Number Settings on my new Auto Set?

[ShelaghDB]

Here is my sleep study report. I was told I had SEVERE sleep apnea
No need to tell me what it means as that has already been done in a much older thread but when I had the S9 Escape so we were not looking at the numbers the machine needed to be set for.

After reading below, it seems that 14 might be my best number? Or so I thought until I looked at the machine and see its set at 13.

Therefore, what range should I be setting the Auto-Set for, 11-15? Or is that too high?

Thank you!!!

STUDY INDICATION: The patient underwent a CPAP titration at pressures of 5 through 14cm H20. Initially a face Forme full face mask was used but because of air leakage this was switched to a Mirage medium face mask.

SNORING: The patient was noted to snore at a moderate intensity until a pressure of 14cm H20 was achieved

SLEEP ARCHITECTURE:

First sleep onset latency was immediate.
Sleep efficiency was mildly reduced.
The sleep stage breakdown was normal except for a marked decrease in the frequency of REM
REM Latency was
There were 2 REM episode (s) with normal distribution.
Sleep Fragmentation:
The frequency of persistent arousals was severely increased with almost
⅔ due to respiratory events.
The frequency of sleep stage shifts was severely increased.
Alpha intrusions were frequent.

Respitory Analysis:
The frequency of persistent respiratory events was severely increased at 40/hr.
The oxygen saturation was well maintained.

Movement Analysis:
Restless legs during wakefulness were not seen. The patient displayed no unusual behaviours during sleep. Periodic limb movements during sleep were not seen.

Additional Comments:
Cardiac rate and rhythm were normal

Impression:
An optimal CPAP titration study at a pressure of 14cm H20. Other than the persistence of snoring and a few respiratory events, the patient also did well at pressures of 11 to 12cm H20

[retired_guy]

11-15 should be fine. I think I'd be more inclined to go 10-14, and see what my Sleepyhead reports show. Then make minor adjustments as needed after a few days.

[gjw]

Hi ShelaghDB
I would go for a low 10 & high 18 setting on APAP, & then analyze in either Sleepy Head or ResMed SW to fine tune afer one week or so.

gjw

[herbm]

I would likely choose something approximately like Retired_guy (10-14), but there is nothing particularly 'wrong' with gjw's max of 18 to start.

Here's the deal: If the machine never needs to get past 14 the 18 setting will be irrelevant; if it does NEED to get up above 14 then the higher setting will be useful.

The only strong counter arguments against 18 (or any number above the 12 from the titration study) are IF you are getting a lot of CAs or can't control the leads at the higher pressures.

Just be prepared to monitor and change it after a few days to a week or so.

If it never goes above 12, it really doesn't matter what the max is as long as it is at least 12.

If you are maxing out ever night at 12, be prepared to CONSIDER upping it a little IF your AHI isn't optimal.

It's not rocket science -- just pick a range that works "Ok" and adjust from there.

[zonk]

If were me, have to start somewhere, as a starting point, I would set the machine in CPAP mode as the the old machine at 13 and monitor the results for a while
Keep an eye on leak rates, AHI and type of events, snoring, flow limitation and of course 'how you feel'

Keep in mind 'Rome was not built in a day'
Things cannot be done instantly ... require time and patience

[ShelaghDB]

First, I see I was wrong. I don't know where i got the idea my machine was set at 13, but that's a minor point.

I think I'd be more inclined to go 10-14

Ok, that sounds about right to me so I think I shall try that. Thank you.

low 10 & high 18 setting on APAP

After a bit of thought, I think I will go with the 10-14 if for no other reason than there is a much higher difference in your numbers and I may have a harder time as a *noob* trying to figure out which way to go and to what if I have to change it again at all.
Up until now, I was using the S9 ESCAPE at, I guess it must have been 14 but I shall double check that once I learn how to get in and read it but whatever it was at, was perfect for me. I did not suffer claustrophobia as many do. The ONLY time I had difficulty was the first 2 nights of switching from a FF to a nasal mask as a mouth breather and at first felt that it was too powerful, the air, coming in but i quickly got past that. Now, more often than not if I watch TV or read before sleeping, as I had the ramp set for about 5 minutes, after some time I would have to pull the mask away from my nose just to double check it was actually working. Hence, I don't even know if the variance in numbers will be needed by me but worth a try of course as that was one of the reasons I was told to get the Auto set.
Thanks for your help ;-)

If were me, have to start somewhere, as a starting point, I would set the machine in CPAP mode as the the old machine at 13 and monitor the results for a while
Keep an eye on leak rates, AHI and type of events, snoring, flow limitation and of course 'how you feel'

Reading what I wrote above to gjw as you will see, as far as I know I haven't been having any problems. I don't think I have had any leak rates since I moved to the nasal mask as i no longer open my mouth when wearing it. Only on the FF do I do that therefore I was looking forward to seeing how it will feel having the range everyone has talked about so I am going to make a small one, rather than leave it at 13, if indeed 13 was the right number....impatient perhaps but I feel as if i have been wasting time for several months waiting to get the Auto-Set.........it may turn out after a while that i wont notice much difference and will will wonder why I bothered to go after the Auto-Set if I didn't have any problems with compliance once I got the right mask. Time will tell ;-)

Unfortunately I am not one of these ones that was tired before I was diagnosed nor am I one that has noticed any changes since I wasn't tired before, at least as far as I know I wasn't....so time will tell on that as well ;-)

Ok, thanks for the input...........now if only i could concentrate long enough to read the instructions and stop getting distracted elsewhere I may actually get this working for tonight

/fingers crossed + off she goes to finally figure out how to do this

[zonk]

I don't think I have had any leak rates since I moved to the nasal mask as i no longer open my mouth when wearing it.

Yes, might be the case but was no leak data to validate it (now, there is), the old machine does not report any leak data or AHI

As for why the AutoSet, beside being full data capable machine, the Autoset can also be used either as straight CPAP or auto-PAP (two machines in one)

[ShelaghDB]

As for why the AutoSet, beside being full data capable machine, the Autoset can also be used either as straight CPAP or auto-PAP (two machines in one)

That confuses me each time I hear it.
So let me get this straight.......I am now setting it up as a auto-Pap, correct?
If so WHY on earth would someone want it to be a straight CPAP? Isn't that what the Escape was?



Here is what i set up on the Auto-Set. I hope i didnt leave anything out or make any mistakes??!!

Max Pressure: 15
Min Pressure: 11

Max Ramp: 20 min I may lower that in a while but I like to read for about 15-20 min. before falling asleep

Start Pressure: 4.0 it was already set at this number, albeit a brand new machine so I figured it knew something I didn't but if that is wrong, do let me know

EPR: OFF
EPR Level: OFF

For tubing, it only offered standard or slimline, although i have 2 of the clear plastic ones plus 3 of those humidifier type ones--the grey ones that are supposedly better so I was thinking I would use one of them so I think I left it at standard?

Climate Control: Auto no idea what this was?
Sleep Quality: Usage
Smart Starts: Off
Access: Full
Date: Right Date Changed Time

It asked me about everything and being reminded in 6 months for new masks etc but even for SD Cards, it needs a new one every 6 months? Can that be right? SD cards can last for months upon months


SERVICE-OFF this was if i wanted to set up a date for service but I didn't so I left it off

PRESS UNITS: cmH20
Temp Unit: F

Left those two alone, Press Units and Temp Unit

[retired_guy]

Max Pressure: 15
Min Pressure: 11

Max Ramp: 20 min I may lower that in a while but I like to read for about 15-20 min. before falling asleep

Start Pressure: 4.0 it was already set at this number, albeit a brand new machine so I figured it knew something I didn't but if that is wrong, do let me know

I think you're going to want to shorten the ramp time. If not tonight, then soon. I kept shortening mine because it was a pain in the neck until I finally just turned it off.

Start pressure of 4 made me think I was going to immediately suffocate. I had to gut through it until it got up to 9 or so.
4 is the factory default, so give it a try if you like and see what happens.

The rest of this stuff? I'm not remembering most of what my settings are so I'll defer to someone with a brain. As far as the tubing is concerned I have always just used the Slimline tube and done fine, so no desire to understand the Climateline.

I do have the EPR turned on my machine and set to 3. Lots of differences of opinion on this, so probably best to start with it off. If you end up with aerophagia or whatever the heck it's called, then maybe turn it on.

[SleepyDreamCatcher]

As for why the AutoSet, beside being full data capable machine, the Autoset can also be used either as straight CPAP or auto-PAP (two machines in one)

That confuses me each time I hear it.
So let me get this straight.......I am now setting it up as a auto-Pap, correct?
If so WHY on earth would someone want it to be a straight CPAP? Isn't that what the Escape was?



Here is what i set up on the Auto-Set. I hope i didnt leave anything out or make any mistakes??!!

Max Pressure: 15
Min Pressure: 11

Max Ramp: 20 min I may lower that in a while but I like to read for about 15-20 min. before falling asleep

Start Pressure: 4.0 it was already set at this number, albeit a brand new machine so I figured it knew something I didn't but if that is wrong, do let me know

EPR: OFF
EPR Level: OFF

For tubing, it only offered standard or slimline, although i have 2 of the clear plastic ones plus 3 of those humidifier type ones--the grey ones that are supposedly better so I was thinking I would use one of them so I think I left it at standard?

Climate Control: Auto no idea what this was?
Sleep Quality: Usage
Smart Starts: Off
Access: Full
Date: Right Date Changed Time

It asked me about everything and being reminded in 6 months for new masks etc but even for SD Cards, it needs a new one every 6 months? Can that be right? SD cards can last for months upon months


SERVICE-OFF this was if i wanted to set up a date for service but I didn't so I left it off

PRESS UNITS: cmH20
Temp Unit: F

Left those two alone, Press Units and Temp Unit

If you want to collect the efficiency data you need to change the "Sleep Quality" setting to "ON". Otherwise you are only going to get the hours used reported.

For the hose settings, "Standard" is used for the wider diameter hoses, climate line for the thinner hoses.


When Climate control set to auto is going to automatically deliver a set level of humidity. I think it's 80% but someone who has been doing this longer than I can tell you for sure. When set to manual you can determine your own level of humidity.

When set to AutoSet ramp always starts at a pressure of 4. I think that's poorly designed, but no one asked me about it when they were designing this model

With EPR set to "OFF," the air pressure when you exhale will be the same as when you inhale.

I hope you have a great night's sleep with your new machine and settings.