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Question about EPR setting + CPAP Mode
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ShelaghDB Offline

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Machine: S9 Auto-Set +Resmed H5i
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Location: Toronto, Ontario, Canada

Post: #1
Question about EPR setting + CPAP Mode
Hi.

Just need a few quick questions answered as i am still trying to copy my S9 AutoSet settings to the S9 Escape and i am not fully there yet.
1 or 2 are throwing me off.

Ok, on the ESCAPE the mode was set to CPAP
my S9 AutoSet is set to AUTOSET

What difference will it make it having this auto set to auto set instead of CPAP?
I am changing it tonight to CPAP so it will be like the other one but i would like to understand what/why I am changing it?
What is the difference that I would notice?


Also on the S9 Escape, under Options, you have Climate Ctrl-(AUTO), Sleep Quality(ON), SmartStart(ON) and Access{FULL).

I didnt see any of those settings on the ESCAPE. I seem to recall a couple of people here telling me to turn on the Climate Ctrl to auto, Sleep Quality to on, Smart Set to on but its the last one, ACCESS(FULL) i don't understand.

AM I to leave this on at FULL on the S9 AutoSet? and perhaps someone could tell me what it is?

Looking at the settings on the S9 ESCAPE, i had climate ctrl(auto), EPR Inhale(Med), Access(Full).
I don't know if those are related to the ones above but i haven't any idea what the Access is and Full, ETC




Perhaps i have missed it but I would LOVE to read a book, something on Sleep Apnea that could explain everything to me from A-Z.
I have about 4500 of the newest best sellers in e-Books, in every format from the NY Times Best-sellers lists and LOTS of Dummie Books but not one for Sleep Apnea and I am surprised no one has yet put together the Dummie Book for Sleep Apnea, IF they Havent??!!



For those that may not know, T.I.A. means "thanks in advance" in case I don't think everyone each time i do a post Smile


T.I.A.
(This post was last modified: 06-06-2014 09:27 PM by ShelaghDB.)
06-06-2014 09:26 PM
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zonk Offline

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Post: #2
RE: Question about EPR setting + CPAP Mode
(06-06-2014 09:26 PM)ShelaghDB Wrote:  Also on the S9 Escape, under Options, you have Climate Ctrl-(AUTO), Sleep Quality(ON), SmartStart(ON) and Access{FULL).

I didnt see any of those settings on the ESCAPE
Sleep Quality indicator on the S9 Escape is usage only and no SmartStart/Stop feature either

EPR, RAMP, Climate Control system, are the same on both machines
06-06-2014 10:48 PM
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PollCat Offline
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Post: #3
RE: Question about EPR setting + CPAP Mode
The simplest difference between the machines is that a CPAP ramps up to a set pressure and stays there; the Autoset varies the pressure according to your sleep and apnea-event patterns.


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06-06-2014 11:27 PM
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Doc J Offline

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Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
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CPAP Pressure: 10-15
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Post: #4
RE: Question about EPR setting + CPAP Mode
I don't remember but if there is not a cpap setting (constant 1 pressure) just set the autoset to the same min and max setting and you get one constant pressure. ie. 11 min 11max equals 11 constant.
Good luck
Doc J
06-06-2014 11:43 PM
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robysue Offline
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Machine: PR Dreamstation BiPAP Auto
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Post: #5
RE: Question about EPR setting + CPAP Mode
(06-06-2014 09:26 PM)ShelaghDB Wrote:  Hi.

Just need a few quick questions answered as i am still trying to copy my S9 AutoSet settings to the S9 Escape and i am not fully there yet.
1 or 2 are throwing me off.

Ok, on the ESCAPE the mode was set to CPAP
my S9 AutoSet is set to AUTOSET

What difference will it make it having this auto set to auto set instead of CPAP?
I am changing it tonight to CPAP so it will be like the other one but i would like to understand what/why I am changing it?
What is the difference that I would notice?
In CPAP mode, once the ramp period is over, the pressure will NOT change.

In APAP mode, once the ramp is over, the pressure is allowed to change. It will always stay between the min pressure and max pressure settings.

For now, just run the AutoSet in CPAP mode since that's what you have been least uncomfortable with.

Quote:Also on the S9 Escape, under Options, you have Climate Ctrl-(AUTO), Sleep Quality(ON), SmartStart(ON) and Access{FULL).

I didnt see any of those settings on the ESCAPE. I seem to recall a couple of people here telling me to turn on the Climate Ctrl to auto, Sleep Quality to on, Smart Set to on but its the last one,
Climate Control = Auto tells the heated hose and humidifier to work together to maintain the desired temperature in the heated hose and 80% relative humidity.

Sleep Quality = On tells the S9 AutoSet to record all the data. It also allows you to access the summary data through the S9's LCD each morning in the Sleep Quality Report. You do need to look at the LCD data before noon, since the machine resets the LCD to 0.0 at noon each day.

Smart Start = On makes the machine turn itself ON and OFF when it detects breathing and no breathing. In other words, you can put the mask on, take a couple of deep breaths, and the machine should turn itself on. And when you take the mask off, the machine will turn itself off after a minute or so of detecting no breathing at the other end. Smart Start is useful if you have trouble reaching the on/off button on the machine, but it can be tempremental with some masks and at low pressures.

Quote:ACCESS(FULL) i don't understand.

AM I to leave this on at FULL on the S9 AutoSet? and perhaps someone could tell me what it is?
Access = Full means that anything that it is possible to allow the patient to change through the patient set up menu is NOT locked. So you can change the ramp settings, the EPR setting, and the Climate Control settings without going into the clinical menu.

Quote:Looking at the settings on the S9 ESCAPE, i had climate ctrl(auto), EPR Inhale(Med), Access(Full).
I don't know if those are related to the ones above but i haven't any idea what the Access is and Full, ETC
These settings correspond exactly to the same settings on the AutoSet, and Climate ctrl = Climate Control by the way.

So use the same values since you're trying to get the AutoSet to feel like the Escape felt.


Quote:Perhaps i have missed it but I would LOVE to read a book, something on Sleep Apnea that could explain everything to me from A-Z.
I have about 4500 of the newest best sellers in e-Books, in every format from the NY Times Best-sellers lists and LOTS of Dummie Books but not one for Sleep Apnea and I am surprised no one has yet put together the Dummie Book for Sleep Apnea, IF they Havent??!!
If you want a good book on OSA itself, find a copy of Sleep Interrupted by Steven Y. Park MD. It explains exactly what happens to the body and why it's bad for you and how PAP helps in quite a bit of detail, but is also written so as to be accessible to a patient who wants to learn (a lot) more than they can learn by reading the info posted to things like WebMD or the short handouts they'll give you or the short videos they show you when you go for your sleep studies and pick up your machine.

But it doesn't cover the ins and outs of using a PAP, nor does it cover anything about what various PAPs can record and what the data means.

Another good book is Sound Sleep, Sound Mind by Dr. Barry Krakow. While the first half of Sound Sleep, Sound Mind is focused on self-help for insomnia, the second half focuses on sleep apnea as an undiagnosed cause of insomnia. Again, there's a lot of useful information even if you're not prone to insomnia.
06-07-2014 02:17 AM
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ShelaghDB Offline

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Posts: 267
Joined: Sep 2013

Machine: S9 Auto-Set +Resmed H5i
Mask Type: Full face mask
Mask Make & Model: Quattro Air FF Mask
Humidifier: resmed H5i
CPAP Pressure: 13
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Female
Location: Toronto, Ontario, Canada

Post: #6
RE: Question about EPR setting + CPAP Mode
I read through all of the answers above and thank you, to all of you, very much.

I asked the difference between the CPAP and AutoSet state and was told this, below:
Quote:The simplest difference between the machines is that a CPAP ramps up to a set pressure and stays there; the Autoset varies the pressure according to your sleep and apnea-event patterns.


Thats exactly what I thought it was although I still don't quite understand why it makes SUCH a difference.


My doctor originally told me my pressure was 13.
When I bought the Auto-Set, i set it to 11-15 thinking that would be perfect.
WRONG!!!!
It was hellish. Sad

I moved it to 9-13
Still hellish!!! Sad


I looked at the S9 Escape a few nights ago and it wasn't at 13 as the Doc had told me but at 10...LOL

So I changed it to 10 and changed the AUTO-SET to CPAP

and last night it was finally fine, back to normal just like before......


The Apnea Index is still very high. I am going to stay with these settings for a week or so and then hopefully either understand it all a bit better or come back her for a spot of advice on which way to change them.


So one question please:

Despite the high number of Apneas at the moment, specifically ones that are Obstructive AS LONG AS YOU ARE using the machine, you are ok, right?


robysue

thank you for all your help there
i shall look up that book and hopefully it is in an e-book format somewhere Smile

But thanks again for everything there................
(This post was last modified: 06-07-2014 06:15 PM by ShelaghDB.)
06-07-2014 06:12 PM
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Doc J Offline

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Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
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CPAP Pressure: 10-15
CPAP Software: ResScan SleepyHead

Other Comments: Knowledge is King and this is the place to find it! Thanks everyone.

Sex: Male
Location: Central Nebraska

Post: #7
RE: Question about EPR setting + CPAP Mode
If working correct in auto mode that machine would not have raised the pressure unless it sensed the need. If you are still having many events the answer may be higher pressure? I hope going back to the old settings will feel better but I guess you will just have to watch the numbers and think about solutions. In your question above "OK" may be better than nothing, I think the benchmark is AHI under 5 for the night? Mine are under 1 most of the time thankfully.
Good Luck.
06-07-2014 08:31 PM
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robysue Offline
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Machine: PR Dreamstation BiPAP Auto
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CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

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Post: #8
RE: Question about EPR setting + CPAP Mode
(06-07-2014 06:12 PM)ShelaghDB Wrote:  My doctor originally told me my pressure was 13.
When I bought the Auto-Set, i set it to 11-15 thinking that would be perfect.
WRONG!!!!
It was hellish. Sad

I moved it to 9-13
Still hellish!!! Sad
Contrary to what some people around here think, not everybody likes APAP. There are people who find the constantly changing pressures in APAP very annoying and even "hellish". If fixed pressure feels better, then use fixed pressure.

Quote:I looked at the S9 Escape a few nights ago and it wasn't at 13 as the Doc had told me but at 10...LOL

So I changed it to 10 and changed the AUTO-SET to CPAP

and last night it was finally fine, back to normal just like before......


The Apnea Index is still very high. I am going to stay with these settings for a week or so and then hopefully either understand it all a bit better or come back her for a spot of advice on which way to change them.


So one question please:

Despite the high number of Apneas at the moment, specifically ones that are Obstructive AS LONG AS YOU ARE using the machine, you are ok, right?
Well, how high is high?

In general if the treated AHI is still above 5, then PAP therapy is not fully effective at managing your OSA. If the treated AHI is well above 5, then in the long run you'll need more pressure if the events are obstructive.

But---your plan on leaving the settings alone for a week or so to see what happens is VERY REASONABLE. In a week, you may be much more comfortable simply sleeping with your machine. If the data makes it clear that 10 cm is not enough pressure and you can't stand APAP, then you can always gently titrate over time: Every week or so you simply increase the pressure by 1 cm until the week's worth of data indicate that you've found a pressure sufficient to control your apnea. If your titration study and original script of 13 are spot on, it may take you several weeks to get there, but end the end you will get your therapy optimized.
06-08-2014 01:49 AM
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ShelaghDB Offline

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Machine: S9 Auto-Set +Resmed H5i
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Mask Make & Model: Quattro Air FF Mask
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CPAP Software: ResScan SleepyHead

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Location: Toronto, Ontario, Canada

Post: #9
RE: Question about EPR setting + CPAP Mode
I am just still trying to read SleepyHead properly....I am not really focus on whether it is too high at the moment. I just want to at least spend about 5 days at this one spot as I believe some will calm down again....I will think about it or ask questions at the 5 day mark, or so.....

LOL for mine are through the roof at the moment ;-)
But for now....

Quote:Well, how high is high?

In general if the treated AHI is still above 5, then PAP therapy is not fully effective at managing your OSA. If the treated AHI is well above 5, then in the long run you'll need more pressure if the events are obstructive.

In SleepyHead you show

Hypopnew
Apnea
Obstructive
Clear Airway

So I assume "Obstructive" is for Obstructive apneas

So is Central apeas, called Clear Airway on this software?



Quote:But---your plan on leaving the settings alone for a week or so to see what happens is VERY REASONABLE. In a week, you may be much more comfortable simply sleeping with your machine. If the data makes it clear that 10 cm is not enough pressure and you can't stand APAP, then you can always gently titrate over time: Every week or so you simply increase the pressure by 1 cm until the week's worth of data indicate that you've found a pressure sufficient to control your apnea. If your titration study and original script of 13 are spot on, it may take you several weeks to get there, but end the end you will get your therapy optimized.


Thank you for that was my next question. How was I to get to my perfect spot and you answered that right there
(This post was last modified: 06-08-2014 01:40 PM by ShelaghDB.)
06-08-2014 01:37 PM
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robysue Offline
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Post: #10
RE: Question about EPR setting + CPAP Mode
(06-08-2014 01:37 PM)ShelaghDB Wrote:  I am just still trying to read SleepyHead properly....I am not really focus on whether it is too high at the moment. I just want to at least spend about 5 days at this one spot as I believe some will calm down again....I will think about it or ask questions at the 5 day mark, or so.....
This is a GOOD plan. Let your body have a chance to acclimate before making any more changes even if the AHI is too high right now. You've done a lot of dial wingin' and that may have made things harder to get used to.


Quote:In SleepyHead you show

Hypopnew
Apnea
Obstructive
Clear Airway

So I assume "Obstructive" is for Obstructive apneas

So is Central apeas, called Clear Airway on this software?
Yes. Obstructive is the OAI; Central is the CAI. And from an autotitrating machine's point of view "Central = Clear Airway" although on a sleep lab with all the wires and belts and whatnots attached to you, "Central" has a very specific definition and it's possible to have a "Central" scored even if the airway happened to be obstructed. But that's a fine point that you don't need to worry about right now.

And Hypopnea = the HI
06-08-2014 03:36 PM
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