- [Man Speaking Off Screen]
Good day guys, Nick here from CPAP Reviews.
Welcome to part three of three on our series on the
Resmed airsense 10 machine
In this part,
we are going to be looking at
how to get into the clinical menu.
This is the menu.
That's a bit more advanced than the patient menu.
And it's a menu where you can change things like
the pressure mode of the machine,
whether you want it to run in Auto (apap) or CPAP
the pressures and things like that.
So it just gives you a bit more access to
the backend of the machine and
it gives you a few more options than your
standard basic menu that you're probably accustomed to.
So in order to get into the
the clinical menu
What we first have to do is
press and hold in the click wheel.
Plus also the top start stop button
at the same time.
Oh, okay.
Sorry. It's the home button and this button.
So you press and hold those two buttons in simultaneously.
Keep holding them in. And then it says
all of a sudden
exit clinical menu. So we're in now.
As soon as that comes up, it says exit clinical menu,
we're into the advanced settings.
So now when we click the settings,
they're going to be a little bit different to
what they said in part two.
All right. So let's just go through some of them here.
The first one here is the mode.
Okay. And it says auto set.
If you have an auto set machine
I suggest you run it in auto set
if you have a fixed pressure machine (cpap),
it's probably only going to have the fixed pressure mode.
But if you've got the auto set one,
you can go between C-PAP there and auto set.
All right. So we're just going to keep it on
auto set.
If we go down a little bit
then you've got your max pressure that says
at the moment of 20.
So that's the upper limit of the automatic algorithm.
And then you've got the low, that min pressure,
which is your lower limit. Okay.
That at the moment
four is as low as you can go.
And 20 on the max is as high as you can go.
So that's the widest range available.
You can't go any more than that.
But what some people would like to do is
they might want to increase the min pressure
a little bit.
If they feel like there's not quite enough
air coming through the mask,
it's feeling a bit suffocating.
They might increase the min pressure,
or if they feel like the pressure is just getting too high
in the nighttime, it's too intense and
it's waking you up.
Then you can use the data.
I'll show you how to do that in a minute to
actually bring down your max pressure limit,
to a point that's more comfortable and
still maintain a good apnea hypopnea index (AHI).
So you can see that I'm bringing it down 13, 14,
bring it down to a level.
What that's going to do is it's going to cap
(coughs)
excuse me.
It's going to cap the auto algorithms so that
it can't go above that value.
And this means that, you know,
there might be a period of the night where
it's just getting too strong and
you might need that pressure to control the apnea
but it's no good to you if
it's going to constantly wake you up.
Cause mask leaks, wake up a Mrs, or the husband or whoever.
So it's a back getting that nice fine balance.
I talk about this a fair bit between getting good therapy,
but also getting good sleep comfort
like, you know,
good sleep comfort you don't want the machine to be
you know,
at a point where, yeah,
it's controlling every single apnea, but to do so
it's waking you up every 15 minutes because
the air is so intense. Okay.
Find that happy balance and that way
you'll be much better off.
So I further down there,
so I'll just set that 14 further down.
We've got the mask, which is a pillows at the moment.
You can change that full face. Nasal.
If you like go a bit further down,
we've got the comfort features coming up now.
So we had ramped, which is auto.
That was also in the patient,
the patient settings in part two,
we've got the start pressure.
So we can change. If you're wanting to do a ramp,
what that pressure starts at
we have EPR,
which is our expect that pressure relief
I was talking about.
So we've got that on at the moment.
I would suggest you have that on,
you can change the EPR.
So the pressure relief,
whether it's full time or just during the ramp period,
I suggest have it all the time.
You don't want to just in the beginning,
have it right through the knot.
If you, if you can, and then you've got your level.
So EPR level can go between one, two and three.
The more you have the higher, the number,
the more the machine is going to drop the pressure,
the higher the pressure.
The higher the number,
the more the machine is going to
drop the pressure as you breathe out.
So as you exhale that numbers on three,
it's going to drop the pressure a lot to
make it really easy for you to
breathe out.
If you have it on two
it's going to drop it a little bit less again,
a little bit less again.
And then you can obviously turn EPR off.
If you don't like it.
Some people say that it throws off their breathing
a little bit with the machine going between
sort of full pressure and then dropping the pressure and
full pressure and dropping the pressure.
Other people say it makes the machines a little bit noisier,
experiment around, find an EPR that's
that's good for you. Whether it be one, two or three.
then we come down to climate control auto.
We went through this in part two
the tube temperature there.
You can change tube temperature.
In winter you obviously want that pretty warm.
In summer you might not need it as hot
same depending on where you're living
whether you're in Queensland or Melbourne,
just find a tube temperature
that's comfortable don't be afraid to change that.
Anti bacterial filter
(static noise) (phone ringing)
just, excuse me here.
That's an antibacterial filter.
So not many people would probably have one of those
on to begin with.
So I generally have that as no
to go down here options, essentials you want on plus
don't have it on just on, have it on plus
that gives you more access to more data on
the actual home screen when
you're in the patient setting.
So have that as plus.
Smart start, you want is on
that's the automatic on, automatic off and
the reminders you can set the reminders there
if you want to
So to change your filter, you know,
it's pretty straight forward to go through there and
change, you know, put in your dates
for the machine to actually remind you
to change certain things if you, if you need to,
then you've got configuration, you know
the language, the date, the time,
the pressure units, the temperature units.
So that's just configuration leave them pretty,
you know, standard. Okay.
Temperature units is Celsius
pressure units as cmH2O
leave that as standard. Okay?
And then you can erase all the data on the machine
if you want to.
And then you can go into it and be back machine to
tell you things like
the year, a number, etc.
So that's pretty much it for the clinical settings.
You know, the main thing here to look at is obviously
the therapy settings, okay.
Especially if it's an auto set between
the min and the max pressure.
So what you can do with that,
if we go back just to home
if we go to our sleep report
this is in the clinical menu still
we go to sleep report,
it's going to have there events per hour.
So the apnea hypopnea index (AHI), if we
scroll down, scroll down, scroll down,
you come to this point where it says pressure, okay.
And that pressure number is going to be,
what's called the 90th percentile pressure,
which basically means 90% of the night
the pressure is below that level.
So only 10% of the night, the pressure is
above that level.
So we can use that number as a guide to
put our, set our upper limit (auto max).
So what we can do,
if we're finding the pressure is getting too high in
the nighttime,
check out what that number is over the week.
Okay. That pressure
check out what that number is.
And then what I want you to do is go back to
go to your settings and
change your max pressure to that value.
All right.
So say that 90% of our pressure came in at 12
change that max value to 12, all right.
And then go to home and then exit clinical menu
run the machine for a night and
have a look at your apnea hypopnea index (ahi) the next day.
All right.
If the apnea hypopnea index is still nice and low,
like it's still below five (ideally)
then you haven't capped that auto max too low
all right?
As long as that apnea hypopnea index is below five,
you can keep bringing that cap, that auto max level down,
if the apnea hypopnea index starts to go up.
So if that starts to get five, six, seven, eight,
then you might've capped that upper limit
of your auto too low.
You might need to bring that up a little bit. Okay.
But you can fiddle around with that to
make the therapy more comfortable.
All right.
Especially for someone who's struggling with
the high pressures, you know
don't be afraid to get in there
cap your limits
but just keep an eye on your apnea hypopnea index and
make sure that it's not going too high.
Alright. I hope you've got some
a bit of insight into that.
It's a little bit more tricky than your
standard patient settings but
at the same time
if you spend a few minutes and you go through it,
I'm sure you can make your therapy a bit more enjoyable,
a bit more comfortable and at the end of the day
that's what it's all about.
Getting obviously your control of your sleep apnea,
but at the same time, you know,
making sure you're nice and comfortable because
cpap is a pain in the ass to sleep with for everybody.
So if you can make it
just that bit more comfortable.
You're gonna be better for it in the future
As always,
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