Feedback please on Resmed "For Her" compared to your old pap

[OkyDoky]

Emma do you not have the Clinical Manual? You can find Den's info there. Here is a link if you don't have it. https://sleep.tnet.com/home/files/resme ... -guide.pdf

[Pugsy]

I have often wondered about the "for Her" special algorithm but I haven't had a chance to get my hands on one of those machines to try it to see how it might compare to the regular algorithm in real life.

I don't know if it mostly hype or not. I got the impression some time ago when I read a research paper that the special algorithm might fit more into the needs of someone with UARS type of flow limitation since those people tend to be highly sensitive and the "gentler" way of doing things would stand less chance of creating an arousal....and since most people with UARS type of stuff tend to be female ResMed decided the target market women like they are doing something special.
From what I read about the new algorithm the more it reminded me of the old A10 algorithm that was used in the machine models S8 and older. ResMed adopted a new auto algorithm with the release of the S9.

From what you describe I don't know that "gentler" is what you need but you know the only real way to know for sure if you would do better with the "for her" algorithm would be to simply try it.
Or maybe use a higher minimum pressure and lessen the chance of the OA happening in the first place so it doesn't matter how the machine responds as much...or use fixed cpap mode at of course a higher pressure all night.

Certain criteria need to be met for the apap algorithm to kick in and if that criteria creates a problem for you then you have to decide how to work around it.
None of the machines out there will respond during the apnea...they all wait until the apnea is done and you are back to normal breathing and then you have the other criteria that is needed like flow limitations or snores or so many apneas within a certain time frame.

I don't blame you for being curious. Heck, I am curious and I am not having the difficulties you are having...I just have a curious nature. Given what you have described I think if it were me I would just try to be more aggressive with the pressure initially unless that causes a problem. Like more minimum or even giving fixed cpap a trial.
But if you can get your hands on the For Her AutoSet A10....it's worth at least trying their new fancy way of doing something that is more like an old way of doing something than they want to mention.

[palerider]

Emma do you not have the Clinical Manual? You can find Den's info there. Here is a link if you don't have it. https://sleep.tnet.com/home/files/resme ... -guide.pdf

and, emma, don't forget to read the bit on the next page that Den missed...

[Wulfman...]

Yep. Missed that. Kind of "circumstantial", but if people fall into those criteria, it's supposed to work that way.

 Minimum pressure (Min. Pressure) that adjusts according to the frequency of apneas:
If two apneas occur within a minute, the pressure reached in response to the second apnea will
become the new minimum treatment pressure until the next treatment session.

Patients who use AutoSet for Her will still get the benefits of ResMed's AutoSet technology
including improved sensitivity to flow-limitation and Central Sleep Apnoea Detection with Forced
Oscillation Technique.


Den

.

[tedtomato]

My Resmed airsense 10 autoset proactively prevents many events from happening.

The view that those machines only change their pressure after events have occurred is just wrong. They are a lot more advanced than this.

I can see it daily...

[Pugsy]

The view that those machines only change their pressure after events have occurred is just wrong.

I don't think anyone ever said that the machines only change pressure after an event.

[tedtomato]

A lot of the wording used is about "reacting" or "respond to events".

My SleepyHead data is showing some fairly steep variations of pressure even before any events are reported. Therefore, it's not just about reacting or responding to events, but also identifying some early symptoms leading to complete or partial obstruction.

[palerider]

My Resmed airsense 10 autoset proactively prevents many events from happening.

The view that those machines only change their pressure after events have occurred is just wrong. They are a lot more advanced than this.

I can see it daily...

your view is clearly ignorant of many facts.

[Pugsy]

My SleepyHead data is showing some fairly steep variations of pressure even before any events are reported.

Yep...as it is intended to work.
You might want to read up on how the algorithm in auto mode responds and what it is designed to respond to and when.

The short version is that it responds to a lot of things and most of them you won't ever see on your software reports because they get prevented and only the stuff that slips past the defenses gets shown on the reports.

No one here has ever said that the machine only responds/increases/reacts after the event.

This discussion start by the OP was because she wanted an algorithm guaranteed to respond faster after a flagged apnea event...hoping to prevent another one from happening so soon.
These machines do NOT do anything at all during the apnea event...they sit by and twiddle their little thumbs all the while thinking I need to maybe make some adjustments so this doesn't happen again. Once the event has cleared up then the machine is free to use the algorithm to figure out what if anything needs to be done. It may or may not elect to increase the pressure more for a little while and then re evaluate things. There's a lot that it analyzes in addition to just a regular apnea or hyponea...it measures air flow, checks for snores, checks for flow reductions, checks for flow limitations and then it takes all those factors in and decides what to do...and that's what it is doing when you see your pressure going up and down and no flags...it's doing its job and preventing.
Sometimes it can't prevent well enough for whatever reason and an apnea event slip past the defenses. It happens, but the machine won't go making major pressure changes based solely on that one apnea event...there's gotta be all that other stuff going on along with it...snores, flow limitations, flow reductions, etc.

These machines respond all night long and not just after an event.

[palerider]

A lot of the wording used is about "reacting" or "respond to events".

My SleepyHead data is showing some fairly steep variations of pressure even before any events are reported. Therefore, it's not just about reacting or responding to events, but also identifying some early symptoms leading to complete or partial obstruction.

you're quite wrong about that.

the machines *ONLY* raise pressure due to evens, however, your definition of "event" is wrong.

there are *four* different events that the machines raise pressure in response to, snores, flow limitations, hypopneas and obstructive apneas.

find a place where pressure goes up without ANY of those happening, and you've found either ramp, or a malfunction.

they aren't psychic, they can't see the future, they don't have a tiny crystal ball inside, they just respond to events.

[emmagoldman44]

Well, very interesting responses although nobody so far actually has any For Her data for me yet.

I've been down with a bad cold this week in case anyone has wondered about the radio silence.
I am still pretty weak but let me just say one thing for now:

None of the machines out there will respond during the apnea...they all wait until the apnea is done and you are back to normal breathing ...

Thank you for your response, Pugsy. The thing is, I have trouble making that statement add up with what I see on my sleepyhead data.

I hyper-expanded the time selection around my OAs so I could really see the sequence of events. And after 6 - 8 seconds of pressure pulses, a steep increase of pressure does precede the reappearance of airflow.

Does anyone else want to check and see if that is true for them?

If you do not see the same thing on your graphs, well, gosh darn it, I'll just have to get on the stick and figure out that imgur thing. An d I will post my data on here and prove it In a couple of days. oohhh... back to bed now....

[palerider]

Well, very interesting responses although nobody so far actually has any For Her data for me yet.

plenty of people have posted charts from 'for her' machines, just pay attention on the forum.

I hyper-expanded the time selection around my OAs so I could really see the sequence of events. And after 6 - 8 seconds of pressure pulses, a steep increase of pressure does precede the reappearance of airflow.

looking forward to your examples of the machine behaving contrary to the documented parameters.

[Pugsy]

Yes, please share your zoomed in reports where the machine is responding with a pressure increase in the middle of a flagged apnea event.
The long standing documentation about response in auto mode is that they wait until the event is over before responding.

Now if it has changed...that's great but it has been changed without much fanfare. If that is indeed happening...it's new and I will be happy to alter my explanations.

[Wulfman...]

Well, very interesting responses although nobody so far actually has any For Her data for me yet.

I've been down with a bad cold this week in case anyone has wondered about the radio silence.
I am still pretty weak but let me just say one thing for now:

None of the machines out there will respond during the apnea...they all wait until the apnea is done and you are back to normal breathing ...

Thank you for your response, Pugsy. The thing is, I have trouble making that statement add up with what I see on my sleepyhead data.

I hyper-expanded the time selection around my OAs so I could really see the sequence of events. And after 6 - 8 seconds of pressure pulses, a steep increase of pressure does precede the reappearance of airflow.

Does anyone else want to check and see if that is true for them?

If you do not see the same thing on your graphs, well, gosh darn it, I'll just have to get on the stick and figure out that imgur thing. An d I will post my data on here and prove it In a couple of days. oohhh... back to bed now....

Check the sections of the reports to see if there are Flow Limitations or Snores that are driving up the pressures.
Those are the two most common "precursor events" that virtually all of the algorithms key on for the pressure increases.


Den

.

[SewTired]

Here is my closeup graph of an event in For Her mode. I don't really understand the graphs that well, so have at it Pugsy!

sorry...tried putting them in between [img][/image] and it just said image.

http://imgur.com/zknEKGn <--- redone to include flow limit

Here's one that just over the 12 cm mark where the For Her mode isn't supposed to be as effective.

http://imgur.com/XiFZOH2 <---redone to include flow limit