HHZ Respiratory Review

AirSense 11 settings explained: Ramp, EPR and more

4 min read By HHZ Editorial Next review

On the AirSense 11 you can change these in MY OPTIONS: Ramp Time (Off, 5 to 45 min, or Auto), Pressure Relief/EPR (Off or 1 to 3 cmH2O), SmartStart and SmartStop, Climate Control (Auto or Manual), Tube Temperature (60 to 86°F) and Humidity Level (Off or 1 to 8). EPR, SmartStart and SmartStop appear only if your care provider has enabled them. Your prescribed pressure is set by your care provider, not from the patient menu. Mask Fit and Airplane mode are under MORE.

Everything here comes from ResMed’s AirSense 11 US user guide. It covers what you can change yourself. Your prescribed pressure, therapy mode and pressure limits are set by your care provider.

The settings at a glance

SettingWhereOptionsWhat it’s for
Ramp TimeMY OPTIONSOff, 5–45 min (5-minute steps), AutoStarts low and rises to your prescribed pressure
Pressure Relief (EPR)*MY OPTIONSOff, Level 1, 2, 3 (1/2/3 cmH₂O)Lowers pressure as you breathe out
SmartStart*MY OPTIONSOn/OffTherapy starts when you breathe into the mask
SmartStop*MY OPTIONSOn/OffTherapy stops a few seconds after you take the mask off
Climate ControlMY OPTIONSAuto, ManualControls tube temperature and humidity together (needs ClimateLineAir 11 and HumidAir 11)
Tube TemperatureMY OPTIONS60–86°F (16–30°C), Off; Auto = 80°F in Climate Control AutoWarms the air in the heated tube
Humidity LevelMY OPTIONSOff, 1–8Humidifier output
Mask FitMORERun testChecks for leaks around the mask
Airplane modeMOREOn/OffTurns off wireless transmission for flights

*ResMed marks these as “features enabled by your care provider”. If you don’t see one, ask your provider.

Ramp

Ramp is the period during which the pressure climbs from a low start pressure to your prescribed pressure. Choose a fixed time of 5 to 45 minutes, or Auto, where the machine raises the pressure once it detects you’re asleep. ResMed’s AirSense 10 quick-start guide suggests Auto Ramp or a longer ramp if high pressure keeps you awake or you feel bloated from swallowing air, and turning Ramp off if you feel you’re not getting enough air (AirSense 10 quick-start guide). See aerophagia.

EPR (Expiratory Pressure Relief)

EPR drops the pressure while you breathe out: 1 cmH₂O at level 1, 2 at level 2, 3 at level 3. ResMed’s specifications say the delivered pressure won’t go below 4 cmH₂O. It’s available in CPAP mode and in AutoSet / AutoSet for Her modes. ResMed says it “can help you get used to therapy”.

SmartStart and SmartStop

With SmartStart on, breathing into the mask starts therapy. If it doesn’t trigger, take a deep breath in and out through the mask. SmartStop ends therapy a few seconds after you take the mask off. ResMed says SmartStop may not work, and should be disabled, with nasal pillows below 7 cmH₂O or with conduit masks.

Climate Control, tube temperature and humidity

Climate Control works only when both the ClimateLineAir 11 heated tube and the HumidAir 11 tub are attached.

ModeWhat it doesRainout
Auto (recommended, default)Tube at 80°F (27°C); humidifier keeps 85% relative humidityResMed says it protects against rainout
ManualYou set temperature and humidity separately”Rainout protection is not guaranteed”

In Auto you can still nudge the tube temperature (60–86°F) if the air feels too warm or too cold. In Manual, if rainout happens, ResMed says to raise the tube temperature first. Then lower the humidity if the air gets too warm and rainout continues.

Without heated tubing, you only have Humidity Level (Off, 1–8). ResMed’s rule: turn it up for a dry nose or mouth, down for moisture in the mask.

ProblemResMed’s suggested changeGuide
Dry nose or mouthRaise Humidity LevelCPAP dry mouth
Water in tube or maskRaise Tube Temperature, then lower humidityCPAP rainout
Air leaksRun Mask Fit; refit the maskCPAP mask leak
Hard to fall asleep at pressureRamp Auto or longer ramp; ask about EPRAerophagia

Mask Fit, Airplane mode and data

Mask Fit (under MORE) helps you find leaks around the mask. Airplane mode turns off wireless transmission. ResMed’s guide says the AirSense 11 meets FAA requirements for all phases of flight, and that the water tub should be empty in transit.

For data to reach your care provider, keep the machine plugged in and out of Airplane mode. ResMed notes that wireless transfer may not work outside the region where you bought the machine. Your care provider may instead ask for the SD card. The myAir app is optional. See myAir and OSCAR explained.

Settings you can’t change yourself

Treatment pressure, the minimum and maximum pressure in AutoSet mode, and the therapy mode are set by your care provider. If your AHI stays high or the pressure feels wrong, talk to your sleep clinician. Don’t look for workarounds to change the prescription.

Verdict

Start with Climate Control Auto and Ramp Auto. If breathing out feels hard, ask your provider to enable EPR. If you’re getting a dry mouth or water in the tube, adjust humidity and tube temperature as above. Leave pressure to your clinician.

Related: AirSense 11 vs AirSense 10, APAP vs CPAP vs BiPAP, how to clean a CPAP.

See also: AirSense 11 review and ClimateLineAir heated tubing explained.

Frequently asked questions

Can I change my own pressure on the AirSense 11?
No, not from the patient menu. ResMed's user guide says your care provider sets the device up for your needs, and lists Ramp Time, Pressure Relief (EPR), SmartStart, SmartStop, humidity and tube temperature as the settings you can personalize in MY OPTIONS. EPR, SmartStart and SmartStop appear only if your care provider has enabled them. Pressure changes go through your prescribing clinician.
What does EPR do on the AirSense 11?
Expiratory Pressure Relief lowers the pressure while you breathe out, by 1, 2 or 3 cmH2O at levels 1 to 3. ResMed says the delivered pressure never goes below 4 cmH2O. It can make breathing out easier while you get used to therapy.
What is the best humidity setting on the AirSense 11?
ResMed recommends Climate Control Auto, its default, when you use ClimateLineAir 11 heated tubing with the HumidAir 11 tub. It targets 85% relative humidity with the tube at 80°F (27°C). Without heated tubing, use Humidity Level 1 to 8: turn it up for a dry nose or mouth and down for moisture in the mask.
What does Ramp Auto mean?
With Ramp set to Auto, the pressure starts low and the device raises it to your prescribed pressure once it detects you've fallen asleep. You can also set a fixed ramp of 5 to 45 minutes in 5-minute steps, or turn it off.
Why doesn't SmartStop work with my mask?
ResMed says SmartStop may not work, and should be disabled, with nasal pillows at pressures below 7 cmH2O or with conduit masks.

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