New settings for auto cpap

Hi everyone, so I did my sleep study and got a prescription for a cpap. It says resmed airsense Autopap. Settings 13 cm H20
The local medical supply place is a complete scam, and I want to buy my machine online. how do I set it to the prescription without dealing with the med supply scam?

Sandalsnsocks wrote: ↑

Mon Jun 03, 2019 8:16 pm

resmed airsense Autopap

If you search for the wrong words, you'll get the wrong thing.

Resmed Airsense 10 AutoSet.

clinical manual for same: https://www.respshop.com/manuals/ResMed ... %20her.pdf

Thanks palerider,
With the autoset I only see settings for minimum and maximum, I’m not sure where they should be set with a prescription of 13

Sandalsnsocks wrote: ↑

Mon Jun 03, 2019 9:49 pm

Thanks palerider,
With the autoset I only see settings for minimum and maximum, I’m not sure where they should be set with a prescription of 13

The autoset can be set for a range, with high and low pressures,
or at a single pressure, whichever works better for you.
The DME is probably ignorant AF--not unusual for that ilk.

Sandalsnsocks wrote: ↑

Mon Jun 03, 2019 9:49 pm

Thanks palerider,
With the autoset I only see settings for minimum and maximum, I’m not sure where they should be set with a prescription of 13

The easiest way is to set the minimum and maximum to the same pressure setting.


Den

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Sandalsnsocks wrote: ↑

Mon Jun 03, 2019 9:49 pm

Thanks palerider,
With the autoset I only see settings for minimum and maximum, I’m not sure where they should be set with a prescription of 13

You *can* set it to cpap mode, but that's not using the machine to it's fullest capacity.

I'd set it for min 13, max 20, and see how things go, you may end up needing more, or less min pressure, after you look at your data.

Sandalsnsocks wrote: ↑

Mon Jun 03, 2019 9:49 pm

Thanks palerider,
With the autoset I only see settings for minimum and maximum, I’m not sure where they should be set with a prescription of 13

When you're just starting out, you ALWAYS want to at least TRY your prescribed pressure for awhile.....to see how close they came to getting it right. After you get some time with that, THEN you can experiment with other settings.


Den

.

Wulfman... wrote: ↑

Mon Jun 03, 2019 10:39 pm

Sandalsnsocks wrote: ↑

Mon Jun 03, 2019 9:49 pm

Thanks palerider,
With the autoset I only see settings for minimum and maximum, I’m not sure where they should be set with a prescription of 13

When you're just starting out, you ALWAYS want to at least TRY your prescribed pressure for awhile.....to see how close they came to getting it right. After you get some time with that, THEN you can experiment with other settings.

There's actually no point in that, other than delaying getting effective treatment.

Running in auto mode, if more pressure is needed, the machine will provide it. If no more pressure is needed, then the pressure won't increase, and you'll know that the rx is actually higher than needed.

I’m not sure why the doc didn’t prescribe a range with an autoset. I’m starting to think I already know more about cpap than them, question: is 13 supposed to be the middle of the range with minimum at 10 or so and max at like 18? Or is 13 the minimum pressure?

To my understating most sleep study results (titration results) indicate a specific, set pressure that accurately treats your apnea (we are all different). If you were to try the straight cpap mode, then you would set your machine at a 13. Then see what happens. If you were to use the autoset mode, which probably most members here do, then I would set the lower number to a comfortable level setting , but not too low that the machine has to travel too far treat a suspected apnea event. If I was just starting out, I would set the lower setting at an 8 or 9, and the upper setting at 20. The upper machine setting is maxed out, but don't worry.... the machine will only rise to whatever pressure it needs to treat an event, then back down to its lower setting. My sleep test result setting was a 10. So, my lower setting is an 8 and my upper setting is a 20. My machine will usually ramp up to a 11-ish to treat my apneas during the night.

Sheriff

Sandalsnsocks wrote: ↑

Tue Jun 04, 2019 6:08 am

I’m not sure why the doc didn’t prescribe a range with an autoset. I’m starting to think I already know more about cpap than them, question: is 13 supposed to be the middle of the range with minimum at 10 or so and max at like 18? Or is 13 the minimum pressure?

Did you have a "in-lab" or "at-home" sleep study?
Do you have a copy of your sleep study to see what it says?
How badly do you want/need your sleep doctor? I've read in these forum pages where sleep doctors have dumped their patients when they started messing with their pressure settings. Yes, it''s YOUR therapy, but that doesn't mean your doctor will tolerate what changes you make. We on the forum advocate the user taking control of their own therapy as soon as possible, but that doesn't mean the doctor will agree with that plan. So, beware.......
Keep in mind that the primary breathing events that drive up pressure on an Auto machine (using a range of pressures) are Flow Limitations and/or Snoring (followed by Hypopneas and maybe Apneas, depending on the machine).
APAP machines can take quite a while to increase pressures (especially if there's a wide pressure range) because they have to stop and see how the previous pressure increase worked before proceeding with more. The minimum time for the machine to determine what was the nature of the event is 10 seconds. APAPs will not attempt to raise pressure while an apnea is in progress. At some point, they will lower the pressure back down to the minimum pressure and start over.
These machines aren't "magic"......they don't know what pressure you need before you need it. They use sensors and sophisticated programs to tell them what to do. But, like anything, what they do may not always be the "right" thing.
If you have lots of nasal congestion (flow limitations and/or snoring) with few hypopneas or apneas, the pressure increases may not be worthwhile in the long run. On the other hand, some people have hypopneas and apneas without the precursor events......and in those cases, the pressures will not rise to try to prevent other events. Pressure changes can also disrupt one's sleep which can affect their sleep quality.
Pressure ranges can also create a number of problems that may "delay getting effective therapy" in that it takes time to figure out what caused a problem and how to solve it. Excessive leaking is one of them.

In my own case, my sleep doctor prescribed a fixed pressure of 18 cm........two centimeters higher than where the sleep study had stopped. I guess I still had some snoring that wasn't resolved and he thought he knew better.
Anyway, I TRIED that pressure ( 18 cm ) for about an hour in my recliner before I came to the conclusion that it was way more than I could sleep with and the leaks were horrendous. So, I changed the pressure to 10 cm. and saw some very good results.......and left it there for about a year. (I had a fully data-capable machine and software to monitor my therapy) My sleep doctor wasn't happy with me, but I fired him shortly thereafter anyway. (he was a jerk)
After a year at 10 cm, I started experimenting with my pressure settings and found that a setting of 12 cm. was even better.
About the same time, I acquired a lightly-used, previously-owned APAP to be a backup machine and to experiment with pressure ranges. I used a range of 10 - 15 cm. for a week and found that my self-prescribed pressure of 12 cm was "just right". I found that I didn't tolerate pressure ranges (and pressure changes) very well and in particular, my quality of sleep. I also found that the Flow Limitations (very few) and Snoring didn't precede my hypopneas and apneas.
Another thing I discovered was that I had a lower AHI using straight pressure than a range of pressures.

So, what I'm saying is to proceed carefully and learn as much as you can as soon as you can. Not everyone can use the same configurations that everyone else uses. That's why an APAP is preferred.......because they have more options with regard to settings.

By the way, to answer your question, 13 would probably be your minimum pressure.

Good luck.


Den

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Sandalsnsocks wrote: ↑

Tue Jun 04, 2019 6:08 am

I’m not sure why the doc didn’t prescribe a range with an autoset. I’m starting to think I already know more about cpap than them, question: is 13 supposed to be the middle of the range with minimum at 10 or so and max at like 18? Or is 13 the minimum pressure?

If they said just 13, then they're not thinking about using an auto machine.

In-lab study suggestions are very often wrong... because they're based on a part of one night.. and if there's anything we've all learned, *sleep varies* from hour to hour and night to night...

So, at the *best* 13 might be good at taking care of most... maybe all your events, but if so, then you probably could spend a good part of the night with less pressure.

But, it's a starting point, that's why I suggested a minimum of 13 and max 20... if you need more pressure, the machine will respond. if, on the other hand, the pressure never goes up during the night, then you could most likely use *less* pressure as a minimum. but I'd suggest starting with a min13... and see how things go for a few days.

Thanks for all the info I really appreciate it! To be clear I had a sleep study at a clinic with all the wires and hoses, then they called me and said they had sent my prescription to a local medical equipment supply, the prescription was from a doc I’ve never met, not the one I saw first. I don’t want to deal with the local local supply store racquet, so asked for a copy of my prescription and they emailed it to me, I’m going to buy the machine online and just want to set it up the way a therapist would to the prescription and get started. I will be using a full mask and live at 4500 feet

Sandalsnsocks wrote: ↑

Tue Jun 04, 2019 4:23 pm

Thanks for all the info I really appreciate it! To be clear I had a sleep study at a clinic with all the wires and hoses, then they called me and said they had sent my prescription to a local medical equipment supply, the prescription was from a doc I’ve never met, not the one I saw first. I don’t want to deal with the local local supply store racquet, so asked for a copy of my prescription and they emailed it to me, I’m going to buy the machine online and just want to set it up the way a therapist would to the prescription and get started. I will be using a full mask and live at 4500 feet

Out of curiosity, was the sleep study done at the same elevation where you live? That might affect the settings that the machine needs to be set too.

bajeiceman wrote: ↑

Tue Jun 04, 2019 10:56 pm

Sandalsnsocks wrote: ↑

Tue Jun 04, 2019 4:23 pm

Thanks for all the info I really appreciate it! To be clear I had a sleep study at a clinic with all the wires and hoses, then they called me and said they had sent my prescription to a local medical equipment supply, the prescription was from a doc I’ve never met, not the one I saw first. I don’t want to deal with the local local supply store racquet, so asked for a copy of my prescription and they emailed it to me, I’m going to buy the machine online and just want to set it up the way a therapist would to the prescription and get started. I will be using a full mask and live at 4500 feet

Out of curiosity, was the sleep study done at the same elevation where you live? That might affect the settings that the machine needs to be set too.

No. All data-capable machines have automatic altitude compensation (and have for quite a few years).


Den

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