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[Pressure] Pressure setings
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Maverick70 Offline

Members

Posts: 4
Joined: Aug 2015

Machine: Resmed S9 AutoSet
Mask Type: Nasal mask
Mask Make & Model: F&P Eson Medium
Humidifier: Resmed H5i
CPAP Pressure: Auto 7-16
CPAP Software: Not using software

Other Comments: EPR Full Time Level 3

Sex: Male
Location: Western Australia

Post: #1
Pressure setings
I was recently diagnosed with mild sleep apnea and managed to get hold of a Resmed Machine that a friend is no longer using. Machine is S9 Autoset with H5i Humidifier and a nasal mask. Settings were already set on auto with min pressure 6 and maximum 20 and EPR on at level 3.

Breathing in is ok but I find it difficult to breath out. Can someone explain how the pressure settings work and why I am finding it difficult to breath. Is this normal when first starting? Over the first 4 days of trying it out I find that I am waking up starving for breath and need to take the mask off.

Would the problem be my settings or maybe an incorrect mask type?
08-29-2015 07:03 AM
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truetopath Offline

Preferred Members-2

Posts: 421
Joined: Feb 2015

Machine: PR system one 560p auto with a flex
Mask Type: Full face mask
Mask Make & Model: Resumed F10
Humidifier: PR system one
CPAP Pressure: 11
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Lake View, NY

Post: #2
RE: Pressure setings
What are your prescribed pressures from your sleep study?

The pressure range of 6-20 is pretty wide open and you probably want to set the range a little closer to your prescribed pressure.

Regarding the EPR, the setting of 1,2,3 is how many centimeters the pressure drops during the exhale. So if your pressure is at 6 with and EPR of 3, the pressure on exhale will drop to 4cm because that's the lowest it will go.

As far as starving for air, that could be because your pressure is too low to start. Most people can't tolerate a pressure as low as 6, so I would bump the bottom number up a bit and see if that helps.

As far as the mask issue goes, were you ever fitted for a mask? The mask is the hardest part of adjusting and everyone's needs are different. You should probably go to a supplier and get a proper fitting, and find out which style mask works best for you.

If you haven't already download the clinician manual at the top of the page and that will help with adjusting the settings. Best of luck with your therapy.
08-29-2015 07:17 AM
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OpalRose Offline

Monitors

Posts: 3,165
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #3
RE: Pressure setings
Hi Maverick70,
Do you know what pressure range your doctor prescribed? Your profile says 9-16, but you state that the machine is set on 6-20, which may be too low of a staring pressure.

If the EPR is set at 3, that is the highest setting to help you breath out easier.

If you can find out your titrated pressure from your sleep study, then we can help your set a more optimal pressure range, then you can download sleepyhead software to watch for awhile and be able to gauge what your needs will be.

OpalRose
08-29-2015 07:21 AM
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trish6hundred Offline

Advisory Members

Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #4
RE: Pressure setings
Hi Maverick70,
WELCOME! to the forum.!
You might move the minumum pressure, (6,) up a bit, maybe 7, and see if that works better for you.
Hang in there for more suggestions and much success to you with your CPAP therapy.

trish6hundred
08-29-2015 09:48 AM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #5
RE: Pressure setings
Hi Maverick70, welcome to Apnea Board.

The Min Pressure is usually just a comfort setting, adjusted to whatever feels most comfortable.

Strange as it may seem, raising your Min Pressure to 7.0 will actually make it easier to breath out, but don't put Min Pressure higher than 7 for now, since you have no trouble breathing in, even when the Min Pressure is as low as 6. In future, if you ever find yourself feeling that inhaling is a little too hard, raising the Min Pressure would be recommended.

Yes, it is perfectly normal for new PAPers to feel the pressure is too high when breathing out. It feels strange and slightly suffocating at first, but in a couple days you will be more used to it and in a couple weeks your chest muscles will be stronger and you'll hardly notice the pressure when breathing out.

When the machine is producing an inhale pressure (IPAP) of 7 or lower, even when EPR is set to 3 the exhale pressure (EPAP) will be not lower than 4, because 4 is the lowest exhale pressure allowed.

A Min Pressure of 7 or higher allows the full EPR of 3 to be used, which will make exhalation easier.

On my ASV bilevel machine the difference between the inhale pressure and exhale pressure is sometimes as high as 9 or 10, and at these times absolutely no effort is required on my part during exhalation. For example, my inhale pressure might be 25 and my exhale pressure might be 15, but the drop of 10 during exhale will let the air out of my lungs with no effort at all on my part. This is how my Central Apneas get treated. To control my obstructive apneas my exhale pressure may be up at 14 or 15, and if a central apnea starts, the machine automatically will start cycling between 15 and a higher pressure like 25, keeping me breathing without any effort on my part. (During my central apneas, the machine will raise the inhalation pressure only as much as needed to keep me breathing close to my recent average amount of air volume per breath.)

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.
(This post was last modified: 08-30-2015 12:02 AM by vsheline.)
08-29-2015 03:58 PM
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Maverick70 Offline

Members

Posts: 4
Joined: Aug 2015

Machine: Resmed S9 AutoSet
Mask Type: Nasal mask
Mask Make & Model: F&P Eson Medium
Humidifier: Resmed H5i
CPAP Pressure: Auto 7-16
CPAP Software: Not using software

Other Comments: EPR Full Time Level 3

Sex: Male
Location: Western Australia

Post: #6
RE: Pressure setings
Thanks for all your replies. I am in Western Australia so you good folk in the US are likely to be tucked up in bed enjoying you CPAP'S. I adjusted min setting to 7 and max to 16. Found it easier to breath and managed to keep it on all night. I did have have some issues with the mask being uncomfortable and found myself trying to adjust it through out the night. I am getting small blisters around my nose.

I had a home sleep study done but because I scored the CPAP with all the gear free, I am trying it out on my own hence the reason I have not had a mask fitting or pressure settings prescribed. The report summary says Mild OSA, worse in REM sleep, with CPAP an option to consider. Not sure what part of all the numbers is titration?

I will down load Sleepyhead or Rescan software (which is better) so I can monitor my results. From what I have read on the forum this is the best way to monitor your progress and find optimum settings. (profile updated) Cheers.
(This post was last modified: 08-29-2015 10:05 PM by Maverick70.)
08-29-2015 09:51 PM
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quiescence at last Offline

Advisory Members

Posts: 753
Joined: Nov 2014

Machine: REMstar System One with Autoflex
Mask Type: Full face mask
Mask Make & Model: Quattro AirFit F10
Humidifier: yes typical setting = 4
CPAP Pressure: 5-13 Autotritrating CPAP
CPAP Software: SleepyHead EncoreBasic

Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

Sex: Male
Location: US

Post: #7
RE: Pressure setings
Sounds likely that your sleep study was without a CPAP machine, so there was no "titration" - which basically means testing to determine which pressure level of CPAP takes away your obstructive apnea events.

QAL

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
(This post was last modified: 08-31-2015 02:01 PM by quiescence at last.)
08-29-2015 10:41 PM
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DeepBreathing Offline
Wiki Editor
Moderators

Posts: 2,294
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #8
RE: Pressure setings
G'day Maverick, welcome to Apnea Board

Getting a mask which fits comfortably and does not leak is more than 50% of the equation. You might find that a mask liner (eg Pad-a-cheek) will improve comfort and help control the nose-bridge problem.

If you did a home sleep test there is probably no titration information, just diagnosis. The good news is that your S9 Autoset will give you most of what you need to know when used in conjunction with the appropriate software. I find SleepyHead a lot more convenient and easier to use than ResScan, though it does have a few occasional hiccups. You can download both and see which you prefer.

Can you share the numbers from your sleep test? In particular the apnea hypopnea index (AHI), obstructive apneas, central (clear airway) apneas, hypopneas, RERA and RDI (if recorded). These will help define an optimal therapy regime.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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.
08-29-2015 10:42 PM
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Maverick70 Offline

Members

Posts: 4
Joined: Aug 2015

Machine: Resmed S9 AutoSet
Mask Type: Nasal mask
Mask Make & Model: F&P Eson Medium
Humidifier: Resmed H5i
CPAP Pressure: Auto 7-16
CPAP Software: Not using software

Other Comments: EPR Full Time Level 3

Sex: Male
Location: Western Australia

Post: #9
RE: Pressure setings
Hi to Paul in Perth and others

I have attached my sleep report data from my test. No CPAP used in the testing, just a bunch of electrodes attached all over the place. I would like to understand my results if there are any tech heads out there.

I downloaded sleepyhead software with the last 4 days results. Saturday night I was hooked up for 9 hours with a total AHI of 0.55%. Pressure 7.00 - 10.88 (95% at 9.86%) EPAP 4.02% - 7.88% (95% at 6.88%) This seems almost too good to be true? Can APAP really work this well?


Attached File(s)
.pdf  Sleep Test.pdf (Size: 111.98 KB / Downloads: 44)
(This post was last modified: 08-30-2015 06:40 AM by Maverick70.)
08-30-2015 05:55 AM
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DeepBreathing Offline
Wiki Editor
Moderators

Posts: 2,294
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #10
RE: Pressure setings
Looking at your report, the key things are the apneas and hypopneas. Hypopneas are a partial closing of the airway, which you have quite a lot of. The AHI is the total number of apnea and hypopnea events divided by the number of hours asleep. Your AHI was 13, which is moderate. You can also see that the rate of events was much higher during REM sleep.

Something doesn't make sense with your results. The Autoset doesn't report EPAP so something's wrong there. Are you sure it's an Autoset, or is something quoted wrong?

The units for pressure are centimetres of water (cm H2O) and the AHI is events per hour, not a percentage, though normally AHI is quoted as a number without units.

Hope this helps.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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.
08-30-2015 07:10 AM
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