Resmed S8 Vantage Settling Time ???

I don't quite understand, and can really find no information, on just what the Settling Time is on the Vantage.

How does it differ from Ramp?

Was explained to me by DME as the time, after turning on, that the machine will wait before responding to any events. As in time to fall asleep.

Slink-
Settling time is a parameter that disables the scoring algorithms during the period of time that you are normally in bed and settling into sleep. Invoking "settling time" will tell your Vantage to disregard your wakeful (non-autonomic) breathing as you fall asleep, and begin scoring only after you achieve true sleep. If you don't enable it, it will begin scoring immediately, and will both score and titrate according to flow dynamics of your wakeful breathing as you settle into sleep. Many of us have sat there and watched as the Vantage abruptly titrates pressure up as we are watching it, awake and presumably breathing "normally" but non-autonomically, and without apneas or hypopneas.

You ought to enable "Settling Time" for the period of time that it takes you to normally fall asleep, in my opinion. ResMeds tend to aggressively score hypopneas, and without "Settling Time" enabled, you'll get artifactually high readings, particularly with regard to Hi.

The down side is that if you awaken during the night to go to the bathroom and turn your Vantage off, it will re-invoke that "settling time" period when you return to bed and turn it back on, and so you will get no titrations during that period as you fall back to sleep. But in return, you will get much more accurate readings (and treatment) than if you choose not to enable settling time.

Hope this helps!

Chuck

GoofyUT wrote:
The down side is that if you awaken during the night to go to the bathroom and turn your Vantage off, it will re-invoke that "settling time" period when you return to bed and turn it back on, and so you will get no titrations during that period as you fall back to sleep. But in return, you will get much more accurate readings (and treatment) than if you choose not to enable settling time.

Hope this helps!

Chuck

Here's what the Clinical Manual says:

Settling**
(AutoSet mode)
Sets the time period the unit waits (at Min
Press) before beginning to adjust pressure
according to the AutoSet algorithm.
------------------------------------------------
Max Settling
(AutoSet mode)
Limits the settling times the patient may
select.

If allowed, it is patient settable and the Max Settling value can limit the length the patient can select, it starts at 5-min and goes to 30-minutes, the patient can select up/down the minutes of Settling desired or not use it at all.

It doesn't re-invoke setting unless you press the button to do so. It works like Ramp, only WHEN you push the button. You can turn On the machine and it will start without Settling enabled.

I think it is a great feature for reasons you mentioned or if you have difficulty falling asleep.

Basically all it does is ignore responding to any SDB events it sees for the time period specified and remains at the Minimum set pressure.

The Remstar AutoRamp works the same way but it allows you to set a "Ramp" pressure lower than the set Minimum pressure. So if you want to have your machine set 8-12cm or higher you can have the AutoRamp drop lower than the 8cm (from 4cm to Auto:Min) and it will start at that lower pressure and increment up by .5cm every 5-minutes until the timer elapses where it then begins autotitration. So it also ignores any response to event during that Ramp or settling period.

Ahhhhhh. THANK YOU, GoofyUT and SnoreDog!! I so appreciate you clear replies.

So on my Elite I started out w/Ramp time at 20 minutes, once I got used to CPAP and mask I just shut it off. I also quit using the EPR. My set pressure is 8 cms.

Sounds like 20 minutes will be a good Settling Time then 'cause that is usually or close to the time it takes me to get to sleep. But after getting up to go to the bathroom I either fall back asleep almost immediately or I CAN'T fall back to sleep and am going to be awake for an hour or two before I can sleep again. There doesn't seem to be any in-between. If I'm not back to sleep w/in 20-30 minutes I give up and get up.

I don't know how I missed that in the SetUp manual, GoofyUT. Duh!

You know, its too bad, in fact it is STUPID that the patient isn't consulted and isn't able to sit down w/the RT when our machines are being set up. Of course, the RT "has" to set the pressure(s) ordered by the sleep doctor, but the other settings could all be set w/input from the patient - or changed w/input from the patient. The medical profession can be so STUPID!

My husband defines Dumb as being born not too smart and Stupid as being born smart and being too STUPID to use the smarts God gave us. The latter descripton sure fits a mighty good share of the medical profession from those who set the regulations right on down to the local DME offices.