Z2 Auto not ramping up

[flythebluesky]

My home machine is a Resmed Airsense 10 with F&P Vitera full face mask; it works well - I usually have less than 2 AHI.
However, I just bought a Z2 Auto for travel, which is really nice and compact and quiet... but I cannot get this machine to ramp up so my AHI is 7+ (some hours its as high as 17).

My settings are 4-15 auto, auto-on-off.

I did test that the machine can ramp up by blocking the hose -- but the ramp up seems really slow (i.e. 10+ seconds to increase pressure by 0.1)

Any ideas on what I can do to get my little sleep buddy working correctly? I disabled auto-on-off for tonight.

Thanks!!

[ChicagoGranny]

My home machine is a Resmed Airsense 10

Which pressure setting are you using with this machine?

My settings are 4-15 auto, auto-on-off.

If these settings are much lower than the ResMed settings, they need to be increased.

but the ramp up seems really slow (i.e. 10+ seconds to increase pressure by 0.1)

That sounds about right = a full 1.0 cm in 100 seconds. If the machines increase pressure too quickly, it tends to interfere with many users' sleep.

[flythebluesky]

Thanks for the response.
I am using the same settings at my Airsense. It's actually set for auto 5 to 15 on both machines. Maybe I need to bump it up to start at 5.5 or 6. I think I'll try that.

My home machine is a Resmed Airsense 10

Which pressure setting are you using with this machine?

My settings are 4-15 auto, auto-on-off.

If these settings are much lower than the ResMed settings, they need to be increased.

but the ramp up seems really slow (i.e. 10+ seconds to increase pressure by 0.1)

That sounds about right = a full 1.0 cm in 100 seconds. If the machines increase pressure too quickly, it tends to interfere with many users' sleep.

[flythebluesky]

After disabling auto-on-off and bumping the initial pressure to 6, the results are worse than the night before; around 1am I had an AHI of 34 and the pressure was 8.7. At midnight and 5am AHI was around 13 with a pressure of ~7.

Clearly the Z2 isn't responding as it should.

Is this a problem with my Z2 unit?
Is it a software algorithm problem?
Is is a settings problem?

[Pugsy]

Your are expecting the Z2 Auto to act and respond like the ResMed and the simple fact is they are 2 different brands with 2 different algorithms and it's like comparing apples and oranges. They just don't taste the same despite both being fruits.

ResMed auto adjusting algorithms are well known to be more "responsive" or "aggressive" than all the other brands.
People almost always have to use a higher minimum with any other brand than they might be able to use with the ResMed machine.
Sometimes substantially higher.

Quit trying to make the Z2 act like a ResMed...it never will.
Instead try adjusting your settings so that you get the results you want and accept the fact that they are just different algorithms involved.
Or return the machine if you can and you are unhappy with the results.

Sorry but those are the cold hard facts of life. Just because you can't get the same results at the same settings as a ResMed doesn't mean something is wrong with the Z2.

[flythebluesky]

Your are expecting the Z2 Auto to act and respond like the ResMed and the simple fact is they are 2 different brands with 2 different algorithms and it's like comparing apples and oranges. They just don't taste the same despite both being fruits.

ResMed auto adjusting algorithms are well known to be more "responsive" or "aggressive" than all the other brands.
People almost always have to use a higher minimum with any other brand than they might be able to use with the ResMed machine.
Sometimes substantially higher.

Quit trying to make the Z2 act like a ResMed...it never will.
Instead try adjusting your settings so that you get the results you want and accept the fact that they are just different algorithms involved.
Or return the machine if you can and you are unhappy with the results.

Sorry but those are the cold hard facts of life. Just because you can't get the same results at the same settings as a ResMed doesn't mean something is wrong with the Z2.

No, you are jumping to conclusions. I am simply trying to get this Z2 to do what it is supposed to do, which is reduce apneas to a normal level and the only other point of reference I have is the Resmed Airsense... and you say adjust the settings: Ok... What settings and how? Can you be specific?

Can anyone else who uses Resmed explain how you got your Z2 to work?

[jsmit86]

After disabling auto-on-off and bumping the initial pressure to 6, the results are worse than the night before; around 1am I had an AHI of 34 and the pressure was 8.7. At midnight and 5am AHI was around 13 with a pressure of ~7.

Clearly the Z2 isn't responding as it should.

Is this a problem with my Z2 unit?
Is it a software algorithm problem?
Is is a settings problem?

Double check your settings, especially the ramp setting. Perhaps try one night with the Ramp feature OFF.
If you read the clinical menu, setting the ramp incorrectly can cause issues.

One other observation. I have a Z2 Auto. I used it for travel, and also for a couple months when my Resmed unit was out of service.
I sometime got high AHI readings. I exported the data using the PC software. I found out the my large AHI events were actually happening around 5AM. I have asthma, and I cough a lot during this time of trying to snooze back to sleep. The software interpreted these coughing events as apneas. My night time asleep data was fine. Typically less than 5.

[Pugsy]

Yes, you have to adjust the settings...most likely the minimum pressure needs to be increased.
It's impossible for me to offer anything beyond what we tell anyone who is using an auto adjusting machine beyond doing the time consuming titration at home.
Pick a minimum and use it and evaluate results and then decide if the results are acceptable or not.
If not...pick a different minimum and give it a try.

This all assumes that the flagged events you are seeing causing the AHI to be higher than you want are real asleep flagged events and not false positive awake breathing events. No where in your comments do you tell us if you slept well or had lots of awake time involved.

Blocking the hose manually while awake....not a way to test machine's response time at all. You weren't asleep.

You have to do your own in home titration at various pressures...takes time and patience.

Without seeing pressure graphs and all that happy horse crap....we have zero way to make any sort of educated guess as to what the settings should be but if you need so and so pressure with the ResMed...it's a real safe bet that you are going to need more with the Z2.

Finally....category of events...does the Z2 separate obstructive from centrals?????
More pressure is indicated for obstructive but won't help centrals at all....so if the bulk of your higher AHI is central apneas then more pressure won't help.

More detailed information is needed but I don't think it is available which makes advising for settings a crap shoot.
Playing the odds...most likely obstructives aren't being dealt with but it wouldn't be impossible for it to be centrals or even awake false positive events.

[flythebluesky]

I bumped the initial pressure up to 8. The pressure didn't fluctuate at all and my AHI was good - 1.33.

This means I got the Z2 working but it's pretty much in CPAP mode, the APAP doesn't seem to work.

[Julie]

Are you sure it is set to Apap mode and not plain Cpap - there may be a note in the clinician manual to show you how to change it (unless there isn't of course).

[flythebluesky]

Yes, APAP I definitely on because I set the minimum and maximum. The problem is that it doesn't ramp automatically so I paid for an APAP but essentially have a CPAP. It doesn't sense and ramp up when it should.

[jsmit86]

Suggest that you call Breas/HDM support, and discuss what you are experiencing.
I actually had a Z2 Auto replaced that was acting wonky. I sent them the data from the PC, and they ended up replacing the machine.
Customer service was actually pretty good once they understood the problem.

[Musiclover1013]

Did you get a resolution on this? I tried my z2 last night prior to my vacation. My home machine is the Resvent ibreeze. I can control my apnea with my home machine with 10-12 for pressure. Unfortunately the highest pressure the Z2 gave me last night was 7 which didn't do a good job controlling my apnea as my AHI was at times 15-20. This is my 2nd Z2 as the first one was defective. Hoping my Respiratory therapist & breas can help.

[Julie]

You need to start your own thread... the person you're trying to reach hasn't been to the forum since July.

[jsmit86]

Did you get a resolution on this? I tried my z2 last night prior to my vacation. My home machine is the Resvent ibreeze. I can control my apnea with my home machine with 10-12 for pressure. Unfortunately the highest pressure the Z2 gave me last night was 7 which didn't do a good job controlling my apnea as my AHI was at times 15-20. This is my 2nd Z2 as the first one was defective. Hoping my Respiratory therapist & breas can help.

It's a good idea to start a clean thread. I have a Z2 and it works well, but I do have my pressures set a bit higher than on my Resmed machines.
IIRC, I also don't bother with RAMP. If that is set incorrectly, it definitely can cause problems.