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Any thoughts on my charts?
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surferdude2 Online

Advisory Members

Posts: 1,077
Joined: Jul 2014

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro & Optilife
Humidifier: ResMed H5i @ #3 if nose breathing & #5 if mouth breathing
CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #11
RE: Any thoughts
Eurika, IMHO, it looks like the response time of the machine is causing it to always be behind time. It appears to me that it responds to your obstructive events too late after the fact and then drops the pressure back down within the next half hour and then the process repeats itself all night long. I agree that raising the minimum pressure would help since it would give the machine a head start on getting the pressure up to the required level to handle the restriction before it gets scored as an event.

Raising the minimum pressure may present a problem of discomfort in getting to sleep so the ramp may become your friend and EPR set at 3 will likely help also.

As has been mentioned, raising the minimum pressure slowly is normally best but if you can tolerate a larger jump, so much the better but if a large jump proves unsatisfactory, don't let that discourage you from going back to smaller changes. I found it remarkable that I was eventually able to tolerate higher minimums since when I first started I found 6 cm to be intolerable. Now I start at 8 cm and feel no discomfort at all, indeed I sometimes wonder if the machine is working! The fact is that exhaling under pressure actually makes the lungs work much more efficiently and that cancels out any perceived losses due to lesser volume.

I had troubles getting my AHI down when I had the starting pressure below 8 cm even though I use the S9 AutoSet. It just didn't have quick enough response when starting from a lower pressure and needing to get to 12 ~ 13 cm in order to handle the obstructions before they got scored.

By having obstructive events uniformly spaced from 30~45 minutes apart, you're playing into the weakness of the AutoSet machine and how it responds. Raising the minimum can work around that weakness.

Good luck with your quest for the proper setting. Do not give up! Trust me, you'll get it mastered in time and be well rewarded for your efforts.
(This post was last modified: 11-15-2014 12:43 PM by surferdude2.)
11-15-2014 12:20 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #12
RE: Any thoughts
ResMed machines do not flag events during Ramp. You can also set Ramp time to Auto
From clinical manual: When Ramp Time is set to Auto, the device will detect sleep onset and then gradually increase from the start pressure to the minimum treatment pressure at a rate of 1 cm H2O per minute. However, if sleep onset is not detected, the device will reach the target pressure within 30 minutes
11-15-2014 03:53 PM
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