Inhale/exhale pressures

Hi I have been using a Resmed S9 for a number of years and just got a new Resmed Airsense10. I find when I am almost asleep it pulses and wakes me up. When my breathing gets low just before I doze off I loose pressure. It seems the machine can't decide whether to pressurize or reduce pressure so I can exhale. My wife uses that same machine and she says hers does it and it's normal but I don't like it. My pressures are set between 7 and 14 same as my old one with no ramp time. I tried with EPR at 1 then turned it off but problem persists. Any suggestions? Increase lower pressure maybe? Thanks

I use the A10 machine and my wife still has the S9. The A10 has a significant improvement over the S9, and that is the AutoRamp feature. While it is called a ramp it really is a "Hold" not a ramp. It holds the pressure at the ramp start pressure until the machine detects you are asleep. Then, it ramps up the pressure fairly quickly to your minimum pressure, if the start pressure is lower than the minimum pressure. If minimum pressure is the same as the ramp start pressure nothing really changes when you go to sleep, other than you turn control of pressure over to the machine. Here is the way I recommend setting up the A10 for maximum comfort (I will assume you have a minimum and maximum of 7 and 14 cm).

Go to the Comfort section of the Clinical Menu and then set this way:

• Ramp Time - Auto
• Start Pressure - 7 cm
• EPR - On
• EPR Type - Ramp Only
• EPR Level - 3 cm

When set this way you will get 7 cm on inhale and 4 cm on exhale, and that does not change until the machine decides you are asleep. Most find it comfortable to have a lower exhale pressure while they are still awake. However reducing exhale pressure while you are sleeping can make the machine less effective, so like you do, I want EPR off when I am sleeping. Like I said AutoRamp is a hold, not really a ramp. The machine gives you up to 30 minutes to fall asleep, and if you have not it will go into auto mode based on 30 minutes elapsed time. If you have a minimum of 7 and the Ramp Start is also 7 there will be no change in inhale pressure when you go into auto mode, but the exhale pressure reduction due to the EPR will stop. I never ever notice when it makes the switch over, and I very seldom time out on the 30 minutes. Here is an example of what my going to sleep looks like in SleepyHead. I have switched to a fixed CPAP mode on my machine and I have that set at 11 cm. I like a little higher start pressure than 7 cm and use 9 cm as start pressure. If you look at the mask pressure graph you will see the machine pulsing up and down on inhale and exhale between 9 cm and 6 cm, and then when I go to sleep the reduction on exhale ends, and the pressure ramps up to 11 cm in my case. I was suffering from a cold this particular night and some of the mask pressure spikes you see are me coughing into the mask. Also I got up for a P, and you can see how the AutoRamp feature works again until I fall asleep. It looks like I fell asleep after about 8 minutes each time.

i use a dreamstation and found using the machine in auto,was constantly running at high pressure,18. i had the same issue and mask leaking during the night.now have the settings at 9 min 11 max,no mask leaks,no puffy cheeks. ahi still<3. total clear airway apneas 5. total obstructive apneas 4,total hypopneas 7. this works for me. no longer have thoughts of putting the machine in bottom of wardrobe and forgetting about it.