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AUTO vs Manual setting
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courtney123 Offline

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Posts: 67
Joined: Jun 2013

Machine: REMstar Auto A-Flex
Mask Type: Nasal pillows
Mask Make & Model: F&P Pilairo
Humidifier: None
CPAP Pressure: 11
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Honolulu, Hawaii

Post: #1
AUTO vs Manual setting
Could someone give me an understanding the benefits of having my CPAP on AUTO instead of manual pressure selection?
I have been on a Respironics RemSTar Auto 560P System One for about 5 months.

The pressure was set to 11 based on a sleep study the month prior.
The study showed 30 apneas per hour. With the CPAP the index is usually under 1.5 now.

While fiddling with the unit a couple of days ago in the SETUP section, I found I could set it to AUTO. So I did and looking in Encore, the pressure numbers ranged between 9 and 15 with 90% at 10.5.

The AIH eased up to 2.0 with RERA Index (which is always high for me) at 2.1.

Not understanding any of the benefit of AUTO, I set the unit back to manual 11.

Can someone take that and explain what was going on and if there's any benefit of AUTO over MANUAL?

Thanks.

Aloha,
MrCourtney
Honolulu, HI
12-03-2013 02:22 AM
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eviltim Offline

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Posts: 408
Joined: Aug 2013

Machine: Resmed S9 VPAP
Mask Type: Full face mask
Mask Make & Model: Resmed AirFit F10
Humidifier: H5i heated humidifer
CPAP Pressure: 5 exhale/9 inhale
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #2
RE: AUTO vs Manual setting
Benefits of auto are that the machine adjusts the pressure as necessary. Thus, if like a lot of people, you have worse AHI in different stages of sleep, the machine allows you to spend some time at a lower pressure (less side effects and leaks) and some time at a higher pressure as needed. Of course it isn't perfect and sometimes you can spend too much time at pressures too low or high for your case.

Now in your case, I would think if it ain't broke don't fix it. Under 1.5 AHI is excellent, and it sounds like the auto algorithm agreed since you spent most of your time near your prescribed pressure.
(This post was last modified: 12-03-2013 02:57 AM by eviltim.)
12-03-2013 02:56 AM
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big_dave Online

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Posts: 411
Joined: Apr 2012

Machine: PR System One DS560
Mask Type: Nasal pillows
Mask Make & Model: F&P Pilairo Q or ResMed Mirage Activa
Humidifier: PR System One
CPAP Pressure: 14 - 20
CPAP Software: SleepyHead

Other Comments: Former ResMed S8 Autoset II user

Sex: Male
Location: Eugene, Oregon

Post: #3
RE: AUTO vs Manual setting
One benefit of auto mode is that it adjusts for positional apnea, where your pressure need depends on your sleeping position. Another benefit is that it allows re-titration at home if your pressure changes over time. You put it in auto mode for a week or two to see what the 90% or 95% pressure is, and then set a new pressure. A drawback of auto mode is that some people are bothered by the pressure swings. It's best to try both modes to see which works best for you.
12-03-2013 03:10 AM
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courtney123 Offline

Preferred Members-2

Posts: 67
Joined: Jun 2013

Machine: REMstar Auto A-Flex
Mask Type: Nasal pillows
Mask Make & Model: F&P Pilairo
Humidifier: None
CPAP Pressure: 11
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Honolulu, Hawaii

Post: #4
RE: AUTO vs Manual setting
(12-03-2013 02:56 AM)eviltim Wrote:  Benefits of auto are that the machine adjusts the pressure as necessary. Thus, if like a lot of people, you have worse AHI in different stages of sleep, the machine allows you to spend some time at a lower pressure (less side effects and leaks) and some time at a higher pressure as needed. Of course it isn't perfect and sometimes you can spend too much time at pressures too low or high for your case.

Now in your case, I would think if it ain't broke don't fix it. Under 1.5 AHI is excellent, and it sounds like the auto algorithm agreed since you spent most of your time near your prescribed pressure.

Thank you. I go fond something else to mess with :-)

(12-03-2013 03:10 AM)big_dave Wrote:  One benefit of auto mode is that it adjusts for positional apnea, where your pressure need depends on your sleeping position. Another benefit is that it allows re-titration at home if your pressure changes over time. You put it in auto mode for a week or two to see what the 90% or 95% pressure is, and then set a new pressure. A drawback of auto mode is that some people are bothered by the pressure swings. It's best to try both modes to see which works best for you.

Appreciate the quick response. I'll probably leave it alone for now.

Aloha,
MrCourtney
Honolulu, HI
(This post was last modified: 12-03-2013 06:38 AM by courtney123.)
12-03-2013 06:37 AM
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eviltim Offline

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Posts: 408
Joined: Aug 2013

Machine: Resmed S9 VPAP
Mask Type: Full face mask
Mask Make & Model: Resmed AirFit F10
Humidifier: H5i heated humidifer
CPAP Pressure: 5 exhale/9 inhale
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #5
RE: AUTO vs Manual setting
(12-03-2013 06:37 AM)courtney123 Wrote:  
(12-03-2013 02:56 AM)eviltim Wrote:  Benefits of auto are that the machine adjusts the pressure as necessary. Thus, if like a lot of people, you have worse AHI in different stages of sleep, the machine allows you to spend some time at a lower pressure (less side effects and leaks) and some time at a higher pressure as needed. Of course it isn't perfect and sometimes you can spend too much time at pressures too low or high for your case.

Now in your case, I would think if it ain't broke don't fix it. Under 1.5 AHI is excellent, and it sounds like the auto algorithm agreed since you spent most of your time near your prescribed pressure.

Thank you. I go fond something else to mess with :-)

A man after my own heart Wink
12-03-2013 11:37 PM
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courtney123 Offline

Preferred Members-2

Posts: 67
Joined: Jun 2013

Machine: REMstar Auto A-Flex
Mask Type: Nasal pillows
Mask Make & Model: F&P Pilairo
Humidifier: None
CPAP Pressure: 11
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Honolulu, Hawaii

Post: #6
RE: AUTO vs Manual setting
(12-03-2013 11:37 PM)eviltim Wrote:  
(12-03-2013 06:37 AM)courtney123 Wrote:  
(12-03-2013 02:56 AM)eviltim Wrote:  Benefits of auto are that the machine adjusts the pressure as necessary. Thus, if like a lot of people, you have worse AHI in different stages of sleep, the machine allows you to spend some time at a lower pressure (less side effects and leaks) and some time at a higher pressure as needed. Of course it isn't perfect and sometimes you can spend too much time at pressures too low or high for your case.

Now in your case, I would think if it ain't broke don't fix it. Under 1.5 AHI is excellent, and it sounds like the auto algorithm agreed since you spent most of your time near your prescribed pressure.

Thank you. I go fond something else to mess with :-)

A man after my own heart Wink

+1

Aloha,
MrCourtney
Honolulu, HI
12-03-2013 11:46 PM
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mdh235 Offline

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Posts: 90
Joined: Aug 2013

Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: ResMed F10
Humidifier: H5i
CPAP Pressure: 12.4 - 12.8
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: West Coast U.S.

Post: #7
RE: AUTO vs Manual setting
(12-03-2013 02:22 AM)courtney123 Wrote:  Could someone give me an understanding the benefits of having my CPAP on AUTO instead of manual pressure selection?
I have been on a Respironics RemSTar Auto 560P System One for about 5 months.

The pressure was set to 11 based on a sleep study the month prior.
The study showed 30 apneas per hour. With the CPAP the index is usually under 1.5 now.

While fiddling with the unit a couple of days ago in the SETUP section, I found I could set it to AUTO. So I did and looking in Encore, the pressure numbers ranged between 9 and 15 with 90% at 10.5.

The AIH eased up to 2.0 with RERA Index (which is always high for me) at 2.1.

Not understanding any of the benefit of AUTO, I set the unit back to manual 11.

Can someone take that and explain what was going on and if there's any benefit of AUTO over MANUAL?

Thanks.

It might be that you set your lower limit too low. If your prescription calls for 11, try setting it closer to that.

I like being able to play with the auto settings, just because. While it's taken a while, I've finally found the magic range for me that results in an AHI below .5 most of the time. On CPAP mode, it was usually around 3.

I know that both numbers are considered "ok", but if I can fiddle with things to tune them, that's just what I do.
12-05-2013 07:29 PM
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courtney123 Offline

Preferred Members-2

Posts: 67
Joined: Jun 2013

Machine: REMstar Auto A-Flex
Mask Type: Nasal pillows
Mask Make & Model: F&P Pilairo
Humidifier: None
CPAP Pressure: 11
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Honolulu, Hawaii

Post: #8
RE: AUTO vs Manual setting
>>> I like being able to play with the auto settings, just because.


I can relate. If I can take it apart - I will.
Putting things back together is another story...

Aloha,
MrCourtney
Honolulu, HI
12-05-2013 10:05 PM
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jgjones1972 Offline

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Posts: 516
Joined: Nov 2012

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro FX
Humidifier: ResMed H5i
CPAP Pressure: 18 - 20
CPAP Software: ResScan SleepyHead

Other Comments: CMS50I PulseOx

Sex: Male
Location: Ohio - USA

Post: #9
RE: AUTO vs Manual setting
The advantage with the Auto is that you could set the pressure range to 11 - 20 and if 11 is enough pressure, then the machine will stay at 11 all night and you will get the same results you got when it was set to a straight pressure of 11. If you sometimes need more pressure though, the machine can raise the pressure to decrease flow limitation or defeat a stubborn obstruction. Your AHI might get a little better if set to Auto 11 - 20, but might not...but you have to remember that AHI is not the "end all, be all". AHI really is a flawed metric in some ways. I would rather have a higher AHI made up of short duration events than to have a low AHI made up of long duration events, for example.

In any case, your AHI was worse because your minimum pressure was set too low.
12-06-2013 12:08 AM
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courtney123 Offline

Preferred Members-2

Posts: 67
Joined: Jun 2013

Machine: REMstar Auto A-Flex
Mask Type: Nasal pillows
Mask Make & Model: F&P Pilairo
Humidifier: None
CPAP Pressure: 11
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Honolulu, Hawaii

Post: #10
RE: AUTO vs Manual setting
(12-06-2013 12:08 AM)jgjones1972 Wrote:  The advantage with the Auto is that you could set the pressure range to 11 - 20 and if 11 is enough pressure, then the machine will stay at 11 all night and you will get the same results you got when it was set to a straight pressure of 11. If you sometimes need more pressure though, the machine can raise the pressure to decrease flow limitation or defeat a stubborn obstruction. Your AHI might get a little better if set to Auto 11 - 20, but might not...but you have to remember that AHI is not the "end all, be all". AHI really is a flawed metric in some ways. I would rather have a higher AHI made up of short duration events than to have a low AHI made up of long duration events, for example.

In any case, your AHI was worse because your minimum pressure was set too low.

Makes sense, thanks.
I may play with it again this weekend. I have a lot of respiratory Related Arousal events overnight (20-30). That's what I'm looking to cut back. My sleep quality is not good.

Aloha,
MrCourtney
Honolulu, HI
12-06-2013 12:37 AM
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