[Pressure] High pressure after bathroom visit

[Roamer321]

I have just had my Resmed S10 for 3 weeks. I cannot get the Respiratory therapist to call me back so I thought I would ask here. When I wake up at night to go to the bathroom I disconnect from the machine. Autosense is activated so it comes back on when I hook back up and get back in bed. I cannot go back to sleep because the machine quickly ramps up to what feels like the maximum pressure. What can be causing this?

[Gideon]

Flow limits typically cause pressure increases on ResMed machines. At a 7-8 pressure per your profile there is not room for much pressure fluctuations. The other possibilities depend on your ramp settings. These are guesses. Download OSCAR and post your daily charts for an answer that is based on data.

[Roamer321]

Flow limits typically cause pressure increases on ResMed machines.  At a 7-8 pressure per your profile there is not room for much pressure fluctuations. The other possibilities depend on your ramp settings.  These are guesses.  Download and post your daily charts for an answer that is based on data.

My machine is set to auto adjust the pressure. I say 7-8 because that is what it is reporting in the morning. It has limits set to 4-20. The ramp is turned off. I do not have an SD card in my S10. What type does it take?

[Gideon]

Any SD card between 2 and 32 GB. One from a Camera should work, as long as in the above range.
The pressure displayed should be what it is set for. 4-20 is nearly 100% not the right settings for you.

The min pressure should be 4 + EPR. A good starting EPR is 2 so
EPR= fullTime
EPR =2
Min pressure = 6
Max Pressure = 12 (to get it away from 20)

The details will not be available until you use the SD card.

[Roamer321]

   
I finally got an SD card and Oscar. I have attached my file for the last three days. You can see the bathroom visit at about 1 am or 2 am.

[DeepBreathing]

Hi Roamer31, thanks for posting that chart. I don't see any break in therapy between 01:00 and 02:00 - it's likely that a flow limitation has occurred causing the machine to increase pressure. There are two breaks, one at 23:30 and one at 04:10. There is a pressure increase after the 04:10 break but it doesn't go anywhere near the maximum - it probably only feels severe compared to the lower pressures you've been experiencing. It is immediately followed by a large leak which has undoubtedly disturbed your sleep.

Can you help us by reformatting the chart please? We need to see the event flags, flow rate, pressure, flow limitation, leak and snore. You can follow these instructions. In addition, can you zoom in on the period where pressure jumps at 01:15 and the break at 04:10 please? We need to see more detail about exactly what's happening.

Overall, though, the therapy looks pretty good at keeping apneas and hypopneas under control. Now we need to work on flow limitations and your comfort.

[Gideon]

Welcome to the forum.

The spikes look like they are being driven by flow limits.
Can you add the flow Limit chart. ResMed algorithm responds strongly to flow limits so that chart is very important to understanding pressure transitions.
Also the lowest min pressure you should set on an AutoSet is
Min = 4 + EPR which is currently 6

The pressure difference between inhale and exhale is what best treats flow limits. When you come back from a break this difference is 0. Setting the min to 6 will make the difference 2. Much better.

[Roamer321]

   

Ok sorry, I did not know that F12 was a screenshot. I thought it captured the whole thing. I have corrected that now. The gaps you see at 23:30 was me disconnecting hose from mask to go to the bathroom and the 4:10 is me taking the mask off or going to the bathroom again I think.

[Roamer321]

   

Here is the chart with flow limits added. What is a flow limit and what can cause it?

[Sleeprider]

Roamer, you have not included the flow limits chart, but we know that that is what is driving up your pressure. For example at 01:15 we can see the flow rate pinching in as flow limitation increases. Your pressure settings are on the default 4-20 and you're using exhale pressure relief (EPR) at 2. We can help you further reduce flow limitation by increasing minimum pressure and EPR. You need to change your settings to 7-20 and turn on EPR Full Time at 3. This will give you 3-cm of pressure relief on exhale which will be both more comfortable and boost your respiratory volume a bit, it will also reduce flow limitation so your machine's pressure will be more stable.