Switched from PR System1 to ResMed AirSense 11 Autoset

palerider wrote: ↑

Sat Aug 20, 2022 3:16 pm

lynninnj wrote: ↑

Sat Aug 20, 2022 3:12 pm

To which I asked for clarity wrt your use of the term “average needed minimum pressure “. I am trying to determine which oscar provided data point would provide that value and listed those that were available.

Asking for clarity doesn’t equal a jump/conclusion.

What word did I use? "average", not Max, (which is what the 95% or 99% effectively is, so why do you make the leap to something completely different from what I said?

A reasonable person would start with "average" if you weren't just trolling, which seems to be your modus operandi lately.

Without compelling evidence that you're not simply being a troll, I'm done with answering your questions about a months old post.

A careful and honest reader would see that I quoted you precisely and asked which data point from an oscar report one would use. I then made no statement and merely asked for clarity as to which data point ine would use to determine “average needed minimum pressure “. YOUR words.

for someone who is such a stickler for nomenclature I am unsure why you don’t understand I am asking you specific question about some thing that you said.

Please don’t confuse my asking a question with being a troll. Trolling is what you do but that really wasn’t a gotcha question.

Perhaps you should read what you said again and then read my question. Maybe that will help you understand I’m asking you for clarification.

I seem to recall you asking many many many posters here to clarify what they mean by a particular term. Do you ask people for clarity because you were trolling them? This is more about you than it is me. If that is the case.

so when a new person comes on here they get a smack down if they don’t look at what is already been discussed already.

So I do some reading on what’s already been discussed and now I’m asking a specific question of a specific poster who typically is very specific about his words and suddenly I am dredging up old posts and trolling.

I started a whole thread at one point about trying to determine minimum and maximum pressure but few had anything constructive to say. I never did get an answer. In fairness pugsywas just going away on vacation.

Maximum pressure settings are generally a moot point and unless there is some sort of problem that requires limiting the machine’s upper range limit I just don’t worry about the max setting. The machine will only go to wherever it thinks it needs to go anyway.
My machine will go to 25 cm but it hasn’t gone above 15 cm inhale in a long time. I could set the max inhale at 15 cm but doing that doesn’t change anything in terms of how the machine functions or how the auto adjusting algorithm works. Doesn’t improve how it works nor does it make into work as well AS LONG AS I NEVER HIT THE MAX.
There simply isn’t any real reason to worry about limiting the max.

Now if someone has a significant problem like aerophagia or centrals popping up above a certain pressure then we have a different discussion. Special circumstances require special settings.

Limiting the range by lowering the max just doesn’t do anything to the auto algorithm. If th machine could go to 100cm but it never went above 10 cm then it doesn’t matter what the max setting is set to.
Be it 10 or 11 or 15 or 25 or 100.
If it never goes to 10 cm it doesn’t matter what the max is set at. There’s no advantage one way or the other.

The minimum setting is the most critical setting because it does the bulk of the work holding the airway open and preventing most tissue collapses.
Then when something a bit unusual happens the machine can adjust upwards for special needs.

Would a 7 cm minimum do better than a 6 cm minimum? Maybe maybe not.
And remember numbers alone don’t tell the whole story.

I used an DS1 for other 5 yrs. When I switched to a AS11 my leak rate went up
using the same N20 I had been using. My AHI numbers didn't change. It's just the way the machines interpret the leaks. If you are getting the sleep you need don't worry about the leaks. I have been a hose head for 18 yrs.

lynninnj wrote: ↑

Sat Aug 20, 2022 4:50 pm

I started a whole thread at one point about trying to determine minimum and maximum pressure but few had anything constructive to say. I never did get an answer. In fairness pugsywas just going away on vacation.

Are you kidding?

I guess I've wasted my time on you.

Dog Slobber wrote: ↑

Sat Aug 20, 2022 6:32 pm

lynninnj wrote: ↑

Sat Aug 20, 2022 4:50 pm

I started a whole thread at one point about trying to determine minimum and maximum pressure but few had anything constructive to say. I never did get an answer. In fairness pugsywas just going away on vacation.

Are you kidding?

I guess I've wasted my time on you.

I was getting answers about upper limits but not where to set lower limits.

You didn’t waste your time at all.

I went back and saw quite a few helpful replies but when I searched for more info I found my way here. There was discussion about batteries etc, all useful but not how to find the sweet spot.

Am I asking the wrong questions? I don’t know.

I feel as though there’s a misunderstanding and I don’t know how to fix it.

lynninnj wrote: ↑

Sat Aug 20, 2022 7:19 pm

I feel as though there’s a misunderstanding and I don’t know how to fix it.

lynninnj wrote: ↑

Sat Aug 20, 2022 2:30 pm

My median pressure was obviously going to be higher when the pressure settings were higher.

Here's where the misunderstanding starts.
The median of any distribution means that 50% of the cases happen at or below the statisitc (the "thing") we are measuring.
The median, as I noted in my previous post is far less affected by extreme values than the average.
You can spend 5% of your time at a maximum pressure of 20, and that will have absolutely no effect on your median pressure.
You can spend 20% of your time at a pressure of 4, and that will have absolutely no effect on your median pressure.

In your example, your minimum pressure was 8 - the machine could not go lower than that.

lynninnj wrote: ↑

Sat Aug 20, 2022 2:30 pm

Because the median pressure was just above the minimum pressure, I wanted to try lowering it a bit just to see what the response was.

So you lowered you miumum pressure. But what was your response to the change? How did feel you and what was your AHI when you spent more time at lower pressure?

Now the median pressure is a little bit lower

And that indicates that you did indeed spend some time at pressure lower than 8.
S0?
What was your response to sleeping more of the night at lower pressures? How did you feel and what was your AHI when you spent more time at lower pressure?

You will have the correct setting for you - the sweet spot - when you sleep well and feel great at the lowest pressure necessary for that to occur. The machine will not - cannot - tell you what the sweet spot is.

Another important bit of information to consider:
Which mode is our machine set to run on? The lower median means far more when your machine is in Autoset for Her mode, because in in Autoset for Her mode the machine itself changes the minimum setting it uses during the night. In regular Autoset, it will drift down to the lowest pressure you give it, and rev up in response to events, again and again. In Autoset for Her, the machine says "uh oh, there were 3 obstructive apnea within X minute[s], I'm not going lower that tonight!" that might result in higher median.

ozij wrote: ↑

Sat Aug 20, 2022 9:03 pm

lynninnj wrote: ↑

Sat Aug 20, 2022 7:19 pm

I feel as though there’s a misunderstanding and I don’t know how to fix it.

lynninnj wrote: ↑

Sat Aug 20, 2022 2:30 pm

My median pressure was obviously going to be higher when the pressure settings were higher.

Here's where the misunderstanding starts.
The median of any distribution means that 50% of the cases happen at or below the statisitc (the "thing") we are measuring.
The median, as I noted in my previous post is far less affected by extreme values than the average.
You can spend 5% of your time at a maximum pressure of 20, and that will have absolutely no effect on your median pressure.
You can spend 20% of your time at a pressure of 4, and that will have absolutely no effect on your median pressure.

In your example, your minimum pressure was 8 - the machine could not go lower than that.

lynninnj wrote: ↑

Sat Aug 20, 2022 2:30 pm

Because the median pressure was just above the minimum pressure, I wanted to try lowering it a bit just to see what the response was.

So you lowered you miumum pressure. But what was your response to the change? How did feel you and what was your AHI when you spent more time at lower pressure?

Now the median pressure is a little bit lower

And that indicates that you did indeed spend some time at pressure lower than 8.
S0?
What was your response to sleeping more of the night at lower pressures? How did you feel and what was your AHI when you spent more time at lower pressure?

You will have the correct setting for you - the sweet spot - when you sleep well and feel great at the lowest pressure necessary for that to occur. The machine will not - cannot - tell you what the sweet spot is.

Another important bit of information to consider:
Which mode is our machine set to run on? The lower median means far more when your machine is in Autoset for Her mode, because in in Autoset for Her mode the machine itself changes the minimum setting it uses during the night. In regular Autoset, it will drift down to the lowest pressure you give it, and rev up in response to events, again and again. In Autoset for Her, the machine says "uh oh, there were 3 obstructive apnea within X minute[s], I'm not going lower that tonight!" that might result in higher median.

THANK YOU

THIS is the info I feel I was desperately in need of.

I FEEL better with the lower number of wakeups. I am seeing the numbers creeping up even before the pressure change. That’s why I felt maybe a tweak was in order. Goodness knows sleep doc was unhelpful (“you need a special card for that” and “you can’t read the data on it anyway “) I am not sure what changed between when I had ahi under 1 and now between 2-3.

Am I expecting too much?

What do you regulars consider the sweet apot for you? under 5? 1?

I had a period there where I felt GREAT and now seems herder to find. thus my quandry.

I want so much to learn more and spend less time defending myself because tone inflection and meaning can be lost in a forum such as this.

and I don’t believe I have evr seen autoset for her on there anywhere. I wonder if that would have been on the sleephq or oscar data somewhere.

I think it’s regular autoset

The "statistics" screen on Oscar, for my AS10, at the bottom of it, informs me of which mode I'm on. I don't know if it's the same for the AS11.

Your SleepHq machine settings doesn't say "for her" so I 'm pretty sure it's regular autoset.
AirSense 11 AutoSet
Settings at Sat August 13th, 2022

https://sleephq.com/public/22ef1f04-882 ... df26ce0d88 -- click on "more" for detailed settings

I'm one of the people who don't respond well to the Autoset - the pressure fluctuations seem to disturb me.

Looking at your one night of data, I notice that you have more CA than OA's, most of your snores occur when the pressure is 6.
If it were my data, I'd try fixed pressure at 6.4 - which is a bit more that the median and may prevent flow limitations, obstructive apnea snores, and pressure fluctuations.

But as I said, I'm biased toward fixed....

I suggest we continue the discussion of pressure ranges - if necessary - to the original thread:

pressure range questions