- [Nick] G'day, everybody.
Nick here from Super Cheap CPAP.
And today I'm gonna be taking you through
a little advanced tutorial
of how to get into the clinical settings
of the Fisher and Paykel ICON Plus, or ICON for that matter.
It's pretty much the same, but we'll focus on the ICON Plus
for today's tutorial.
Now the clinical settings are sort of advanced settings.
Obviously you have your normal patient settings,
which you can check out in your manual
if you wanna learn how to change them.
Plus, we've also just done a video on that.
But clinical settings are settings
that actual CPAP consultants and sleep scientists use
to adjust things like the CPAP pressure.
So they're just a little bit more advanced,
but I'm gonna show you how to get into them
so you can actually start, I guess,
getting personal with your own therapy
and learning how to control your own sleep
and your own therapy.
So in order to do this with this machine,
all the different machines
have a little bit of a combination you need to do,
and with this one it's quite simple.
All we do is, with one thumb,
we hold in the round middle button here
and, with our finger, we rotate the dial right around
to six o'clock and now we're in clinical settings.
It's that easy, very simple.
Now I'm gonna take you through
all these different ones here, so you know what to change.
So the first thing up on here, it says auto with that dot.
If we click that, that auto starts flashing
and we can actually rotate the dial
and change it between automatic and CPAP.
Automatic being variable pressure.
So the machine automatically titrates the pressure
throughout the night to give you more of an optimal therapy,
more of a tailored therapy.
And CPAP being fixed pressure.
So actually the machine's gonna be set
at one fixed rate of pressure.
The machine will just run at that, ramp up to that pressure
and sit at that one pressure throughout the night.
So I'm just gonna keep it auto for now.
So I'm just gonna lock in auto.
If I go down one now,
so one around to the right here,
you can see that it says auto min and four.
This is the base level of therapy.
So this is where the lower limit of therapy.
You can't go any lower than four.
Four is the minimum that it produces.
And sometimes people on four might feel like
there's not enough actual pressure coming through the device
so we can actually change this minimum pressure.
We can go upwards.
All I've done there is click the middle button
and just rotate the dial,
and you can see the number goes up.
So we can actually increase the lower limit.
All right?
Sometimes, you know, if you have a full face mask,
you might be better off starting at five or 5.5
because sometimes four can feel a little bit suffocating.
But this is sort of how you change that.
So let's just increase that to five.
We will increase the auto min to five.
And then once we click it again, it says auto max,
and this is the maximum therapy, the maximum pressure limit.
Okay, and the highest it can go is 20.
So if we leave it at 20, at the moment,
the machine can run between five and 20, that's the range.
And the machine will determine what the correct pressure is
based on your breathing, okay.
But that's where it has the rules
where it can go between five and 20.
If we're still finding that at the beginning
there's not enough air coming through,
we can go up higher than five.
Sometimes people like six, seven, eight, nine, 10.
It's all just personalized.
So just find what's comfortable for you.
But that's how you change the minimum.
One reason why you might change...
Sorry, if you don't press any buttons after a little while
it just gets out of that clinical setting.
So you have to go back into it.
So I'll just go back in again.
Press and hold, go back in.
So let's go to that maximum pressure again.
So, we'll click it.
So we've got five days.
You've got to click it to get through to the max.
Okay, max 20.
One reason we might like to change the maximum pressure
is if the pressure's getting so high
that it continually wakes us up
and it makes the therapy very difficult to use.
Obviously the machine is going up to that high pressure
because it's trying to open up your airway,
but sometimes it can have the negative effect
of just frequently making life difficult
and making your sleep fragmented
because you continuously wake up due to the high pressure.
So it's kind of defeating the purpose of it, if you will.
So sometimes what we do is
we actually bring the max, we actually cap the pressure
at a lower level just to provide a bit more comfort.
And I'll show you in a sec
how we can actually tailor this comfort
so that we're not, you know, decreasing that,
we're not capping it too low
so that the the actual therapy becomes inefficient
and stops working for us.
But we can do that.
That's something we can do if we need to, okay.
But for now I'll just leave it at 20.
So if we go down one more again,
this is, it says menu two here.
This is if I want to change it
so that it's a very basic menu for an actual patient.
So I can change it between one and two.
Two, you can see it's got a whole lot more features.
And one they only got a couple of features.
It's only got the humidity.
So if I don't want to get, you know,
make it too complex for a patient, I set it on menu one.
It makes it very easy for them.
Otherwise, if I set it on number two there,
you've got a lot more options
and it can sometimes confuse people, okay.
But I'm gonna leave it on number two
because obviously I know what I'm doing.
Then I've got the sense awake, this one here, okay.
I talked about sense awake last video.
The machine, if you've got it switched on,
the machine will drop the pressure
if it senses you're awake to help you get back to sleep.
Okay, it's a really cool feature.
And then you've got whether or not they show
the time or the pressure.
So we can set it so it's running,
it shows the time as a clock
or gets it as it shows the pressure and we go down one.
This is the time.
So we can set the time.
Click and you can change the time if you need to.
Leave it as it is for now.
All right.
And then obviously you've got the data as well
that you can check out.
The data.
(Nick clicking)
And last one is it just tells you a little bit
about the machine.
How many hours it's used, what version the software is
and just a few things that, you know,
it's currently automatic with sense awake
and thermos smart is plugged in.
So that's pretty cool.
It's not too difficult.
Don't shy away from it.
Now, just while I've got you here and your attention,
I'll just show you how we can sort of fine tune
that upper and lower limit if we want to, if we need to.
So I'm just gonna go back out again to the patient settings.
I'm gonna rotate the dial all the way around
down to the little squiggly line, the data one there.
I'll just maybe come in a little so you can see.
So the data one, it's just a little bit right
from six o'clock.
And then click that and I'm gonna rotate the dial round
to where I see 90% pressure.
Okay, it's down here.
It says 4.5.
So this is that number that tells us
that the machine is, the pressure...
I always struggle to explain this part.
90% of the night, the machine is below this number.
All right, so 90% of the night machine is below 4.5.
So if your machine was say,
you say this 90 percentile pressure would say 12.
Well, realistically you could set your upper limit at 12
and it will control 90% of your sleep apnea.
Okay, so that's a way to sort of workout
where your upper limit can be.
You might wanna give it a little bit of breathing room,
so may 13 or 14.
This is only if it's bothering you, by the way.
If your upper limit isn't bothering you
and the pressure is not getting really, really high
and waking you up, then don't worry about it.
But if it is, these are some things you can do
to sort of just make your therapy a bit more comfortable.
So we look at this number and we go, okay, you know,
4.5 is quite low, but let's just choose to say it's 10.
Excuse me.
If it's a 10, we can go back out of this, you know,
go back into our clinical settings
and bring the upper limit down to 10.
And we know that, you know,
the machine is still gonna be able to
treat 90% of our sleep apnea, which is a pretty good value.
90% is pretty good.
We don't have to get every single event, you know,
just aiming to take the stress off the body of the night.
Stress off the body during the night
so that we can get a nice sleep cycle.
So I'm gonna go back out now
and just imagine this number's 10.
So I'm gonna get back up to the top here, click it.
I'm gonna go back and get out of this.
And now I'm gonna go into the clinical settings,
like we did before, press and hold, rotate, rotate,
rotate, rotate down.
And now I'm going to click,
just rotate one down to the where it says auto min five,
click that, and we're gonna leave that at five.
So I click it again.
We've got to go through this,
it's the only way to get to the auto max, click it again.
And it'll say auto max 20.
So I'm gonna bring that down now to 11.
My P90, my 90th percentile was 10.
I'm gonna bring it down to 11,
just to give me a little bit of a buffer
and that way now my machine's gonna run from five to 11.
I know that the machine's gonna stay
really nice and comfortable for me
because it's not gonna be going
into those really extreme pressures.
But at the same time, I'm gonna be able
to get 90% of my apnea under control,
which is really, really good.
And what I can actually do then as well,
I can actually check this at the day
to check my apnea hypopnea index
to double check that that's okay.
So if I keep going round here, say I've just, you know,
say I've just changed,
this is the first night of change
that I've woken up the next day,
I go to the graph where my therapy is,
I rotate down to where the apnea hypopnea index is.
You'll see it, it says AHI there, AHI 2.0.
And I click 'cause at the moment it's on 30 days.
If I click, I wanna see last night's.
And last night's came in as 2.2.
Well, you know, I know that my apnea
is really well controlled at 2.2.
So I'm pretty happy with that pressure change I've done.
I'm not getting those extreme pressures
that were waking me up previously.
And now I know that my breathing's
also really, really well controlled
and my apnea's under control.
So I've made my therapy a whole lot more comfortable
than it previously was,
but without affecting my apnea hypopnea index.
And that way you're getting maximum benefit
out of your machine.
So I hope you've enjoyed this little demonstration video.
Please like it.
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if you want a few more educational videos.
We're starting to put together a bit of a library there.
You can head on over to our website, supercheapcpap.com.au.
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And if you like, we have a little chat that we run
down the bottom right-hand side of the website page
so you can chat to experts anytime of the day.
Thanks again.
I hope you're getting some good sleep
and I hope we can help you get a better sleep.
Cheers, bye.