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Glitch on Resmed S10 Autoset : ventilatory support
#1
Hello,

I use a Resmed S10 Autoset 4-12 EPR 1.

Sometimes ventilatory support is active on this engine and helps me finish my breaths. There is a breath that ends my inspirations (I can not finish it all alone). This breath is small but significant, and without him I can not breathe fully. When not, I feel like a junkie in the morning, with enormous fatigue signs. Except when it appears, I feel very well. To make it appear, I have to breathe hard and deep. However, I feel that breath only 1 out of 10 times approximately.

I know that this machine is not supposed to have ventilatory support reagent on respiratory rate, yet I'm sure that aid is sometimes active.

Did someone already feel the same fact? Is there a way to activate it each time?
Thanks, have a good day
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#2
Hi florian1993,

It is unfortunately common that some doctors set the Min Pressure setting too low or leave it low (like 4) for longer than a few days or weeks. Your Min Pressure of 4 is very low and most new users will prefer the Min Pressure setting to be raised to 5 or 6 or higher within a few hours or days or weeks of starting CPAP use.

I think your problem is that your Min Pressure (4) is too low and is not letting EPR work to help you inhale fully.

When the Pressure (meaning IPAP, the pressure which the machine is using during inhalation) is above 4 the machine will lower the pressure used during exhalation by as much as 1 or 2 or 3 (depending on whether the EPR is set to 1 or 2 or 3), but the machine will never lower the pressure below 4.

If you raise your Min Pressure to 5 or higher, your EPR setting (which presently is 1) would always be able to lower the pressure when you exhale. And when you finish exhaling and start to inhale, the pressure would return higher, which would help you breathe in more fully.

You are sometimes feeling EPR helping you to breathe in and out (when EPR drops the pressure, it helps us breathe out, and when we start to breathe in, the EPR ends and the pressure raises back to the normal IPAP pressure, and this helps us breathe in), but you feel it helping only when the machine has raised the pressure higher than 4, because EPR cannot drop the pressure lower than 4.

Actually, it sounds to me like you would probably benefit from raising the Min Pressure setting to 7 and raising the EPR setting to 3. This would support breathing in and out more deeply.

And if the Ramp feature is enabled, I suggest turning it off.

However, I suggest raising the Min Pressure setting and the EPR setting gradually, not all at once.

For example, tonight you could turn off the Ramp and raise just the Min Pressure to 5 and leave EPR at 1.

If you find that feels better and you like that, the next night you could raise the Min Pressure to 6 and raise the EPR to 2.

If you like that even better, then on the next night you could raise the Min Pressure to 7 and the EPR to 3.

Both the Min Pressure setting and the EPR setting are usually considered merely "comfort" settings which the user should adjust to whatever is most comfortable. However, usually, forum members recommend making only one small adjustment (to only one setting) and then leaving the settings alone for at least a week before considering another change. This is good advice in general, especially if raising the Max Pressure setting (which you would not be changing) or if raising the Min Pressure setting or the EPR setting (which you would be changing).

So, be sure to slow down (stop increasing the Min Pressure or EPR) if the changes in settings make things harder or worse.

And please take a look at your sleep data in SleepyHead after each change.

Take care,
--- Vaughn

(06-18-2016, 09:31 AM)florian1993 Wrote: Hello,

I use a Resmed S10 Autoset 4-12 EPR 1.

Sometimes ventilatory support is active on this engine and helps me finish my breaths. There is a breath that ends my inspirations (I can not finish it all alone). This breath is small but significant, and without him I can not breathe fully. When not, I feel like a junkie in the morning, with enormous fatigue signs. Except when it appears, I feel very well. To make it appear, I have to breathe hard and deep. However, I feel that breath only 1 out of 10 times approximately.

I know that this machine is not supposed to have ventilatory support reagent on respiratory rate, yet I'm sure that aid is sometimes active.

Did someone already feel the same fact? Is there a way to activate it each time?
Thanks, have a good day

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. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#3
Thank you for your response vsheline. I can not fully breathe at night, and the machine does not help me, even with the EPR 3. I always feel terrible in the morning. I think I need a ASV machine, I see the sleep center in a few months.

Someone can you tell me if my stats of my Breathing Rate, Minute Wind, Insp Time and Time Exp are okay?

I made radios lung + ultrasound of the heart, everything is very good. The doctor told me I had a heart for sports.

I should therefore have the same numbers as you all.

Thank you


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#4
Sorry for double post, i just attach my 3rd screen shot.

Stats : i am 23 years old, 141 lb (64 kg).

Average Pressure : 8.99
Average EPAP : 8.99
Average Minute Vent : 4.95
Average Resp Rate : 13.84
Average Flow limit : 0.02
Average Insp Time : 2.31
Average Exp Time : 2.21
Average Tidal Volume : 363.80

Also, I filmed my night over a period of 6 hours. Seen me turn often while I sleep all this time.

https://www.youtube.com/watch?v=lOEAfZpYwM8

If someone wants to play detectives with me, I'm really really really bad. Feel free to tell me what you think. My pulmonologist does not want to follow my condition. It's just for wait my rendez-vous to the sleep center.

Have a good day.


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#5
Hi florian1993,

I don't know enough about sleep movements to be able to offer an opinion on that subject.

But regarding APAP use, on June 4 your AHI and leaks were low, and your other stats were normal.

I think there is nothing in the SleeyHead report which would alarm a doctor, unless the apneas or hypopneas are lasting a very long time, such as over a minute. There is a thread active right now on how to use SleepyHead to see how long events are lasting:
http://www.apneaboard.com/forums/Thread-...#pid165846

On June 4 you had about 1 central apnea per hour. This is also considered normal and does not indicate that an ASV machine is needed.

On June 4 the median pressure was near 9.5 and the reported 95 percentile pressure was near 11, and I think it would probably be very helpful to you to raise the Min Pressure up to 7 and to raise the EPR to 3, in the manner suggested in my first post.

From what you are saying, it sounds to me like you may need an Auto Bilevel machine like the AirCurve 10 VAuto rather than an ASV or your present APAP (AirSense 10 AutoSet).

If patients "fail" CPAP or APAP because they cannot breathe well enough under pressure, they may need (and should qualify for) a bilevel machine with adjustable Pressure Support, which is the boost in pressure during inhalation (IPAP) which helps us breathe in more deeply and more easily. (EPR allows IPAP to be higher than EPAP by only as much as 3.) Some patients find they require Pressure Support of 4 or higher, and it sounds to me like probably you are one of them.

Take care,
--- Vaughn




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. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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