Soft Response Mode in Resmed

[drmaestro]

Hi,

I am trying to compare the soft response in Resmed Autoset with the algorithm from Autoset for her. I have seen an explanation in Resmed's web site comparing the standard algorithm with the for her algorithm:

   

According to this graphic and to my understanding, soft mode reacts to even single flow limitation events by slightly increasing the pressure while the classic algorithm waits for a few of them to happen and then increases pressure to a higher level. In the end you get normal airflow but for her algorithm achieved it by staying at a lower pressure. I am having difficulty understanding why the more agressive algorithm has to go to a higher pressure, if it works faster. I'd assume, because it is increasing faster, it would be able to prevent the need to go higher. I am probably missing something. However my real question is, where does the soft mode come in? If you use the soft mode, which ability do you gain? The one where it increases the pressure slower, so it is similar to for her? But then, if it doesn't react to every flow event, like the for her does, wouldn't that mean it will require significantly longer time to achieve the same result, allowing more events to happen? 

Thanks....

[StevesSp]

Good question. Hopefully somebody will answer.

[sleepyp]

Soft is not the same as for her.
Soft is a more gentle version of the normal autoset algorithm.
In the graph you’ve shown it will respond the same as autoset, but not increase by as much. The increase amount is more like the “for her” mode, but it responds with the same trigger as the autoset algorithm, ie. after 2nd and 3rd flow limited breath, not the first like the first one that the for her does.

[ragtopcircus]

I think soft mode was first available on the “For Her” model, but it is separate from the For Her mode. I think the more recent regular Airsense 10 Auto machines have it also, but I don’t know the firmware version that introduced it.

[becker44a]

I recently upgraded from a Resmed S9 Autoset to an Airsense 10 Autoset For Her.  I am still running an experiment to see which of the 3 Auto modes works best for me, and I'll post a report of the experiments soon.  However, the early results indicate that the Soft response mode will be the one that works best for me.  In my case, AHI is virtually always below 1, mostly below .5, so that parameter is insignificant.  But I experience Aerophagia, so anything that lowers pressure is an advantage for me.  With the S9, my 95% Pressure was 14.7.  With the A10 Soft, the 95% Pressure was just over 11, a drop of more than 3.5 cm.  This is huge for someone with Aerophagia.

Hope this helps.

[Crimson Nape]

The pressure range you're displaying in your profile shows 10-20 cm. I believe the "For Her" mode only works on pressures under 10 cm.

[ragtopcircus]

“ AutoSet for Her mode
AutoSet for Her mode is based on key aspects of ResMed’s AutoSet algorithm and delivers therapeutic responses tailored to the characteristics of female OSA patients.
The AutoSet for Her is similar to ResMed’s AutoSet algorithm with the following modifications:
 Reduced rate of pressure increments designed to help prevent arousals.
 Slower pressure decays.
 Treats apneas up to 12 cm H2O and continues to respond to flow limitation and snore up to 20 cm H2O”

[becker44a]

The pressure range you're displaying in your profile shows 10-20 cm.  I believe the "For Her" mode only works on pressures under 10 cm.

 
Hi Red,
Excerpt from the Clinician's Manual:

"AutoSet for Her mode is based on key aspects of ResMed’s AutoSet algorithm and delivers
therapeutic responses tailored to the characteristics of female OSA patients.
The AutoSet for Her is similar to ResMed’s AutoSet algorithm with the following modifications:
* Reduced rate of pressure increments designed to help prevent arousals.
* Slower pressure decays.
* Treats apneas up to 12 cm H 2 O and continues to respond to flow limitation and snore up to
20 cm H 2 O."

I take this to mean that while the starting pressure may not be above 12cm, it will escalate pressure as needed by Flow limits, etc. up to the set limit or machine max.

I can say now from personal experience that the Autoset For Her mode seems to be working as does the Autoset mode in my pressure range.  The OSCAR max pressure (99%) I have seen  is 13.74 in 7 days.  I'm planning to run For Her mode for another week, and post the results of my experiments comparing my old S9 and the 3 Auto modes of the new machine.

[Crimson Nape]

Thanks!  That is good to know.   I'm curious as to what happens to apneas above 12 cm. . .

[ragtopcircus]

Thanks!  That is good to know.   I'm curious as to what happens to apneas above 12 cm. . .

I started my wife in the For Her mode to get her reacclimated to therapy (she had given up and put her old machine in the closet). We had to take her up very gradually because of aerophagia (and she still needs to be a bit higher than she’s comfortable with), and FH helped with that, but 12 cm was not enough to stop some of her OSA events. She uses the regular Auto mode now.