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resmed s9 autoset ramp fails
#1
Question 
resmed s9 autoset ramp fails
The S9 ramp function moves the air pressure from the start pressure (fixed at 4.0 cm) to whatever the therapy demands. In my case, the pressure stops at the start pressure.

Anyone seen this?
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#2
RE: resmed s9 autoset ramp fails
Hi geoffleach,

Are you saying that the therapy pressure never increases above the starting pressure of 4 if the ramp function is used?

If so, are you basing that on your sleep data from the machine or is your own observation while laying in bed? The latter is not going to result in any pressure increases above the minimum because you're awake. If you're awake then the machine has no need to increase the pressure above the minimum since your airway is already open.
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#3
RE: resmed s9 autoset ramp fails
(08-07-2013, 01:27 PM)Paptillian Wrote: Are you saying that the therapy pressure never increases above the starting pressure of 4 if the ramp function is used?

If so, are you basing that on your sleep data from the machine or is your own observation while laying in bed? The latter is not going to result in any pressure increases above the minimum because you're awake. If you're awake then the machine has no need to increase the pressure above the minimum since your airway is already open.

Yes, that's what I'm saying. Based on my observation while laying in bed (and gasping for air)

A more detailed scenario is this. I put the mask on and breath to start the air (S9 feature). In the past, the pressure begins to ramp up. Now, it just sits at 4.

FWIW, in CPAP mode, the pressure adjusts itself to the set value. And, if one watches the ramp display when the machine is started, it ramps from 0 to 4, then stops.
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#4
RE: resmed s9 autoset ramp fails
It sounds to me like your ramp function is actually turned off. That's why in CPAP mode it doesn't ramp (as you said, goes straight to the therapy pressure). When in Auto mode it "stops" at 4 because that's the default minimum starting pressure, unless you've programmed it to be higher in the clinical settings menu. From there, it will automatically increase as needed once you fall asleep.

Do you see a green ramp icon on the main screen (under the humidifier icon)? What time value is it set to?
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#5
RE: resmed s9 autoset ramp fails
(08-07-2013, 02:15 PM)Paptillian Wrote: It sounds to me like your ramp function is actually turned off. That's why in CPAP mode it doesn't ramp (as you said, goes straight to the therapy pressure). When in Auto mode it "stops" at 4 because that's the default minimum starting pressure, unless you've programmed it to be higher in the clinical settings menu. From there, it will automatically increase as needed once you fall asleep.

Do you see a green ramp icon on the main screen (under the humidifier icon)? What time value is it set to?

Set to 15. Changing to 5 (lowest non-off) does not change behaviour.
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#6
RE: resmed s9 autoset ramp fails
If your ramp is set to anything other than "off", and your machine is in CPAP mode with a fixed pressure of 8, but it still doesn't ramp and just goes immediately to 8... then it's acting up.

Some folks suggest unplugging the machine and restarting it once in a while.
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#7
RE: resmed s9 autoset ramp fails
(08-07-2013, 02:35 PM)Paptillian Wrote: If your ramp is set to anything other than "off", and your machine is in CPAP mode with a fixed pressure of 8, but it still doesn't ramp and just goes immediately to 8... then it's acting up.

Some folks suggest unplugging the machine and restarting it once in a while.

In CPAP mode, it ramps to 8 an holds. My problem is with AutoSet. Sorry for the confusion.

As it happens, the S9 is powered down every am. I'm off the grid, so power conservation is important.
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#8
RE: resmed s9 autoset ramp fails
What pressure range is your AutoSet prescription set to? If it's set to start at 4, then you're not going to see any increase above that until you're actually having apnea or hypopnea events (in other words, you're asleep).
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#9
RE: resmed s9 autoset ramp fails
(08-07-2013, 03:07 PM)Paptillian Wrote: What pressure range is your AutoSet prescription set to? If it's set to start at 4, then you're not going to see any increase above that until you're actually having apnea or hypopnea events (in other words, you're asleep).

I have the S9 set to a minimum of 4 cm and a maximum of 14. Increasing the minimum does not change the unit's behaviour - the ramp stops at 4, the start pressure.

I discovered the problem when the unit dropped the pressure to 4 cm in mid-sleep. I was awoken by the fact that 4 cm was too low for comfortable breathing. I'm guessing about that - its taken me several days to come to an understanding of what is happening with the S9.

What I'd really like is a "reset button" that would return to unit to a manufacturer-defined "pristine" state, so that I could be sure that my fiddling with the configuration has not somehow confused the software.

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#10
RE: resmed s9 autoset ramp fails
I think your unit is working but you just may not be liking the low pressure of 4. Since 4 is your low pressure setting, that's where it'll start (ramp or no ramp). If you change your prescription settings to a higher minimum pressure (say 6) then the ramp will cause it to start at 4 and then slowly raise to 6 where it will hold until you are having flow restrictions or apneas.

Here's some info from the S9 clinician manual:

Quote:Ramp

Designed to make the beginning of treatment more comfortable, ramp is available in CPAP, AutoSet or APAP modes.

In CPAP mode during ramp time, the pressure increases from a low pressure to the prescribed treatment pressure.

In AutoSet and APAP modes, ramp time defines the period during which the pressure gradually increases from a lower more comfortable start pressure to the minimum treatment pressure before the auto-adjusting algorithm commences. In previous products in the AutoSet range, settling was the period where the device was at a minimum treatment pressure until the auto-adjusting algorithm commenced.

[Image: viewer.png]

It's also normal for the unit to decrease its pressure all the way to the minimum while you are sleeping if you are not having any events or flow limitations which warrant a higher pressure. My own machine goes back down to 4 several times during the night.

I suspect you either need to learn to breathe at 4 cmH2O without feeling like you're not getting air (I admit, it took me a few weeks) or you should ask your doctor about maybe increasing your minimum pressure a bit.
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