New CPAP Machine

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Well I had to go to the VA hospital for a checkup and thought I would call the Sleep Center a few days before going in as I had been having some issues with the humidifier on my Respronics REMstar M series CPAP machine. I think the contacts are getting a little dirty because when I select 1 or 2 on the humidifier it doesn't light up unless I fiddle with it a bit. Not a big deal this winter as I have been running higher humidity levels but thought I would ask about it since I was going to be there anyhow. She looked me up in the system and mentioned that I had a pretty old machine and to bring it in.

So I show up with my machine today and she walked in with a shiny new ResMed S9 with the H5i humidifier. She powered up my old unit and went through the logs. From my last sleep study I stopped breathing 16 times an hour and from the logs I am down to an average of 1.2. She said they like to see less than 5. Then noted the pressure setting of 11 for transferring the settings over. She asked if I had been using it. I said that I had and the logs showed 7 sessions for 7 days and 30 for 30. Then gets to summary data. Therapy Hours: 16,664.8 Blower Hours: 16,793.7 Total Sessions: 2339. She just said, "Wow, I guess you have been using it to get to those numbers.

So the new machine is all set up. She fit me for a new style mask, new hose, year supply of filters and hose cover. Then brought in a special pillow that they have now. They are sending one out as they didn't have any more.

From there went to Audiology for a hearing test. Asked about formed ear plugs as I had lost one of mine. He looks it up and said it was 07 that the last set was made so I was due for new ones. After the hearing test they took the impressions so I should have a new set in 2 weeks.

So I had a pretty good haul from the hospital today.
 

Blrfl

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One thing about the S9: If you're collecting data, there's some weird skew in the clock that sometimes accumulates on the timestamps in the data. You can solve it by reformatting the SD card once a month or so. I think rebooting the machine fixes it, too.

If you want to see the data the machine has to offer, download Sleepyhead from SourceForge. There are pre-built binaries for Windows and OS X. I've had difficulty getting the Linux binaries to work or the source to build properly, but part of that is a lack of effort on my part.

--Mark
 
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One thing about the S9: If you're collecting data, there's some weird skew in the clock that sometimes accumulates on the timestamps in the data. You can solve it by reformatting the SD card once a month or so. I think rebooting the machine fixes it, too.

If you want to see the data the machine has to offer, download Sleepyhead from SourceForge. There are pre-built binaries for Windows and OS X. I've had difficulty getting the Linux binaries to work or the source to build properly, but part of that is a lack of effort on my part.

--Mark
Hmm, I will have to look at that. I saw it has a SD Card that was put in it and was planning on tossing it in the laptop to see what was stored on the card after a few days. I kind of figured that the data may not be in a readable format without some software but I hadn't looked into it yet.

A few things I noticed about my first night:

1. Not sure I like the new mask. The old one was a little bigger and went down below my chin. The new one is a ResMed Quattro which covers the nose to between the lower lip and chin. For some reason it seemed like I couldn't get enough air when breathing through my nose. I would breath through my mouth and it was better but I would wake up later and be breathing through my nose. Tried loosening the straps a bit which helped but I still woke up again around 1AM at which time I went back to my old mask. I also missed the quick release. This one just has hooks that you slip the head gear on or loosen the Velcro. As a note I did see in the settings where you have to tell it what line you are using and mask type. I used the slimline hose with both masks and they are both full face masks so I did the change in the middle of the night without changing any settings on the machine.

2. The S9 I have is the one with the Autoset mode. The old machine was a constant 11 cm H2O unless I had enabled ramp mode which I used the first few months but once I got used to it I just skipped it. The new one she enabled Ramp so it is there if I need it. Then she set the pressure to 11 but left Autoset enabled so it can adjust up to 20 if needed. I was watching some videos on this and discovered if you press and hold the two buttons on the right side for about 3 seconds you can get a detailed report right from the device. So this morning I looked at it had to say about lastnight. I do know I woke up a couple times in the night when I think the machine was boosting the pressure and then there were the mask issues. I can see where it said it was running a little higher than 13 cm H2O. Not sure if this is an average for the night or peak pressure. Maybe I can get more info from the SD Card. Leak was 0.00 which is good but I had an AHI of 5.3. Not sure if this was because of the mask that I had been fighting with most the night or what. With my old machine I was getting AHI averages in the 1.4 range over 7 days @ 11 cm H2O. It is only one night so not enough data to make any conclusions. I think I will run the old mask for a while until I get used to the new machine and then maybe introduce the new mask. Change one thing at a time.

3. Filling the tank. Not sure I like that as much as the old one. I was pouring in distilled water and if you don't hit the little hole the water can run out the little tab part you use to lift the tank out of the humidifier. Not sure why they designed that open like that. Not a big deal I will get used to it.

For those running the S9 do any of you use the Climateline? Have you used both the Climateline and the traditional line? Just wondering if it is worth it. It is only $40 and being I got everything else free, I might just buy one and try it. From time to time I have issues with condensation in my old machine. With the new one they gave me the new slimline and a cover but it isn't heated so not sure if it is much different from what I was using. Just a little smaller in diameter.

I will say that this unit is a lot quieter than the old one.
 
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I use the climateline and use it exclusively. You can often get it on Ebay for $30 delivered. I do think it could be more 'sturdy' but with care there's no problem.
I'm new to this hose 'stuff' but , as you know, the mask is very personal to each user. Whereas, the Quattro has been around for a while and has devotees, some don't like it. The name escapes at the moment, but my next mask will be a different ResMed mask, if insurance allows. They do charge a bit of $ for their masks.
I take the humidifier out of the machine to fill and take the top off. Easier that way.
I do agree, if one uses the hole to fill with distilled water that spills can/will occur.
Good luck with you mask.
I haven't shopped much for the hose but did a quick search and saw it for $40 shipped on Amazon. I figured I would try ebay and a few other places before ordering. Not sure if it would be more useful in the winter when I am typically running higher humidity or better to just use it year round.

I take the tank out of the machine and keep a gallon of distilled water next to the nightstand for filling things up. So I was sitting on the bed filling it when I discovered the odd design getting water all over the carpet. Oh well. It happens.

I agree with the mask thing. If one worked for everyone there would probably be only one mask made. I started with the nasal pillows but moved to the full mask as I had too many mornings with the cotton mouth if it opened while sleeping. Once I got used to the full mask it isn't a big deal. I might get used to this one but time will tell. I think I introduced too many changes at once lastnight. They said that if I don't like this new mask, that I could still get the older design. It isn't one that they stock but it can be ordered. I think it is a Respornics. I just need to tell them which one I want when I order new ones as now I have 3 different ones in my profile.
 

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Hmm, I will have to look at that. I saw it has a SD Card that was put in it and was planning on tossing it in the laptop to see what was stored on the card after a few days. I kind of figured that the data may not be in a readable format without some software but I hadn't looked into it yet.
It's all EDF. ResMed's software is clunky, but it works, and Sleepyhead is a little nicer.

1. Not sure I like the new mask. ... For some reason it seemed like I couldn't get enough air when breathing through my nose.
If you're running the machine on Auto, it may be the machine and not the mask. Mine was set for 6-20 when I got it, and I didn't feel like I was getting enough air at lower pressures, so I bumped the minimum up to 10 and things improved. You can change that in the secret setup menu. Do your starts in leak test mode and you'll get the maximum pressure for a couple of minutes and then it will kick down to the minimum.

The Quattro (I presume it's the standard one and not the FX) takes some technique to put on properly, some of which is outlined here: CLICKY.

2. The S9 I have is the one with the Autoset mode. The old machine was a constant 11 cm H2O...
I had mine on AutoSet from 2010 until a couple of months ago, when I switched to a fixed value based on the data I was pulling out of the machine. I've found that I sleep better because the machine is preventing apneas instead of reacting to them. Less variation in the pressure also seems to help keep my mask in the same shape, which prevents leaks. If you had a fixed pressure that works for you, I'd stick with that.

I was pouring in distilled water and if you don't hit the little hole the water can run out the little tab part you use to lift the tank out of the humidifier.
Think of it as an improve-your-aim exercise. :) You must have the disposable tank. I don't like that one, either. When you come up for replacement, see if you can get the re-usable version, which you can throw in the dishwasher for cleaning and opens so you can get all the water out before you travel.

For those running the S9 do any of you use the Climateline?
I've only used the ClimateLine and can say that I've never had rainout, ever. Well worth the extra money. The S9 will let you set the air temperature, which I find handy.

--Mark
 
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It's all EDF. ResMed's software is clunky, but it works, and Sleepyhead is a little nicer.
I will check it out this weekend if not tonight.
If you're running the machine on Auto, it may be the machine and not the mask. Mine was set for 6-20 when I got it, and I didn't feel like I was getting enough air at lower pressures, so I bumped the minimum up to 10 and things improved. You can change that in the secret setup menu. Do your starts in leak test mode and you'll get the maximum pressure for a couple of minutes and then it will kick down to the minimum.
It is set to 11-20 in my case. 11 being the fixed setting that my old one was at. It seems like it kicks in and holds 11 as much as I can tell by feel. When I loosened the mask it wasn't as bad. When I went to my old mask the issue seemed to go away in terms of breathing through the nose. Though I think the spikes as it reacted was waking me more than normal. It did that with my old mask as well and I am not used to pressure changes like that. I really doubt it is running at 20 when I power it on as it feels about the same as my old machine.
The Quattro (I presume it's the standard one and not the FX) takes some technique to put on properly, some of which is outlined here: CLICKY.
Standard not the FX as you assumed link
I'll check that out. Might run my mask tonight either way though. I am a bit more sleepy today as I was up a lot more than normal lastnight.
I had mine on AutoSet from 2010 until a couple of months ago, when I switched to a fixed value based on the data I was pulling out of the machine. I've found that I sleep better because the machine is preventing apneas instead of reacting to them. Less variation in the pressure also seems to help keep my mask in the same shape, which prevents leaks. If you had a fixed pressure that works for you, I'd stick with that.
That makes sense. Like I said, one restless night isn't what I want to use to pull data from for changes. I will give it some time before tweaking things. The fact remains my numbers were pretty good at a fixed 11. Maybe that is where I should be but if the low setting is what my fixed was, that should mean as long as I don't use ramped start (I don't) then it should always provide 11 at a minimum and go up from there if needed. If those reactions are too disrupting then maybe a slightly higher fixed level would make more sense or see how it goes at fixed 11 like I had. For now I will give myself some time to get used to it. If it doesn't work it can be changed.
Think of it as an improve-your-aim exercise. :) You must have the disposable tank. I don't like that one, either. When you come up for replacement, see if you can get the re-usable version, which you can throw in the dishwasher for cleaning and opens so you can get all the water out before you travel.
The tank I have has a clip snap on each of the 4 sides and fully separates. So I can dump it out and wipe dry. She didn't say anything about tossing it in the dishwasher. I have always hand washed them. I guess I could open it and fill but I would think in opening it all the time that the tabs may break off.
I've only used the ClimateLine and can say that I've never had rainout, ever. Well worth the extra money. The S9 will let you set the air temperature, which I find handy.

--Mark
My worst case I have shared here before I think.

I was in Mexico in January. I had been on the machine for a couple months. Coming from MN in the winter I had the humidifier on max and not thinking about it I left it there and put water in the tank. Middle of the night I am kind of woke up by this strange sound and sensation on the air pressure. I was using the nasal pillows at the time. As I am half asleep I kind of roll over or pull on the hose a bit. All of a sudden a wave of water if forced right into my nose. I went from half asleep to being water boarded and start gasping for air. Needless to say the wife wasn't happy as I jump up out of bed making all kinds of noise and I woke up our then 3 year old daughter who was with us on the trip.

I did see a video where once you hook up the Climateline it switches from 0-6 for the humidity control to a temp. I think I will shop around a bit and see what I find. $30-40 isn't bad. If it were $100 I might think about it more or maybe limit use of it for times of year when it is more beneficial. But for that price I might just get one and if I like it run it year round.
 
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I did a quick search and I think you guys might be right. The tank I have is whatever came with the H5i.

Mine looks like this one.

Tank

It says not dishwasher safe.

I think the one that you guys have is this one.

Link Which says it can go in a dishwasher.

I found the nasal mask was easier to get used to initially. Once I got used to the full mask I get better sleep overall. Though I am having some issues with the new full face. So keep in mind that they are not all the same and what works for one may not work for others.

I have seen where there is a chin strap that holds your mouth closed. Might be an option as well if you can't find a full face that fits right or accustomed to it.

Link

Never used one personally but something I have seen out there.
 
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By chance did they supply a battery pack for your new CPAP machine? This is probably the biggest thing to keep me from camping when I ride, I need the CPAP but a battery pack would be great.
 
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By chance did they supply a battery pack for your new CPAP machine? This is probably the biggest thing to keep me from camping when I ride, I need the CPAP but a battery pack would be great.
No battery pack. I have been looking at options as well. There are battery pack options out there but they would only work for short trips and no humidifier. When I camp, I don't use it right now.
 
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Lastnight was better. Slept all night without interruption. The report showed pressure of 12.2 and 2 AHI. Way better than the 5 I had yesterday. This was with the new slimline hose and my old mask.
 

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By chance did they supply a battery pack for your new CPAP machine? This is probably the biggest thing to keep me from camping when I ride, I need the CPAP but a battery pack would be great.
This is depending on the model, check your power supply. My cpap (System One) is 12vdc. I can just use a standard automotive battery and a direct cord. With the humidifier on low (1 of 5) I use 12~14amps in 8 hours.
Without humidifier, a third of that.

You can buy a pre-made 20ah LiFe battery for about $200.
 
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One note on the battery power option. It is true that many of the systems are 12-15V DC. There is the option to run an inverter off an automotive or deep cycle battery but you would be better off to get the optional 12V DC power supply that they many times have. No sense to go from 12V DC to 110 with an inverter to have the power supply go back to 12-15v DC. It is more efficient to stay right at 12v DC.
 

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One note on the battery power option. It is true that many of the systems are 12-15V DC.
The S9, unfortunately, requires 24 and 5 VDC. Fortunately, you can produce both from 12 with a DC-DC converter. The bad news is that the power connector on the S9 is proprietary, so you'd have to cut and connectorize the one on your AC adapter or find a dead one to cannibalize.

--Mark
 
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The S9, unfortunately, requires 24 and 5 VDC. Fortunately, you can produce both from 12 with a DC-DC converter. The bad news is that the power connector on the S9 is proprietary, so you'd have to cut and connectorize the one on your AC adapter or find a dead one to cannibalize.

--Mark
Yeah I haven't looked at the S9 specifically. My old one was 12V. I did see that they make the DC power adapter with a cig plug so it would be beneficial to power from that vs using an inverter that one may have laying around and the original power cord. That was the main point I was making.
 

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I've got both a Respironics PR System 1 Remstar Plus (compliance data only, non-auto version), and a Resmed S9 Autoset.

I use the S9 at home, nicer features, data, nicer EPR pressure waveform, quieter, etc. Standard slimline tubing, never had rainout - so I don't get the heated one. I like being able to check the AHI in the morning - I can correlate a good night from a bad night pretty easily - it's nice to confirm. AHI typically running 0.5-2.0.

The PR-S1 is relegated to spare status, traveling, and when I want to operate off 12V. The C-Flex exhale pressure thing was never comfortable - I just turn it off and run a straight pressure. The DME med tech guy swore up and down it did data - but this is compliance data only (days, hours of use). If you want full data (pressure waveforms, AHI, leak rate, etc) you needed the "Pro" version.

I'm using the Resmed Swift FX Nasal Pillows. Super comfortable, I can roll around to my side, almost face down, and it stays in place and stays comfortable. Yeah, there are maybe 1 or 2 days a year when I get a cold and would like a full mask - but it's never enough to bother buying one.
 
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