Switching from PR System One to Airsense 10 --??s

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MarylandCPAPer
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Switching from PR System One to Airsense 10 --??s

Post by MarylandCPAPer » Wed Jul 01, 2015 6:57 pm

I got my Airsense 10 for Her (S10) yesterday, after using a PR System One in APAP mode for 5.5 years. I used the new machine last night and I am not a happy camper. I very much sympathize with the CPAP newbies who are having trouble the first few nights, although the reasons for our troubles probably differ.

If any one has any insights, my questions include:
1. If used to and happy with APAP mode on the PR System 1, which is most comparable-- Auto mode or "Auto for Her" mode? Mine is set to "Auto For Her."
2. Is there any way to see AHI, 90% pressure and other performance data on the machine display? I didn't find any.
3. I have not yet set up Sleepyhead and/or My Air or any other software. I never needed it before. Which is easiest to set up and use, and which will easily give me #s and / or easy graphs that will help me compare my feelings about the night's APAP experience with the actual machine performance? I will eventually install and use both, but I just want a little simple information (NUMBERS), not frowny and smiley faces. I don't have much patience or ability to concentrate at the moment.
4. On the A10, is there any way to hit the equivalent of a "PAUSE" button during bathroom breaks, so the pressure doesn't 't go back to the bottom pressure of the APAP range and cause one to have to start over getting the pressure back up to where one had been sleeping comfortably? I never remember this being a problem on the System One machine, but I was called by nature numerous times and dreaded having to go back to starting at ramp (or 10, once I shut off ramp mode).
5. Is there a way to get the A10 to start at the lowest pressure in an APAP range (10 in my case), instead of starting at zero and going up to 10 in however many seconds? With the System 1, I wasn't using ramp, and when the machine came on, I think it was at 10 from the start. I have it set so putting on the mask starts the machine, same as on the System 1, and those few seconds between 0 and 10 were AGONIZING--worse than ramp.
6. What is the shortest ramp period that can be set on the A10, and does it actually start at the ramp pressure or do the 0-ramp speed routine? I can't remember and I turned ramp off. If the machine starts on ramp at 7, I probably want a ramp of about one minute.
7. How do you change EPR, or turn it off? I assume it is in the clinician's menu? The DME set it to 2, since I didn't know how it works. I think I want to turn it off.
8. Do some people just never adjust to a S9 or A!0 after a System 1 and go back? Unfortunately, my System 1 machine is about to die after 5.5 years of extensive use, so if a System 1 machine is what I REALLY need, I would have to get another machine at my own expense. I assume I am stuck with the S10, since that is what I got my dr. to write on the CPAP prescription and the DME provided?

After 2 hours of using the A10 machine with a ramp set to 7 / auto by the DME and APAP set to 10-20, I realized that I was going to be at 7 all night and feeling like I was suffocating, if I never fell asleep (which sometimes happens). I finally found that I can turn off ramp--about the only thing one I found that I could do without getting into the Clinician's menu, which I didn't know how to do. After 2.5 hours use of the S10, with some sleep, I awoke very irritable and irritated, which is not normal for me. Mostly, after 2.5 hours on CPAP on the System One, even with no sleep, I was relaxed. I got some sleep after killing the ramp feature. Total use of the S10 was about 8 hours. At that point, I felt ok, not irritable or irritated, and ok to drive.

I went to a cardiologist today for the first time for reasons not related to high blood pressure, which I never have had. Today, my blood pressure, at its best, was 170/110, which would put me in the Stage 2 Hypertensive category! They did 3 EKGs on me because they said I was "not relaxed," so the first 2 EKGs were all over the place. I have had EKGs before and they were always normal on the first try. Has anyone had their blood pressure RISE because of using a CPAP / APAP machine? My normal blood pressure at dr offices lately has been about 134/80. I wasn't over-stressed out about going to the cardiologist. although I evidently was pretty stressed out at her office. I give the credit to the A10 for almost causing me to be prescribed medicine for high blood pressure!! Fortunately. the cardiologist had access to past medical records that showed that 170/110 was an aberration.

Any insights or answers, especially from people familiar with both machines and/ or who have had to adjust from System One to Resmed S9 or A10, will be greatly appreciated.

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Have also used Opus 360, Swift LT for Her, Optilife, and Breeze Nasal Pillows masks.
Last edited by MarylandCPAPer on Mon Aug 03, 2015 6:06 pm, edited 2 times in total.
Started CPAP 12/18/09 Pressure 13. Changed to APAP 1/18/10, Pressure 10-16. 4/2014:Switched to AirFit P10 mask. PR System One REMstar Auto Series 550 with A-Flex for 5.5 years. 7/2015 to present: AirSense 10 AutoSet FOR HER. Range: 10-20

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Re: Switching from PR System One to Airsense 10 --??s

Post by JDS74 » Wed Jul 01, 2015 8:15 pm

There is a minimum pressure setting and an Off setting for the ramp function. Perhaps those changes will get it closer for you. If Ramp is on, then it will take some time, however short,mto get to the min pressure.

CAVEAT: This information comes from the clinical manual and not from personal experience with the S10.

Your experience is why I always recommend that folks who have been having a good experience with one manufacturers CPAP don't change to a different one. Mostly, it is OK but sometimes it really is not. Subtle differences in how different manufacturers do things can turn out to be really irritating.

Have you talked to the DME about what it would take to swap? It might be cheaper than buying a whole new unit on your dime. It may be just a new scrip and a few dollars.

I'm so sorry that you are having these problems.

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MarylandCPAPer
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Re: Switching from PR System One to Airsense 10 --??s

Post by MarylandCPAPer » Wed Jul 01, 2015 9:11 pm

Thanks, JDS. I'm hoping that things get better once I make a few adjustments. After all, it has only been one night. I had a sleep study last month, where I think they used Respironics equipment. I only got 2 hours sleep the whole night at the sleep study.

Thanks also to Pugsy for the PM. I wasn't able to send you a PM back to thank you.

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Have also used Opus 360, Swift LT for Her, Optilife, and Breeze Nasal Pillows masks.
Started CPAP 12/18/09 Pressure 13. Changed to APAP 1/18/10, Pressure 10-16. 4/2014:Switched to AirFit P10 mask. PR System One REMstar Auto Series 550 with A-Flex for 5.5 years. 7/2015 to present: AirSense 10 AutoSet FOR HER. Range: 10-20

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Re: Switching from PR System One to Airsense 10 --??s

Post by palerider » Wed Jul 01, 2015 9:17 pm

MarylandCPAPer wrote:bunch of questions.
  1. for her is supposed to be more gentle, and less back and forth with the pressure. some recommend it for hims too.
  2. grab a copy of the clinicians manual, your provider set it up in 'dumb mode' that can be turned off. set "essentials" to "plus"
  3. sleepyhead is where you get the graphs you see others post. myair is dumbed down, though not as much as the 'essentials' setting.
  4. no, and the prs1 doesn't have that either, but maybe you didn't have ramp on... I'd suggest turning of ramp, or raising the ramp start pressure.
  5. resmeds have a soft start, instead of the slap in the face of the respirs, can't change it.... but you could hit the start button as you start to mask up....
  6. Ramp Time can be set to Off, 5 to 45 minutes or Auto.
  7. clinicians menu. epr drops the pressure between inhales, making it easier to exhale.
  8. many people latch onto the resmeds and never look back, I'm one of 'em. give it some time.

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Re: Switching from PR System One to Airsense 10 --??s

Post by bwexler » Wed Jul 01, 2015 9:23 pm

I have used an S9 Autoset but not an A10.
If you were using the System 1 with no ramp, turn off the ramp on the A10.
You can get on screen stats on the A10 but you may need to get to the clinical menu to turn on the ones you want. The DME could have done this, but they don't want us mere mortals to know anything about what is going on. Heck, its only are health at stake, nothing important.
If you don't like EPR turn it off. It is a comfort feature. It sounds like it makes you uncomfortable.

Have you ever heard the terms, My blood is boiling, my head is about to explode. That sounds like how you felt after fighting your strange new machine. Your timing was very bad, scheduling a cardiologist appointment after your first night with a new PAP machine. Well that is in the past now. lets move forward and tune in that new machine, and lets if it isn't even better than the series1.

I do recommend setting up SleepyHead software. You will find information a beginner can understand, and more detailed info you will grow into with help from the experts here. The pie chart and table to the left of the charts is simple and may be all you want at first. But the detail graphs will give almost everything you could want to know about your therapy as you learn how to read and understand it. After 5 years I am about half way to understanding what it is trying to tell me. but the basics are always right there and easy to understand.

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MarylandCPAPer
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Re: Switching from PR System One to Airsense 10 --??s

Post by MarylandCPAPer » Wed Jul 01, 2015 9:47 pm

Thanks, Palerider and bwexler. It sounds like the "Auto For Her" setting may not be for me, at least not now. I've turned off ramp. It was the only thing the machine let me do last night. Also, I'm thinking about turning off EPR. It is currently set to 2. It sounds like I can increase the display data by changing the Essentials setting. What a relief that is!!

The DME said he would get data daily and any instructions to change settings, and could do it remotely. He said I could not make changes. I think that he interpreted the "FOR HER" aspect as meaning "FOR IDIOTS" and thought the only difference was the decoration on the machine. He did not know there was an additional setting of "Auto For Her" until I told him I'd heard there was an additional Auto setting. Unfortunately, I let him set it to "FOR HER."

I plan on making the changes myself. If he is monitoring usage remotely, I assume he will be able to see I made changes that can only be done through the clinician's menu. Is there any REAL problem if he discovers the changes? I'm not brand new to treatment. I used the System One machine for 5.5 years.

The DME provided a smaller diameter hose for the A10 than I was using. I started off the night using the System One machine but realized I was not going to get any sleep, and I desperately needed sleep in order to get to the cardiologist visit.I moved the larger diameter hose from the System One unit, with the mask attached. Does the hose diameter make a difference in air delivery? I have to use a hose cover because my cat has punched holes in past hoses. I got one for the A10 hose but I haven't set it up yet.

Thanks, everyone, for all of your help.

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Have also used Opus 360, Swift LT for Her, Optilife, and Breeze Nasal Pillows masks.
Started CPAP 12/18/09 Pressure 13. Changed to APAP 1/18/10, Pressure 10-16. 4/2014:Switched to AirFit P10 mask. PR System One REMstar Auto Series 550 with A-Flex for 5.5 years. 7/2015 to present: AirSense 10 AutoSet FOR HER. Range: 10-20

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MarylandCPAPer
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Re: Switching from PR System One to Airsense 10 --??s

Post by MarylandCPAPer » Wed Jul 01, 2015 10:11 pm

I also found that there is a setting for a Slimline or Standard hose. I changed it to Standard. I tried the mask with the changes. I was finally able to see sleep data. What a relief!! According to the sleep data, my AHI was 0.2 and I could see a pressure setting.

I think things will go much better tonight. Thank you. I'd be lost without the expertise and help here.

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Have also used Opus 360, Swift LT for Her, Optilife, and Breeze Nasal Pillows masks.
Started CPAP 12/18/09 Pressure 13. Changed to APAP 1/18/10, Pressure 10-16. 4/2014:Switched to AirFit P10 mask. PR System One REMstar Auto Series 550 with A-Flex for 5.5 years. 7/2015 to present: AirSense 10 AutoSet FOR HER. Range: 10-20

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Re: Switching from PR System One to Airsense 10 --??s

Post by HoseCrusher » Wed Jul 01, 2015 10:19 pm

Caution:

If they can see your settings, they may change them back with every download (every day). Before you go to sleep you need to check your settings and re-set them to what you want. You should not have any issues with changes if you have documentation that the changes are helping. There may be some "posturing" about who is in control but just remind them that you are dealing with your health. When they get their machine they can do what ever they want but you are interested in optimum therapy.

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Mask: Brevida™ Nasal Pillow CPAP Mask with Headgear
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MarylandCPAPer
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Re: Switching from PR System One to Airsense 10 --??s

Post by MarylandCPAPer » Wed Jul 01, 2015 10:33 pm

Is there any way to turn off the automatic transmission of data to the DME?? Do they download data every day? That feels creepy. The DME is not Santa Claus but he can tell when I am sleeping, whether I've been bad or good?

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Have also used Opus 360, Swift LT for Her, Optilife, and Breeze Nasal Pillows masks.
Started CPAP 12/18/09 Pressure 13. Changed to APAP 1/18/10, Pressure 10-16. 4/2014:Switched to AirFit P10 mask. PR System One REMstar Auto Series 550 with A-Flex for 5.5 years. 7/2015 to present: AirSense 10 AutoSet FOR HER. Range: 10-20

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Re: Switching from PR System One to Airsense 10 --??s

Post by HoseCrusher » Wed Jul 01, 2015 10:35 pm

Airplane mode...

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Re: Switching from PR System One to Airsense 10 --??s

Post by palerider » Wed Jul 01, 2015 10:41 pm

MarylandCPAPer wrote:The DME said he would get data daily and any instructions to change settings, and could do it remotely. He said I could not make changes. I think that he interpreted the "FOR HER" aspect as meaning "FOR IDIOTS"
doubtful.

AutoSet for Her mode is based on key aspects of ResMed’s AutoSet algorithm and delivers
therapeutic responses tailored to the characteristics of female OSA patients.
The AutoSet for Her is similar to ResMed’s AutoSet algorithm with the following modifications:
 Reduced rate of pressure increments designed to help prevent arousals.
 Slower pressure decays.
 Treats apneas up to 12 cm H 2 O and continues to respond to flow limitation and snore up to
20 cm H 2 O.
Minimum pressure (Min. Pressure) that adjusts according to the frequency of apneas:
If two apneas occur within a minute, the pressure reached in response to the second apnea will
become the new minimum treatment pressure until the next treatment session.
MarylandCPAPer wrote:Is there any REAL problem if he discovers the changes? I'm not brand new to treatment. I used the System One machine for 5.5 years.
only to his ego, tell 'em to piss off.
MarylandCPAPer wrote: moved the larger diameter hose from the System One unit, with the mask attached. Does the hose diameter make a difference in air delivery?
yes. that's why there's a setting in the patient menu for hose type. if you have it set wrong, your pressure at the mask will be wrong.

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MarylandCPAPer
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Re: Switching from PR System One to Airsense 10 --??s

Post by MarylandCPAPer » Wed Jul 01, 2015 10:52 pm

palerider wrote:
MarylandCPAPer wrote:The DME said he would get data daily and any instructions to change settings, and could do it remotely. He said I could not make changes. I think that he interpreted the "FOR HER" aspect as meaning "FOR IDIOTS"
doubtful.

AutoSet for Her mode is based on key aspects of ResMed’s AutoSet algorithm and delivers
therapeutic responses tailored to the characteristics of female OSA patients.
The AutoSet for Her is similar to ResMed’s AutoSet algorithm with the following modifications:
 Reduced rate of pressure increments designed to help prevent arousals.
 Slower pressure decays.
 Treats apneas up to 12 cm H 2 O and continues to respond to flow limitation and snore up to
20 cm H 2 O.
Minimum pressure (Min. Pressure) that adjusts according to the frequency of apneas:
If two apneas occur within a minute, the pressure reached in response to the second apnea will
become the new minimum treatment pressure until the next treatment session.
The DME respiratory therapist said that he has only supplied 2 "FOR HER" units. When I mentioned that it had an additional algorithm for auto titration, he commented something like "I wouldn't know an algorithm if I walked into it." He only found the "AUTO for Her" setting after I told him about the additional algorithm. I am pretty sure he thought the difference with "FOR HER" was purely in the appearance of the machine. The other person who got one asked, "Can't I get it in blue?" His implication was that only an idiot cared what the machine looked like, as that was the only difference he knew about from the standard model.

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Have also used Opus 360, Swift LT for Her, Optilife, and Breeze Nasal Pillows masks.
Last edited by MarylandCPAPer on Wed Jul 01, 2015 10:59 pm, edited 1 time in total.
Started CPAP 12/18/09 Pressure 13. Changed to APAP 1/18/10, Pressure 10-16. 4/2014:Switched to AirFit P10 mask. PR System One REMstar Auto Series 550 with A-Flex for 5.5 years. 7/2015 to present: AirSense 10 AutoSet FOR HER. Range: 10-20

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MarylandCPAPer
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Re: Switching from PR System One to Airsense 10 --??s

Post by MarylandCPAPer » Wed Jul 01, 2015 10:55 pm

HoseCrusher wrote:Airplane mode...
Brilliant!! Airplane mode is now on and there are no wireless bars available. THANK YOU!!

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Have also used Opus 360, Swift LT for Her, Optilife, and Breeze Nasal Pillows masks.
Started CPAP 12/18/09 Pressure 13. Changed to APAP 1/18/10, Pressure 10-16. 4/2014:Switched to AirFit P10 mask. PR System One REMstar Auto Series 550 with A-Flex for 5.5 years. 7/2015 to present: AirSense 10 AutoSet FOR HER. Range: 10-20

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palerider
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Re: Switching from PR System One to Airsense 10 --??s

Post by palerider » Wed Jul 01, 2015 11:05 pm

MarylandCPAPer wrote: His implication was that only an idiot cared what the machine looked like, as that was the only difference he knew about from the standard model.
I guess he'd say I'm an idiot then, mine looks like this:
Image

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MarylandCPAPer
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Re: Switching from PR System One to Airsense 10 --??s

Post by MarylandCPAPer » Thu Jul 02, 2015 6:50 pm

How did you get your machine to look like that, Palerider?? That is pretty cool!

I slept most of 14 hours with the new CPAP machine. Thank you for all your help with the settings last night and the link to the manual to get into the settings. Although I would like to pop out of bed after fewer hours with my pain gone and me full of energy, this is a success for me. I can live with this machine. Big sigh of relief!!

I set it on Airplane made so the DME doesn't change my settings remotely. Bright and early this morning, I had a phone call that I didn't answer. I thought,"Wow, the DME is really on the ball, noticing they got no data from me, LOL." Alas, it was some other useless call. With the holiday weekend coming up, I doubt that the DME will notice they're getting no data until at least Monday.

After the change in settings last night (turning off EPR, changing from AUTO FOR HER to AUTO mode, turning on airplane mode, changing the hose size to standard from Slimline, and changing Essentials to Essentials Plus so I could see #s and not just smiley/frowny faces), the machine sounded noisier. I don't even remember hearing in on the previous night (my frustrating Night 1 on the new machine). I didn't add water to the humidifier,as the water level was above medium). Is there anything in the setting changes or water level that would cause it to be noisier?

I went to sleep pretty fast, thinking about the song, "Sleeping with a Jet Plane." It's very unusual I got to sleep so fast, not so unusual that I didn't want to detach from the machine for 14 hours. I had to get up only once (upon demand of my cat for food), and I am usually get up a lot more times than that and detach from the machine a lot more quickly.

AHI was 2.9 and leak was something like 29L/minute. Does this mean I am sleeping with my mouth open (when I think it is totally shut all night!!) or that the nasal pillows that fit like a glove (inside my nose) are maybe too small and I should try Large? I use the Airfit P10 nasal pillows and thought I had a great fit with Medium. I can feel no leaks of air coming out of my nose. 14 hours is a long time, though, and it appeared at the end that the pressure was 10, when I was used to being closer to 15 (with an APAP range of 10-16 on the System One).

Does Sleepyhead work on Windows 8.1, 64 bit? I downloaded Sleepyhead last night and see no exe file. I got a message that I was missing a file starting with MSV and looked at the recommended program to install if you get such a message, but in my confused state before sleep last night, was not convinced I wanted to download it.

Thanks again for all of the help. I think I am going to love sleeping with my jet plane, even if it gets no quieter.

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Have also used Opus 360, Swift LT for Her, Optilife, and Breeze Nasal Pillows masks.
Started CPAP 12/18/09 Pressure 13. Changed to APAP 1/18/10, Pressure 10-16. 4/2014:Switched to AirFit P10 mask. PR System One REMstar Auto Series 550 with A-Flex for 5.5 years. 7/2015 to present: AirSense 10 AutoSet FOR HER. Range: 10-20