Resmed sleep therapist adjustements

[Ghandi]

Good morning everyone. 

Before increasing the minimum pressure from 5 to 7-9 on my resmed the sleep therapist did 2 things to try to improve my sleep therapy
She removed the EPR and changed auto set for her to regular autoset

It did destroy my OA but now i have large leaks

Mode: APAP
   


What are those leaks? Is it because my mouth is open? Is related with EPR removed or regular autoset. I have rarely seen this much leak.
Maybe it's just a random nigth.

Here are the data from the previous nigth with autoset for her and EPR at 3.
   

What do you guys think?

[OpalRose]

Ghandi,
The two charts you posted are identical, same day, both say Apap mode, EPR set to 3 (ramp only).

Please repost. Here are the graphs we need to see: Events, Pressure (not mask pressure), Flow Rate, Flow Limitations and Leak Graph.

Always include left side bar, minus pie chart and calendar.


Use the link in my signature line for guidance in organizing the chart.

[Ghandi]

Ghandi,
The two charts you posted are identical, same day, both say Apap mode, EPR set to 3 (ramp only).

Please repost. Here are the graphs we need to see:  Events, Pressure (not mask pressure), Flow Rate, Flow Limitations and Leak Graph.

Always include left side bar, minus pie chart and calendar.


Use the link in my signature line for guidance in organizing the chart.

It is fixed now. Thanks for helping me with this.

[SarcasticDave94]

The only setting change I saw was EPR is now Ramp Only. This should not affect leak rates. It's possible this was a difference between nights, because each night is going to be different. If leaks are a concern to you, you need to address whether or not the mask cushion is the right size and that it's adjusted properly. I can't see how the proposed setting changes should affect leaks.

The secondary thing is for you to edit your UserCP to reflect the correct machine on your user profile so that those looking at your posts know the machine and settings you are on.

[Ghandi]

The only setting change I saw was EPR is now Ramp Only. This should not affect leak rates. It's possible this was a difference between nights, because each night is going to be different. If leaks are a concern to you, you need to address whether or not the mask cushion is the right size and that it's adjusted properly. I can't see how the proposed setting changes should affect leaks.

The secondary thing is for you to edit your UserCP to reflect the correct machine on your user profile so that those looking at your posts know the machine and settings you are on.

About the user CP I will do. Currently it's a trial from the CPAP vendor. I own a dreamstation fixed.

About the leak. I have been using that mask for 6 years now with the dreamstation and previous respironnics machine. It's the third night with the resmed machine and I never had leaks in that range before yesterday.  I find it really odd. Could be coincidential. 

Also it was set on autoset instead of autoset for her and I had 1 rera compared to the previous nights

[Ghandi]

The follow up is on this thread: http://www.apneaboard.com/forums/Thread-...justements

[Sleeprider]

I appreciate that you posted the chart from before the RT changes, however we like members to stick to one therapy thread if possible in order to help us keep the history together. As I recall, we previously demonstrated that you tolerate a higher fixed pressure with better results than auto pressure in a wide range. While OA was lower without EPR using the same pressure of 5-15, it simply shows that EPR was undercutting the needed EPAP pressure to keep OA controlled. We were working on increasing minimum pressure, but maintaining EPR. I think that is still your best course for comfort and effectiveness. I'm pretty sure we could match the performance of 5-15 without EPR, by using auto pressure at 9-15 wtih EPR at 2 or 3, and your comfort would increase, and pressure changes would be fewer. If you want to keep EPR off, then you still need to raise the minimum pressure to near the median of 7.0.

I'm not a big fan of the Autoset For Her mode, and usually get better results with Autoset Standard. I think that probably has more to do with better control of OA than the other changes.

[Ghandi]

I appreciate that you posted the chart from before the RT changes, however we like members to stick to one therapy thread if possible in order to help us keep the history together.   As I recall, we previously demonstrated that you tolerate a higher fixed pressure with better results than auto pressure in a wide range.  While OA was lower without EPR using the same pressure of 5-15, it simply shows that EPR was undercutting the needed EPAP pressure to keep OA controlled.  We were working on increasing minimum pressure, but maintaining EPR. I think that is still your best course for comfort and effectiveness.  I'm pretty sure we could match the performance of 5-15 without EPR, by using auto pressure at 9-15 wtih EPR at 2 or 3, and your comfort would increase, and pressure changes would be fewer.  If you want to keep EPR off, then you still need to raise the minimum pressure to near the median of 7.0.  

I'm not a big fan of the Autoset For Her mode,  and usually get better results with Autoset Standard.  I think that probably has more to do with better control of OA than the other changes.

It all makes sense. I will post in the other thread when I get new data. Is there anyway to merge my original post from this thread to the other one?

What about the leaks? Do you think it's coincidential as well?

Thanks

[OpalRose]

Ghandi,
Your two threads have been merged.

[Ghandi]

Ghandi,
Your two threads have been merged.

Awesome