Question about autoset pressure range

[Tformhals]

So I got an autoset machine! DME was nice enough to swap out my Resmed Airsense 10 CPAP for an Airsense 10 autoset! They set my pressure range at 4-14. My pressure from my sleep study is 8. wondering if 6-10 or 6-12 would be more appropriate? I got a copy of my sleep studies and also have a question about limb movements and arousal index. My PLMS index was 20.1 events per hour and PLMS with arousal index of 2.9 events per hour. The arousal index was 7 events per hour. What does this all mean? Are these normal values?

[palerider]

So I got an autoset machine! DME was nice enough to swap out my Resmed Airsense 10 CPAP for an Airsense 10 autoset! They set my pressure range at 4-14. My pressure from my sleep study is 8. wondering if 6-10 or 6-12 would be more appropriate? I got a copy of my sleep studies and also have a question about limb movements and arousal index. My PLMS index was 20.1 events per hour and PLMS with arousal index of 2.9 events per hour. The arousal index was 7 events per hour. What does this all mean? Are these normal values?

8-20 would be more appropriate.

[robysue]

So I got an autoset machine! DME was nice enough to swap out my Resmed Airsense 10 CPAP for an Airsense 10 autoset! They set my pressure range at 4-14. My pressure from my sleep study is 8. wondering if 6-10 or 6-12 would be more appropriate?

In my opinion, I think I would start with 6-10 rather than the 4-14 that the DME set the machine to or PaleRider's suggestion of 8-20.

But I am someone who had severe problems with aerophagia and I always urge caution when it comes to pressure settings. You can always slowly increase the min and max pressures later if the data warrants it.

So: If you have aerophagia problems OR if CAs have been a problem, set a reasonable upper limit on the max pressure and go with something like 6-10 to start with. On the other hand, if aerophagia is no problem AND CAs aren't a problem AND you are worried that 8cm is significantly below your real pressure needs, then use PR's suggested range of 8-20.

I got a copy of my sleep studies and also have a question about limb movements and arousal index. My PLMS index was 20.1 events per hour and PLMS with arousal index of 2.9 events per hour. The arousal index was 7 events per hour. What does this all mean? Are these normal values?

There is a poster here who has a lot of experience with PLMS. I would suggest that you start a NEW thread with just this question in it and the phrase PLMS question in the title of the thread so that this question catches her attention.

[Pugsy]

I think if it were me I would try 6 minimum and 10 or 12 max and see what happens.
You might end up needing more minimum and you might not. Maybe that original RX of 8 was a worst case scenario pressure and maybe you won't be in a worst case scenario all night.

The maximum really isn't that critical UNLESS you end up being like RobySue and have problems with higher pressures (like the aerophagia) and then it only is a factor if they are needed.
The machine may not even want to go up very far and if it doesn't go very far the max becomes a moot point.
Just because it can go somewhere doesn't mean that it will go somewhere and if it never goes there it really doesn't affect the response or anything like that.
Hurts nothing to be cautious though until you see what is happening and decide if further adjustments are need or not and cross that bridge if/when you come to it.

[D.H.]

What's the highest the machine actually went? If it never hit the max, turning up the max will have no effect. If it did hit the max, you might want to consider raising the max.

Conversely, if it's spending a lot of time above the min, you probably should turn up the min.

[Tformhals]

How would I know if I need more minimum pressure? I have EPR turned on to 3 so my exhalation pressure will drop to 4. I have read about CO2 buildup at low pressures. Is this a concern? How would I know this is happening? I should add this will be my first night with this machine. Have been on straight CPAP until now.

[LSAT]

If you were on a fixed pressure of 8, you should not even notice with a range of 6-10. With an EPR of 3 the machine will not go lower than 4. Sleepyhead will help determine what specific pressures will give you the best therapy.

[Pugsy]

How would I know if I need more minimum pressure?

It's easily figured out by looking at the Sleepyhead report.

I have read about CO2 buildup at low pressures. Is this a concern? How would I know this is happening?

I wouldn't worry about it even if you started at 4 cm unless your breathing was extremely shallow for some reason or other (lung disease maybe). For most people there is enough carbon dioxide expelled for it to be a non issue. Now they may not always feel comfortable at 4 (if can feel stifling/suffocating and since you have been using 8 cm I am betting it won't be all that comfortable) but we don't suffocate despite it maybe feeling like it.

Carbon dioxide build up symptoms..I think primarily headache...maybe some light headedness or dizziness. Of course there are other reasons for headaches...like my bad neck that hurts like a SOB today and I have the headache to go with it.

At a minimum of 6 cm with your EPR...I wouldn't worry about it at all even if your breathing was shallow. There's going to be enough air movement to move the carbon dioxide out of the mask.

[Tformhals]

Thank you! I am so glad I found this forum. Pugsy you and everyone else has been so very helpful.

[Tformhals]

Little bit of a rough night last night on the auto. Pressure jumped to max before I fell asleep. Going to get an sd card reader after work today.

[LSAT]

Little bit of a rough night last night on the auto. Pressure jumped to max before I fell asleep. Going to get an sd card reader after work today.

You don't need a card reader if you have a computer with a card slot (most do). You need to download Sleepyhead and then insert your SD card into your computer where Sleepyhead will read it.

[Tformhals]

Little bit of a rough night last night on the auto. Pressure jumped to max before I fell asleep. Going to get an sd card reader after work today.

You don't need a card reader if you have a computer with a card slot (most do). You need to download Sleepyhead and then insert your SD card into your computer where Sleepyhead will read it.

My desktop doesn't have one. My laptop was to old for sleepyhead I think all the graphics were black. And resscan wouldn't install on the laptop.

[robysue]

Little bit of a rough night last night on the auto. Pressure jumped to max before I fell asleep. Going to get an sd card reader after work today.

What did you set the max pressure for?

Keep in mind that if you are very restless at the beginning of the night, the machine can score events that are not real. But the machine WILL react to those events exactly the same way it would IF you were asleep.

This may be a case where judicious use of the "AutoRamp" feature might be useful. The AutoRamp is supposed to delay raising the pressure until after the machine thinks you are asleep and it decides you are asleep once your breathing pattern settles down and becomes very, very regular.

So you might want to turn the AutoRamp feature ON and set the beginning ramp pressure to 1-2cm below your min pressure setting. In other words, if you set the min pressure at 8cm, then set the beginning ramp pressure to 6 or 7 cm. That should prevent the machine from zooming up to the max pressure before you can actually fall asleep.

[Wulfman...]

Little bit of a rough night last night on the auto. Pressure jumped to max before I fell asleep. Going to get an sd card reader after work today.

I'm not surprised. Just remember what I told you.
Since you're using EPR, you may want to try turning that off, too.
They wouldn't have used it in your titration, so your pressure of 8 cm. was just that......."straight 8".
It can take a bit to get things figured out and tweaked.

If you've got a Walmart nearby, you may try to see if they have a "Digipower" "42-in-1 Multi-Card Reader/Writer" - DP-MCR4. They're about $10. That's the one I bought some time back. Don't need it for my CPAP, but would work for my digital camera SD card if I might need it.


Den

.

[Tformhals]

Pressure was set at 6-12 with an EPR of 3. I need to check out the auto ramp feature I was probably 5 minutes in and it had jumped to 12. So I turned the ramp time on to 15 mins and fell asleep. I didn't know it had an auto feature. Am I understanding correctly that the machine will ramp up but not back down?