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Pressure setting on Autoset machines
#1
I am a new user of a ResMed S9 Autoset with H5i humidifier and am wondering if Pressures need to be adjusted on "autoset" machines.
AHI is currently 15.5
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#2
First, AHI is Apnea Hypopnea Index, a measure of how many times per hour you had an apnea or hypopnea event. Apnea - no breathing for at least 10 seconds, Hypopnea - 50% decrease in your breathing volume for at least 10 seconds. 15.5 is high if that is what you're seeing on treatment but fairly low if it is from your sleep study.

The first thing you need to know is the data from your sleep study and what your 95% pressure is. 95% pressure is the pressure your machine deems required to mitigate your apneas 95% of time of use. If you don't know what it is or don't have access to your sleep study, use the machine a few nights (I'd recommend 4 - 6), then check your data to see what the report 95% pressure is.

Now, your actual question. Many autoset machines are supplied in what we call the "wide open" settings, 4 - 20 cmH2O. Many people have reported increased comfort, and more efficient treatment, but limiting the pressure range to about 2 cmH2O above the machine reported 95% value and about 3 cmH2O below the machine reported 95% value. These are rules of thumb, but I'd recommend you try this and then adjust to what is most comfortable to you.

To adjust, you'll need to request a copy of the Resmed Clinician manual from this forum. There are instructions to do so in the files section and I'm sure one of the members will post links to them for you.

Finally, I recommend you download the ResScan software that allows you to look at the details of your treatment from the machine. It is a lot of data and may take a while to get the hang of, but the Autoset has some of the best data reporting capability on the market.

That enough. Please post any question you have here and someone will help you. One of us has had the same problem, addressed the same issue, and found a solution. We try!
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#3
Hi fbphillips,
WELCOME! to the forum.!
What jdireton said.
Hang in there for more responses to your post and best of luck.
trish6hundred
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#4
Welcome
To answer you question - autoset machines can be set in Auto mode and CPAP mode. in CPAP it is set at a fixed pressure and may very well need manual intervention to move the pressure to a better one for you.
In Auto mode an upper and lower pressure are set and the machine can adjust itself inside this range. if this range covers what you need for effective therapy it is all good - if not then manual adjustment of the range is needed.

As you have an AHI of 15 it appears on the face of it that it is not adjusted for you properly.

moving on to the next step - how should it be adjusted - which is why you want your sleep study results - they give you a starting point. And why you want to download your data from the machine into the analytic software - they tell you what your current settings are doing for you and give you the insight on how it needs adjustment.

15 AHI on treatment is above the target range. Is this a one off or what you are usually getting?
The strategy to sort it depends on what type of apneas they are. Are they obstructive, central or hypopneas?
Get the software and download the data - it ill tell you as per post above.

I would strongly urge you to take ownership of the therapy as it is not hard but if you are not comfortable tuning your machine yourself then get your data chip to your clinical support for them to analyse and tell you what you need to do - if you are regularly seeing 15+ you need to get it attended to.
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#5
(09-13-2013, 12:04 PM)fbphillips Wrote: I am a new user of a ResMed S9 Autoset with H5i humidifier and am wondering if Pressures need to be adjusted on "autoset" machines.
AHI is currently 15.5

How long have you used the autoset CPAP machine? How did you find out that your AHI is currently 15.5? Is it your AHI or your pressure that is 15.5? Just asking so we can better guide you.
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#6
I just got mine the other day also...have a quick question if you don't mind...my DME set my s9 auto for the pressure of 4 to 20. I end up fighting my way to about 10 (where my last cpap pressure was set) before I get any good sleep.

My question is: The next night, does it start at 4 again? Or will it realize your average pressure is higher?

I know I can change the setting, but they told me I am basically renting the machine until my insurance makes sure im compliant. In a month, I have to mail in the computer card for them to read...after that, I guess it's mine....I feel I have one heck of a long month ahead of me...lol
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#7
(09-13-2013, 09:35 PM)Bobshouse Wrote: I just got mine the other day also...have a quick question if you don't mind...my DME set my s9 auto for the pressure of 4 to 20. I end up fighting my way to about 10 (where my last cpap pressure was set) before I get any good sleep.

My question is: The next night, does it start at 4 again? Or will it realize your average pressure is higher?

I know I can change the setting, but they told me I am basically renting the machine until my insurance makes sure im compliant. In a month, I have to mail in the computer card for them to read...after that, I guess it's mine....I feel I have one heck of a long month ahead of me...lol

If your pressure setting on your auto set is 4 - 10, then yes, each time you use your cpap machine, it will start at 4 and it will stay there until you fall asleep (I presume that while you are awake, as with most of us, we can breath on our own without any problems) and then the pressure will adjust to a higher pressure as you need it. Have you downloaded your stats in a software program to see what your pressure is throughout the night? Your DME can change the settings but they may require a new script from your doc (or you can as well). If your set pressure setting was 10, you could have your settings be 8 - 20 and adjust the upper number after you watch your stats for at least 2 weeks. Hope this answers your question. Let us know if you have other questions or my answer wasn't what you were looking for.
(09-13-2013, 09:35 PM)Bobshouse Wrote: I just got mine the other day also...have a quick question if you don't mind...my DME set my s9 auto for the pressure of 4 to 20. I end up fighting my way to about 10 (where my last cpap pressure was set) before I get any good sleep.

My question is: The next night, does it start at 4 again? Or will it realize your average pressure is higher?

I know I can change the setting, but they told me I am basically renting the machine until my insurance makes sure im compliant. In a month, I have to mail in the computer card for them to read...after that, I guess it's mine....I feel I have one heck of a long month ahead of me...lol

One other question....are you using the ramp feature? If you are, that could be why your pressure starts at 4 and increases up to the minimum pressure setting. You can turn the ramp off if you want to. Hope this helps.
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#8
Thanks Me50. I was afraid that was the answer. I'm not using the ramp, but I did turn on EPR. Now I gotta call the DME on Monday...got the dreaded "Dove" whistle going on when I exhale, sad thing is I never would of heard it if the machine wasn't that quiet...lol.
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