Just got into my clinical settings the other day for the first time. Noticed my ResMed Air Sense 10 Autoset was set up as CPAP rather than Autoset. What might be the reason for that. I would think Autoset would be a better choice. I have been on therapy since 1999. Have gone from a BiPap to now a CPAP as of my last sleep study. I don't have any of the data from the study but I must say my data from the my air indicates I have very few incidents during the night. I changed the setting from CPAP to Autoset a couple of nights ago and my last two nights don't indicate any bad results. Thursday night .7 events per hour and last night .1 events per hour. That's .7 and .1 . My question is why would the Dr's office or the resp. ther. not make use of the Autoset feature if the machine has it. I have also lost 35lbs since May 1 and may need to be retitrated to adjust settings. For CPAP I was set at 4 and 10 and AutoRanp. I left those settings for Autoset and turned on EPR to 2, I believe. I have had dry mouth for about the last month or so and thought maybe my settings might be a little high since I lost the weight. I have noticed my breathing when I first start my machine has become less pronounced. Losing the weight using KETO, Intermittant Fasting, and one meal a day, and fasting. Guys, it works.
Welcome to the forum and congratulations on the weight loss. That can help with the apnea frequency. I use a AirSense 10 AutoSet and initially ran in Auto mode. I was diagnosed with a home study, and immediately put on the APAP with a setting of about 8 to 15 cm, and EPR at 3. Since my wife was on APAP before me and the provider of the equipment told us about SleepyHead, we had been using it on her machine, and then my machine. It told me that unlike her, I was having a high proportion of clear airway (central apnea) events. I went through many different iterations for pressure and EPR. After several months I finally concluded that my hypopnea events were driving the pressure up to 15 cm, and my suspicion was that the hypopnea events were central in nature, not obstructive. My first step to address that was to lower the maximum pressure and increase the low pressure. I got to the point where my pressure was almost fixed, so I made the change in the machine from AutoSet to CPAP. I tried a few different variations in pressure but settled on a fixed pressure of 11 cm and EPR at 3 cm, but in Ramp Only mode. I found that having EPR on increased my pressure requirement when I was sleeping. But still having EPR on when going to sleep was more comfortable. I think that is the best feature that the AirSense machine has. Now my settings are a Ramp Start pressure of 9 cm, fixed pressure of 11 cm in CPAP, and EPR of 3 in Ramp Only.
I can't explain why the doctor would have given you a Auto machine and then immediately put it in CPAP. The traditional way of diagnosing apnea with an in lab study, that is usually followed by a titration study which determines the optimum pressure. A pressure too low usually does not optimize the reduction of obstructive apnea, and a pressure too high can cause more central apnea. An AutoSet is almost the same price as a AirSense Elite which is a fixed CPAP pressure only, so you got the Auto machine in case your needs changed. Just a guess. My thoughts are that if one suffers from central apnea a fixed pressure may be better than an auto pressure mode. This is just based on my experience only. My wife still runs her machine in auto mode.
The reality is now with Auto machines, the titration study in most cases is not necessary. I never had one. If you look at the results with an initial wide pressure range for the Auto machine with software like SleepyHead you can determine what your pressure requirements are. It is kind of like having a titration test every night. However even with a machine in Auto, most users will bring their max pressure down just to prevent unnecessary excursions up, and they also bring the minimum pressure up. Having the pressure start higher helps avoid early in the sleep apnea incidents which might wake you up just after going to sleep.
As far as settings go, it sounds like you are doing well with either a fixed pressure or auto pressure range. If you download SleepyHead and view your detailed data which should be on the SD card in your machine, you will see what has been going on, and what pressure range may be idea. The software is free. It is no longer being developed but works with the AirSense machines. You need a computer to run the software and a SD card reader to get the data from your machine into the program. If you post the Daily report here of a night when it is in AutoSet mode I can give you my comments. My thoughts based on what you have said in your post would be to move your start pressure up from 4 cm to 7 cm, set EPR to 3 and for Ramp Only, and increase your minimum pressure to 8 cm. What that will do is give you 7 cm on inhale and 4 cm on exhale while you are awake in the AutoRamp mode. I find a start pressure of 4 cm is far too low and can feel somewhat suffocating, but it is a personal thing. Then when you go to sleep, the pressure will ramp up to 8 cm and the EPR will stop. After that the pressure will adjust up and down between the limits of 8 cm and 10 cm. Once you see what it is doing, some further refinement of the min and max pressures may be possible.
Thanks for the info. I downloaded Oscar the other day. Need to install. Did I read something about taking the SD card from the machine does something to it. Causes some problem when you put it back in the machine. Don’t know where or what I read. My PC has a built in card reader.
To be safe, you should slide the tab to the locked position on the SD card before you put it into the card reader. I think some older systems like Windows 8 could write something to the data card that messes it up. I use Windows 10 and have never locked the card, but locking the card is the safe thing to do. Just remember to unlock it before you put it back in your AutoSet machine or you will not collect any new data.
I think that many providers are not giving enough credit to machines that run on automatic. When I changed my CPAP settings to APAP, my life changed. I had good intentions every night going to sleep with my CPAP only to find it elsewhere in the AM. Since switching all the settings to Automatic, I actually wake with my mask still on most nights. My non-existent scores of the past because I didn't leave it on long enough to register now are ranging in the 80 to 90 range. A friend told me in some countries that APAP machines are actually sold at the local drug store as the settings will adjust to your needs.
