First Day on Resmed Autoset II - Settings?

[macmermaid]

My husband will start therapy next Wednesday on the Resmed Autoset II if all goes well at the DME. They have the machine in the office and we have an appointment scheduled with an RT.

In my husband's sleep study, they put a CPAP on him and adjusted it up to level 9 (it was a Respironics machine) and determined that was the right pressure for him - although they didn't get to level 9 until the last hour or so of the study.

The prescription from the Sleep Doctor for the Autoset II says to use the default setting - 6 - 20.

We were thinking maybe we should start with the Autoset in CPAP mode set at level 9, for a week or so, and look at the data. We have the card reader and software. That way we could have a "baseline" similar to what already seemed to work in the sleep lab.

Then we would try the Auto mode for a week or so to see if: a) it is more comfortable for him, and b) if the results can be improved (if there is room for improvement). I was reading the clinician's manual and it seems that the Auto mode is able to detect snoring and handles it in a particular way - in addition to apneas and hypoapneas around 40 per hour, my husband also had significant sleep disturbance (RERAs of around 40 an hour) just from his snoring alone, so we are curious about how the auto machine will deal with it.

How does this sound for a plan? Would it be better to start in Auto mode as prescribed? Is 6 - 20 a good place to start when he has already been "titrated" to level 9?

Thanks!!

[sronsen]

Running the S8 Autoset II in CPAP mode won't give you the information you want and, IMHO, defeats the advantages of the APAP.

Running it at 6 - 20 will give you an idea of how much over the 9 cm your requirements get, and for how long in your home environment, which is different from the sleep lab. This will allow you to zero into a narrower range, like 7 - 11. In APAP mode, you can fall asleep at the lower pressure and have the machine raise the pressure when needed. If the range is narrow, 4cm, most users don't find the pressure change noticeable. Some, however, are bothered by the pressure change and revert to straight CPAP mode.

You're lucky that you're getting an APAP without a fight. Good luck.

[frogman]

macmermaid,

Since I am very new at this I can only offer insight from my limited experience. Without more data from the sleep study to indicate different setting requirements for different sleep positions, and since there wasn't much time spent at the 9 cm setting, it may be better to start in auto mode, as prescribed, and let the machine perform its intended job of finding the optimum pressure for each situation. After a couple of weeks data have been collected there should be more to go on. As far as the snoring, I snored like a freight train before APAP and my daughter, whom I used to disturb in the next bedroom, says she hasn't heard a single snore since I began using APAP (luckily, as long as my wife fell asleep prior to me she was able to put up with my snoring all those years). I would not be surprised if your husband sees similar results.

Good luck!

frogman

[Wulfman]

My husband will start therapy next Wednesday on the Resmed Autoset II if all goes well at the DME. They have the machine in the office and we have an appointment scheduled with an RT.

In my husband's sleep study, they put a CPAP on him and adjusted it up to level 9 (it was a Respironics machine) and determined that was the right pressure for him - although they didn't get to level 9 until the last hour or so of the study.

The prescription from the Sleep Doctor for the Autoset II says to use the default setting - 6 - 20.

We were thinking maybe we should start with the Autoset in CPAP mode set at level 9, for a week or so, and look at the data. We have the card reader and software. That way we could have a "baseline" similar to what already seemed to work in the sleep lab.

Then we would try the Auto mode for a week or so to see if: a) it is more comfortable for him, and b) if the results can be improved (if there is room for improvement). I was reading the clinician's manual and it seems that the Auto mode is able to detect snoring and handles it in a particular way - in addition to apneas and hypoapneas around 40 per hour, my husband also had significant sleep disturbance (RERAs of around 40 an hour) just from his snoring alone, so we are curious about how the auto machine will deal with it.

How does this sound for a plan? Would it be better to start in Auto mode as prescribed? Is 6 - 20 a good place to start when he has already been "titrated" to level 9?

Thanks!!

That is ABSOLUTELY the right thing to do! I always advise people to at least START with their titrated pressure and adjust from there (if necessary). There's about a 50% chance they got the pressure right (or darn close) in the sleep study and you need to either prove or disprove it.

From my observations, Autos/APAPs present too many problems (like leaks) for new users to comprehend and the adjusting pressures can disturb their sleep. Do NOT start in Auto mode with a range of pressures.
If you start out at the titrated pressure and the data looks reasonably close, sometimes an adjustment (tweak) of one or two centimeters of pressure is all it takes to make it better.

Give it a few nights to a couple of weeks of data gathering before tweaking. It's quite common for the apnea/hypopnea numbers to come down (on their own) in that amount of time


Den

[Paul56]

My husband will start therapy next Wednesday on the Resmed Autoset II if all goes well at the DME. They have the machine in the office and we have an appointment scheduled with an RT.

In my husband's sleep study, they put a CPAP on him and adjusted it up to level 9 (it was a Respironics machine) and determined that was the right pressure for him - although they didn't get to level 9 until the last hour or so of the study.

The prescription from the Sleep Doctor for the Autoset II says to use the default setting - 6 - 20.

We were thinking maybe we should start with the Autoset in CPAP mode set at level 9, for a week or so, and look at the data. We have the card reader and software. That way we could have a "baseline" similar to what already seemed to work in the sleep lab.

Then we would try the Auto mode for a week or so to see if: a) it is more comfortable for him, and b) if the results can be improved (if there is room for improvement). I was reading the clinician's manual and it seems that the Auto mode is able to detect snoring and handles it in a particular way - in addition to apneas and hypoapneas around 40 per hour, my husband also had significant sleep disturbance (RERAs of around 40 an hour) just from his snoring alone, so we are curious about how the auto machine will deal with it.

How does this sound for a plan? Would it be better to start in Auto mode as prescribed? Is 6 - 20 a good place to start when he has already been "titrated" to level 9?

Thanks!!

Save yourself some fiddle time... and start with running it in AUTO mode from 9 - 20 and do keep in mind that the algorithm of the Resmed Auto will not respond to anything above pressure of 10.

Do keep a daily record of what the results are and review them after a week. Keep the machine on the same settings for a week before making adjustments.

To summarize my own personal experience... I spend weeks fiddling with the machine in AUTO and landed up doing BEST with the machine running in straight CPAP at a fixed pressure. Of course, your own mileage and experience will vary.

[macmermaid]

My husband will start therapy next Wednesday on the Resmed Autoset II if all goes well at the DME. They have the machine in the office and we have an appointment scheduled with an RT.

In my husband's sleep study, they put a CPAP on him and adjusted it up to level 9 (it was a Respironics machine) and determined that was the right pressure for him - although they didn't get to level 9 until the last hour or so of the study.

The prescription from the Sleep Doctor for the Autoset II says to use the default setting - 6 - 20.

We were thinking maybe we should start with the Autoset in CPAP mode set at level 9, for a week or so, and look at the data. We have the card reader and software. That way we could have a "baseline" similar to what already seemed to work in the sleep lab.

Then we would try the Auto mode for a week or so to see if: a) it is more comfortable for him, and b) if the results can be improved (if there is room for improvement). I was reading the clinician's manual and it seems that the Auto mode is able to detect snoring and handles it in a particular way - in addition to apneas and hypoapneas around 40 per hour, my husband also had significant sleep disturbance (RERAs of around 40 an hour) just from his snoring alone, so we are curious about how the auto machine will deal with it.

How does this sound for a plan? Would it be better to start in Auto mode as prescribed? Is 6 - 20 a good place to start when he has already been "titrated" to level 9?

Thanks!!

Save yourself some fiddle time... and start with running it in AUTO mode from 9 - 20 and do keep in mind that the algorithm of the Resmed Auto will not respond to anything above pressure of 10.

Do keep a daily record of what the results are and review them after a week. Keep the machine on the same settings for a week before making adjustments.

To summarize my own personal experience... I spend weeks fiddling with the machine in AUTO and landed up doing BEST with the machine running in straight CPAP at a fixed pressure. Of course, your own mileage and experience will vary.

Paul56 - what does it mean that "Auto will not respond to anything above pressure of 10"? Thanks

[Slinky]

It is a mis-leading statement that I get tired of seeing w/o the full explanation of how Resmed's algorhythem responds and why being given.

[peppi]

This will allow you to zero into a narrower range, like 7 - 11. In APAP mode, you can fall asleep at the lower pressure and have the machine raise the pressure when needed.

This is exactly the range I use and my machine usually says 9.2 as a pressure when I wake up from a very restful nights sleep.
I start off at 7 and I get a very natural, unnoticed pressure while I'm awake. I set the EPR to 2 which to me gives even more nature exhale/inhale recovery.

My AIs are at 0 the last three nights and HIs at 3-4 with zero leaks so I think I'm set to optimum. Especially since false HIs detections when awake are averaged to those real when asleep .

I love the autoset feature and wouldn't think of turning it off. I allows me to get to sleep faster without having the unneeded extra pressure while I'm falling asleep.
Just my two cents.

Good luck.

Phil

[billbolton]

do keep in mind that the algorithm of the Resmed Auto will not respond to anything above pressure of 10.

<sigh>

Resmed S8s will not respond to frank apneas (that is - apneas without any evident precursor events, which could well be central apneas) above 10cms H20, but will respond to apneas with evident precursor events.

[Slinky]

THANK YOU, Bill Bolton for explaining in such short and simple terms!!!!!

[macmermaid]

Thanks for clarifying. No central apneas, just snoring RERAs and apneas and hypoapneas.

[GaryG]

do keep in mind that the algorithm of the Resmed Auto will not respond to anything above pressure of 10.

<sigh>

Resmed S8s will not respond to frank apneas (that is - apneas without any evident precursor events, which could well be central apneas) above 10cms H20, but will respond to apneas with evident precursor events.

Thanks, Bill.

[Muse-Inc]

I sleep much much better with my APAP set 6.4-15 than I did with CPAP set at 9 (my latest sleep doc recommended pressure).

[Paul56]

Wow... I make a few personal observations and get tarred 'n feathered because I don't offer up the technical details.

Lighten up folks.

[Muse-Inc]

Ah, Paul, things have been...er, lively, here on several threads and everyone's a bit touchy these days it seems. Maybe the holidays are adding stress to our already stressful lives?