Setting pressure with S8 autoset II

[rbtgjns]

Night 3
Settings: Pressure MIN. 16, Max 20
Pressure 95% 16
EPR 1 FULLTIME
MASKS LEAKS 0.26
MASK ULTRA MIRAGE II
AHI 12.8
AI 2.9
HI 9.9
USAGE 6.41 HRS.
IMPROVED HI
Humidifier set at 4.5
QUALITY FAIR--NOT WELL RESTED

plan---into CPAP mode setting at 13 EPR 2 fulltime Activa mask
Try to get copies of the sleep study for data..

Reply to DEN no GERD or other reflux symptoms

[rbtgjns]

4 night

CPAP MODE
Pressure setting @ 15 EPR at 2 Full Time, EPR inhale at fast
start at 7 ramp at 5 minuets
mask mirage activa shallow
leaks .54l/s
AHI 9.0
AI 1.6
HI 7.4
USAGE 6.37HRS.
AUSSI HEATED HOSE
SOME CONDENSATION IN THE 8" OF EXPOSED HOSE

Sleep Quality--good, but think there can be improvement!

Plan--repeat all setting to dup. results for comparison. want to reduce leaks and HI results.

Have all three previous sleep studies--will post summaries soon.

[rbtgjns]

Night 5 BEST SO FAR !!!!
CPAP MODE
PRESSURE SET 13.0
AHI 8.1
AI 2.1
HI 6.0
MASK ACTVIA NASAL
LEAKS .20L/S
RAMP 5 MIN.
ERP FULL TIME LEVEL 1
ER INHALE--FAST
SLEEP 6.06 HRS
QUALITY--RESTED AND COMFORTABLE
IMPROVED AHI, AI, HI
PLAN REVIEW SLEEP SUDIES AND CONSIDER AUTU MODE WITH LOWER PARAMETERS ( 8 TO 14)

ANY IDEAS ??????

[rested gal]

Night 5 BEST SO FAR !!!!
CPAP MODE
PRESSURE SET 13.0

QUALITY--RESTED AND COMFORTABLE
IMPROVED AHI, AI, HI
---
ANY IDEAS ??????

My goodness! With that kind of success, I don't think I'd be considering this...

PLAN --- CONSIDER AUTU MODE WITH LOWER PARAMETERS ( 8 TO 14)

I'd just stick to plain CPAP mode at pressure of 13.

Might be a good idea to stick with settings for at least 3 or 4 nights in a row before making another change.

[Wulfman]

I agree with RG. Especially the part about (not) going back to Auto mode. Let everything "settle in" for a week or so and see what things look like.


Den

[Autopapdude]

Try 13 or 14/ 20. I think you need a higher min pressure as a good guess, based on your numbers.

[rbtgjns]

Night 6

CPAP mode--ramp 7,Pressure 12.6
Mask activa nasal
EPR--ramp ONLY EPR 2
EPR inhale set at FAST
Leak 0.30
AHI 14.6
AI 3.9
HI 10.7
usage 9.09hrs

SLEEP Quality - alittle tired (thought that small change in setting would improve experience???what went wrong--slept too long?)

Plan to return to best settings: CPAP 13, EPR all time @2
Limit sleep to less than 8 hours

[rested gal]

Night 6

SLEEP Quality - alittle tired (thought that small change in setting would improve experience???what went wrong--slept too long?)

Plan to return to best settings: CPAP 13, EPR all time @2

There are going to be natural variations in results, experience, etc. There is no magic, perfect, pinpoint CPAP setting (or autopap range) that will be "THE SETTING" for a person. And even if CPAP is doing its part of the job well (keeping a person's airway open) there can be OTHER reasons for not feeling great the next day. Could be nagging arthritic pain, even very mild, disturbing one's sleep all night long without the person even being aware of the constant arousals.

There are a lot of things besides sleep disordered breathing that can affect how we feel....other health issues, stress, med side effects, sleep hygiene problems, household noises, neighborhood noises...the list could go on and on.

I would not make new tweaks every night. I'd stay with one set of settings for at least several days. Expecting each and every change to result in a corresponding change in your sleep experience, or in how you feel, is not going to happen, imho.

Limit sleep to less than 8 hours

I wouldn't limit my sleep hours. You may need a full 8 hours (or even more) every night or on some nights.

rbtgjns, you are doing a great job keeping meticulous records of your results. Perhaps now's the time to start giving a setting some more time.

I wouldn't expect the results to stay the same at "same setting", or to change with each tweak to the settings. Even people who sleep/breathe absolutely normally and have no need for CPAP have changes in the quality of their sleep, changes in how they're breathing during their sleep on some nights, and changes in how rested and refreshed they feel the next day. It's not going to be a steady line of feeling better or feeling good.

If, for some other reason, we don't feel the way we expect we should the next day after making a small change in settings, it's not necessarily the change that's responsible for that. Could be something entirely unrelated to CPAP or sleep disordered breathing making us feel one way or another the next day.

I think Den's excellent advice bears keeping in mind:

Let everything "settle in" for a week or so and see what things look like.

Den

[Wulfman]

The only other thing I have to add (I agree with RG, again) is that I'm wondering why you dropped your pressure. I've felt that you ultimately need a little more......you just need to find what it is......but leave it at each setting for at least 3 nights because this therapy is all about averages and we don't sleep or breath the same every night.

And, again, don't limit your sleep time just because you think it may be affecting your numbers. Your body has been sleep and oxygen deprived for a long time and it needs to heal.


Den

[Colombia]

Hello:

I'm a newbie and have enjoyed reading and hopefully learning from this forum. I would have been completely lost without your help. I live in Medellin, Colombia and had my unit delivered by a friend. I'm still waiting for the results of my sleep test. (some things take longer in South America)
The tech told me I had a moderate Apnea problem following my examination and I purchased the unit in case it was needed. I hope to be talking with a doctor in the next few weeks and I'm scheduled for another sleep over. I know I jumped the gun on the machine purchase without having the results of my sleep study first, but it's not everyday I have someone willing to hand deliver a package to Colombia.

I have been using my S8 autoset 11 for the last three days and attempting to tweak the unit for best results. The tweak on 24 Oct. was a great improvement over the first two nights especially the comfort level. (EPR Full Time) The following readings were taken from the machine each morning.

Thanks again for sharing.

Leo


Date Hours Press Leaks AHI AI HI Notes
22-Oct 10.60 0.64 16.30 0.60 15.70
23-Oct 7:20 11.20 0.46 12.40 2.40 10.00
24-Oct 4:56 10.80 0.20 9.10 3.40 5.70 A1

24 Oct. Changed to Settling 5 Min, Min 8.0, Max 15, EPR Full Time, EPR Level 2, Good comfort, side position

[Colombia]

Sorry about the earlier format.
I'm still learning.


Date Hours Press Leaks AHI AI HI
22-Oct 10.60 0.64 16.30 0.60 15.70
23-Oct 7:20 11.20 0.46 12.40 2.40 10.00
24-Oct 4:56 10.80 0.20 9.10 3.40 5.70

[rbtgjns]

Sleep Study (3)
Dates ......................... 6/10/03 ............................ 8/26/03...........................1/18/05
Sleep Efficiency----------------- 81%---------------------------------- 82.7%-------------------------------- 77.6%
stage 1--------------------------- 51.7%------------------------------- 29.%---------------------------------- 10.%
stage II --------------------------48.3%-------------------------------- 56.9%---------------------------------78.1%
slow wave -----------------------none---------------------------------none------------------------------------none
REM ----------------------------- none-----------------------reduced@13.6% -----------------------reduced@11.3%
respiratory dist. index-------- 57.9 (no mask)------------------ 4 @ CPAP 15 ------------------------ 0.2 @ 13
apnea index -------------------- 20.3 per hour (duration 23.4 sec)
hypopneas---------------------100 per hour (duration 30.1 sec)
Ox Desat--------------------- 74.5%---------------------- maintained above 90%---------------------- above 90%
arousals (OSE)---------------52.3 per hr.--------------------- 7.7 per hr------------------------------.7 per hr.
spontaneous arousals ------8.3 per hr -----------------------19.6 per hr----------------------------- 33.2 per
bradycardia ------------------ yes ------------------------------ yes -------------------------------------yes
PVC--------------------------- rare---------------------------- none-------------------------------------- none
tritation---------------------10------------------------------- 15------------------------------------------13

Conclusion--sleep architecture disturbed, severe sleep anpea, severe desaturation

[rested gal]

I have been using my S8 autoset 11 for the last three days and attempting to tweak the unit for best results. The tweak on 24 Oct. was a great improvement over the first two nights especially the comfort level. (EPR Full Time)

---------

24 Oct. Changed to Settling 5 Min, Min 8.0, Max 15, EPR Full Time, EPR Level 2, Good comfort, side position

Welcome to the board, Leo. It looks like you're doing an excellent job getting your treatment dialed in. Well done.

The leak rates of 0.64 and 0.46 for your first couple of nights were too high, but you probably were adjusting your mask quite a bit as you got used to the equipment. Possibly you were taking the mask on and off several times to reseat it on your face with the machine still blowing.

Your leak rate of 0.20 on Oct. 24 was a big improvement. A perfect leak rate with a ResMed machine is 0.0. Keeping the leak rate below 0.20 is good. A leak rate of 0.40 or higher is bad.

[rbtgjns]

Night 7
mask--mirage activa nasal
CPAP @13.2
leaks 0.20
AHI 13.7
AI 3.6
HI 10.1
SLEPT 6.33

quality--mildly tired (work day ahead-awake at 5am)

[rbtgjns]

Night 8----------------------------S8 AUTOSET II/S8 ELITE DATA COMPARISON
mask actvia nasal--------------MIRAGE ULTRA II
leaks 0.36----------------------6 MONTHS AVE 0.12
AHI 12.7-----------------------6 MONTHS AVE 9.2
AI 3.1--------------------------6 MONTHS AVE 2.0
HI 9.6---------------------------6 MONTHS AVE 7.7
USAGE 6.26 HRS--------------6 MONTHS 6.59
CPAP MODE--------------------CPAP
PRESSURE 14.0---------------13.0
EPR FULL TIME----------------EPR FULL TIME
EPR @ 2------------------------EPR @ 2
INHALE FAST-----------------N/A

SLEEP QUALITY FAIR .....TIRED

CONCLUSION 1. ULTRA LEAKS LOWER THAN MIRAGE, 2. AI AND HI LOWER WITH ULTRA, 3. ACTIVA MORE COMFORTABLE

COMMENTS 1. NO GERD. 2. NO ARTHRITIS, 3. BECOMING TIRED IN LATE AFTERNOON/EVENING (MICRO SLEEPS @ HOME---BRADYCARDIA?)

PLAN-----TRY TO REPLICATE OLD FINDINGS WITH ULTRA MASK AND OLDER S8 ELITE (COULD THE TWO MACHINE NOT BE PERFECTLY CALIBRATED . WILL make A MANOMETER (SEE IF BOTH MACHINE FLO SETTING ARE IDENTICAL)....If I did'nt feel so tired I would be having fun with this.
THEN...........USE AUTOSET IN CPAP MODE ONE NIGHT @ 13.0 TO SEE IF THE MASK IS MAKING THE DIFFERENCE. I do set the MASK clinical menu to the proper ResMed mask AND CHECK MASK FIT BEFORE LIGHTS OUT-----FIT IS ALWAYS RATED AT EXCELLENT.

NOTE====HAVE AN APPOINTMENT WITH A MD WITH POST DOC. DIPLOMAT E IN SLEEP STUDIES ON 11/12 .

BEST FINDING-----AUSSI HOSE WORKS WELL (HOT HUMID AIR FEELS GREAT)