Autoset ll Problem?

[Fireguy24]

I just started treatment on 12-10-08 and it is definitely not fun. They gave me the ResMed S8 Autoset ll because my doctor just put on the script 8-15 for my pressure. The place I got the machine from put the minimum # at 4 and the high at 15. I understand what the machine is suppose to do, but I think I'm asking to much from it. My problem is when I wake in the middle of the night from the blast of high pressure and I become fully awake I wait a minute or 2 but the pressure does not drop back down to accommodate my breathing at a normal level. It seems I have to restart the machine to do this. So I guess I'm asking, does this sound right or I'm I missing something?
Thanks
Glen

[packitin]

Hello,
We'd like to have more information on your settings. The Autoset II is a great machine, and you'll do fine with it. I've had mine now over 2 months. I began to take control over my settings myself, as soon as I got my machine.

I have mine set to 6.6 - 18, EPR =1, and ramp at 30. My pressure has been ranging very close to 8. Have you been looking at the data in the efficacy mode each day? What mask are you using? What is your leak numbers? For the last few days, I've kept my AHI under 2.

Keep us informed. There are lots of persons here who can help you. I'm relatively new at this myself. Also, do you use the Rescan card?
See ya,
Jay

[Slinky]

Glen, you've been given one heck of a top of the line CPAP!!! Cross your fingers and hope like h*ll you get to keep it and that it isn't just a temporary loaner and they insist on exchanging it for some bare bone, compliance data only CPAP. (Keep in mind for now that insurances pay by HCPCS code, not brand and model, and that autoPAPs are coded as CPAPs)

Legally, the DME supplier's RT is NOT supposed to set your pressure other than what your doctor scripted. In the "long term", ask your sleep doctor for a copy of your equipment order (script) so that you have PROOF of the pressure settings ordered (scripted). And while you are at it you might as well request a copy of the doctor's dictation (1-2 pages) and of the full scored data summary report w/condensed graphs from your sleep evaluation (5+ pages).

In the short term, go ahead and turn it off and then back on again to restart at the lower pressure. Once you are SURE of your SCRIPTED pressure settings, let us know, we can PM you w/the directions for resetting your pressure settings yourself.

[Fireguy24]

I didn't know about the efficacy mode until you just mentioned it. It says NO DATA for the day, but for the week it reads as follows: Leak = .16, AHI = 3.9,
AI =.4, HI = 3.3. I must admit I have no idea what any of these mean. I guess I need to start doing some homework on this. I have the EPR at 2 and the ramp at 30 min. On the ramp time it seems the machine doesn't catch on if you fall asleep before the time frame and start snoring either. My wife said she could hear me snoring about 10 minutes in, and the machine sounded the same. I do have the card but I have to bring it to the supplier to have them read it for me.
Glen

[Slinky]

You have to check the Efficacy Data before noon. These CPAPs run on an internal, 24 hour, noon to noon, clock.

A Leak rate of .16 is acceptable, your AutoSet can compensate for that. It means that you spent 95% of the night AT OR BELOW that level of Leak. It could be from your mask fit, or more likely your mouth or lips allowing some of the therapeutic pressure to escape rather than into your airway.

An AHI of 5 is considered "normal". AHI is apnea/hypopnea index, i.e. the number of apneas AND hypopneas you experience PER HOUR for the night.

AI is apnea index, i.e. number of apneas per hour
HI is hypopnea index, i.e. number of hypopneas per hour

An EPR (expiration pressure relief) of 2 means that your CPAP pressure can drop 2 cms less than your current pressure setting.

It sounds like you don't need that long of a Ramp time if it is set at 30 minutes and you are asleep in 10 minutes. I'd reset it to 15 minutes.

You might want to consider purchasing the ResScan 3.7 software and cable reader to do your own downloads, bypassing the wait for the DME to do so. Many of us have done so. Meanwhile, each time the DME does a download request a copy of the printout so you can see for yourself. Amongst other things the download will tell you, not only the 95th percentile but also the Median and Maximum values.

[Fireguy24]

Thanks Slinky for the definitions. I had a pretty good night last night. I kept the mask on all night so I guess thats a plus. My readings for last night were as follows: PRESS = 10.0 , LEAK = .06 , AHI = 9.6 , AI = 2.1 , HI = 7.5.
Glen

[GuyK]

Glen, I have the same machine as you, but a different mask. My machine is set for 10/20, and my average nightly pressure runs somewhere from 10.8 to 11.8. I'd guess that since you are set for 4/15, but the doctor spec'd 8/15, and your pressure last night was running at 10, the doctor was pretty much on the mark.

I'd like to have a leak rate as low as yours (maybe my mask isn't serving me as well as it should), but my typical AHI numbers aren't quite that high. When my leak rate is in a reasonable range (below 0.50), I get an AHI as low as 2.0 and an AI of 0.1 or 0.0.

All that being said, I don't get the feel of a blast of air in the middle of the night. In fact, I'm pretty comfortable all night, so I'm chalking that up to having adapted well. I am not running EPR. Maybe that's what you should be doing.

Guy

[Slinky]

Sounding good, FireGuy!! Don't worry about that high AHI just yet since most of that AHI is composed of hypopneas. See what your averages look like after 7 full nights. One night doesn't really tell you much. We don't sleep the same every night. "They" say that the Resmeds tend to score hypopneas a bit higher. Let us know when you've got a full 7 nights as therapy settings just what the weekly data has to say.

[turbosnore]

I have heared that if you divide the ResMed-given HI by two the result is comparable to the HI given by other machines.
I wonder if you have the same problem as I: The machine sometimes starts chasing snores way above the optimal pressure.
The pressure rises and so does AHI. I guess my optimal pressure is somewhere about 12 or 13, but sometimes the
machine runs upto 16. I have Autoset Spirit I and my pressure settings are 9 - 16.

Please comment ye more knowledgeable.

[randyd501]

I have the Auto Set II also and I can't figure out how to turn on the Autostart?
I know how to get into the clinical mode but the Autostart function gives me no option.
Any answers?

[Wulfman]

I have the Auto Set II also and I can't figure out how to turn on the Autostart?
I know how to get into the clinical mode but the Autostart function gives me no option.
Any answers?

There is no setting for it. It's SUPPOSED to "Autostart". HOWEVER.....I've read that the mask setting of "Mirage Full" will effectively turn it off. You might want to check your mask settings and see if it matches the actual mask you're using.

Den

[GaryGarland]

clincian menu - from main screen, hold down right and down for about 3 seconds.
smartstart - i prefer it on - i met with my respiratory tech yesterday, and we tried fitting a full face mask. i set the machine for it. at night i went back to the lt, and couldn't figure out why it wasn't smart starting - i had set the machine back to swift. then i saw it was turned off - setting for a full face mask can do that.

[randyd501]

clincian menu - from main screen, hold down right and down for about 3 seconds.
smartstart - i prefer it on - i met with my respiratory tech yesterday, and we tried fitting a full face mask. i set the machine for it. at night i went back to the lt, and couldn't figure out why it wasn't smart starting - i had set the machine back to swift. then i saw it was turned off - setting for a full face mask can do that.

Tried it and doesnt work get every option in the Clinical menu and when Smart Start comes up there is no apply option to change just an exit option or up and down same with H3i.
I can change every other option and changed facemask to different ones and still cant turn on Autostart

[Portageegal]

I've had the same problem with my machine a few times. In the middle of the night the mask is blowing off my face and won't quit. I have to turn it off and then on again.

[Slinky]

I'm thinking maybe the S8 IIs don't give us the option to use or not use the SmartStart, that we are just stuck w/that option on and working whether we like it or not. I should dig the manual out and check.