Larrypac [Therapy Thread]

[staceyburke]

No the max is the highest the machine will go up to counter apnea   It may not get that high but again that is the most it can go. This was suggested so your mask will not “blow out”.

[Sleeprider]

Larry, the suggestion is to use EPR (exhale pressure relief). You have to turn on EPR full-time in settings and use an EPR setting of 3. Based on the suggestions earlier, this will start you at a pressure of 8.0/5.0 (inhale/exhale). Your Autoset works a lot like a bilevel (BiPAP) machine with EPR. The suggested range of 8.0 to 12.0 will produce bilevel pressures of 8.0/5.0 to 12.0/9.0. EPR directly treats flow limitation which is the reason your pressure is rising, however it would really help to see an OSCAR daily details chart to see why pressure is rising. There may be other events we need to consider. The Resmed Airsense 11 Autoset will increase pressure as a result of obstructive sleep apnea and flow limitations. Please post a chart and we can do more to help.

Setting recommendations:
Mode: Autoset Standard
Minimum Pressure: 8.0
Maximum Pressure 12.0
EPR: On Full Time
EPR Setting: 3

[Larrypac]

Thanks.  I'm beginning to understand how this works.  I have downloaded Oscar and will try to access the data, latah (I'm from Maine)  L{

[Larrypac]

So I imported the info from the card.  attaching screenshots of last night

[Sleeprider]

From that information we can see your 95% flow limitation is 0.12 which is the reason your pressure rises. Your EPR in this session was set to 2, and EPR at 3 should help. Please look at the wiki on how to organize your Oscar charts http://www.apneaboard.com/wiki/index.php...ganization This will give us even better information if we see the flow rate, pressure, events and flow limitation through the night.

To learn more about the relationship of flow limitation to pressure and what flow limitation even is, read the wiki. http://www.apneaboard.com/wiki/index.php...imitations

[staceyburke]

Again to get you started look at YouTube. Search for “ using OSCAR”.
And “ResMed 11 clinician menu”

[Larrypac]

Here are Oscar data from a: the only night I managed to fall asleep without being jerked awake by high pressure leaking around my mask, and b: last night, when i tried for 30 minutes or so, twice but di not fall asleep.  I have no clue what the graphs mean.  Hopefully someone can enlighten me.  Last night  I set the pressure at 5 and 10 with EPR full time at 3.  The other time pressure was set at 5 and 20 and and EPR was 2, which was how it was set for me by the therapist.

[SarcasticDave94]

You'll likely benefit from EPR 3 full time if you raise Min pressure to 7. Mathematically it's not working now as it could. Your machine will never go below the minimum pressure 4, but your setting of min pressure 5 EPR 3 wants it to drop to 2, but again it's not going to happen.

Pressure 4 EPR off equals minimum pressure 4
Pressure 5 EPR 1 equals Min 4
Pressure 6 EPR 2 equals Min 4
Pressure 7 EPR 3 equals Min 4
Or min pressure X minus EPR Y = Z but it will never go below min 4 ever.

Second item. You're robbing yourself therapy time with Ramp. You're Min pressure 5 is already pediatric level, so why bother with Ramp. Turn off Ramp.

You need to sit in a chair, edit your settings, then with your mask on, run the CPAP and get used to this therapy. With better settings, it's going to feel better.

[Larrypac]

First, thanks to everyone who has chipped in with advice.  I turned off ramp and raised EPR to 3, full time , yesterday at the advice of one of the members. Last night I tried twice for 30 minutes and failed to fall asleep.  For what it's worth, I am picking up a nose mask tomorrow, hoping it works better for me.  I find the full mask a bit distracting which makes it harder to fall asleep but the worst is the blast of air I was getting when pressure increased quickly and leaked a lot around the lower edges.  If I tighten the mask enough to prevent leakage at higher pressures, it is even more distracting..  I'd welcome any comments on this strategy and recommendations for type of nose mask.  Should I get a chin strap?  



You'll likely benefit from EPR 3 full time if you raise Min pressure to 7. Mathematically it's not working now as it could. Your machine will never go below the minimum pressure 4, but your setting of min pressure 5 EPR 3 wants it to drop to 2, but again it's not going to happen.

Pressure 4 EPR off equals minimum pressure 4
Pressure 5 EPR 1 equals Min 4
Pressure 6 EPR 2 equals Min 4
Pressure 7 EPR 3 equals Min 4
Or min pressure X minus EPR Y = Z but it will never go below min 4 ever.

Second item. You're robbing yourself therapy time with Ramp. You're Min pressure 5 is already pediatric level, so why bother with Ramp. Turn off Ramp.

You need to sit in a chair, edit your settings, then with your mask on, run the CPAP and get used to this therapy. With better settings, it's going to feel better.

[Sleeprider]

The main problem with settings is the ramp. I would just turn it off unless you really need that 4-cm start. Even if you keep it, I would raise Ramp pressure to 6.