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How to Set my Autoset
#1
How to Set my Autoset
After finding out my DME supplier had bricked me, I went out and got the ResMed Airsense Autoset 10.  This thing is REALLY slick.  Popping the SD into Sleeyhead I am amazed by all the data it collects.

My prescription was for a setting of 12.  I used my regular Airsense at 10 because 12 was too much constant air.  I would often wake up and take it off at 12, although discovering EGR made a huge difference.  I set the Autoset to a min of 8 and a max of 13.  At that setting, it hit 13 4-5 times throughout the night.  Last night I bumped it up to 15.  It only hit 15 once.  I think that because the airflow is adjusting, I can sleep throughout the night with occasional bursts of higher pressure (although when it did hit 15, it got a big leak but it did not wake me up).

My AHI for the last two nights have been 1.66 (max 13) and 1.9 (max 15).  Longest apnea event was 17 seconds and that was in a cluster of them when the pressure when up to 15.

So I guess my question is, how high should I set the machine?  I've seen some people set it as high as 20 but I am pretty sure that will blow the mask right off!  Is there a negative to setting it higher, asides from mask leak and potentially waking me up.  And how much tinkering do I do?  Does anyone ever get an AHI of 0?  Is that a reasonable expectation or is 2.0 good enough?

Thanks!
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#2
RE: How to Set my Autoset
Hello Swampyankee

Welcome to the forum. Well done on getting yourself one of the best equipments to treat your apnea.

I see that you have registered to obtain Myair info. That can be reassuring but the only way to truly dial into optimum personal pressure is to download the free software-sleepyhead and upload your data here.

There are handy tips to do that in my signature.

Once done, many will chime in to discuss and offer answers to your queries.
Sleepyhead in 5 easy steps
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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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#3
RE: How to Set my Autoset
My signature has the tutorials for how to organize Sleepyhead graphs and post them as attachments to the forum. It sounds like you're getting good results, and I wouldn't second guess that without more information. Sometimes it is worthwhile to limit maximum pressure. We should be able to tell once we see the data. Welcome, and glad you got the Airsense 10 Autoset.
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#4
RE: How to Set my Autoset
It might be that if you put up the lower pressure a little you might get even less AHIs but Sleepyhead is the way to find out what is going on, however, you are doing fine as it is, but tweaking might get you even better results.
>^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^<
I am NOT a doctor.  I try to help, but do not take what I say as medical advice.

I am just a long term user of c.p.a.p. and therefore I have some experience in using these machines and equipment.

However, I am NOT an expert, so advice given should be taken as given in good faith only and NOT medical advice.

Every journey, however large or small starts with the first step.   Coffee
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#5
RE: How to Set my Autoset
There is no right answer as to how low is low enough. It depends on the person. Some people toss around a lot which often causes CA events to be registered so that their numbers never go below 2. I don't thrash so my AHI average is 0.3.
Limiting the max pressure should only be done as a necessary evil since you are accepting more obstructive apneas.
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#6
RE: How to Set my Autoset
(05-14-2018, 08:13 PM)tedvpap Wrote: There is no right answer as to how low is low enough.  It depends on the person.  Some people toss around a lot which often causes CA events to be registered so that their numbers never go below 2.  I don't thrash so my AHI average is 0.3.  
Limiting the max pressure should only be done as a necessary evil since you are accepting more obstructive apneas.

Actually limiting maximum pressure is a common practice to prevent pressure runaways due to flow limitations and leaks. 15cm sounds like it's working well as a maximum pressure for now.
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#7
RE: How to Set my Autoset
(05-14-2018, 08:21 PM)Walla Walla Wrote:
(05-14-2018, 08:13 PM)tedvpap Wrote: There is no right answer as to how low is low enough.  It depends on the person.  Some people toss around a lot which often causes CA events to be registered so that their numbers never go below 2.  I don't thrash so my AHI average is 0.3.  
Limiting the max pressure should only be done as a necessary evil since you are accepting more obstructive apneas.

Actually limiting maximum pressure is a common practice to prevent pressure runaways due to flow limitations and leaks. 15cm sounds like it's working well as a maximum pressure for now.

I agree that it is commonly done.  But limiting the machine from doing what it has been design to do should only be done as a compromise.  Flow limitations mean that more pressure is needed.  Leaks should be addressed by improving the interface if possible.  

If you are limiting the max pressure then you are accepting more obstruction - maybe it is a necessary evil.
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#8
RE: How to Set my Autoset
(05-14-2018, 08:56 PM)tedvpap Wrote:
(05-14-2018, 08:21 PM)Walla Walla Wrote:
(05-14-2018, 08:13 PM)tedvpap Wrote: There is no right answer as to how low is low enough.  It depends on the person.  Some people toss around a lot which often causes CA events to be registered so that their numbers never go below 2.  I don't thrash so my AHI average is 0.3.  
Limiting the max pressure should only be done as a necessary evil since you are accepting more obstructive apneas.

Actually limiting maximum pressure is a common practice to prevent pressure runaways due to flow limitations and leaks. 15cm sounds like it's working well as a maximum pressure for now.

I agree that it is commonly done.  But limiting the machine from doing what it has been design to do should only be done as a compromise.  Flow limitations mean that more pressure is needed.  Leaks should be addressed by improving the interface if possible.  

If you are limiting the max pressure then you are accepting more obstruction - maybe it is a necessary evil.

Actually it was recently brought up that increased pressure support not increased maximum pressure treats flow limitation.

If the pressure support is limited than flow limitation can drive the pressure all the way to 20cm and still not be resolved.
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Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#9
RE: How to Set my Autoset
(05-14-2018, 09:11 PM)Walla Walla Wrote:
(05-14-2018, 08:56 PM)tedvpap Wrote:
(05-14-2018, 08:21 PM)Walla Walla Wrote: Actually limiting maximum pressure is a common practice to prevent pressure runaways due to flow limitations and leaks. 15cm sounds like it's working well as a maximum pressure for now.

I agree that it is commonly done.  But limiting the machine from doing what it has been design to do should only be done as a compromise.  Flow limitations mean that more pressure is needed.  Leaks should be addressed by improving the interface if possible.  

If you are limiting the max pressure then you are accepting more obstruction - maybe it is a necessary evil.

Actually it was recently brought up that increased pressure support not increased maximum pressure treats flow limitation.

If the pressure support is limited than flow limitation can drive the pressure all the way to 20cm and still not be resolved.

I think we are confusing each other, and perhaps ourselves. 
Pressure treats flow limitations, H, OA, and all things related to obstruction.  Whether the increased pressure is needed on inhalation or exhalation can vary.  
The OP's machine controls inhalation pressure (within a prescribed range).  The exhalation pressure is lower, depending on the EPR setting.
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#10
RE: How to Set my Autoset
(05-14-2018, 09:42 PM)tedvpap Wrote:
(05-14-2018, 09:11 PM)Walla Walla Wrote:
(05-14-2018, 08:56 PM)tedvpap Wrote: I agree that it is commonly done.  But limiting the machine from doing what it has been design to do should only be done as a compromise.  Flow limitations mean that more pressure is needed.  Leaks should be addressed by improving the interface if possible.  

If you are limiting the max pressure then you are accepting more obstruction - maybe it is a necessary evil.

Actually it was recently brought up that increased pressure support not increased maximum pressure treats flow limitation.

If the pressure support is limited than flow limitation can drive the pressure all the way to 20cm and still not be resolved.

I think we are confusing each other, and perhaps ourselves. 
Pressure treats flow limitations, H, OA, and all things related to obstruction.  Whether the increased pressure is needed on inhalation or exhalation can vary.  
The OP's machine controls inhalation pressure (within a prescribed range).  The exhalation pressure is lower, depending on the EPR setting.

This exchange sounds suspiciously familiar. For what it's worth here's a reference for Flow limitation.  http://www.apneaboard.com/wiki/index.php...Limitation

Now I'll move on.
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Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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