cpapian wrote:
Thu Mar 08, 2018 10:12 am
Isn't the S9 an old machine? Why not get the newest model?
I have 2x S9 autoset units with humidifier already.

oldest unit has ~14000 hours.
my daily driver has ~4000 hours.

The idea is to have interchangeable spare parts.

Also thinking about getting one of these
https://www.inergysolar.com/product/kodiak/
and possibly one or more of these.
https://batteryclerk.ca/collections/ajc ... la-battery

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Re: setting up old machine for wife

Post by Jack Burton » Fri Mar 09, 2018 8:30 am

Last night's results, first night of therapy.
Lots of CA events.

Could I be harming her instead of helping her?
What to do about the CA events?
Screen Shot 2018-03-09 at 8.53.44 AM.png
Screen Shot 2018-03-09 at 8.53.44 AM.png (245.94 KiB) Viewed 3340 times

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Pugsy
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Re: setting up old machine for wife

Post by Pugsy » Fri Mar 09, 2018 8:32 am

Ask her if it is possible that she was awake when those Centrals were flagged?
Like how was her sleep last night? Does she remember waking often or staying awake for prolonged periods of time.
If they are awake events being flagged...they don't count and aren't important.

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Jack Burton
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Re: setting up old machine for wife

Post by Jack Burton » Fri Mar 09, 2018 10:19 am

Pugsy wrote:
Fri Mar 09, 2018 8:32 am
Ask her if it is possible that she was awake when those Centrals were flagged?
For the first cluster she was almost certainly awake.
The second cluster she was probably awake.
Not sure about the third cluster.

Also she said she felt more tired than usual this morning.
Baseline is she almost always feels tired in the morning.

The good news is she says her mask is comfortable.
setting and epr of 1 tonight as she indicated to me that she thought it might help.

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Re: setting up old machine for wife

Post by Pugsy » Fri Mar 09, 2018 10:29 am

Not surprised she is complaining of feeling tired...she slept poorly.
Does she have any specific ideas as to why she may not have been able to stay asleep or go back to sleep when she woke up during the night?

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Re: setting up old machine for wife

Post by Mikebear » Fri Mar 09, 2018 10:36 am

Set the machine to FIXED cpap mode, pressure of 6 EPR 1. She probably woke up because her pressures went too high.

See what happens. I'll bet the majority of CA's will vanish. If so, you can go from there after you see what happens with that for a few nights.

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Jack Burton
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Re: setting up old machine for wife

Post by Jack Burton » Fri Mar 09, 2018 12:47 pm

Pugsy wrote:
Fri Mar 09, 2018 10:29 am
Not surprised she is complaining of feeling tired...she slept poorly.
Does she have any specific ideas as to why she may not have been able to stay asleep or go back to sleep when she woke up during the night?
I just checked and she thinks she was awake for all three clusters.

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Re: setting up old machine for wife

Post by Pugsy » Fri Mar 09, 2018 12:51 pm

Doesn't surprise me...first night and didn't sleep so great.
The machine doesn't know sleep status at all. All it measures is air flow or lack of and awake breathing is irregular and can cause the machine to flag something that isn't a real apnea.

I suggest working on getting to sleep and staying asleep and trying to get right back to sleep if at all possible...first.

Then once there are more solid blocks of sleep with minimal awake time on the machine with mask on then worry about what the AHI shows.
Right now there's probably so much awake breathing false positive flags that it makes things really hard to evaluate or trust the data.

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