Resmed 10 air pressure too strong

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?

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.

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

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.

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.

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.

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.

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.

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.