Adjusting Settings on Airsense 10

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sleepquest21
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Adjusting Settings on Airsense 10

Post by sleepquest21 » Sun Jul 17, 2022 6:44 am

I just purchased a new Airsense 10 CPAP machine. It was set so that the initial pressure setting is only 2, which makes me feel like I am not getting enough air flow when I first put on the mask. After taking care of all of the things I need to do before bed, including climbing the stairs, I need more air flow to feel comfortable. I am look for a way to bump up the starting value to provide a bit more air flow.

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LSAT
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Re: Adjusting Settings on Airsense 10

Post by LSAT » Sun Jul 17, 2022 7:19 am

Your setting cannot be 2...The lowest the machine will go is 4. You can see your pressure settings on the screen when you turn on the machine. Maybe you need to turn off the ramp....https://www.youtube.com/watch?v=vHkJuuZuhfc

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sleepquest21
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Re: Adjusting Settings on Airsense 10

Post by sleepquest21 » Sun Jul 17, 2022 8:52 am

Thanks! You are correct. The minimum pressure is 4. I saw that when I uploaded the data to OSCAR. I have a lot of events in the phase where the machine is slowly ramping up to a higher pressure. Maybe turning off ramp would solve that as well.

I pushed the starting pressure up to 6 to see if that would be enough. Now that I know how to make the adjustment, I can tweak it to get the setting that works best for me. I left on the ramp for now, but nice to know that I have the option to just turn it off if I want to.

I was also able to reset the clock for my time zone, so now the times in OSCAR will make more sense. Thanks again for your help! :D

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Pugsy
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Re: Adjusting Settings on Airsense 10

Post by Pugsy » Sun Jul 17, 2022 9:05 am

Can you post a detailed report from OSCAR so we can see what you are seeing?
During ramp itself most ResMed machines don't record anything so it's odd that you say you see stuff happening during ramp.
I wasn't aware of ResMed changing the "no recording during ramp" to "recording events during ramp" and if that is indeed happening we need proof to adjust the advice we give people.

Not to mention you say you have
sleepquest21 wrote:
Sun Jul 17, 2022 6:44 am
Airsense 10 CPAP machine.
and that model doesn't offer pressure graphs to evaluate....so I don't know what model you have but it isn't what you state it is....which can totally change what people are offering in terms of advice.
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Re: Adjusting Settings on Airsense 10

Post by Dog Slobber » Sun Jul 17, 2022 9:24 am

Instead of telling us what the graphs say, post the graphs.

What do you mean by Ramp?

Ramp has a well defined meaning with regard to CPAP, it's a setting for the initial pressure of the machine before therapy begins. Ramp is also often used by many to describe the machine increasing pressure. "the machine is slowly ramping up to a higher pressure"

You are using the term "ramp" both ways, and the Ramp setting doesn't typically influence how quickly the machine "ramps" up pressure. The one exception being, when the machines Ramp period ends, if the pressure is too low then when therapy begins the machine might respond by immediately increasing pressure.

Is this what's happening? If this is the case than yes, turn off ramp?

Having a minimum pressure of 4 is almost always problematic, and often results in patients feeling starved for air and poor therapy as the machine responds to events.

Your post doesn't accurately describe your device and is different than what your signature states.

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Re: Adjusting Settings on Airsense 10

Post by Dog Slobber » Sun Jul 17, 2022 9:34 am

Pugsy wrote:
Sun Jul 17, 2022 9:05 am
During ramp itself most ResMed machines don't record anything so it's odd that you say you see stuff happening during ramp.
I wasn't aware of ResMed changing the "no recording during ramp" to "recording events during ramp" and if that is indeed happening we need proof to adjust the advice we give people.
I don't think ResMed's have started reporting during Ramp.

As stated to the OP, one of the problems is the OP and many people here use the word "Ramp" in two different contexts. Ramp the CPAP setting, and ramp to increase pressure, the machine ramped up its pressure. Using the latter causes confusion, as demonstrated in this topic.

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Re: Adjusting Settings on Airsense 10

Post by Pugsy » Sun Jul 17, 2022 9:42 am

Dog Slobber wrote:
Sun Jul 17, 2022 9:34 am
Pugsy wrote:
Sun Jul 17, 2022 9:05 am
During ramp itself most ResMed machines don't record anything so it's odd that you say you see stuff happening during ramp.
I wasn't aware of ResMed changing the "no recording during ramp" to "recording events during ramp" and if that is indeed happening we need proof to adjust the advice we give people.
I don't think ResMed's have started reporting during Ramp.

As stated to the OP, one of the problems is the OP and many people here use the word "Ramp" in two different contexts. Ramp the CPAP setting, and ramp to increase pressure, the machine ramped up its pressure. Using the latter causes confusion, as demonstrated in this topic.
Yep. Totally agree. That's why I want to see the detailed report...in addition to the obvious other reasons.
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Re: Adjusting Settings on Airsense 10

Post by sleepquest21 » Sun Jul 17, 2022 9:45 am

I am still learning, but I interpreted the rash of events early in the session as occurring while the machine pressure was slowly ramping up to a higher pressure. The pressure immediately goes to 4, but then it seems to take a while to gradually move up to a higher pressure. The time period from 21:45 to around 22:30 is what I was referring to.

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Re: Adjusting Settings on Airsense 10

Post by Dog Slobber » Sun Jul 17, 2022 9:59 am

All those events *did* happen while the machine was "Ramping" up the pressure, but it was not in ramp.

Your post exactly reflects my commentary about the Ramp the setting and ramp the verb.

I would switch off Ramp (or increase Ramp Pressure), depends how you are acclimating to CPAP. I would also increase your minimum pressure. Consider turning on EPR to help you with pressures.

Your graphs are missing a lot of settings on the left and traces. FLs being one.

Who ever stuck you on a 4-20 default setting machine is incompetent.

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Re: Adjusting Settings on Airsense 10

Post by chunkyfrog » Sun Jul 17, 2022 10:14 am

Good that you have the Autoset; but 4-20 is not a "setting".
That is wide open--the default--it leaves the factory that way.
Fortunately, you can set it yourself for a narrower range, allowing for effective therapy.
Many of us have titration studies, which give us an idea where our pressures might be.
Range refers to the high and low settings, and kicks in once you nod off.
Ramp is the time allowed before it reaches the MINIMUM pressure.
You might choose to shut "ramp" down to a shorter time--or off.
With a super low minimum, ramp is not doing you any good.

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Re: Adjusting Settings on Airsense 10

Post by Pugsy » Sun Jul 17, 2022 10:43 am

There does appear to be a time with "real ramp" being used...Looks like maybe 30 minutes and most likely from the pressure graph line it's going to be "Auto Ramp".... Nothing was flagged during whatever ramp mode was used.
Ramp ended at 21:45 and THEN the pressure started increasing from the 4 cm minimum upwards per what the auto algorithm felt it needed to do in response to what it was sensing going on

The above report is a prime example of why we tell people that the machine increases the pressure rather "slowly" in an effort to better prevent airway collapses.

This is why we tell people that the machine can't/won't increase the pressure to a point to hold the airway open "in the blink of an eye". It simply has to go through all the processes it needs to go through with the auto adjusting algorithm to get to where it needs to be to stent the airway open and keep it open.

This is why we tell people to use a more optimal minimum/baseline pressure as a headstart for the machine to get to where it needs to be to keep the airway open and prevent the airway collapse.

The actual "ramp" feature isn't what we see increasing with flagging...we are seeing the machine increasing the pressure up to where it needs to be to hold the airway open and once the machine gets up there...you can see that nothing much happens after that.

Can't tell all the statistics or settings to confirm because the calendar is hiding things but I suspect that this person would do better with a minimum setting for the pressure upwards around 10 or 12 and then the machine could get to where it needs to be in a more timely manner and all that crap that occurred between 21:45 and 22:30 would either not have happened or it would be less dramatic.

That minimum starting point of 4 cm can do a decent job for some people (like if they only need 8 to 10 cm to prevent apneas) but when people are needing pressures over 10 cm to keep the airway open and prevent the collapsing...it just can't get there soon enough and crap happens until it does get there...and then when the pressure drops a bit then more crap happens until the pressure stabilizes. There could be some positional component or even REM at play here but the easiest fix...increase the minimum to at least 10 or 12..maybe a little more.
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Re: Adjusting Settings on Airsense 10

Post by Pugsy » Sun Jul 17, 2022 10:55 am

sleepquest21 wrote:
Sun Jul 17, 2022 9:45 am
I am still learning, but I interpreted the rash of events early in the session as occurring while the machine pressure was slowly ramping up to a higher pressure. The pressure immediately goes to 4, but then it seems to take a while to gradually move up to a higher pressure. The time period from 21:45 to around 22:30 is what I was referring to.
Terminology or rather correct terminology is critical to understand and conveying thoughts.
Ramping up would be a wording that infers the ramp portion of the actual night.
A better choice of words would be "while the machine as slowly INCREASING to a higher pressure for that period between 21:45 and 22:30."

You are using ramp but with the minimum set to 4 cm it has no where to go or ramp up to...hence the flat line during the rather short ramp period. With the machine having no where to go there is no typical linear ramp up to see...so hard to know if you are using ordinary ramp or auto ramp.
Ordinary ramp gives a linear increase to the minimum setting ...if the setting were higher than 4 cm
Auto ramp stays at 4 cm until you are either asleep or 30 minutes have passed and then there is a marked increase up to the minimum setting.

At this point quibbling over "ramp" isn't the issue...the issue is you need more minimum than the 4 cm minimum the machine is currently set at. You can clean up your reports simply by increasing the minimum setting to probably around 12 cm or there abouts....doesn't matter which ramp you use or even if you choose to not use ramp.
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Re: Adjusting Settings on Airsense 10

Post by sleepquest21 » Sun Jul 17, 2022 8:01 pm

Thanks to everyone for the advice. I will start tonight with a higher minimum to see if that does the trick. I know that 4 seemed way too low, so I may need to experiment with some different levels. I will try setting the minimum at 8 tonight to see how that goes. I never had access to the settings on my old machine, so I will have to work things out through a bit of trial and error.

I think that the face mask test feature uses close to the maximum pressure, which is too high for falling asleep easily. I am hoping to find a good comfortable minimum setting that will allow me to fall asleep and that still takes advantage of the auto ramp feature of the machine. I am also still working out the humidity settings; I like not waking up completely dried out, but in the summer, I cannot tolerate the heat.

Thanks again to everyone for your help!

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Re: Adjusting Settings on Airsense 10

Post by sleepquest21 » Fri Jul 22, 2022 7:03 am

I increased my pressure in two stages. First, I increased minimum pressure to 8.0 for two days, but my AHI was still 6.52. Then, I increased the minimum pressure to 10.0 for three days, and my AHI dropped to 3.60. The good news is that with the higher pressure, I feel like I am getting plenty of air flow which allows me to fall asleep easier.

I am getting used to using the CPAP again, so my hours of use are increasing. I have over 6 hours of data from each of the last few nights, and thankfully for most of that time nothing happens. I am thinking that most of my events occur when sleeping on my back, so I have to keep working on side sleeping.

Thanks to everyone for your advice. This site is so helpful! :D

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Re: Adjusting Settings on Airsense 10

Post by zonker » Fri Jul 22, 2022 10:59 am

sleepquest21 wrote:
Fri Jul 22, 2022 7:03 am
I increased my pressure in two stages. First, I increased minimum pressure to 8.0 for two days, but my AHI was still 6.52. Then, I increased the minimum pressure to 10.0 for three days, and my AHI dropped to 3.60. The good news is that with the higher pressure, I feel like I am getting plenty of air flow which allows me to fall asleep easier.
Image

good work, you! slow and steady wins the race and you seem to be pulling ahead of sleep apnea.

good luck.
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