Advise Pressure Setting and Mode

[wolf911]

I will be getting my RESMED S10 Autoset today and masks (ordered a Swift and a Nuance pillows) tomorrow and wanted to just get some advise on how i should set the pressure settings. I have my tritration sleep study summary below. Im thinking set it for 7 min and 9 max on auto or should i just go straight 8 CPAP. what are your thoughts on these starting positions. i do sleep on my back almost all the time but occationally on my side.
Also any RESMED s10 users whats a good starting position for the humidity and heat or should i just start with the auto set. im sure ill figure these settings out but just looking for somewhere to start.

INTERPRETATION
this is a cpap titration overnight performed in a sleep laboratory under the direct supervision of a sleep technician. Total recording time 418 minutes, total sleep time is 342 minutes, and sleep efficiency is 82%. Latency to sleep onset is 19 minutes, latency to REM is 81 minutes, and wake after sleep is 56 minutes all normal.

SLEEP ARCHITECTURE
The hypnogram demenstrates 13 arousals, 3 REM episodes, and 7 awakenings. The patient spent in stage N1 6.4% of the time, stage N2 63.8% of the time, stage N3 15.5% of the time, and stage REM 14.3% of the time.

POSITIONAL SUMMARY
The patient spent 100% tme supine.

AROUSALS
There were 13 arousals in total: 1 due to apnea/hypopneas, 5 due to snoring, and 6 spontaneous.

MOTOR EVENTS
There were no motor events.

HEART RATE ANALYSIS
The average heart rate 61 and the nadir 53. No arrthymias were seen.

CPAP TRITRATION
CPAP tritration was started at 4 and tritrated all the way up to 7. At 7 acually the patient had 2 hypopneas with an apnea/hyponea index of 3. CPAP between 7 and 8 is the recomended. Would be better 8 if the patient can tolerate with a Nuance Pillow mask, no spplemental oxygen will be needed.

IMPRESSION
This is a patient with severe obstructive sleep apnea with an apnea/hypopnea index of 30.8. This is a CPAP tritration polysomnography. It is technically adequate, the patient had enough REM, supine, and would treat, although with CPAP 7 the index is acceptable at 3, my preference would be 8 if the patient can tolerate it with Nuance pillow mask. No spplemental oxygen needed.

[LSAT]

Wherever you are getting your equipment from should set the machine to the pressure indicated on your prescription.

[wolf911]

Wherever you are getting your equipment from should set the machine to the pressure indicated on your prescription.

im on my own on this

[Pugsy]

Base on what the titration report says....I think I would start with a modest apap range of 7 minimum and 9 maximum and see what happens....or split the difference if you want to use cpap mode and do 7.5 cm and see what happens.

EPR use ...your choice or preference...and see what happens on the reports. May or may not need to adjust the pressure a little to compensate for EPR reduction (if you elect to use it).

[wolf911]

Base on what the titration report says....I think I would start with a modest apap range of 7 minimum and 9 maximum and see what happens....or split the difference if you want to use cpap mode and do 7.5 cm and see what happens.

EPR use ...your choice or preference...and see what happens on the reports. May or may not need to adjust the pressure a little to compensate for EPR reduction (if you elect to use it).

if ive never used EPR or any CPAP (except the one night in study) should i start with or without EPR. which would be better to get a base to start from. in the sleep study do you think they use EPR. i didnt feel the pressure much falling asleep but in the morning i could sense the pressure was much higher than when i had started

machine came today, looks new, just as stated. masks arrive tomorrow. good thing this forum exists.

[Julie]

EPR is generally used for people who are conscious of difficulty exhaling (consistently), and you'd only set it - to whatever level suits you - if you have a problem... some do, some don't.

[Wulfman...]

I will be getting my RESMED S10 Autoset today and masks (ordered a Swift and a Nuance pillows) tomorrow and wanted to just get some advise on how i should set the pressure settings. I have my tritration sleep study summary below. Im thinking set it for 7 min and 9 max on auto or should i just go straight 8 CPAP. what are your thoughts on these starting positions. i do sleep on my back almost all the time but occationally on my side.
Also any RESMED s10 users whats a good starting position for the humidity and heat or should i just start with the auto set. im sure ill figure these settings out but just looking for somewhere to start.

INTERPRETATION
this is a cpap titration overnight performed in a sleep laboratory under the direct supervision of a sleep technician. Total recording time 418 minutes, total sleep time is 342 minutes, and sleep efficiency is 82%. Latency to sleep onset is 19 minutes, latency to REM is 81 minutes, and wake after sleep is 56 minutes all normal.

SLEEP ARCHITECTURE
The hypnogram demenstrates 13 arousals, 3 REM episodes, and 7 awakenings. The patient spent in stage N1 6.4% of the time, stage N2 63.8% of the time, stage N3 15.5% of the time, and stage REM 14.3% of the time.

POSITIONAL SUMMARY
The patient spent 100% tme supine.

AROUSALS
There were 13 arousals in total: 1 due to apnea/hypopneas, 5 due to snoring, and 6 spontaneous.

MOTOR EVENTS
There were no motor events.

HEART RATE ANALYSIS
The average heart rate 61 and the nadir 53. No arrthymias were seen.

CPAP TRITRATION
CPAP tritration was started at 4 and tritrated all the way up to 7. At 7 acually the patient had 2 hypopneas with an apnea/hyponea index of 3. CPAP between 7 and 8 is the recomended. Would be better 8 if the patient can tolerate with a Nuance Pillow mask, no spplemental oxygen will be needed.

IMPRESSION
This is a patient with severe obstructive sleep apnea with an apnea/hypopnea index of 30.8. This is a CPAP tritration polysomnography. It is technically adequate, the patient had enough REM, supine, and would treat, although with CPAP 7 the index is acceptable at 3, my preference would be 8 if the patient can tolerate it with Nuance pillow mask. No spplemental oxygen needed.

That's where I would start.........7 or 8 centimeters.
I would probably not advise using exhale relief (EPR) at those low pressures. They wouldn't have used it in your titration and the pressure drop on exhale can actually affect the results in actual use.

Use some software and monitor your data.......and adjust if necessary.


Den

.

[Pugsy]

EPR is your personal choice or preference. Some people think that 7 cm feels like a tornado and they can't handle exhaling against it and others think "what pressure" so you just need to play with it and see what feels best for you.
I doubt that any sort of exhale relief would have been used at the titration study but we don't know for sure...anyway you are home now and you can use it or not depending on what feels the best to you.
Exhale relief and to use it or how much is up to the person doing the using. I don't have to use it but it sure is nice so my preference is to use whatever exhale relief is available. It feels more like natural breathing rhythm and for me that means more "comfort" and more comfort means better sleep for me. Others don't like the way it "feels" and prefer to not use any.

You will find that pretty much all this cpap stuff comes with a really big YMMV sticker and you have to sort it out yourself...like humidity needs. What my nose likes (Palerider thinks I am a swamp monster because I can't get too much humidity) your nose might hate and again it's personal preference.
When in doubt...pick a middle of the road setting and start from there.

[wolf911]

.[/quote]
That's where I would start.........7 or 8 centimeters.
I would probably not advise using exhale relief (EPR) at those low pressures. They wouldn't have used it in your titration and the pressure drop on exhale can actually affect the results in actual use.

Use some software and monitor your data.......and adjust if necessary.


Den

.[/quote]
7 or 8 in CPAP mode?

i will get the software and start monitoring

[Wulfman...]

7 or 8 in CPAP mode?
i will get the software and start monitoring

Yes.


Den

.

[patrick112]

What software do you recommend Den?

[Bill44133]

What software do you recommend Den?

Most of the people use SleepyHead.. It is free and tutorial links are on the top of the start page here.

[Wulfman...]

What software do you recommend Den?

Most of the people use SleepyHead.. It is free and tutorial links are on the top of the start page here.

Yeah, what Bill said.
You don't have your machine in your profile, Patrick, but if it's a newer (data-capable) ResMed or P/R machine, then the Sleepyhead software would probably be the way to go. Some still use the ResScan software for ResMed machines and some still use the various Encore software versions for the P/R machines, but sometimes it's a little more problematic to get hold of those. Sleepyhead is readily available.


Den

.

[wolf911]

i took a screenshot from sleepyhead and followed the tutorial ON HOW TO upload to imgur(was succesful) but when i click large thumbnail and Linked BBcode(as the tutorial says) and then copy and paste the link to the forum it shows up full size not as a thumbnail. any one know what im missing.

[Pugsy]

i took a screenshot from sleepyhead and followed the tutorial ON HOW TO upload to imgur(was succesful) but when i click large thumbnail and Linked BBcode(as the tutorial says) and then copy and paste the link to the forum it shows up full size not as a thumbnail. any one know what im missing.

Large thumbnail is a pretty big thumbnail and often is big enough that we don't need to click on it to see further details.

Put an image here using the large thumbnail code (last line in the box of addresses) and let's see what happens.
It's really kinda nice to have a large thumbnail image that doesn't always require clicking on it to see the details.