Newbie advice -Resmed AirSense10 autoset

Thanks all.

I've downloaded SleepyHead and look forward to learning how to read it (I like that sort of geeky stuff).

I managed over 7 hours straight last night, and my hubby returned from overseas and slept with me for the first time since I started treatment - he said I seemed to sleep well and it was much quieter than the snoring

At one stage last night I started to feel anxious with the mask and struggling against it. So I told myself it was delivering "magic" air that would help me think more clearly. Pretty silly really, but it helped!

Anyone ever wonder if this treatment will go down in medical history as a bizzare form of torture? As in, in 100 years when there's a really simple treatment for apnea people will be amazed that so many had to go through this. Either that or absolutely everyone will sleep with pumped air!

I am curious - I saw my sleep doctor this week (2 weeks into trial) and he looked at my results and said it looks like I need a pressure of 9.2. He then changed my settings from APAP (6-18 range from memory) to CPAP mode with autoramp, EPR, pressure relief and smartstart on, and a start pressure of 7.2. I've slept reasonably well with this setting, and am no longer experiencing a suffocating sensation at start (as experienced with ramp off). But I think the main change that's benefited me is I asked for medium instead of small pillows so they're no longer trying to crawl up my nose all night long. And he upped tube temp higher than I'd dared, which has helped stop rainout.

But why choose CPAP? What are the benefits over APAP?

But why choose CPAP? What are the benefits over APAP?

My doctor also initially prescribed straight CPAP mode and I didn't question it because I didn't know any better. A few months down the road, after MUCH reading here, I switched to APAP mode because hip pain was forcing me to sleep on my back. When I next saw my doctor, he noted the change I had made and was curious but he certainly didn't feel troubled or threatened. He explained that he initially prescribes CPAP mode because some people find their sleep disturbed by the pressure changes of APAP mode.

Also, I recently bought a battery to use for camping this summer and have been experimenting with my settings to see if CPAP mode uses less power My normal settings are 11-15. I tried straight CPAP settings of 11 and 11.6. At both those levels, my AHI was right in line with my average AHI in APAP mode. (And power consumption was virtually the same.)

BTW . . in your initial post you asked about the Slimline vs Standard choice for hose, even though you have the Climateline. In case you didn't get that issue squared away, I checked my machine (same model) . . . the choice between Slimline & Standard only appears onscreeen when you don't actually have the Climateline hosenplugged in. Once it's plugged in, the machine is smart enough to recognize it.

Thanks Hopeful, you hit the nail on the head with the disconnected hose I'd hung it up to dry and didn't think about having it connected while I played with the settings!

Now for a more general question...

I am just over halfway through my 5 week trial and need to use this time to work out best equipment for me before buying my own online.

I'd love some feedback on my sleepyhead graphs, and in particular am wondering if I should trial a different mask style. The P10 pillows seem OK but I can't seem to get them sitting right and am wondering if I should be concerned about leaks. Most importantly I'm half waking through the night (at least 10 times a night) needing to adjust them, either because it feels like they are touching/irritating my septum (was worse on smalls, now I'm trialing mediums) and/or that the seal has broken. But sometimes I wake and have to check that they're there at all and machine is on, so maybe it's all just part of getting used to the equipment! I'm just aware that my time to easily try different masks is running out.

For my first two weeks machine was set to APAP and here's a sample graph of a night I slept through:




Then I went to my sleep doctor and he prescribed CPAP of 9.2 with a ramp of 7.2. Here's my last three nights:






I try to switch machine off briefly when I wake to record arousals, but 2 nights ago moved unit to under my bed because I found it noisy on my bedside table, and now it's harder to find the off button without waking my hubby.

Should I ask to try a different mask/pillows while I have the opportunity?

Thanks

Nedge wrote:Should I ask to try a different mask/pillows while I have the opportunity?

If you can try something else out just to satisfy your curiosity and it not cost much by all means try something else.
You can always go back to the first choice if it does work out. Sometimes by trying other masks we learn more about our own needs or preferences with masks so that we get a better idea just what we find is important to us as the individual.
I have tried lots and lots of masks over the years and sometimes all I learned was how bad I hated a certain mask but sometimes I learned that there were features to some masks that I really liked and didn't think I would.

When making your final decision on which machine to get ...cpap vs apap...if you can afford the apap go ahead and get it. You never know when that apap mode might come in handy even if you start out in cpap mode.
It's always better to have something and not need it than need it and not have it.

Thanks Pugsy. I contacted the clinic and they said they'd look at my results to see if I need to trial a FF mask. I'm interested to test options in this early learning phase rather than having to chose between ceasing treatment or testing masks while I have a cold. From what I've read lots of experienced users have more than one style of mask, and yes I am curious to know what FF feels like.

Any thoughts on my graphs? I'm keen to learn how to read them so have been studying the feedback you and others have given to other posters. There's so much to learn and I'm grateful for the time given by experienced pappers to us newbies.

When trying out full face masks, don't skip the ResMed Quattro. It's an oldie but goodie despite its size and kludgy forehead pad. I've tried several FFMs over the years but none work as well for me or are as comfortable.

My advice is this, from what I see on your graphs. Go back to APAP. Set your machine to 7-16, with no ramp. I have no idea why he switched you to CPAP. Also on your charts, you should remove the pie chart and here is a brief tutorial on how to organize your sleep charts to have the most pertinent information: https://sleep.tnet.com/resources/sleepyhead/shorganize

Overall your numbers look good on the chart, from what I can see. Keep up the good work and stay positive. It will only get easier and better for you.

GoodGuysFinish wrote:first thing you want to do is arrange your hose so that the hose runs downhill to the cpap machine. the water vapor that collects will run into the tank. that usually means the machine must be lower than your pillow.
I am unfamiliar with the machine you are using, but check the settings and instruction book to determine if the heated hose is actually in the on mode.
also, I would check if your humidity level of 4 isn't still too high - my machine has settings 1 thru 5, and 5 is the most moist. try bumping your humidity level down to 3 or even 2.

I think your machine counts only the hours you are asleep (when it thinks you are asleep).

Your oxygen level during untreated sleep could easily have been that low, and treatment for the apnea is essential. I am basing this on the (perhaps wrong) conclusion that your oxygen level is normal (95+) during wakefulness. Do you have any O2 deficiency during the day? supplemental oxygen is sometimes prescribed in addition to CPAP to cover this indirectly related illness.

good luck. if you do have a reading of AHI on the machine info panel, why not post this info as well.

GGF

The machine counts the time it is on. It doesn't know whether you are asleep or not.

Marillion wrote:My advice is this, from what I see on your graphs. Go back to APAP. Set your machine to 7-16, with no ramp. I have no idea why he switched you to CPAP. Also on your charts, you should remove the pie chart and here is a brief tutorial on how to organize your sleep charts to have the most pertinent information: https://sleep.tnet.com/resources/sleepyhead/shorganize

Overall your numbers look good on the chart, from what I can see. Keep up the good work and stay positive. It will only get easier and better for you.

She admits she is sleeping well with the new fixed setting....Great AHI...What would be the advantage of Auto????

Nedge wrote:Any thoughts on my graphs?

Pretty boring... Which is good. I don't see anything that I would change as long as you are sleeping well and feeling decent during the day.
AHI nice and low...leaks extremely well controlled and minimal. Couple of little spikes but they were very short lived and certainly nothing to worry about. I guarantee you that your leak line looks better than mine.

About auto adjusting pressure mode or apap...it's nice to have available and some people do better with it and some do better with cpap mode. I happen to prefer apap mode myself because sometimes in REM sleep I need 6 to 8 cm more pressure and it's a lot nicer to use lower for the bulk of the night and only use the higher pressures in REM if needed. I could use cpap mode if I had to...but since the pressure changes don't bother me or cause problems I prefer apap mode. REM normally makes up around 20 % of the total sleep time. It's much nicer at least for me, to use the higher pressures only when needed.

I see no reason to change your pressures unless you are having some issues with the current settings.

Thanks All, that's sounding very positive.

LSAT wrote:

Marillion wrote:My advice is this, from what I see on your graphs. Go back to APAP. Set your machine to 7-16, with no ramp. I have no idea why he switched you to CPAP. Also on your charts, you should remove the pie chart and here is a brief tutorial on how to organize your sleep charts to have the most pertinent information: https://sleep.tnet.com/resources/sleepyhead/shorganize

Overall your numbers look good on the chart, from what I can see. Keep up the good work and stay positive. It will only get easier and better for you.

She admits she is sleeping well with the new fixed setting....Great AHI...What would be the advantage of Auto????

Because I didn't see any reason why she would have been switched to CPAP in the first place and her events increased, albeit by a small amount. I did say her numbers were overall very good. I just couldn't see the reasoning or advantage of switching to CPAP... Do you?

Sent from my SM-G920W8 using Tapatalk

I've finished my trial with resmed airsense 10 auto & the hire company has recommended I buy the elite (fixed pressure) model. They also "can't discount from RRP because they are not owned by Resmed", although they put part of the hire fees towards the cost. They were strongly resistant to my trialling any other machines/masks during my trial, which annoyed me. And admittedly my results were very good on machine/mask they provided, so to their thinking why change anything? Their elite price is about double what I can get elsewhere in Australia "but we make up for it by providing really good ongoing support".

I don't think I owe them anything and don't want to be out of pocket, especially when my results indicate my settings are unlikely to get complicated. I think I'll get just as good (if not better) support with sleepyhead + advice from forum members if I run into issues.

I have a number of choices to make and am partly getting them down in writing provide myself some clarity, but would appreciate any advice.

Choices:

1. Fixed vs auto
Forum recommendations strongly support auto, but my results were fine on fixed and for the price difference maybe I shouldn't dismiss straight CPAP?

2. New vs secondhand
With new from Australia I get back $600 from my insurance. With 2nd-hand unlikely to get warranty.

3. Australian online supplier vs local shopfront vs US online supplier
Noting resmed will not sell new online in Australia (company policy), and I am in Canberra which does not have as many shopfronts as other cities.

Current options below:

(Out of pocket costs in Aussie dollars include humidifier, heated tube and resmed P10 mask, and deduct insurance claim where applicable)

FIXED PRESSURE
-REMstar Pro C-flex 60 series $450 (new, online)
-Dreamstation humidHT pro $895 (new, online)
-Resmed 10 Elite $659 (new, Aust online - if I can buy Resmed online)
-Resmed 10 Elite $1060 (new, local shopfront)
-Resmed 10 Elite $1522 (new, from where I hired)

AUTO PRESSURE
-REMstar auto A-flex 60 series $705 (new, online)
-Dreamstation auto humidHT $1281 - new, online
-Resmed 10 Autoset $1000 (secondhand, zero hours, used to test battery packs)
Resmed 10 Autoset ~$1050 ("gently used" from secondwind USA)
-Resmed 10 Autoset $1281 (new, Aust online - if I can buy Resmed online)
-Resmed 10 Autoset $1600 (new, local shopfront)
-Resmed 10 Autoset $1822 (new from where I hired)

Unfortunately I don't have model numbers.

I'm a bit tempted by the by the 60 series auto REMstar, but don't know if it's a good idea to buy such old technology? I also don't know difference between C-flex, A-flex, system one, etc.

Thanks in advance for any input! And apologies for such a long post...

Nedge wrote:-Resmed 10 Autoset $1600 (new, local shopfront)

Please clarify...is the $1600 after the $600 reimbursement from insurance or before?

Respironics are still good machines ...even the "old technology" ones. I have one myself.
I can explain about the various Flex if you wish.
It is different from the way that ResMed does the exhale...and feels quite nice in A Flex...C Flex... not so much at least what I tried. It's more of a timing thing than a per cm drop during exhale and the most drop you can get is 2 cm even at the setting of 3. How much of an actual drop you get is based on how forcefully you breathe. Feels very natural....the drop...a bit smoother than EPR drop but only ever so tiny bit smoother.

Up to you to decide on fixed vs auto ....I always think it is better to have something and not need it than to need it and not have it but if the difference in price is a hardship for you...get the fixed.
I do better with auto adjusting but I am currently using a fixed pressure AirCurve 10. It was used (but not horribly used) and I got for dirt cheap price and couldn't pass it up. I have made it work. I had to make a couple of compromises on the pressure settings to maintain optimal therapy but I did it.
So you can make it work should something change later. It's just a bit easier to figure out what you might need later with an auto adjusting mode.
It's not impossible with fixed...just easier with auto....should something change in terms of pressure needs.