Airsense 10 ramp up question

New user, just got the Airsense 10 auto on Friday. Having trouble falling asleep. Feels like I'm suffocating when I'm on the verge of going to sleep. I'm thinking the pressure is inadequate. Doc has prescribe a range of 5-20...when I get to sleep I can sleep with virtually no events. Prior to that time my events are through the roof. Do I need to contact the doc to set the minimum higher? Right now the ramp is set to off. Would setting that to auto make a difference?

Congratulations on starting treatment for your sleep apnea -- and on using Oscar.

Many people find that they feel somewhat starved for air with a minimum less than 7, so try increasing your minimum to 7 and see whether that feels better. You can do that yourself if you're comfortable changing your settings; you can access the clinical settings by holding down the home button and the round knob simultaneously for a few seconds.

For the chart you posted, around what time do you think you actually fell asleep?

On the above report I see the first break in therapy so I assume you didn't sleep that first short segment.
On the second session....about how long were you awake before you finally went to sleep?

Auto ramp...it is limited to 30 minutes or when it thinks you are asleep...or whichever comes first.
It won't flag awake breathing flagged events during ramp so the AHI should reduce if the bulk of your AHI is more from awake breathing false positives.
Awake/semi awake flagged events don't count...you must be asleep.

Ramp usually starts out at 4 cm and the gradually moves up to the set pressure. Going from 4 to 5 cm isn't much of a trip but you can set the ramp to start higher if you wish. It is a setting available in the clinical setup menu area.
See the manual here for how to get into the setup menu are where changes can be made.
I think it is page 14.
https://www.respshop.com/manuals/ResMed ... %20her.pdf

During any ramp time the machine won't flag anything or respond to anything...whether it is auto ramp or regular ramp.

The bulk of your flagged events are central apneas (CA/clear airway events on the OSCAR report). Those might be simply awake breathing pauses in your own breathing because we pause our breaths all the time and don't know it.
Some might be what we call sleep onset central apneas and these are normal to see and not normally a big deal unless we have a bunch of them and they cause us to either have desats or bounce us back to awake stage and we can't progress to sleep.
It does sound like you might be having a bunch of sleep onset central apneas but we don't know for sure.
Sometimes a fine line between a real sleep onset central and an awake/semi awake pause in breathing flagged central.
http://freecpapadvice.com/sleepyhead-free-software
Watch the videos here to help you spot awake vs asleep breathing flagged events.

Obviously the main problem is sleep onset...and whatever is happening either just from a comfort aspect or central event aspect with sleep onset centrals.

My suggestion to start with...Turn EPR off or set it to ramp only if you need it but it really shouldn't be needed with a minimum of 5 cm..but you can set it to ramp only and make use of the ramp feature.

Turning EPR off effectively increases the baseline pressure a bit and removes the chance of EPR being a trigger for central apneas though to be honest I doubt that EPR is the cause of your central apneas.
But it might be a trigger for sleep onset centrals (assuming you are having some of those that keep bouncing you out of sleep).
Hurts nothing to remove it from the equation just to check it out and see.

The chart depicts what I was feeling--sorry that it is a bit blurry. There is a file size limit so I had to shrink it. From about 10:30 to 1:30 I feel like I didn't sleep at all. And pulled my Dreamwear full faced mask off a couple of times because it felt suffocating just when it seemed I was drifting off to sleep. Around 1:30 I took a pee break and left my machine on after I removed the mask. When I put the mask back on I felt more pressure and went soundly to sleep right away. From 1:30 to 4:30 I thought that was good sleep.

So my doc won't be upset it I changed the minimum pressure? 4 to 6 feels like nothing to me. I don't feel discomfort with higher pressure levels. EPR is new to me..... That's a changeable setting, eh? Just googled it. I appreciate your comments and help.

Kargurin wrote: ↑

Sun Aug 08, 2021 12:36 pm

So my doc won't be upset it I changed the minimum pressure?

Why care? It's your therapy. Your health. If he doesn't like it, find a better doctor. Or none at all. I quit my sleep medicine provider. My GP, who admits he knows almost nothing about CPAP, is happy to provide me with the annual script I need for supplies.

Thinking positively, your doctor may be happy to have a fully engaged patient. Most of his patients probably don't know a minimum pressure setting from a hole in the ground.

Depends on the doctor if he gets upset over the patient changing the pressure...how big of a power trip he likes to go on.
I figure if he prescribes the auto range....why should it be a big deal if the minimum gets adjusted upwards a bit because the machine can do it automatically.
Most doctors are (or should be) familiar with the comfort side of things and the fact that lower pressures sometimes are a bit suffocating like feeling for some people. Not everyone is happy with minimal starting pressures. I know the reason a lot of docs start with the low minimums is because to start higher can be a bit overwhelming to some people but they forget that starting low can also be a bit overwhelming for another group of people.

Not to mention the therapy side of things but I have always maintained that we need to get to sleep first and without sleep none of this matters so anything that we can do to help us get to sleep and stay asleep is fair game to try and any doctor who isn't on board with that fact is not a good enough doctor to warrant my business.

Next time you try a screen shot you might try jpg file type and see if that comes in for a smaller file than the png file type.
Forum attachments limit the file to 1 MB.
Or you can use an outside photo hosting website like imgur.com to host larger files that won't attach.
No need to redo the above image at this time though. I can see well enough and the statistics which are the blurriest, not all that critical at this point. I have seen enough of these reports to have a good idea what the statistics are showing.

How to change the pressure on the ResMed AirSense 10 AUTOSET CPAP machine
https://www.youtube.com/watch?v=tBgNdoJ6-bI

Great vid.... Many thanks for the responses. I notched up minimum and starting pressure up one after I took pics of all my default settings. Leaving EPR as is at the moment. It's currently set as 3. I'm turning ramp off (as it was) since I don't think that is going to impact things much.

Kargurin wrote: ↑

Sun Aug 08, 2021 11:44 am

New user, just got the Airsense 10 auto on Friday. Having trouble falling asleep. Feels like I'm suffocating when I'm on the verge of going to sleep. I'm thinking the pressure is inadequate. Doc has prescribe a range of 5-20...when I get to sleep I can sleep with virtually no events. Prior to that time my events are through the roof. Do I need to contact the doc to set the minimum higher? Right now the ramp is set to off. Would setting that to auto make a difference?

Your image is too small to get any good information out of, do *not* shrink the images, the forum will do that for you.

You either need to raise the minimum, or fight with you doctor, who left the machine, basically, at factory settings.

I'd guess at a minimum of 8.

Maybe I missed something on the upload but the message I got when I tried to upload the screenshot was that it was too big.

Attachments are limited to 1 MB file size.
Shrinking whatever you shrank ended up shrinking the details (numbers) so not a great option.
A lot of time people shrink the image itself and that's where they get into trouble.

Lets try it again....I'm on a Mac. I am new to them. Everything looks small to me but I can see this clearly.

Kargurin wrote: ↑

Sun Aug 08, 2021 2:42 pm

Lets try it again....I'm on a Mac. I am new to them. Everything looks small to me but I can see this clearly.

Perfect, if you right click on the image and open it in another window, it's full size.

I'd still go for 8 for a minimum pressure, *maybe* 7, but 8 would give you a little margin, if you look at the pressure curve, you see that several times when it gets below 8, you have some breathing events that cause the pressure to jump up again.

While it may look small initially I can open it in a new tab and then zoom in or increase the image to make it easily readable.
Good job.
Whatever you did to get this new image....success.

You probably are going to want to increase that minimum a bit at some point in the near future.
The minimum pressure is the setting that does the bulk of the work holding the airway open in the first place and PREVENTING obstructive collapses. That's the main job of cpap...preventing the collapse in the first place...not dealing with it after the fact.

Now the central apneas...real asleep or awake...more pressure won't fix those.
But maybe preventing the collapses in the first place will allow for more solid sleep and less chance of either sleep onset centrals or awake breathing false positives from ever happening.

I just googled starting pressure vs. minimum pressure and can't see anything of help. I would think those things are the same. But they are not. What is the difference. BTW, I do think before I sleep tonite I'll ratchet the minimum pressure up another notch. Should I make starting and minimum the same?