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Resmed 10 air pressure too strong

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Sleepyken +0 points · about 4 years ago Original Poster

Hello, just got my resmed 10 with nasal mask in and I'm using the ramp up mode 45mins. When the machine first starts it is at a pressure of 4 but 2-3 minutes later it shoots up to 10 and at that point it just feels like a hurricane blowing in my nose and I'm struggling so hard to exhale. When it starts at 4 I can hear the machine react to my inhale but once it shoots up to 10 it's just a continuous barrage of air to my nose. There is no way I can fall asleep this way when I can't even breathe properly. Is this normal? Is my machine defected?

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wiredgeorge +0 points · about 4 years ago Sleep Enthusiast

Sleepyken, Welcome! You didn't mention your prescribed pressure setting or settings, only the ramp. I tried a mask which only fit over my nose and found the holes too small to allow me to exhale. I couldn't exhale normally even when not connected to my machine. As you go along, you may want to try different mask types. I use an Amara View and can exhale normally but with the nasal mask found myself unable to exhale much at all the mask filled with moisture from my exhale to a disgusting degree.

You mention ramp; I am not sure what the curve on the ramp is supposed to look like but it should shoot up. It is there to ease you into falling asleep and climb gradually. My pressure is 25 and I don't use the ramp but some folks are more sensitive to pressure than me, I guess. Without ramp, pressure starts at 4 then climbs quickly to the max of 25 in about 15 to 20 seconds I am guessing. I think your ramp is NOT working or not working as it should. With a 45 minute ramp, you should not see max press till 45 minutes, I am guessing (not really positive). The ramp setting is one that you can control on the front panel so familiarize yourself with the control if you haven't already done so and make sure you are on ramp and set for the 45 minutes you believe it is. If it was set by the DME, they may not have actually set it as you think... good luck.

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Sierra +0 points · about 4 years ago Sleep Patron

Ken it does seem possible that your machine is defective if you are sure it is set up they way you say. There is one more pressure that is in the mix though. That is the Ramp Start pressure. That defaults to 4 cm, but can be set higher up to as much as the minimum treatment pressure. When functioning properly the machine should go to that ramp start pressure in a few seconds. Then it should ramp slowly over the 45 minute ramp period of time to your minimum treatment pressure.

I have the ResMed AirSense 10 also but have it set a little differently. I use the Auto Ramp feature which holds the pressure at the Ramp Start Pressure until it decides you are asleep. Then it ramps up to the minimum treatment pressure. I also have my EPR (Expiratory Pressure Relief) set at 3 cm and set to be active only during the ramp. The EPR stops when I get to the treatment pressure. Using EPR during the ramp lets me set the ramp start pressure higher so I can get the benefit of the EPR reduction on exhale while keeping the inhale benefit of higher pressure.

But, I think I would first check with your sleep technician to see if the machine is defective or improperly set. If you want to check the settings yourself see the manual at the link below. Instructions to find what your settings are start on page 14.

AirSense 10 Manual

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Sierra +0 points · about 4 years ago Sleep Patron

One other thought came to mind. Is it possible that you have somehow initiated a mask fit test? That will ramp pressure up to your maximum set pressure.

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S2S +0 points · about 4 years ago

Turn on the EPR to reduce the pressure when you breath out. If it is not turned on, you can get it turned on or you could do this yourself. Ask you provider if you can do it yourself or if they say no, ask then to do it. If you have the manual you can do it if it has the Clinicians part in it.

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Sleepyken +0 points · about 4 years ago Original Poster

Hello thanks for the reply all! A tech came in and set the machine up for me, fitting and settings. I checked my fit and it was fine as well. My max pressure is set to 20. Is the air supposed to be continuous and nonstop? Pressure of 10 is so strong that I can't imagine breathing through that all night. Also if my ramp up is set to 45 mins then shouldn't it stay at 4 for 45 minutes? Also EPR is already on and set to 3 but it does not feel any easier exhaling.

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Sierra +0 points · about 4 years ago Sleep Patron

After the ramp the pressure should self adjust between the minimum and maximum set pressure. Those two pressures will be displayed for about 10 seconds after you start the machine. During the ramp it should start at the Ramp Start pressure or the default 4 cm if the Ramp Start pressure is not set. It should increase slowly from the ramp start to the set minimum over the 45 minutes. If the ramp start is set at 4 cm then the EPR can't do anything because the machine will not go below 4 cm.

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Sleepyken +0 points · about 4 years ago Original Poster

Hmm very strange, my ramp is set to 45 mins but it just jumps from 4 to 10 in roughly 2-3 minutes. At ramp 4 I can still feel and hear the machine react as I breathe in and out. The ERP doesn't do anything when its at 10 just full blown suffocating air. Wonder if my machine is faulty.

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Sierra +0 points · about 4 years ago Sleep Patron

I think your machine may be faulty based on what you are describing.

You should be able to change your ramp time with the user menu. I would try changing the time setting from 45 minutes to some other time and to Auto just to see if it behaves the same. But I agree if it is working as designed it should work with a 45 minute setting for the ramp.

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wiredgeorge +0 points · about 4 years ago Sleep Enthusiast

4 to 10 in seconds? That is what my machine does as the lighted face stays on and I can still read the numbers. By the time I flop into bed, the light has gone off and I am at 25 pressure and don't feel it is "full blown suffocating" but comfortable. Opens up my sinuses and allows me to breathe easily through my nose. I believe you are reacting to the pressure differently than I do and the machine ramp is not really turned on or at least isn't working as it should. Try a ramp of 20 minutes (you can set yourself) or some other time. Shouldn't take that long to fall asleep anyway and if the machine behaves the same way, have them bring another machine.

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Sleepyken +0 points · about 4 years ago Original Poster

Thanks for the reply. for it me went from 4 to 10 in roughly 2 minutes and sometimes I take longer than that to fall asleep but I imagine if i did and it shot to 2, I would wake up cause it is almost suffocating. It is extremely hard to blow out through my nose and when I try to breathe out through my mouth (also super difficult) the way the air is circulating through my sinus forces me to make a snorting noise.

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Sierra +0 points · about 4 years ago Sleep Patron

If you have a PC or Mac and a SD card reader, you may want to consider downloading the free SleepyHead software which allows you to chart your detailed data from the SD card in the machine. It would allow you to show your supplier what the machine is doing and potentially expedite a replacement. Here is what my chart looks like when using the Auto Ramp, Ramp Start Pressure of 8.4 cm, EPR at 3 cm Ramp Only. It generally gets me to sleep in 15-20 minutes.

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Sleepyken +0 points · about 4 years ago Original Poster

Unfortunately I don't have an SD card reader. I just tried the machine again with a different ramp time and timed it and it went from 4 to 10 in under 2 minutes. Question, is the air supposed to continuous and nonstop or is it supposed to be matched to your breathing pattern? I cannot imagine anyone sleeping with such a strong air flow blowing into their nose non stop. I had to open my mouth just to exhale and gasp for air and I ended up snorting due to the intense air flow. At level for I could at least feel and hear the machine adjust to my exhales and inhales which I imagine is the ERP? Sorry I am still new to all of this.

I have already reached out and left a voice mail to my CPAP provider. Maybe I got a faulty returned machine, it did look like it had a few scratches on the front.

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Sierra +0 points · about 4 years ago Sleep Patron

If you do not have the EPR turned on the pressure will be steady. When you breath out the air should flow out the vent on your mask. With the EPR turned on, the pressure will cut back a little bit when you exhale. You can see that with the blue line on the graph in my report above. The pressure fluctuates up and down with each breath during the ramp hold. Then it stops fluctuating when I am up to pressure. I have no difficulty breathing out against 12-13 cm of pressure.

You can get a small portable SD to USB card reader for about $10-$12. It would be worth it to be able to monitor your results on SleepyHead.

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Sleepyken +0 points · about 4 years ago Original Poster

Thanks so much for your help. I'll wait for a tech to come out and possibly replace my machine and I'll look into using SleepyHead.

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S2S +0 points · about 4 years ago

I never use ramp these days, I did try when I had a Sullivan machine (a long long time ago) it was slow in raising pressure, but it reached a pressure where I found it very difficult to breathe, around 7 or 8 if I remember. So I stopped using it early and just start at full pressure, this has the advantage of finding leaks early on. I always made sure I was settled before turning on the machine. Later I got a machine with EPR on it, this reduces pressure when you breathe out, and supplies the pressure the machine is set for when you breathe in again. An APAP (Auto) machine will go to the pressure it thinks you need. It is up to you if you use the EPR or whatever name they call it on other machines, all it does is reduce the pressure when you breathe out and go straight back to the pressure it is set for as soon as you stop breathing out, or in an auto machine the pressure you require at the time. I have not used the ramp on my ResMed Airsense10Autoset since I got it as I was so used to just powering up, so I don't know how it normally behaves. The idea behind ramp was to allow you to get to sleep before it reached full pressure (pressure set or what you require) and this used to go up in slow steps. It is a bit odd that the ResMed should go up to pressure in a few seconds, unless it thinks you are asleep! The ols Sullivan used to go up in five minute steps so when it reached the pressure I found it hard to breathe I had to wait five minutes before I found it easy to breathe again. This is why I stopped using ramp and I find it easier to go straight to required pressure. When I switch on the ResMed it takes a few seconds to reach a pressure of 13 anyway, it does not just jump right in at pressure.

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Sierra +0 points · about 4 years ago Sleep Patron

The ResMed AirSense 10's AutoRamp function is a significant improvement over the old timed ramp system in the S9 machine. I would encourage you to give it a try. It is not really a ramp at all, as all it does is hold a setable ramp start pressure until the machine detects you are asleep, and then it ramps up fairly quickly to the Minimum set pressure. This is really useful as you do not have to try to guess how long it will take you to get to sleep. You just pick a ramp start pressure that feels the most comfortable to you, and that is what you get until you go to sleep. No, slowly ramping up in pressure. And if you go to sleep quickly the machine goes to the treatment mode right away instead of having to wait until the ramp timer expires.

And this can be improved even more by using the ResMed feature that allows you to use EPR on the ramp only. When you use EPR on ramp only when set at 3 cm and the ramp start set at 8 cm you will get a very comfortable 8 cm on inhale and 5 cm on exhale. Then when you go to sleep the EPR gets turned off and the pressure ramps to minimum treatment. During the ramp hold, the EPR is a harmless comfort feature. But during treatment EPR reduces EPAP, which reduces treatment effectiveness. The machine will increase pressure to compensate if the maximum allows. But, you will endure higher IPAP pressures to get the same treatment effectiveness. This can be an issue with those of us that use higher pressures and suffer from mask leaks as pressure goes up. Also some incur more central apneas as pressure goes up.

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