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Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Wed Dec 02, 2009 6:01 pm
by Pirateghost
rested gal wrote:tactical logic wrote:Prescribed pressure is 12.
Bruce
I'm not a doctor and this is just my non-medical opinion. If I were prescribed a pressure of 12, and I got a ResMed autopap,
and I used it in auto mode, I'd set the pressure range this way, depending on what degree of "full time" EPR I set it for:
EPR off
min pressure 11
max pressure 20
EPR 1
min pressure 12
max pressure 20
EPR 2
min pressure 13
max pressure 20
EPR 3
min pressure 14
max pressure 20
It's always a good idea to give CPAP mode a try, imho. In fact, I'd try it in CPAP mode first before using the auto settings above. But I know how hard it would be to resist using a new autopap in auto mode right off the bat, so that's why I went into what "auto" range I'd use first.
If I set it for CPAP mode, I'd use these settings -- again depending on how I set "full time" EPR:
EPR off
pressure 11
EPR 1
pressure 12
EPR 2
pressure 13
EPR 3
pressure 14
After looking at the overnight separate AI (apnea index) and HI (hypopnea index) for several nights using one setting or one "set" of settings, if I saw the AI was below one and I saw that
by mentally cutting the HI in two, the HI was below 5.0, I'd figure the treatment was effective.
That's just me, and that's the way I'd go about titrating myself with a ResMed machine.
I think it's important with
any autopap being using in "auto" mode to use the
minimum pressure setting in a way that helps the machine perform its job -- that job being to prevent apneas; not letting an apnea happen in the first place.
Best way to help an autopap do that is by setting the
minimum pressure up high enough to prevent most apneas right from the get-go.
In other words, I like to set the autopap's
minimum pressure almost as if it were a straight CPAP. The higher maximum pressure setting can then provide a margin of mostly unused pressure up above if needed occasionally, but for the most part the machine will be able to keep the airway nicely open with just the minimum pressure.
That is,
if the minimum pressure is set high enough in the first place.
Just my opinion.
----------------
Some links to my thoughts (not that I'm right) about minimum pressure with autopaps:
Results: 1st night with Auto A-Flex (topic started by TSSleepy)
Two nights graphs posted using pressure range 4 - 20 and 10 - 20
viewtopic.php?p=348963#p348963
November 2008 Just got an APAP (topic started by turbosnore)
viewtopic.php?p=319619#p319619
October 2008 Turning off Aflex and Cflex (topic started by DoriC)
viewtopic.php?p=307265#p307265
September 2008 New Guy - Need Help w/Settings (topic started by alanhj13)
viewtopic.php?p=294319#p294319
Wulfman, DreamStalker, and ozij explain why autopaps make changes slowly.
December 2008 Why adjust APAP. Isn't it auto? (topic started by oxygenium65)
viewtopic.php?p=323218#p323218
---------------------
And my thoughts about the minimum pressure setting when using EPR:
Nov 2008
viewtopic.php?p=310021#p310021
Aug 2008
viewtopic.php?p=289264#p289264
RG, great reply. Thanks for taking the time. Another quick question - If one has pressure set on M-series at 9-12, does the correspond to another made/model? Would s8 be the same?
Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Wed Dec 02, 2009 6:03 pm
by Slinky
Love you guys.
Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Wed Dec 02, 2009 6:26 pm
by rested gal
Pirateghost wrote:RG, great reply. Thanks for taking the time. Another quick question - If one has pressure set on M-series at 9-12, does the correspond to another made/model? Would s8 be the same?
If you didn't turn on EPR in the ResMed autopap, then 9-12 would probably do about the same for you in a ResMed machine. However, if you turn on EPR in the ResMed machine, I'd raise the minimum pressure one cm for every "one cm of drop" you had set EPR to give. EPR 1 - 1 cm of drop in exhalation pressure, EPR 2 - 2 cm drop in exhalation pressure, EPR 3 - 3 cm drop in exhalation pressure.
EPR in a ResMed machine and C-Flex (or A-Flex) in a Respironics machine do not work the same way, so no, I don't think you'd necessarily want to use the same "range" of pressures in a ResMed machine that you were using in a Respironics machine -- not when it comes to the minimum pressure setting with EPR turned on, anyway.
In a Respironics machine, when using C-Flex (or A-Flex) the therapeutic pressure comes back in before the exhalation is finished. In ResMed machines, when using EPR, the pressure stays down throughout the exhalation and during the pause at the end of exhalation. That lower EPR pressure might (
or might not) be enough to hold the airway well and truly open in order to get an inhalation started again.
Side note to Slinky... you were talkin' to the crazy guys called Wulfman and carbonman, but I do love a good love fest, so ...
I love them too, and I wuv U, Slinkifer!!!!
Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Wed Dec 02, 2009 6:45 pm
by Wulfman
Slinky wrote:
Love you guys.
Love ya, Slinky.
Den
Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Wed Dec 02, 2009 7:14 pm
by carbonman
Slinky wrote: Love you guys.
Slinky, RG, wulfman,
....hey, I can make an @$$ of myself w/the best of'em.....
...I'll always give credit where credit is due....
...and when it comes time to eat crow.....I'll pick the bones clean.
In so many ways, I owe my life to you guys.
You're the best!
Thanks!
Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Wed Dec 02, 2009 7:21 pm
by Wulfman
carbonman wrote:Slinky wrote: Love you guys.
Slinky, RG, wulfman,
....hey, I can make an @$$ of myself w/the best of'em.....
...I'll always give credit where credit is due....
...and when it comes time to eat crow.....I'll pick the bones clean.
In so many ways, I owe my life to you guys.
You're the best!
Thanks!
You've done well......Grasshopper.
Den
Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Wed Dec 02, 2009 7:43 pm
by FoxNewsFan
Just went to a new sleep doc yesterday. Wow, am I happy. He is actually interested in my sleep apnea.
My present machine is noisy. He said I should really get an S8 Autoset II. He said that the technology has changed so much that my present machine, (only 1 1/2 yrs.old), is almost obsolete. I will be getting the new machine in 10 days.
In the discussion above, I don't think I noticed the following point, which he emphasized-
The pressure during REM sleep, where most events occur tends to be at it's highest. The pressure during non-REM sleep with an auto will be lower and therefore more comfortable. (paraphrased from ResMed)
He really likes the added comfort during non-REM sleep. Hope this helps the OP.
I have been reading this forum and studying the literature for 1 1/2 yrs. now. My new Doc and I talked intensively for 45 mins. Wow, it was exhausting. He was impressed with my knowledge and invited me to the next dinner meeting of all the sleep doctors in the area in March. He never said what my function would be. Hope I'm not the guest speaker.
Ed
Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Wed Dec 02, 2009 7:54 pm
by Muse-Inc
FoxNewsFan wrote:....He was impressed with my knowledge and invited me to the next dinner meeting of all the sleep doctors in the area in March. He never said what my function would be. Hope I'm not the guest speaker.
Do good, Ed, you're standing in for all us who manage our therapy! Seriously, sound like a good doc. Post what happened at dinner.
Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Wed Dec 02, 2009 8:25 pm
by peppi
I love my Resmed S8 Autoset II. EPR is very natural and I do not even notice the pressure at all. (min set a 7)
Very quite although the mask makes more noise than I would like.
Ill probably try the Opus mask next, the Swift LT nasal pillow mask expels the air pretty loud and my wife is starting to complain about it.
Phil
Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Wed Dec 02, 2009 8:31 pm
by rested gal
FoxNewsFan wrote:I have been reading this forum and studying the literature for 1 1/2 yrs. now. My new Doc and I talked intensively for 45 mins. Wow, it was exhausting. He was impressed with my knowledge and invited me to the next dinner meeting of all the sleep doctors in the area in March. He never said what my function would be. Hope I'm not the guest speaker.
Ed
Wow, Ed. Wow. Take a tape recorder with you. We want a detailed account of what's discussed at that dinner meeting. Don't want you to forget a single word!!
He probably wants to show you off as a "patient" like no other that any of them have ever seen before, and he's proud of you!
What a good doctor!
Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Thu Dec 03, 2009 7:56 am
by Slinky
Awww, RG. Its just habit to say "guys", even when I'm talking only to "girlfriends"! You have been such a great mentor and help to me .....
And, Ed, PLEASE do take along a tape recorder as suggested. What a GREAT sleep doctor you've found. I sure wish he were in MY area!!! You MUST have made quite an impression on him! I'm impressed that he was impressed. I'm in AWE that he was impressed! If only all sleep doctors were so open-minded!
Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Thu Dec 03, 2009 8:40 am
by Wulfman
FoxNewsFan wrote:Just went to a new sleep doc yesterday. Wow, am I happy. He is actually interested in my sleep apnea.
My present machine is noisy. He said I should really get an S8 Autoset II. He said that the technology has changed so much that my present machine, (only 1 1/2 yrs.old), is almost obsolete. I will be getting the new machine in 10 days.
In the discussion above, I don't think I noticed the following point, which he emphasized-
The pressure during REM sleep, where most events occur tends to be at it's highest. The pressure during non-REM sleep with an auto will be lower and therefore more comfortable. (paraphrased from ResMed)
He really likes the added comfort during non-REM sleep. Hope this helps the OP.
I have been reading this forum and studying the literature for 1 1/2 yrs. now. My new Doc and I talked intensively for 45 mins. Wow, it was exhausting. He was impressed with my knowledge and invited me to the next dinner meeting of all the sleep doctors in the area in March. He never said what my function would be. Hope I'm not the guest speaker.
Ed
Ed,
Maybe they're going to let you pick up the tab......
Anyway, let us know how it goes.
Den
Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Thu Dec 03, 2009 9:10 am
by rested gal
Wulfman wrote:
Ed,
Maybe they're going to let you pick up the tab......
**cough, splutter** Well, there went my sip of tea!!!!
Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Thu Dec 03, 2009 5:02 pm
by packer
I know its been discussed before [ and it is hard to discuss- to put in words]
how does aflex compare to EPR for those who have tried both?
[ I use afles at 11 to 14 - set on 3 - I do not like fighting the exhale and thought aflex was great improvement
I am at about 3 years now- usually AHI around 2 ]
I can get new machine and have to decide soon which one to get [ deductible met for year- basically a freebie before Jan 1]
some of the people I respect most would have me try the Resmed- I was thinking PR one- so am undecided
I know about data but honestly- only run encore 1 time a month or so
thanks for any more discussion you are willing to give
packer
Re: Thanks to all Now it's decision S8 Auto or PR ONE
Posted: Thu Dec 03, 2009 8:22 pm
by FoxNewsFan
Whew, I feel the pressure.
Take a tape recorder? I'll ask but I would think the doctors would be a lot more candid if they weren't "on the record"
Luckily, I have excellent recall and my brain get sharper when I'm under stress. I'll take notes as soon as I get home.
A good idea would be to put Judy, Laura and Den on speakerphone and let them help me out. Re: sleep apnea, they are PHDs, I'm a kindergartner.
Ed
PS Don't forget, this dinner is in March.