S9 Autoset goes to Max pressure with N30i mask

[elliotg]

I have downloaded sleepyhead and will try it out in the next day or so.  I already use EPR.  Interestingly, I have a loan Dreamstation Go Auto for the next week or.  And I notice that the same masks that were giving me the straight to max issue did not have the same issue on this machine.  Testing them (awake) resulted them staying very close to the minimum setting.  At present I am still using my S9/Mirage Activa setup for my overnight sleep, but at the weekend I may give the N30i a go with the Dreamstation and see how it goes with in a real run.

[Sleeprider]

I have downloaded sleepyhead and will try it out in the next day or so.  I already use EPR.  Interestingly, I have a loan Dreamstation Go Auto for the next week or.  And I notice that the same masks that were giving me the straight to max issue did not have the same issue on this machine.  Testing them (awake) resulted them staying very close to the minimum setting.  At present I am still using my S9/Mirage Activa setup for my overnight sleep, but at the weekend I may give the N30i a go with the Dreamstation and see how it goes with in a real run.

The Resmed machines are highly responsive to flow limitation, which we discussed earlier. Philips machines are not very responsive to flow limit, so pressure does not increase.  In some people, flow limitation is a precursor to hypopnea and obstructive apnea events.  For those that have the events, the Resmed is better because it increases pressure to prevent them. If you have flow limitation without events, the maximum pressure of the Resmed can be limited to what is comfortable.  If you were using Sleepyhead, our advise would be more concise.

[elliotg]

I have downloaded sleepyhead and will try it out in the next day or so.  I already use EPR.  Interestingly, I have a loan Dreamstation Go Auto for the next week or.  And I notice that the same masks that were giving me the straight to max issue did not have the same issue on this machine.  Testing them (awake) resulted them staying very close to the minimum setting.  At present I am still using my S9/Mirage Activa setup for my overnight sleep, but at the weekend I may give the N30i a go with the Dreamstation and see how it goes with in a real run.

The Resmed machines are highly responsive to flow limitation, which we discussed earlier. Philips machines are not very responsive to flow limit, so pressure does not increase.  In some people, flow limitation is a precursor to hypopnea and obstructive apnea events.  For those that have the events, the Resmed is better because it increases pressure to prevent them. If you have flow limitation without events, the maximum pressure of the Resmed can be limited to what is comfortable.  If you were using Sleepyhead, our advise would be more concise.

What is the best way of sending a sleepyhead result to this forum?  I tried Print to PDF but the document was rejected as too large!

I will for now just paste in a few screen shots pasted into a word Doc
Ignore the first run - it was with the wrong cushion.

Let me know if you find anything useful.  Incidentally, I love Sleepyhead

[jaswilliams]

To upload information press F12 in Sleepyhead and it will take a screen shot to a screenshot folder in your sleepyhead data directory, that can be uploaded directly here. Look in my signature for further information

[elliotg]

Okay. The F12 is magic!  I have now added 3 screenshots to cover all of the all of the info.  To clarify, the is a short run to show what happens when I use the n30i mask with the Resmed s9.  I also did a run with the mask attached to the Dreamstation.  The pressure stayed at 6.  I could not get this data into Sleepyhead due to a lack of a MicroSD data card! They don't come with this.  I will certainly get one.

Elliot

[Sleeprider]

Your settings on the S9 Autoset are a minimum pressure of 6.0 and maximum pressure of 12 with EPR at 3. This chart is based on a therapy session of only 15 minutes, so there is a limit to what we can conclude from this short sample, and it is likely you have no sleep in this sample. The chart does not include flow limitations, but the summary indicates they are very prevalent, and if you zoom in on the flow rate graph I'm certain you would see a flattened or downward sloping wave form. Your EPR setting at 3 does help with flow limitation.

The Resmed machines recognize flow limitation as obstruction, and the autoset algorithm will rapidly increase pressure. Normally this results in fewer events, but for people with chronic flow limits, it is often necessary to limit the maximum pressure with settings. Philips auto CPAP machines do not respond very fast to flow limitation and for some people, this leaves them vulnerable to more hypopnea and OA events as pressure stays too low to treat events before they occur. The behavior of the Dreamstation Go is predictable in this context. We don't have enough data (time in therapy) to know whether your flow limitations eventually give rise to obstructive events, so it's hard to conclude what approach works best for you.