new machine settings

[Miscanthus]

These are the results after putting my machine on autoset and setting pressure to min 15 max 20. AHI is an improvement from the above 8 I have been routinely getting. Should I continue to tweak it and if so what do you suggest?
You guys are awesome. Thanks,
Roy

[JDS74]

Things look quite good in the charts. I suggest waiting a few days and seeing if the results stay the same.
The bulk of the apnea events seem to be clear airway events and these may be a result of the IPAP pressure.
They may also be the result of partial arousals (sleep-wake junk) and therefore not of any concern at all. Note that the duration of these events is quite short and is not causing any difficulty.

If this pattern continues for a few days, you might consider reducing the IPAP pressure just a little bit to see if that helps. In any event, the numbers look really good.

[Miscanthus]

Thank you so much. What is the IPAP pressure?
Thanks again.

[JDS74]

You have indicated the range to min of 15 cmH2O and max of 20 cmH2O but the chart indicates that the min is about 11.5 cmH2O so perhaps you have either not set it correctly or made a typo in your original post.

In any event, it appears that the pressure support on your machine seems to be about 3 cmH2O so the initial EPAP is 11.5 (min pressure) and the initial IPAP if 14.5 (min + pressure support).

To reduce the IPAP (inhale pressure) just a little, reduce the pressure support just a little.
To reiterate, it makes good sense to just leave the settings where they are for a few days to see in all goes well before tinkering. There too many other variables that affect sleep quality to make any decisions based on a single night's data.

[Miscanthus]

You have indicated the range to min of 15 cmH2O and max of 20 cmH2O but the chart indicates that the min is about 11.5 cmH2O so perhaps you have either not set it correctly or made a typo in your original post.

I set he autoset at min 15 max 20.

In any event, it appears that the pressure support on your machine seems to be about 3 cmH2O so the initial EPAP is 11.5 (min pressure) and the initial IPAP if 14.5 (min + pressure support).

To reduce the IPAP (inhale pressure) just a little, reduce the pressure support just a little.

How does one reduce the pressure support?

To reiterate, it makes good sense to just leave the settings where they are for a few days to see in all goes well before tinkering. There too many other variables that affect sleep quality to make any decisions based on a single night's data.

I will leave the setings as is for a few more nights. Thanks.

[Miscanthus]

I've discovered my EPR is set at 3
My ramp is set to auto and the beginning pressure is 4. Would that be related to the 11.5 number you mentioned?

[palerider]

just ignore everything that jds74 said, he's confused about what's going on.

I'd suggest setting the min pressure to 14 and try EPR 2.

[robysue]

Thank you so much. What is the IPAP pressure?
Thanks again.

Miscanthus,

You are using an AirSense 10 AutoSet and you have EPR turned on. It looks like the EPR setting is set to 3.

Your pressure settings are:

• min Presssure = 15
  max Pressure = 20

and you are using the ramp and it looks like your initial ramp pressure is set to 4cm

The IPAP that JDS74 is talking about is just your pressure level at any point in the night. It's the pressure when you are inhaling.

Although JDS74 doesn't use the acronym, the pressure when you are exhaling is often called the EPAP. Because you are using a Resmed AirSense 10 AutoSet with EPR = 3, your EPAP = Pressure setting - 3 when the pressure is greater than 7cm.

To JDS74 when I look at the pressure graphs, it sure looks to me like the EPAP >= 12 (and IPAP >= 15) after the ramp period is over. It's also worth noting that the ramp period is used in the SH statistics for computing minimum, median, 95%, and average pressures for the night.

[JDS74]

Robysue:

I certainly wouldn't ague about the values in the graph since the resolution is a little fuzzy. You may be correct about the min being 12 + a little rather than 11.5 or so but maybe that's just my aging eyesight.