And the wait begins...

I don't think there was a single pressure listed on my prescription. It's set to auto mode, and the pressure range I believe is set between 4.0 and 16.0. I used it last night without the EPR on and had a good sleep (felt like the older Vantage machine).

Pulled these readings off it this morning (no software, so just from the machine's display):

Leak: 0.30 L/s
AHI 9.7
AI 2.5
HI 7.2

Trying to figure out if these figures are good or bad.

weebl wrote:I don't think there was a single pressure listed on my prescription. It's set to auto mode, and the pressure range I believe is set between 4.0 and 16.0.

I'd go into the clinical setup menu today, and I'd write down every single setting...every word, every number. That's so you'll know for sure what all the settings are.

I'm not a doctor, but if it were me (and IF the minimum pressure really is set at "4") I'd move that minimum setting up to 6 at the very least. But that's just me. Actually, if I had no prescription number to go by and was just guesstimating what pressure would keep my airway open, I'd set the minimum up higher than six...probably more like at 9 or 10 for the minimum.

weebl wrote: I used it last night without the EPR on and had a good sleep (felt like the older Vantage machine).

With EPR turned off, the Autoset II was operating just like the older Vantage. What range did you have set on your Vantage?

weebl wrote:Pulled these readings off it this morning (no software, so just from the machine's display):

Leak: 0.30 L/s
AHI 9.7
AI 2.5
HI 7.2

The leak rate looks very high. Ideal leak rate with a ResMed machine is zero. A leak rate of 0.40 L/s would be much too high, and your rate of 0.30 is getting awfully close to that. If you know that you were taking the mask on and off to make mask adjustments while leaving the machine running, perhaps there's a temporary reason for that high leak rate. But if you put the mask on and pretty much just left the mask in place, I'd go to work on figuring out where the leaks are coming from and getting them under control.

That (leak control) really needs to be addressed before doing much, if any, pressure tweaking.

well, said Rested Gal. getting the leaks under control is very important. leaks not only rob you of the benefit of the therapy, but can just make sleeping uncomfortable and interrupt your sleep.

unfortunately, the values displayed on your machine in the morning don't tell the whole story. it only shows you the end result of the night. you could go for example almost all night - 7 hours let's say at 0 leaks, then roll over and bump your mask for a few seconds and it will show up on your display in the morning as 0.3 or something.

if you really want to know what's going on while you sleep, you'll need the software to allow you to view the data. the numbers in the morning are interesting, but not nearly as informative as what the software allows you to see. it will also allow you to see if there is any correlation between the leaks, pressure changes, and apneas.

Thanks, guys. The 4.0 pressure was set by the sleep clinic I went to in town and that's what they recommended, however when I mentioned it to the place I ordered from, they seemed to think it sounded low, but would have someone qualified look at it to see if that was acceptable. I guess it was.

I think I will probably want to look into getting the software. I don't know what figure the leak reading was based on, but if it was an average over the night, I think I know the causes. A couple of times, I pulled the mask slightly off to scratch my nose with the machine running, and a couple of times, if I had my chin too low while laying awake, it leaked slightly. The second I will address tonight by trying to fit the mask on better (same mask I used on the trial and that had never occurred). I will also avoid taking the mask off while it's running for any reason.

Once I get the leak issues under control (would half the value be acceptable?), then I will move on to tweaking the minimum pressure.

weebl wrote:Thanks, guys. The 4.0 pressure was set by the sleep clinic I went to in town and that's what they recommended, however when I mentioned it to the place I ordered from, they seemed to think it sounded low, but would have someone qualified look at it to see if that was acceptable. I guess it was.

many find that 4.0cm is uncomfortable - like they can't get enough air. 6.0cm seems to work well for many, myself included. but, as long as you're able to handle the low pressure - then good for you. the less changes the better.

weebl wrote:I think I will probably want to look into getting the software. I don't know what figure the leak reading was based on, but if it was an average over the night, I think I know the causes. A couple of times, I pulled the mask slightly off to scratch my nose with the machine running, and a couple of times, if I had my chin too low while laying awake, it leaked slightly. The second I will address tonight by trying to fit the mask on better (same mask I used on the trial and that had never occurred). I will also avoid taking the mask off while it's running for any reason.

Once I get the leak issues under control (would half the value be acceptable?), then I will move on to tweaking the minimum pressure.

there are some good discussions in this forum as to how the leak figure is calculated. i've never been accused of being smart, so most of the math i couldn't understand. but, seeing it graphically by means of the software made it easier for me to visualize how things went the night before, which i find much more informative than the number.

as for the software, do a search here in this forum to find out how you can get it in canada. you can order the card reader from cpap.com, the hosts of this forum, but you may have to go to their site in australia for the software, since it is not sold in the us. and if you didn't get a card with your machine, you can get that also from cpap.com.

but i think you'll find the software very helpful in improving in the use of the cpap machine. it took me a few months to get the leaks consistently under 0.1, but now it's 0.0 most nights. you should do a search for that here also for suggestions. while it's not necessary to obsess over the '0.0 holy grail', the lower you can it the better as it may change the other numbers.

weebl wrote:Once I get the leak issues under control (would half the value be acceptable?), then I will move on to tweaking the minimum pressure.

Half of the .30 you were seeing would be .15. I'd want to keep it under .20, so 0.15 L/s would be acceptable. Of course the closer to zero for the leak on the ResMed machine, the better.

The thing about setting the minimum pressure up higher than 4 is not just about not feeling stifled trying to breathe at only 4 cm H2O pressure. That doesn't feel stuffy at all to some people. Another, perhaps even more important, reason for setting the minimum up higher is so that the autopap doesn't have to take so long to blow a higher pressure when needed to correct flow limitations and try to prevent apneas.

Autopaps are not designed to yo-yo therapeutic pressure up and down quickly. They move pressure up relatively slowly and deliberately, testing how your breathing is responding at various points. So, if your throat is beginning to collapse rather fast, like when a person turns on his back or goes into REM, it's better if the minimum pressure is already up there at, or pretty close to "at", the pressure that will keep the airway open during those worst case scenarios (on one's back, and/or in REM sleep.)

It's said that statistically it takes a pressure of 10 to keep most people's airways open. A pressure of 4 is awfully far away from 10. Would take the machine quite awhile to move up slowly from 4 to 10 if 10 happens to be what you need most of the time...and that could be very likely.

That's why I said that barring any other info to go on, and no single prescribed pressure from a sleep study, I personally, would want to set the minimum pressure for 9 or 10 when using an autopap.