First Night with IntelliPAP

[Cotay]

On my PRS1 I’ve been getting an average AHI of 2.8 set to 8cm-14cm. Yesterday I received my new IntelliPAP Auto and with the machine set to 8cm-14cm I received the following stats:

% Days at least 4 hours 100%
Day Count 1
Days at least 4 hours 1
95th Percentile Pressure 10.5
90th Percentile Pressure 10.0
AHI 5.5
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 0.00
EPI 26
While Breathing Hours Last Day 8.4

I’m thinking I need to increase my lower number to 8.5cm or 9cm at this point to get that AHI down. Any other suggestions on what else might be going on here? Honestly I’m not sure the significance of the EPI number. ..what does knowing the number of Expiratory Puffs really tell me?

[Emilia]

You've only used it one night so I would give it a couple of more to see if your settings are something you adjust to and settle into. It is possible you need to bump up the lower number by .5, but I'd wait until a couple of more nights of data to see if your 95%tile remains at 10.5 or if your AHI remains at 5 or higher. You might also bring the higher pressure down a notch to 12.5 or 13 as we generally use two above and two below the 95%tile to set the range. Either adjustment or both should yield a lower AHI, but I still would wait another night or two before changing it.... unless you are feeling badly then make the change(s) now.

EPI is defined as events where you breathe in through your nose and out through your mouth in shallow puffs. 26 is high...so it is possible you are losing some therapy via your mouth. My EPI is almost always 0.

Check your PM for some information I am giving you on your machine.

[Slartybartfast]

The machines don't all calculate AHIs the same way. My S9 Autoset usually shows 0.0 to 0.5 AHI, while my Intellipap usually shows 1.5 to 2.5 AHI with the same settings. I don't believe the difference at that leve l is of any real significance. My advice is to collect more data and make small changes and see what effect they have on your AHI over a week's time. Night by night variation is considerable.

It might be that you are unaccustomed to the feel of the way the Intellipap is responding to your breathing. Look at your I-rounding and E-rounding settings and SmartFlex settings http://c0192001.cdn.cloudfiles.rackspac ... -chart.pdf I set my I-rounding and E rounding to 5, the maximum, and the EPR to 3, also the maximum. That way, the Intellipap breathes just like my S9 Autoset and I sleep just as well on either machine.

It might be that playing around with those settings will allow you to breathe more naturally. If you're not fighting the machine you will sleep better.

[Cotay]

Thank you Emilia and Slartybartfast! Your replies are extremely helpful and I'm looking forward to reading the links you've both provided.

I did immediately notice the different "feel" of the IntelliPAP compared to the PRS1. I'll see if the Exhalation Comparison reveals any appropriate adjustments.

[Cotay]

Slartybartfast, I moved my I-rounding and E-rounding each to 4 and set the Smartflex setting to 2. I left my min/max pressures the same as the night before.

The good news is that I didn't struggle with the machine any longer & the EPI dropped dramatically. I'll give it another day or two on the AHI and then start adjusting the min/max levels.

% Days at least 4 hours 100%
Day Count 1
Days at least 4 hours 1
95th Percentile Pressure 11.0
90th Percentile Pressure 10.5
AHI 6.0
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 0.25
EPI 2
While Breathing Hours Last Day 7.8

[Slartybartfast]

That's my standard caveat for new users of the Intellipap. The factory settings are rather harsh, and the machine needs to be set up correctly. That's a benefit and a liability for DeVilbiss, I think. The machine is very customizable, but at the same time, if someone picks it up and plugs in without setting it up, or having the DME set it up correctly, it can feel rather odd.

I'm glad you took the time to make the adjustments. Don't be afraid to play around with settings on that machine. Learn what works for you.

[Cotay]

So last night I got home very late from work and had to be up early...I feel like crud today and from my AHI last night I can see why.

% Days at least 4 hours 100%
Day Count 1
Days at least 4 hours 1
95th Percentile Pressure 12.0
90th Percentile Pressure 11.5
AHI 9.0
Pressure Plateau Time 5%
High Leak Flow Time 0%
NRI 0.25
EPI 1
While Breathing Hours Last Day 6.3

The night before last I had an AHI of 4.5...so I don't know what happened. This is by far the worst night I've had since starting therapy...does this just happen once in awhile?

[Emilia]

Your adjustment of the Flex settings probably is the culprit. When you have it set at 4, you are essentially reducing your pressure by 4 so you were getting much less pressure last night. My SmartFlex is set on Full Time at 2, but my iRounding is at 2 and my eRounding at 1. Everyone has to adjust these to your own liking, but keep in mind the impact it has to your pressures. If you want to keep them at 4, I certainly bump up the pressures to compensate. Might take a bit more tweaking because of this.....

[Dormejo]

Hi, forgive my ingnorance what are the 'I' and 'E' settings that are mentioned above in other posts. I am new to CPAP and trialling the Intellipap for an upcoming camping trip. My first weeks using FP Icon were really good now I find using the Intellipap im back to the start again.....feeling a little frustrated with all the data info and adjustments that can be made. I find the intructions from Devilbiss are a little confusing.
thanks

[Dormejo]

what are the 'I' and 'E' settings that are mentioned above in other posts

thanks