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Chip McDonald
Unread post  Post subject: Does Autoset "reset", or just triggers post-ramp?  |  Posted: Thu Aug 30, 2018 8:35 am

Joined: Sat Jul 28, 2018 3:32 pm
Posts: 28
Location: North Augusta S.C. USA
PAP Mask: Dreamwear nasal cushion
PAP Machine: Resmed Airsense 10 Autoset climateline
Humidifier: Humidair
Pressure Setting: 8

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Sorry, this seems basic but I can't get this figured out from reading a ton of posts, or Resmed's site. On an Airsense 10 Autoset

Autoset starts "detecting the onset of sleep"

1) *during the ramp*
2) *after the ramp duration*
3) Resets if your respiration changes from "post-onset of sleep"?
4) Supercedes the lower range of your low/high pressures? Set to low=8 high = 9, it operates within that range or "?"?
5) Does the clinical setting changes take effect immediately, or do you have to stop the machine, or do you have to unplug/restart it completely?


Thanks AOT


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Pugsy
Unread post  Post subject: Re: Does Autoset "reset", or just triggers post-ramp?  |  Posted: Thu Aug 30, 2018 9:19 am
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 832
PAP Mask: ResMed AirFit P10 or DreamWear Gel nasal pillows
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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There are 2 different ramp use options available.

1...regular ramp...it takes so many minutes (whatever you set) to get from the starting pressure to the minimum pressure (if using apap/auto mode) or the fixed pressure if using cpap mode. It doesn't do anything else. Whether it thinks you are asleep or not...doesn't matter as it's just plain ordinary dumb ramp.

2..Auto Ramp...it is supposed to be able to sense if you are asleep by the breathing pattern and if it thinks you are asleep it will accelerate the ramp so that it gets to the minimum pressure sooner.
So which ever comes first..sleep or 30 minutes and the machine will be at the minimum pressure fairly quickly. I can't get specific time frames.....my manual website is down at the moment.
Once it thinks you are asleep it doesn't change back if you wake up or not.
It doesn't reset itself until you actually turn the machine off.
All this is dependent on the machine getting it right that you are even asleep.

Unless you are starting out with a relatively high pressure setting...don't even worry about the ramp.
The ramp is pretty much not a big deal when a person is using 6 or 7 pressure...shouldn't even be needed.
Now if someone's starting pressure was in the mid teens then yeah might be helpful.

Personally if I was going to use ramp I would use the regular ramp and just set the time frame for approx how long it normally takes me to get to sleep...which is in my case maybe 5 minutes.
I don't use the ramp though because my starting pressures are 7 with EPR at 3. No one should need ramp at those settings.


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Chip McDonald
Unread post  Post subject: Re: Does Autoset "reset", or just triggers post-ramp?  |  Posted: Thu Aug 30, 2018 10:33 am

Joined: Sat Jul 28, 2018 3:32 pm
Posts: 28
Location: North Augusta S.C. USA
PAP Mask: Dreamwear nasal cushion
PAP Machine: Resmed Airsense 10 Autoset climateline
Humidifier: Humidair
Pressure Setting: 8

Offline
Thanks (again).

I just tried napping, and I through caution to the wind and set it in soap with epr on 3 - but with my low range on 8.4. Dozing off, waking up happened, but with less of the "I'm not inhaling!" panic. I'm thinking my minimum needs to be higher?


A more specific description of what I feel is that I wake up, my mouth is closed, I'm not breathing *but need to inhale*. Though I know the machine is at a minimum of what - 6 (8 - 3 for epr?) The immediate sensation is the mask is doing nothing, like it's waiting for me to inhale.

Thanks again Pugsy...


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Chip McDonald
Unread post  Post subject: Re: Does Autoset "reset", or just triggers post-ramp?  |  Posted: Thu Aug 30, 2018 10:38 am

Joined: Sat Jul 28, 2018 3:32 pm
Posts: 28
Location: North Augusta S.C. USA
PAP Mask: Dreamwear nasal cushion
PAP Machine: Resmed Airsense 10 Autoset climateline
Humidifier: Humidair
Pressure Setting: 8

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... Makes me think it should be more like 11 CPAP with epr 3, or soap higher than 8 but no epr? I believe the epr helps me feel less anxious..

Ahg


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Pugsy
Unread post  Post subject: Re: Does Autoset "reset", or just triggers post-ramp?  |  Posted: Thu Aug 30, 2018 11:11 am
User avatar

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 832
PAP Mask: ResMed AirFit P10 or DreamWear Gel nasal pillows
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

Offline
EPR works off whatever the current pressure setting is.

Example...I use apap mode...minimum of 7 cm and I like EPR at 3...so I am using 7 on inhale and 4 on exhale.

Sometimes people have to make an upward adjustment in that pressure setting when adding EPR to allow for the drop during exhale but it's not always a given that person has to automatically add the equivalent to the pressure setting. Let your data tell you if you need more minimum pressure or not. It will tell you plain enough.

Now some people just find that they are more comfortable in terms of breathing in general at higher pressures than they might technically need to keep the OSA under control. That's fine too. Doesn't hurt to use more pressure than you might actually need as long as it doesn't create a problem like aerophagia or something.

If using EPR helps you feel more comfortable and less anxious then by all means use it. It's there to help you if you want it. Your choice.
I happen to really like EPR and if it would go to 4 I would like it even more... But it won't with this machine and I am okay with its limitations.

I actually did a controlled experiment sometime back where I played around with EPR/pressure support settings and I discovered that I actually slept better, felt better and slept about an hour longer when using EPR/pressure support than when I didn't.
When using an auto adjusting pressure machine I didn't even have to increase the minimum either. I just let the machine sort it out.

That extra hour of sleep is a critical thing for me because my sleep is already fragile from some issues unrelated to sleep apnea. For that reason I will always use some sort of exhale relief either full EPR on the ResMed AutoSet or if using a big boy bilevel I will use 3 or 4 pressure support.
Pressure support is nothing more than the difference between inhale and exhale.

When you use EPR on your ResMed machine you are essentially creating a bilevel situation where inhale is one pressure and exhale is another pressure. EPR is pressure support.

Use whatever settings allow you to be comfortable with the machine, the mask, your breathing and when you are comfortable you will sleep better.
Whatever lets you sleep better is fair game to do.


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Chip McDonald
Unread post  Post subject: Re: Does Autoset "reset", or just triggers post-ramp?  |  Posted: Fri Aug 31, 2018 5:52 pm

Joined: Sat Jul 28, 2018 3:32 pm
Posts: 28
Location: North Augusta S.C. USA
PAP Mask: Dreamwear nasal cushion
PAP Machine: Resmed Airsense 10 Autoset climateline
Humidifier: Humidair
Pressure Setting: 8

Offline
A Big Revelation that wasn't clear to me is that "Autoramp" isn't an integrated feature to "ramp" settings on the machine - but that it has to be set to "AUTO".

Which doesn't appear unless you spin the dial all the way over. I presumed it was all ramp settings - that it would take over during the ramp setting time you specified. Set it for 30 minutes, and if you feel asleep sooner it would bring it up faster, etc..

Uhg.


EPR: I was concerned about EPR thinking that the EPAP level would after the immediacy of the inhale pressure - that it would be an issue based on the rise time versus a constant pressure.


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