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Help Changing from CPAP (fixed pressure) to Resmed AutoSense 10 for Her
#1
Help Changing from CPAP (fixed pressure) to Resmed AutoSense 10 for Her
Wife has been on CPAP since sleep study in CY2008.  She will be receiving her third replacement machine shortly..  It's a ResMed AutoSense 10 for Her. 

She has been on fixed pressure (8) on previous two machines.  Initial sleep study in 2008 had AHI of 25

Current Machine is a Philips Respironics REMstar Auto (System One 60 Series) (560P).  She has been using this machine for 5 years.

Data for SD card attached extracted using Oscar.

Question:  Looking for help and advise on a trial of the therapy mode "Autoset for Her" available in the new ResMed Autosense 10 for her machine.

DME will only set fixed pressure because that's what's on the sleep study (12 years old). 

Have already downloaded provider manual from this site.  Know how to change/adjust settings.


Thank you and great board!


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.pdf   Edited Kay Old Data.pdf (Size: 11.28 KB / Downloads: 23)
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#2
RE: Help Changing from CPAP (fixed pressure) to Resmed AutoSense 10 for Her
Consider setting the pressures a couple of numbers above and below what it has been. After getting through an adjustment period look at the data.

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#3
RE: Help Changing from CPAP (fixed pressure) to Resmed AutoSense 10 for Her
Thanks.  Saw this in a post from 11-22 "Can I set Up my CPAP myself"

nitially set your machine as follows:
  • Minimum pressure: 7
  • Maximum pressure: 15
  • EPR: 3
  • Ramp: Off

Would you agree with these starting settings?  She has been on constant CPAP pressure of 8 for 10 years
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#4
RE: Help Changing from CPAP (fixed pressure) to Resmed AutoSense 10 for Her
They look a reasonable starting point
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#5
RE: Help Changing from CPAP (fixed pressure) to Resmed AutoSense 10 for Her
Don, this machine is going to be great for your wife. Its not just the autoset pressure, but the ability to use EPR which drops the pressure during exhale from 1 to 3 cm from the inhale CPAP pressure. This is actually a bilevel machine, limited to 3-cm of pressure support, and that means it will finally treat the flow limitations that lead to her hypopnea with her current machine, and the Autoset is also capable of preventing obstructive apnea by raising the pressure as needed.

I recommend starting with a minimum pressure of 7.0 and maximum pressure of 12.0 in Autoset or Autoset For her mode. Be sure to go to the comfort settings in the clinical menu and turn on EPR, Full Time, and use a setting of 2. This will make her actual starting pressure 7.0/5.0 (inhale/exhale) which should be very comfortable. The machine will be able to rise to 12.0/10.0 as needed. In addition to setting pressure and EPR, go to Essentials and change the setting from On to Plus. This won't change therapy, but will give more on-screen information in the Autoset sleep report. This machine is worlds apart from the PRS1 Auto CPAP in terms of comfort and ability to treat her sleep disordered breathing. Give it a few nights, but I'm sure she will not want to go back.

If you don't already have it, get the clinician setup manual from the forum (see link at top of page). There is really good information there on how the Autoset For Her works and especially how EPR works to improve comfort and results.
Sleeprider
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#6
RE: Help Changing from CPAP (fixed pressure) to Resmed AutoSense 10 for Her
Thank you for the detailed explanation and advice on initial settings.

Have two week delay.  Out of the box the first machine had a low frequency oscillating tone on inhale/exhale with a noticeably higher level of vibration at the air filter end of the machine.  (We both received identical machines at the same time as Medicare replacements).  This was the ResMed Autoset.  I wan't aware of the Resmed AutoSet for Her until I read about it on this board

DME Service Representative, at time of pickup, had mentioned they've had a few of these machines returned for this problem. 

After the first night of use (keeping both of us awake),  I measured the sound of each machine (mask on) with an Octave Band Analyzer for Ipad.  Your could see a noticeable difference in her machine in a low frequency band and the dB level was higher than mine. 

DME was very cooperative when I reported this and ordered her a new machine.  At my request they ordered the AutoSet for Her.  Waiting now for the new machine to begin the effort.  Back to the old machine in the meantime.

I've got local events and my post out of sequence but any rate it was (1) get ResMed AutoSet machines for both of us (2) join this board (3) first night trial (4) post for hep on settings (5) return her ResMed Autoset for noise issues (6) waiting new machine

I will try your recommendations for her machine as soon as it arrives.  In the meantime, I'll try them on myself first.

After a week trial of the settings on the Resmed Autoset for Her, I'll post info and ask for opinions on what things look like.

Thank you
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#7
RE: Help Changing from CPAP (fixed pressure) to Resmed AutoSense 10 for Her
If you're having any issues, post a question or describe the issue with a standard look on the OSCAR chart to give a visual of the data. Even if things are going well, you need not wait a week. Post up in a day or so and we can offer guidance as needed. Best to you. And welcome to Apnea Board.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Help Changing from CPAP (fixed pressure) to Resmed AutoSense 10 for Her
Finally resolved problems with machine.  Now have ResMed AirSense 10 for her.  Adjusted settings to post from Sleeprider, i.e. 7/12 EPR2

She has been using it for about a week. 

All suggestions appreciated


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#9
RE: Help Changing from CPAP (fixed pressure) to Resmed AutoSense 10 for Her
How is comfort? Based on this one chart there is a minor improvement from previous therapy. OA keeps sneaking in so maybe flow limit is not preceding events. Please include the flow limit cart in future posts. It looks like we might increase minimum pressure, but I’d like more feedback.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Help Changing from CPAP (fixed pressure) to Resmed AutoSense 10 for Her
       
Thanks for the feedback


I've included a chart from May 16th the first night she had the new machine.  It was set at Fixed 8.0 for that night by the DME per sleep study recommendation of 12 years ago.

I've also included a chart from last night May 23rd and moved the flow limit graph up '

Overall comfort level is good.  She does comment that at times she feels like there is too much pressure.  She says that she wakes up seeming to gasp for breath when it's too low and also wakes up at times with a sensation that the pressure is too high.

Perhaps a contributing factor.......she was in a near fatal car wreck in the late 90's and has a plate in her neck that fuses all vertebrae but the top two.  She has much difficulty finding a comfortable position at night and usually wakes in the AM with a very stiff neck

Advice very helpful....thanks for the interest and time


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