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New machine - setup help please
#1
New machine - setup help please
Today I received my new Resmed Autoset10 for her and I am confused about how to set up the EPR (yes, I've read plenty of threads about this but am still confused).  I ordered this machine from supplier 33 and it arrived quickly and in perfect condition but has what appear to be standard presets; 4-20 pressure, EPR off, etc.  I read the clinicians manual and have set the new machine to match my old settings

My old machine is a 560P and set at 7.5 - 12.  I have the ramp disabled on the old machine because I felt suffocated when the ramp was enabled.  I usually run the humidification pretty high.

 After I set up the new machine, I quickly tried it out (maybe for 3 minutes).  The pressure seems high to me.   I tried the mask fit test and the pressure flipped to over 9 and my ears instantly felt over revved - stopped up. When the test ended and I went back to regular run settings, ear pressure returned to normal.


What do I do with the EPR settings?

Here are some screen shots of last nights data on old machine and an overview from many months (I think - still tussling with sleepyhead)


Attached Files Thumbnail(s)
       
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#2
RE: New machine - setup help pleasei
Welcome to the Apnea Board Forums.

EPR per ResMed is a comfort setting, in that regard try several settings, I'd suggest starting at 1, then 2, then 3 and see which you like better.

We frequently recommend using EPR as a therapeutic setting similar to Pressure Support on a bilevel machine.  PS is used to manage Flow Limits and Hypopneas.

I would suggest posting redacted copies of your sleep studies, full copies, not the summaries.  Frequently the summaries do not mention important info about the results.
Also post your nightly Sleeplyhead charts.  Please dowload Sleepyhead (free) and organize the charts as indicated in the Organize link in my signature.  There are many charts and not all of them are needed for an initial review.

Fred
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
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Attaching Charts

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: New machine - setup help pleasei
...or off if you prefer, it's generally more useful at higher pressures
Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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#4
RE: New machine - setup help pleasei
Just a heads up - I edited post 1 to add attachments but see that I still have some work to do regarding getting screen shots... reading bonjours links now.
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#5
RE: New machine - setup help pleasei
At the AHI levels that you have been having the important question is How do you feel?  Once your numbers are "good" this is what becomes more important.

We like to see data, and Sleepyhead provides the best data, because we will see if your charts back up what you are saying, good or bad, and as such it gives us a much better position to offer advice from.  Simple question, would you rather get advice based on data or from guesses?  Duhhhh, that's what I thought.

Fred
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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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#6
RE: New machine - setup help pleasei
(01-19-2019, 11:21 PM)bonjour Wrote: I would suggest posting redacted copies of your sleep studies, full copies, not the summaries.  Frequently the summaries do not mention important info about the results.

Fred

My sleep studies are several years old now and I can post after scanning but they were alarming (at least to me).  

Here is the thumbnail of those numbers

TIB - 460
TST - 304
Sleep onset - 21 mins
Sleep efficiency - 66.1%
% inter Sleep/wake - 31.1 %
REM onset - 390
AHI - 75.4 /hour
RERA - 97.1/hour
RDI while on back - 104.0/hour

Oximetry data:
Average O2 awake - 96
Average O2 in REM - 95
Average in nonREM - 93
SAO2 @ lowest was 75
Mins below 90% - 34.1

Pap therapy has made a big difference for me and I'm a little nervous about changing machines.  I've gotten used to waking up feeling great and don't want to return to my pre-treatment numbers as I suspect (although my dr has never said) that I was perilously close to a major health crisis.
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#7
RE: New machine - setup help pleasei
Based on your dream station settings I would use min pressure 7 max pressure 12 and epr of 1 and see how you get on. The mask fit uses the max pressure of 12 your mach8ne normally does not go over 10 so don’t worry about the mask fit setting, as long as you don’t leak too much.
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#8
RE: New machine - setup help pleasei
Last night I tried the new machine with the EPR at 2.  After a few minutes I moved it to 1 and that seemed better.  This morning I got myair mail with some goofy info saying I scored a 96 ?  Here's that the data card says

   

Would you suggest any changes?
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#9
RE: New machine - setup help pleasei
That was better than my numbers last night.

How do you feel?  This is much more important than chasing numbers.

Your chart is missing important charts but I expect with your number do not contain much data.

Events - this shows us when they occurred so we can see what was driving them.
Flow Rate - you have - shows much detail of what is happening
Flow Limits - you have - triggers pressure increase response - can be reduced in size.
Snores - triggers pressure increase response - can be reduced in size. 
Pressure - shows what is happening with pressure
Leak Rate - gives the best indication of mouth breathing.

also turn off the pie chart, it ends up hiding important machine settings.

Do not need Mask pressure

Changes,  I would increase both min pressure and EPR by 1 so Min 8.4 and EPR 2 to lessen Flow Limits.  These changes are not needed because your numbers are awesome.

Again, How do you feel?

Fred
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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: New machine - setup help pleasei
I feel pretty good although my throat seemed a little irritated this morning - maybe coincidence...  I also slept a long time... unusual.

Here (I think) are the screen shots you suggested.  How do you get all the rows to appear on one screen shot?

       

I travel a lot and have had 2 machines for a long while, both the same model.  I take one traveling. Now I have this new machine and one old one. Will sleepy head have any trouble going back and forth between the data from the two machines since they are two different models?
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