Strange Test Results?

[palerider]

And why did you thought that?

Not listed in the manual...

https://www.resmed.com/us/en/healthcare ... r-her.html

The pioneering new algorithm used in the AirSense 10 AutoSet for Her works by increasing sensitivity to flow limitation and optimizing the response to these events. By responding to each flow-limited breath, the algorithm helps provide comfortable therapy for women.

I'm not sold it was the setting change, it could have just been a bad night. My pressure variation is minimal so I doubt it makes that much of a difference which setting I use.

"Optimizing response" does not inherently mean "more responsive", though I can see how you would assume that.

What you think is optimal, and what the machine thinks is optimal may very well not be the same.

Also, I am surprised that an engineer such as yourself would base their ideas on marketing fluff.

[Geer1]

"Optimizing response" does not inherently mean "more responsive", though I can see how you would assume that.

What you think is optimal, and what the machine thinks is optimal may very well not be the same.

Also, I am surprised that an engineer such as yourself would base their ideas on marketing fluff.

The algorithm video on their website shows that autoset for her reacts to each flow limited breath and shows a chart of it reacting earlier than the regular autoset setting, the autoset reacts more once it does react though. In that video it is almost like the autoset for her algorithm increases a set amount of pressure for each flow limited breath whereas autoset algorithm calculates a running average and then reacts depending on the number of/degree of flow limited breaths. Just a guess though since the manual doesn't discuss this level of detail on either algorithm.

I guess which algorithm is advantageous depends on a persons type of flow limitation. I am fairly certain mine is rem related so the heavier handed reaction by autoset may be more helpful. The other algorithm differences; slower pressure increases/decreases, lack of response to apnea over 12 cm and session minimum pressure increases after consecutive obstructive apneas wouldn't have any difference in my case as my pressure changes are minimal, I never go over 12 cm and rarely have obstructive apneas (even untreated).

AHI wise the two nights I used it rank as my 1st and 3rd worst nights and I had higher flow limitation both nights as well. It could have just been coincidence/bad nights but I don't think it offers any significant advantage in my case and will stick to autoset.

[slowriter]

Hi,

I have been fighting some health issues (wide range of symptoms, fatigue being on of the main ones) for a while now and I was finally given my first diagnosis, sleep apnea.

I was looking over the results and it seems that there is definitely something wrong but based on the little knowledge I have this does not seem to be typical sleep apnea. I am going to do some research but figured I would post on here to get others thoughts as I assume some of you are much more knowledgeable/experienced then I am....

Was this an at-home test, without EEG?

Because I note there's no arousal data, which would be good to have.

[Pugsy]

lack of response to apnea over 12 cm

Just wanted to clarify this for people reading this in your thoughts or the manual.
It won't respond to any OAs with pressures above 12 when the OA isn't accompanied by snores or flow limitations.
Apneas without accompanying snores or flow limitations are rare but they can happen.
People read this and think the machine in the for Her mode won't do anything if they need more than 12 cm and that's simply not the case.
It will respond and go higher as long as flow limitation or snores are also present and most of the time if you have an OA or hyponea...you have some sort of flow limitation or maybe some snores.

I have used the for Her mode...and I my OSA is worse in REM and I have often seen the machine go over 12 cm in the for Her mode.
Most of the time it appears to coincide with a time frame where I am likely in REM.
So it will indeed go over 12 if needed as long as something else is going on that the machine's algorithm is designed to respond to.

[Geer1]

Was this an at-home test, without EEG?

Because I note there's no arousal data, which would be good to have.

I was unable to talk my doctors and sleep therapist into doing an in clinic test. Even private (not covered by healthcare) in clinic tests require a doctors referral so all I could have done was the home study...

I agree, I wish I had arousal data. I did my own video recording test prior to starting treatment and there was ~ 30 obvious arousals (changing position etc) s they are clearly a factor. Now on treatment I see signs in my flow trend of arousals throughout the night but some of those are due to machine etc. Prior to many of the arousals in video recording I had leg or arm twitches, I am curious if that was due to desaturation or periodic limb movement. I plan on waiting until I am sleeping comfortably/consistently with APAP then will do another recording to compare to.

[Geer1]

Yes Pugsy, I was summarizing.

For those that don't know the autoset for her algorithm reacts to flow limitations and snores but not obstructive apnea when above 12 cm pressure. Apnea events often have flow limitation or snores present or prior to apneas so autoset for her will reach pressures above 12 cm, it just responds differently then the autoset algorithm does in those situations.

[Geer1]

I am actually a really good example for seeing how the different algorithms respond to flow limitation as I have very few obstructive apnea and snore events so flow limitation is the main thing my APAP pressure responds too.

Here is the regular autoset graph. As you can see it responds sharply after a few flow limitations then lowers down fairly quick after the moments of higher flow limitation. When single flow limitation events (as shown at 2:03) occur the pressure setting is unchanged.

screenshot-20191130-113455.png (113.19 KiB) Viewed 349 times

Here is the autoset for her graph. It appears it may react to individual flow limitation events more readily but it reacts in a slower, more blunted increase in pressure especially when multiple flow limitations occur in a short period. This seems to in my case allow larger flow limitations to occur.

screenshot-20191130-113437.png (113.12 KiB) Viewed 349 times

Anyways neat differences and I can see how both have their advantages. I would recommend others try them out and see what works best for you.