New ASV: Dreamstation or Aircurve 10?

[CreativeChris]

Not all leaks are mouth breathing leaks.
Remember there are also mask movement leaks as well.
Unless your tape came loose....

Completely side note Pugsy I LOVE the pic!!! I had 2 pugs, a fawn and a black, and my boisterous one was the black one. Her name was Madison.

[BrianinTN]

Not all leaks are mouth breathing leaks.
Remember there are also mask movement leaks as well.
Unless your tape came loose....

Good point. However, I generally haven't had much leaking when my mouth stays shut on the PRS1. Here's a good PRS1 night versus last night on the ResMed. As you can see it's a lot more volatile.

Encore.png (251.51 KiB) Viewed 6761 times

SH Resmed.png (808.38 KiB) Viewed 6761 times

[Jas_williams]

The leaks are not huge until just before you actually get up, I would raise the minimum Epap to 6 rather than 4 but other than that looks a reasonable night.

[BrianinTN]

The leaks are not huge until just before you actually get up, I would raise the minimum Epap to 6 rather than 4 but other than that looks a reasonable night.

Yes, it does looks that way. But I feel like I didn't sleep at all, versus how I felt on the PRS1 ASV, which was generally acceptable.

[Jas_williams]

The Resmed ASV is an active machine and its pressure delivery is different to the Philips which you have been using for a long time, any change will feel strange to start with, give it a few nights and you will settle down

[BrianinTN]

The Resmed ASV is an active machine and its pressure delivery is different to the Philips which you have been using for a long time, any change will feel strange to start with, give it a few nights and you will settle down

Thanks. I hope so. Last night was even worse than the night before. I felt like I was in a constant state or arousal the last several hours before getting up. Reminds me of the “zombie” feeling when they just kept increasing the pressure on CPAP and BIPAP.

[Mark Sadler]

Sorry you’re having a rough time with your dream
Station ASV.
My original ASV was a dream station ASV.
Used it for 6 months and Never got used to it. In the morning I would cough for an hour at least to clear my lungs. It felt like I was Always fighting with the machine. I averaged an 8 or so AHI. Some days it was a 6 and som days it was 12. It never leveled out like i never would get an 8 two days in a row.
I switched to the Aircurve ASV after reading many different posts similar to yours. I purchased out of pocket because my insurance wouldn’t cover Resmed machines.
The first night I slept on the Aircurve ASV was sooo much better I never used my dream station ASV again.
I’ve been using the Aircurve ASV for over 6 months now and it’s still great. My AHI averages around 3.6
I don’t care much about my AHI score anymore as I always wake up with clear lungs and no coughing and clear headed. Of course some days are better than others but no foggy mornings.

[BrianinTN]

I’m 8 days in, and this AirCurve is killing me. I feel like I’m in a constant sleep-wake cycle the last few hours of the night, which is when I usually get my restorative sleep. Since I generally feel worse at higher pressures, I’ve tried lowering max PS, and that’s helped a little — but only a little. (The AHI remains negligible, so those higher IPAPs it was doing before seem unnecessary for me personally).

How much more time should I give it before giving up and going back to Respironics? Anything else I should do? I’m feeling increasingly spaced out and brain fogged from the constant sleep deprivation . But if you all think there’s a useful tweak or just a few more days might help, I’m game.

Thanks!

[Pugsy]

Go back to Respironics now. I can't think of a tweak that will make the ResMed behave like the Respironics and you shouldn't have to since you did quite well with the Respironics.
Some people simply just do better with the way one brand does things especially when they have used that brand for years and years...that's what your body and brain is used to.

[BrianinTN]

Go back to Respironics now. I can't think of a tweak that will make the ResMed behave like the Respironics and you shouldn't have to since you did quite well with the Respironics.
Some people simply just do better with the way one brand does things especially when they have used that brand for years and years...that's what your body and brain is used to.

Okay. Thanks, Pugsy. That does make sense. I’m disappointed since I always felt a little worse when treating the apnea than when not, and I was hoping the brand switch might lead to algorithms that would work better for me — not worse. Oh well. It was worth a shot.

Since this ASV was on a rent-to-buy plan, I’ll have to see if the DME company is willing to swap for a Dreamstation or just wants to wash their hands of me.

[zorki1c]

Used the S9 for five years. Decided to try the Dreamstation when i replaced theS9. Couldnt get comfortable with the Dreamstation and my AHI was often above 10. Switched to the A10 and problems pretty much went away. I do like the Dreamstation water reservoir better. Much easier to clean. But overall the A10 seems better built. Maybe it’s because the A10 is more like the S9 but it works better for me.

[ajack]

The machine isn't set up properly and you have leaks. Generally the resmed is prefered. I'd also post on apneaboard.
You need to sort the leaks out. Do you have a FFM for now? I think that will help a lot. ASV need a decent seal and no mouth leaks
try
Min epap 5
min PS4
after the leaks are fixed. along with pressure, also put up your tidal volume and minute vent

[BrianinTN]

The machine isn't set up properly and you have leaks. Generally the resmed is prefered. I'd also post on apneaboard.
You need to sort the leaks out. Do you have a FFM for now? I think that will help a lot. ASV need a decent seal and no mouth leaks
try
Min epap 5
min PS4
after the leaks are fixed. along with pressure, also put up your tidal volume and minute vent

I have indeed tried those exact settings —and many many more — on the PRS1. That’s how I’ve arrived at the conclusion that “more pressure” is generally a bad thing for how I feel. I’d only be speculating as to why. I can only mitigate that with heavy duty pharmaceuticals like temazepam; Lunesta gets the job done with the PRS1 but not the AirCurve. Anyway, Min EPAP = 4 and Min PS = 2 has empirically been the sweet spot for ASV treatment for me. At the settings you mentioned, I had more centrals and hypopneas.

On leaks, agreed 100%. I’ve tried many FFMs and hated them all, but perhaps it’s worth another trial! All that said, with the chin strap and more aggressive taping, I’ve had nights on the AirCurve with a flat leak line and an AHI of 0.0 and still feel worse. Perhaps it’s the speed with which the AirCurve adjusts (or something else) that’s so good for so many but disruptive to me?

Believe me. No one wishes this weren’t the case more than me.

[ajack]

The machine isn't set up properly and you have leaks. Generally the resmed is prefered. I'd also post on apneaboard.
You need to sort the leaks out. Do you have a FFM for now? I think that will help a lot. ASV need a decent seal and no mouth leaks
try
Min epap 5
min PS4
after the leaks are fixed. along with pressure, also put up your tidal volume and minute vent

I have indeed tried those exact settings —and many many more — on the PRS1. That’s how I’ve arrived at the conclusion that “more pressure” is generally a bad thing for how I feel. I’d only be speculating as to why. I can only mitigate that with heavy duty pharmaceuticals like temazepam; Lunesta gets the job done with the PRS1 but not the AirCurve. Anyway, Min EPAP = 4 and Min PS = 2 has empirically been the sweet spot for ASV treatment for me. At the settings you mentioned, I had more centrals and hypopneas.

On leaks, agreed 100%. I’ve tried many FFMs and hated them all, but perhaps it’s worth another trial! All that said, with the chin strap and more aggressive taping, I’ve had nights on the AirCurve with a flat leak line and an AHI of 0.0 and still feel worse. Perhaps it’s the speed with which the AirCurve adjusts (or something else) that’s so good for so many but disruptive to me?

Believe me. No one wishes this weren’t the case more than me.

before you can move forward, you have to fix the leaks.
If the odd night you mention with resmed is saying no leaks, 0.0 and you feel worse. I think your sleep issues may be elsewhere.
The resmed doesn't tag CA, all UA are obstructive. It does take a lot longer to get use to ASV than cpap and they are meant to act very fast. Faster than iVAPS, which also has variable PS for example.
When you have the leaks fixed and put up a new chart or put up the old chart where you got 0.0 and no leaks. You will get opinions

[BrianinTN]

before you can move forward, you have to fix the leaks.
If the odd night you mention with resmed is saying no leaks, 0.0 and you feel worse. I think your sleep issues may be elsewhere.
The resmed doesn't tag CA, all UA are obstructive. It does take a lot longer to get use to ASV than cpap and they are meant to act very fast. Faster than iVAPS, which also has variable PS for example.
When you have the leaks fixed and put up a new chart or put up the old chart where you got 0.0 and no leaks. You will get opinions

Here's one. Virtually no leak, 0.0 AHI, and yet me feeling like something out of Night of the Living Dead.

I started on ASV treatment way back in 2010. The Respironics System One ASV is just much less disruptive to my sleep. It's not good, but it's not nearly this bad. I suspect that Pugsy is (as usual!) spot on, and that different people simply respond differently. I add all this knowing how wonderfully useful it's been when I've stumbled across other people's experiences on the forums, and hoping it might be of use to someone in the future who sees this and says, "Hey, me too!"

resmed_0ahi_nl.png (490.29 KiB) Viewed 6590 times