Another new user (Looking for Sandman Auto Comments)

Hi Cory

I have just tried to emulate your procedure.

My machine stabilizes at 3.0 with the mask off, then the lcd goes dark. Looking through the darkness I can see it says "mask unplugged". It will not raise the pressure with the mask on, I have to hit the start button again.

Your simplest solution is to start the machine with the mask on, and stop the machine before taking the mask off. Its just a matter of implementing a new habit, with me that usually takes about 5 years, if I manage at all.

I agree that an Obs AHi of 8 is better than 15 or 20, but it is still more than what is considered safe, and with fine tuning I am sure you will get it down.

cheers

Mars

mars wrote:Hi Ozij

OK - I think I have now got it.

So the first 5 minutes of non-data collection is at the set CP. Then, as you say, when auto sets in it will -

then switch to Auto functioning, taking the pressure higher, or lower (if you've set a lower minimum) depending on the analysis of breating patterns.

This means you can set CP about where your Rx is, and a lower, minimum to which the machine will drop to, if possible.

I am now testing the Command on Apnea function, with fast decrease. The results are the same as without it - Total Obs and Cnt AHi of 2.2 with a pressure range of 11 - 13 over a period of 10 days. The next 10 days I will be testing the slow decrease in pressure.

I have found that I can use about a dozen different settings, and still get between 2.0 and 2.4 Obs/Cnt AHi on all of them.

What do you think would be a significant difference? e.g. 0.1 or perhaps 0.4.

cheers

Mars

I'm not sure I understand your last question, Mars.
But if I wanted to see the effect of the CP, I'd try a slightly wider range and set the CP somewhere above where it is at now.

coreyg wrote:By the time I got to the bottow of the first post, I forgot the questions.

With the Sandman software, is there a way to tell the difference between Hypopneas and Apneas on the time-line graphs? And, is there a way to tell how long the apneas are?

Not that I know of. It was changed for the worse from the PB 420E

And more generic,
Do snores really indicate a need to increase pressure when in auto mode?

Usually yes, rarely no.

When I'm in auto (10 to 16cm), the pressure goes up to 16 very quickly and stays there most of the night and when I look at the graphs, it's the snores that are generally raising the pressure. I didn't really want to increase beyond 16 although I'm now thinking about it to see what the pressure does (and whether snores decrease with higher pressure).

My experience with the PB420E is that raising the lower pressure, in a way that keeps events from starting will often have you needing less of the higher pressure as well.

I just tried putting the mask on when it was at this lower pressure and after a minute it didn't go back to my normal auto settings. I don't understand why it has this low pressure setting. It could just turn off or it could stay at the min pressure but why does it go to a very low pressure and then it seems to not go back to normal auto settings?

Did you try a view huffs and puff to tell your machine "hey, I'm here now!"?

Ok, your suggestion makes sense. I don't like putting the mask on when the air is not on but I'll try it this way and see if I can get used to it. The data is messed up a bit at the start and end but I know that so it's not bad (and sandman software does have the exclude invalid data option).

Neither do I. I always turned the PB on first, and then put on the mask, and vice versa (mask off machine off) when stopping. If I understand the manual correctly, session data recording doesn't even start before 5 minutes have passed. Large leak ("mask unplugged" data) is recorded. See page US-12 or thereabouts in the Sandman Therapy manual.
And the non-recording time is as long as the first ramp you define -- letting you get organized and fall asleep before recoding starts.

Hi Ozij

re:

I have found that I can use about a dozen different settings, and still get between 2.0 and 2.4 Obs/Cnt AHi on all of them.

What do you think would be a significant difference? e.g. 0.1 or perhaps 0.4.

In auto I have tried many different pressure ranges, variations within a range of from 10.0 to 13.5, and also different cpap settings - 11, 11.5, 12.0.

Over an average of 10 days in each setting, I get an Obs/Cnt AHi of between 2.0 and 2.4.

Is there a measurement - 0.1, 0.2, 0.3 or 0.4 or perhaps even more, where the difference becomes significant in terms of general well-being in regard to the therapy. On a personal level I cannot tell a difference.

It's kind of like the cutoff safe AHi of 5.0, would there be a legitimate need to do something if the AHi was 6, or 7, or 8, etc, or would those few points be insignificant. Where did the wisdom come from that it was safe to have 5 events an hour?

I asked a similar question in December 2009, and now I have 3 months more data, which still supports many different range settings = same result (more or less).

viewtopic.php?f=1&t=47236&p=425980#p425980

I know logically that no events would be best, and I hope that one day there will be a way (apart from death) to achieve this. Hope this explains my question, Ozij.

cheers

Mars

Edited for spelling mistakes

Hi All

After reading the manual again I see the Sandman Manual uses the term "Comfort Pressure" with two different meanings.

I originally had an Info machine, and read about the ramp feature and comfort pressure. I assumed that was the only explanation of Comfort Pressure, and when I got an Auto I must have missed out on the different use of the phrase "Comfort Pressure".

I owe Thunder Road an apology, and also CoryG. I apologise to them and to anyone else I have misled.

I have learned a lot by sticking to this thread, and I had thought I knew my machine. I was wrong

So I hope you guys will accept my sincere regrets for my wrong, sometimes ill-mannered and too often, ill-advised, posts.

Mars

I do undertand your question now, Mars, but I don't know the answer.

Yes, there's a difference in "Comfort Pressure" between CPAP mode and AUTO mode. The fault is the PR people's: I'm sure it was they who tried to stick the word "Comfort" wherever they could. In the previous version, There was no way Ramp and Initial pressure could be confused -- and -- what is more -- I think that in this context, "Comfort Pressure" in an Auto is just about as misleading as you can get.

Has anyone except me noticed that a Sandman on fixed pressure can be set up to let the patient move the pressure 1 cm and 1 cm down?

O.

Mars,

After reading your post I started to doubt myself and the functionality of the Sandman. Thanks for the apology although it is not necessary. I am following this thread and if I was wrong I would like to find the correct answer in order to maximize the use of the machine. Thanks for your diligence with these issues.