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Auto pressure setting advice
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AshSF Offline

Advisory Members

Posts: 356
Joined: Oct 2014

Machine: PRS1 D560TS
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10, Bkup: Airfit F10 & Quattro Air
Humidifier: PRS1 60 series with Heated Tube
CPAP Pressure: 8 - 8 w/ Aflex 3
CPAP Software: SleepyHead

Other Comments: Using APAP mode with fixed pressure

Sex: Male
Location:

Post: #11
RE: Auto pressure setting advice
I started with wide open settings at 4-20 on a PRS1 60 series Auto, with A-flex set to 3. My AHI quickly fell to consistently < 1.5 everyday after 3 weeks of being on it.

I raised the minimum to 5 and my AHI went below 0.5 on almost every night. I also got 2 perfect 0.0 scores.

Raised it again to 6 and AHI went a bit up to 0.5 - 1.1 range. I was thinking why. The probable answer is in A-flex. A-flex is not triggered below 6. So when I was on 5, my EPAP was 5. But on 6, my EPAP is 4 (since A-flex providers a ~2 cm relief).

Then I raised it again to 7, and it feels like a much better experience. Air flow is ample. I never feel suffocated at any level of ambient temp/humidity. And my AHI is < 0.5 again. Also, my RERAs and FL reading has gone down. I feel much more rested now. This tells me that AHI is not the whole story. RERAs are important too.

So, my algorithm to self-titrate in your case will be:
1) Put the minimum to 8 (since you have experienced this starting pressure before and are comfortable with it).
2) Put the ramp to 0.
3) Keep the upper limit wide open to 20.
4) Evaluate you therapy numbers using sleepyhead for 10+ days.
5) If you see clusters of events (O, C, H) still when pressure shows 8, its time to raise the minimum by 1.
6) If you see Centrals when the pressure is on the high side, you may want to reduce the top limit by 1.
6) Repeat steps 4, 5 & 6 till you feel good consistently.

YMMV.

Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
12-09-2014 01:25 PM
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quiescence at last Offline

Advisory Members

Posts: 753
Joined: Nov 2014

Machine: REMstar System One with Autoflex
Mask Type: Full face mask
Mask Make & Model: Quattro AirFit F10
Humidifier: yes typical setting = 4
CPAP Pressure: 5-13 Autotritrating CPAP
CPAP Software: SleepyHead EncoreBasic

Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

Sex: Male
Location: US

Post: #12
RE: Auto pressure setting advice
@AshSF - In my short time here, this is one of the best posts I have read on settings. Thanks a bunch.

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
12-09-2014 03:23 PM
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Ghost1958 Offline

Advisory Members

Posts: 957
Joined: Aug 2014

Machine: PRS1 Series Sixty Auto Aflex
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: PRS1 with Heated Hose
CPAP Pressure: 10.5 min 16 max
CPAP Software: SleepyHead EncoreBasic

Other Comments: Moderate to Severe SA Obstructive. Rapid O2 desat off the machine.

Sex: Male
Location: KY

Post: #13
RE: Auto pressure setting advice
I have the same machine. Go into clinical and enable Opti start. Then set the max at about 2cm above your titrated pressure. Then watch software to see if its getting that high or not or getting up to where you capped the max and sitting there with events still happening which would mean raise it a bit.

After thirty hours the machine will start diplaying and starting at your best min pressure. BUT you will need to go into clinical and set your min pressure manually to what Opti start picked. If you dont manually reset the min to the Optistart min pressure the machine will start at the new pressure but lower back to preset pressure if after a short time you have no events.

I use that feature anytime I change masks or think I need to change my max. In thirty hours of use it will recalculate the optium start pressure based on events etc or changes caused by the mask change.

Its never failed to pick a good min pressure that narrows the range to its best spread min to max.

With a simplus FFM with me on my machine and a max of 18 Opti start calculated a starting pressure of 10.5. up from 8. However I seldom went as high as 18.

And as another said AFlex wont engage under a pressure of 6. However set at 3 it will give a 3cmh20 relief "or down to 4cm if 6 is the min" 2 a 2 cm relief and 1 a 1 cm relief.

You can also run Cflex in auto mode which has a different feel that isnt quite as smothery as Aflex for some.
(This post was last modified: 12-09-2014 03:43 PM by Ghost1958.)
12-09-2014 03:27 PM
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AshSF Offline

Advisory Members

Posts: 356
Joined: Oct 2014

Machine: PRS1 D560TS
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10, Bkup: Airfit F10 & Quattro Air
Humidifier: PRS1 60 series with Heated Tube
CPAP Pressure: 8 - 8 w/ Aflex 3
CPAP Software: SleepyHead

Other Comments: Using APAP mode with fixed pressure

Sex: Male
Location:

Post: #14
RE: Auto pressure setting advice
(12-09-2014 03:23 PM)quiescence at last Wrote:  @AshSF - In my short time here, this is one of the best posts I have read on settings. Thanks a bunch.

Thank you QAL. I really appreciate your kind encouraging words.

Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
12-09-2014 04:00 PM
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Seismic Snorer Offline

Members

Posts: 9
Joined: Dec 2014

Machine: PRS1 Series 60 Auto A-flex
Mask Type: Full face mask
Mask Make & Model: Resmed airfit f10
Humidifier: Heated hose humidifier
CPAP Pressure: 7 - 14cm
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Melbourne, Australia

Post: #15
RE: Auto pressure setting advice
Thanks for the great advice.i went to bed before anyone had a chance to reply,so I stuck with the 8-12 last night.i will check my results on sleepyhead after work.The opti-start feature sounds like a good idea.Thanks again.
12-09-2014 05:10 PM
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quiescence at last Offline

Advisory Members

Posts: 753
Joined: Nov 2014

Machine: REMstar System One with Autoflex
Mask Type: Full face mask
Mask Make & Model: Quattro AirFit F10
Humidifier: yes typical setting = 4
CPAP Pressure: 5-13 Autotritrating CPAP
CPAP Software: SleepyHead EncoreBasic

Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

Sex: Male
Location: US

Post: #16
RE: Auto pressure setting advice
I took the plunge and did two things - (1) narrowed the band a little from 4-20 cm to 6-13.5 cm and (2) set Optistart to ON.

Awaiting any response from Optistart, but see what seems to be a good trend in AHI from setting pressure bands.

I picked 6 as low, even though it is above the median of most days. This is because I wanted to determine if I could get used to or reset A-flex and heard this would only kick in when I get above 6.

A-flex=1 (A-flex of 2 was awful)
PRS1 resist=X1
DIY mask vent diverter installed.
RAMP= 4.5 cm for 15 minutes. (use rarely)

[attachment=1161]

net positive result in felling rested, energy, and concentration

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
12-20-2014 11:39 AM
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quiescence at last Offline

Advisory Members

Posts: 753
Joined: Nov 2014

Machine: REMstar System One with Autoflex
Mask Type: Full face mask
Mask Make & Model: Quattro AirFit F10
Humidifier: yes typical setting = 4
CPAP Pressure: 5-13 Autotritrating CPAP
CPAP Software: SleepyHead EncoreBasic

Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

Sex: Male
Location: US

Post: #17
RE: Auto pressure setting advice
Update - 5 days on new pressure band, 3 of the days AHI was under 5. A definite improvement.

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
12-21-2014 09:38 AM
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