RedMed 10 Min/Max setting - recommendations?

[Kris1]

Hi all, 


I have been given a RedMed 10 for OSA. Untreated my AHI was 30. The RedMed has been working really well for me since I started using it about 6 weeks ago. 

When issued the min/max flow rate was 4/20. I was told that the machine would just do its thing. And to be fair it has. But I was reading more about the clinical menu and various threads about min pressures not being sufficient. I saw on the screen display my average pressure was 14-15 so it occured to me that min of 4 was unlikely to be used often. So I courageously went to 5, and then to 6. I didn't want to increase the min too much if there's a lot of variation around the 15.  

Today I used OSCAR for the first time and have taken the screenshots attached from last night. I see the pressure at 95th centile of 12.7, and 99.5 centile at 13.9. The median is 8.82 (that's what I think I'm reading anyway!).

My question is to a better-trained eye than mine, what would you 'recommend' my min/max settings to be? 


When I look at the OAs through the night, these are the pressures before they occur: 
00:46 -- 7.7
03:46 -- 6.9
04:10 -- 7.6
04:49 -- 7.0
04:51 -- 7.9
04:52 -- 9.3

I've added a full screenshot and a zoomed version on a small group of OAs. 
Any thoughts are welcome!


   
   

[Crimson Nape]

Hi Kris1!  -  
I would try setting your pressure range to 9cm minimum and 15cm maximum.  The minimum pressure should address the hypopneas and OAs.  The maximum is dialed in, so you will not have a very uncomfortable runaway.   If you increase your EPR to 3, then you need to add a 1cm to both pressures.  This will maintain the EPAP pressure to the same values.

EDIT: I just noticed that you posted this in the Software forum. Since it is about your CPAP therapy, I am moving it to the Main forum.

- Red

[Kris1]

Thanks v.much @crimson! I'll give it a go tonight on those settings. On EPR - is there any advantage to not using it? I have it at 1 currently, set by the nurse, to "make it a bit more comfortable". But I don't know why that and not 3. I presume its the closest thing to a bipap machine without it being one, is that right?

Apologies for the wrong forum tbw, I wasn't too sure and guessed the wrong way.

[Crimson Nape]

Your charts indicate the EPR is set to 2.   Going to 3 may help with flow limitations.  Its value is the amount in centimeters reduction in the EPAP pressure versus your set IPAP pressure.  This is double sword.  While it may decrease flow limitations, it may induce or increase CAs.  Resmed terms this feature a "comfort" setting, but is a sudo bi-level in reality.   Oddly, the same thing on a true Bi-level machine is termed Pressure Support (PS) and its value is added to the set EPAP pressure as opposed to EPR being subtracted from the IPAP pressure.  In the end, they both achieve the same physical pressure difference.

- Red

[Kris1]

Cool, many thanks. I must have adjusted the EPR as well. Will try the EPR3 and see if I get any uptick in central apneas, but I have hardly any at the moment. Thanks for the advice!