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I have had problems with my Resmed S9 APAP staying at 20 cm for 2-3 hours at a time which wrecks me the next day.

This problem has been ongoing for many months and when I think I have fixed it it comes back

Using Sleepyhead I can see that during this spell of high pressure it looks like I am double inhaling.

Is this possible??

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I think its time to make a decision.

Either buy another make of APAP or get referred to another hospital which supplies a different make

Before I make a decision I am going to try something different.

I have noticed that when it goes up to 20 most times it has done so when the pressure has dropped to minimum which is 12 at present.

I will increase the minimum pressure to 14 so hopefully this will keep my airways open.

Might work

Don't rule out a fault with the machine or restricted airflow.

I would also not rule out that you might be one of the few that needs a different machine.

In any case, it should not go to 20 and sit there, I would get it checked or replaced.

If you get another machine and it does the same then the problem is with you rather than with the machine.

Have you contacted the hospital and complained about it?

I would stick with ResMed gear if I could, it is considered the best option by many.

However, I have used Resperonics as well and it worked fine, but the ResMed was a little quicker in reacting to events.

However, it looks like your machine is over reacting.  If you are awake and it still sits at 20 then complain it is faulty.

Insist on getting another machine.

Its me not the machine.

The S9 has been checked by Resmed and no fault was found but the circuit board was changed as a precaution.

I have used another S9 but had the same problem.

I have been told by the hospital that despite my AHI being under 1 most of the time my Apnea was getting worse so I needed the pressure to be at 20

I thought I had found the cause of the problem as I found that the Climateline hose had developed a kink where it was suspended by the hose lift. Buying a new hose seemed to have fixed the problem.

I was advised by Resmed that despite using a full face mask my nasal problems, Polyps and deviated septum, could be causing the problems

I have found a old compliance report from when I used a Remstar. and even though the maximum was set to 20 the pressure rarely went above 15.

So Im tempted to buy a machine ,either a Sleep cube or another Philips APAP 

Or the other option is to get referred to another local hospital which supplies Philips 



Sleep2snore said:

Don't rule out a fault with the machine or restricted airflow.

I would also not rule out that you might be one of the few that needs a different machine.

In any case, it should not go to 20 and sit there, I would get it checked or replaced.

If you get another machine and it does the same then the problem is with you rather than with the machine.

Have you contacted the hospital and complained about it?

I would stick with ResMed gear if I could, it is considered the best option by many.

However, I have used Resperonics as well and it worked fine, but the ResMed was a little quicker in reacting to events.

However, it looks like your machine is over reacting.  If you are awake and it still sits at 20 then complain it is faulty.

Insist on getting another machine.

I have finally found the answer 

I have increased the EPR to 3

This has kept my pressure below 14 for the last 3 days .

Im very annoyed that the hospital and Resmed had not increased this 

For some reason increasing the EPR has reduced the Flow Limitations which is the reverse of what should happen.

If it works .........

Hummmm!  That just shouldn't work!

There must be something unique to the way you breath when sleeping confusing the machine.

It is all a bit strange and a bit confusing!  The Resperonics machines are slightly slower to respond, so it may have been this and setting the EPR to 3 on the ResMed machine that might just be holding off the response for the ResMed machine.  It is pure speculation though.

I think the combination of nasal polyps ,deviated septum and COPD is too much for the Resmed to sort out.

The polyp in my left nostril does act like a one way valve and closes on exhale which may explain why the EPR increase helps. It looks like the only option as far as masks is to get a Oracle Yuck!!!!! 

I have also seen my GP who is going to refer me to a hospital that supplies Philips Dreamstations with humidifiers!!!!

Lastly having nasal surgery is out of the question as its too risky. As the ENT consultant said "I can still breath through my mouth"

That sounds like a get out for the ENT surgeon.

There are a lot of people gone through this op' and even bigger op's to the nose.

Maybe he is just not up to it?

Im on Warfarin for life because of leg DVT,s and Warfarin would be stopped 5 days before the operation. This could leave me at risk of another DVT.. Also the last time my Warfarin was stopped I has to self inject Heparin so my belly turned into a very bruised pin cushion.

Also I weigh 135Kg so a general anesthetic would be risky

As the consultant said " I can still breath through my mouth"

 



Sleep2snore said:

That sounds like a get out for the ENT surgeon.

There are a lot of people gone through this op' and even bigger op's to the nose.

Maybe he is just not up to it?

I have found out why setting the EPR to 3 resolves the problem with high pressure .

Setting the EPR to 3 smoothes out the waveform between exhale and inhale . I have read this about Remstar A flex but not Resmeds EPR.

I have Sleepyhead graphs showing that between Exhale and Inhale the waveform stays on the zero line which is not the case when the EPR is set to 2

I thought EPR was just a comfort feature

EPR just reduces the pressure when you breathe out, this makes it easier to breathe out when on higher pressure.

Current thought is that the higher setting the EPR is the higher pressure is required, however I have not found this, but it does affect my AHI, it goes up slightly when using a higher number of EPR!

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