Need help with the settings on Airsense 10 Autoset for her

[Jay Aitchsee]

So... not having seen my actual sleep study I don't know HOW good this is, but this seems pretty good, right?

I think it looks real good...especially for a first night. I would continue as is for a while. How do you feel?

[Morbius]

If your prescription says 9 cm., why wouldn't you at least TRY that pressure (to either validate or disprove the effectiveness) before experimenting with ranges?

Because I have more faith in the technology of the machine than I do in my doctor.

That was certainly the rationale behind Airsense For Her!

http://www.zacks.com/stock/news/167153/ ... sdb-device

[PollyCT]

How do you feel?

I feel pretty good. I woke up several times because my mouth fell open and I could feel a dry mouth, but I fell right back asleep. That's pretty exciting for me, as I would often wake up and then never get back to sleep, so falling back asleep is a win. 7 hours sleep is a lot for me (that first hour was me testing the equipment), so it'll be really great if I can do that on a nightly basis, and have it be good quality sleep.

[InsomniacGuy]

Curious as to the drivers behind the Autoset increasing pressure in light of so few events. From the summary statistics, the snoring and flow limitation appear low as well.

[Pugsy]

Curious as to the drivers behind the Autoset increasing pressure in light of so few events. From the summary statistics, the snoring and flow limitation appear low as well.

We have no way to document or record how many events were prevented during the night. What we see left is just the events that slipped past the defenses.

[palerider]

So... not having seen my actual sleep study I don't know HOW good this is, but this seems pretty good, right?

it's a great start!

based on the pressures that the machine maintained, I'd suggest raising the min pressure to 9. if you're good with the starting pressure of 6 on the ramp, you can leave it, or raise it, based on how comfortable it was for you.

I'd be interested in seeing the snore and flow limitation graphs, you can shrink the first four graphs a little to get the other two on the page..

excellent start

[palerider]

If your prescription says 9 cm., why wouldn't you at least TRY that pressure (to either validate or disprove the effectiveness) before experimenting with ranges?

Because I have more faith in the technology of the machine than I do in my doctor.

wise words.

wulfman (den) is our resident champion against auto machines, it's a horse he beats with vigor. sometimes he's got a point, sometimes, I think he's a little overzealous, but he does have good intentions.

[Wulfman...]

If your prescription says 9 cm., why wouldn't you at least TRY that pressure (to either validate or disprove the effectiveness) before experimenting with ranges?

Because I have more faith in the technology of the machine than I do in my doctor.

Well, I had NO faith in my doctor, either.......BUT, at least I DID TRY my "prescribed" setting of 18 cm. for about an hour before resetting it to 10 cm., so I could get some sleep. 18 cm. was WAY too much to start out with and I suspected I didn't need that much. And, by using software, I was able to show him that I was getting less than 1.0 AHI nightly readings using 10 cm...........and then I fired him! I was right and he was wrong, but I followed my instincts and proved it to him.

Good luck with your therapy. I'll be making no more suggestions to you.
In spite of palerider's sarcastic comments, I do have close to a 10-year "track record" on the forum of helping people get their therapy "dialed in" and improving their sleep.


Den

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[palerider]

If your prescription says 9 cm., why wouldn't you at least TRY that pressure (to either validate or disprove the effectiveness) before experimenting with ranges?

Because I have more faith in the technology of the machine than I do in my doctor.

Well, I had NO faith in my doctor, either.......BUT, at least I DID TRY my "prescribed" setting of 18 cm. .... I'll be making no more suggestions to you.
In spite of palerider's sarcastic comments, I do have close to a 10-year "track record" on the forum of helping people get their therapy "dialed in" and improving their sleep.

oh, c'mon Den, unbunch your panties... you KNOW as well as I do that if someone had said "my prescription says 8-12, but I want to try 9..." you wouldn't have said "boo", you'd probably have been all "yeah! do it!".

so what if I give you a little poke now and then about you being the champion of fixed pressure. you still have lots of good ideas, and for a few people, the fixed pressure seems to suit them better. don't go off and sulk, in fact, don't even go away. there's quite likely things that Polly will run into that can benefit from your experience and wisdom.

[Wulfman...]

oh, c'mon Den, unbunch your panties... you KNOW as well as I do that if someone had said "my prescription says 8-12, but I want to try 9..." you wouldn't have said "boo", you'd probably have been all "yeah! do it!".

so what if I give you a little poke now and then about you being the champion of fixed pressure. you still have lots of good ideas, and for a few people, the fixed pressure seems to suit them better. don't go off and sulk, in fact, don't even go away. there's quite likely things that Polly will run into that can benefit from your experience and wisdom.

Not likely. My point is (and has always been) to at least TRY the prescribed settings FIRST.
( Although if someone had been through an in-lab sleep study, it's highly unlikely that they'd have been prescribed a range. From what I've seen, "ranges" are PRESCRIBED for people who the doctors don't seem to have a clue and it's like saying "I don't know, try this." )
In the last 10 years, I've seen the spectrum of mis-prescribed pressure settings.......too high, too low and everything in between. Same thing with DMEs setting up machines with the wrong settings. So, this has been what has opened my eyes to the fact that the USERS need to be the foremost advocates of and being in charge of their own therapy......including being knowledgeable about as many aspects of it as possible. Especially, having a fully data-capable machine, the software to monitor their therapy and knowing what to change, when and why.


Den

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[PollyCT]

So today I got the summary report from my doctor's office. She'd received it from the sleep study place two weeks before anyone called me to let me know I have OSA. My AHI was 10.8 something (not right in front of the report right now, so that's an approximation.) The Oxygenation (probably not the right word for it) was .81. That's all the summary said. I did not get the full report, just the summary, which also said "primary care physician should meet with patient to discuss." It also recommended the CPAP at 9, and a specific mask (not the P10 mask I bought, but the nasal mask they tried on me in the sleep clinic). (Side note, how do they even say what mask you should have without even asking you anything about your preferences, or how the mask felt, or anything? I mean, that thing comes in pretty intimate contact with your face for 8 hours a day, so we should at least be asked how it feels.)

So anyway, Den (Wulfman), I feel like I'm too old (at 54) to listen to what doctors' say without questioning what they say. I'm also a techno-geek, and I know that computers can be programmed to think more logically than humans (or not, depending on the programmer). If starting with the prescribed machine and level works for someone I truly think that's great, but for me I've been burned too many times by doctors fitting me into a mold not to want to cut to the chase. But I do appreciate your perspective, I really do.

And palerider, here's a new screen shot with the additional graphs. I'm definitely open to the lower level of 9, and will probably tinker with the ramp as well. I'm not sure I even noticed the ramp, I was out so fast. (It had a been a few days of not much sleep, so was really tired and out like a light.) If you notice anything else please let me know.

[Wulfman...]

So today I got the summary report from my doctor's office. She'd received it from the sleep study place two weeks before anyone called me to let me know I have OSA. My AHI was 10.8 something (not right in front of the report right now, so that's an approximation.) The Oxygenation (probably not the right word for it) was .81. That's all the summary said. I did not get the full report, just the summary, which also said "primary care physician should meet with patient to discuss." It also recommended the CPAP at 9, and a specific mask (not the P10 mask I bought, but the nasal mask they tried on me in the sleep clinic). (Side note, how do they even say what mask you should have without even asking you anything about your preferences, or how the mask felt, or anything? I mean, that thing comes in pretty intimate contact with your face for 8 hours a day, so we should at least be asked how it feels.)

So anyway, Den (Wulfman), I feel like I'm too old (at 54) to listen to what doctors' say without questioning what they say. I'm also a techno-geek, and I know that computers can be programmed to think more logically than humans (or not, depending on the programmer). If starting with the prescribed machine and level works for someone I truly think that's great, but for me I've been burned too many times by doctors fitting me into a mold not to want to cut to the chase. But I do appreciate your perspective, I really do.

And palerider, here's a new screen shot with the additional graphs. I'm definitely open to the lower level of 9, and will probably tinker with the ramp as well. I'm not sure I even noticed the ramp, I was out so fast. (It had a been a few days of not much sleep, so was really tired and out like a light.) If you notice anything else please let me know.

For what it's worth.......
I'm close to 67 and retired six years ago after working with computers for over 40 years. Virtually all aspects of mainframes, minis and micros, including administration. Did some programming, too...COBOL, Basic, DBase/Foxbase, etc.
So, if you're familiar with "programming", yes, that's what these machines do (in Auto mode)......."If this, then this, otherwise something else". And, these machines use sensors along with the programs (algorithms) to interpret "air flow". If it interprets your breathing in some pre-programmed way, it signals the program and machine to do what it's programmed to do. It WILL DO "something" it was programmed to do. However, YOUR breathing characteristics MAY differ from the "standard" they used in writing the algorithm. So, be aware of that when you're reading your reports. Not everyone who has apneas have preceding events like Flow Limitations or Snores. Some people have Flow Limitations or Snores without subsequent hypopneas or apneas.

And, after looking at your report, your Flow Limitations are what is driving your pressures up......for no "good" reason.


Den

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[PollyCT]

For what it's worth.......
I'm close to 67 and retired six years ago after working with computers for over 40 years. Virtually all aspects of mainframes, minis and micros, including administration. Did some programming, too...COBOL, Basic, DBase/Foxbase, etc.

You definitely have me beat - I only go back to Basic in 1978!

Point taken!

[palerider]

And, after looking at your report, your Flow Limitations are what is driving your pressures up......for no "good" reason.

you are making statements driven by your bias that you cannot prove.

the machines attack snoring and flow limitations *for a reason*. because it's a proven indication that there is danger of the airway closing, plus, flow limitations and snoring are in and of themselves potentially harmful due to the extra work that they put the respiratory system to, and the extra pressures put on the heart as a result.

the fact that her pressure went up and she didn't have hardly any subsequent hypos or obstructives more likely means that the machine *was working as designed* and proactively preventing them from happening in the first place.

[palerider]

And palerider, here's a new screen shot with the additional graphs. I'm definitely open to the lower level of 9, and will probably tinker with the ramp as well. I'm not sure I even noticed the ramp, I was out so fast. (It had a been a few days of not much sleep, so was really tired and out like a light.) If you notice anything else please let me know.

nice. as long as your snore graph is that dull and boring (dull and boring is *GOOD* in cpap world) you can leave it off future screenshots.

as Den mentions, the primary driver of your pressure increase is the flow limitations, the machine responds rapidly to flow limitations because they are seen as an early warning of apneas to come, so better to raise the pressure and avoid them in the first place.

have you watched the sleep disordered breathing video from resmed?
https://www.youtube.com/watch?v=-gie2dhqP2c it explains a lot of things