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[Equipment] Settings For ResMed AirSense 11 AutoSet
#1
Settings For ResMed AirSense 11 AutoSet
I have been using a Respironics DreamStation for 4 years, and due to the recall, my Dr. was able to get a local DME to get me an ResMed AirSense 11 AutoSet, heated tubing, N30i nasal mask.  Because I didn't want to change both machine and mask, I'm still using my Respironics DreamWear nasal mask.

With the DreamStation, the algorithm they use would adjust to my exhaled breaths within ~30 seconds, and thereafter, was extremely "transparent" breathing and didn't bother me at all.

With the AirSense 11, it didn't seem to reduce pressure much when I exhaled, and was a bit uncomfortable to breath with it--the DME tech assured me I'd get used to it.

First thing I did when I got home was to get the clinician manual (I was very familiar with adjusting and perfecting my DreamStation settings) and after getting it, checked out the settings.  It looks like they just left all default settings, set the type to CPAP (not AutoSet), turned on EPr of 3, and put in my required pressure of 9.0 cm H2O.  And, that seemed to be the issue.

I changed the type to AutoSet, but am running into another problem--looks like you have to input min and max pressures, which default to 4 and 20--problem is, I don't see anywhere to put in my required pressure of 9.0?  And, it doesn't seem like the minimum pressure ramps up, so was staying at 4, but would jump to around 7 when I exhaled (?).  All night I felt like I was not getting enough pressure, which was pretty unpleasant.

Soooo...what do I need to setup so that I'm getting my required pressure of 9.0, but also AutoSet is monitoring things and is self-adjusting so exhalations are easy, extra pressure comes in if/when needed?  Do I need to setup 9 as the min pressure (with...what...as max), or is there some other setting I'm missing?

The other issue I ran into, is that my nasal mask got full of water by the morning--I have the machine lower than my head, using the heated tubing, with the Climate/Heating/Humidity all set to Auto.  Do I need to set them to manual, and lower humidity and/or raise tube temperature?

Thanks!!!
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#2
RE: Settings For ResMed AirSense 11 AutoSet
Min pressure of 7, this allows EPR to work.
Max = 20 is ok because you should never go there. 12 is ok too
EPR=3. Unlike flex on PR, EPR is very effective at treating hypopneas
, Flow limits RERAs and UARS. Also because of an agressive algorithm ResMed typically optimize at lower pressures and lower AHI than PR machines.
Try these settings and we will help you optimize from there. Just pos OSCAR screenshot and tell us how you feel. Note, I feel fine is not a good answer, be critical and specific
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#3
RE: Settings For ResMed AirSense 11 AutoSet
Ask your sleep doc's office for a copy of the prescription.  The prescribed autoset pressure range should be there.

The alternative is....   

If your previous min on the Dreamstation was 9, then set the AS11 for Auto and 9-20.  Alternately, if you know what your max was on the Dreamstation, set max to that.  The machine will start at 9 (less ramp), but won't go any higher than it needs to (mine is set 8-20, and never gets above 12).  Set EPR the same Flex was on the Dreamstation, too, but also make sure you set EPR for "Full time" and not "Ramp only".  Set the ramp time as desired (again, if you know what it was on Dreamstation, you can start there).

That should be a good starting point, and you can fine-tune from there based on your results and data.

If you set Auto and 9-20, the machine will start at 9 for inhale (less any ramp value during ramp, if defined).  EPR (0, 1, 2, 3) will be deducted for exhale, keeping in mind it can't go lower than 4 (i.e., if you have a ramp time set, pressure will initially start at 4 and EPR won't have any effect until pressure increases).   At the end of any ramp time, the AS11 will be at 9cm for inhale, and adjust up/down as needed address flow and events (staying min and max), while always dropping exhale pressure lower than inhale by the defined EPR amount.

My personal preference, at a min pressure of 9, would be to turn Ramp off entirely if using EPR.  But some people like the ramp even at low min pressures.

Hope that helps.
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#4
RE: Settings For ResMed AirSense 11 AutoSet
Thanks, Gideon!

I was using SleepyHead, but, will grab Oscar and try it!

Question on the min pressure...does the machine work backwards from the EPR setting + min setting to make the "normal" pressure be that level?  Probably not being clear, but if I set min to 7, EPR to 3, then will it go to 10 as starting pressure, so, if needed, it can reduce down to 7?  Coz, when I set it at 4-10 with EPR of 3, it basically just stayed at 4 and didn't really go up any (felt like I was suffocating all night).

Thanks, again!!
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#5
RE: Settings For ResMed AirSense 11 AutoSet
I’ll try to explain -

Min is the inhale pressure
Exhale pressure is the min-EPR

4 is the lowest the machine can go

So normally min 7 and epr 3 would give you 
inhale 7
Exhale 4
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#6
RE: Settings For ResMed AirSense 11 AutoSet
Thanks, Stacey!

That's kinda what I thought on the exhale side, on the inhale side, I assume since the machine is in AutoSet, that could vary up or down to the limits (probably not all the time or all the way)?

Since my diagnosed pressure was 9.0, should I use 9.0 as the min, or by using 7, the machine will simply adjust as required to provide the accurate pressure for whatever is going on with my breathing?

Thanks, ScottZZZ!

I DO have a copy of my study, and range is 9-20, which is what my DreamStation was set to.  I will try the same range on the AirSense 11, with EPR of 3, and see how that works.  Once I get Oscar working, I can send in results.

Appreciate the advice!
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#7
RE: Settings For ResMed AirSense 11 AutoSet
Just remember that the DreamStation requires a higher min (9) to stay ahead of events which can, if you wish, lower pressures on ResMed.
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