High AHI on Dreamstation v Airsense 10

[marcus10]

Hi all,

First of all, hello to everyone as this is my first post on the forum.

A bit of background. I'm currently in the tail end of my CPAP trial having been diagnosed with mild sleep apnoea (AHI of 9.5 but elevated RDI with frequent RERAs). Mask-wise, I'm pretty settled on the Dreamwear. Tried the Nuance but it wasn't comfortable and the P10 strap just felt a little loose even after adjusting. I'm in the position now where I need to decide on a machine.

This for me is a choice between the Airsense and the Dreamstation. I've trialled three different machines on my trial, the REMstar, Airsense and Dreamsation. The Airsense was good and my AHI was between 0 and 1. I was very much looking forward to the Dreamstation as I liked the features, the app and being within the Respironics ecosystem.

However, my AHIs on the Dreamstation have been poor relative to the Airsense. My AHIs have been between 2.5 to 3.5 and last night my AHI was 4.9. To me, that seems unacceptably high.

I appreciate the choice of machine is highly individual to the user, but does anyone have any input into this AHI issue? I'm now thinking of going with the Resmed on the following basis:

- $500 cheaper
- A little more compact
- Better AHI results

Any thoughts?

[BanjoPaterson]

HI Marcus,

In comparing machines using their AHI just be aware you may not be comparing like-for-like. I'm not sure about the Dreamstation, but between the S9, which I have, and the S8, which I had before, my AHI rapidly dropped (!). But (!!), on closer inspection, what actually dropped was the scoring of the hyper apneas, not the obstructive apneas -- as well, the S9 (and the AS10) can differentiate between an obstructive apnea and a "central apnea". So, in the end, once I ignored the hyper apnea score, I found that the S9 and the S8 were a lot closer than the numbers suggested. One key different was the S9 would ramp up the pressure higher than the S8, because (I suppose) it could tell the difference between an obstructive apnea and a central one and didn't need to be as conservative in therapy.

In the end it came down to "how I felt", and in that instance the S9 ticked the box better.

So, in your case, I would not just check the AHI, but what apneas it has recorded -- in particular obstructive -- and also how it adjusted the pressure and reacted. You may want to investigate using Sleepyhead, a software tool that can read the data from these machines. The final analysis, I believe, is how you feel since I think people are much better at determining what works using "their instincts" than are given credit for. So which one, after using it, makes you feel more alert and better rested? Different people seem to prefer one machine over the other because that machine's software support their apnea/sleep patterns better.

In a perfect world we'd all be able to afford the xPAP machines we need, but we're not there yet to price is a factor. If you can afford the extra to get therapy that, you feel, is better then you should. To put it bluntly, this is the machine that's going to keep you alive longer, what pennies is ones life worth? If money is a factor then either of these machines are darn fine and will give excellent therapy.

My 2 cents.

[palerider]

However, my AHIs on the Dreamstation have been poor relative to the Airsense. My AHIs have been between 2.5 to 3.5 and last night my AHI was 4.9. To me, that seems unacceptably high.

I appreciate the choice of machine is highly individual to the user, but does anyone have any input into this AHI issue? I'm now thinking of going with the Resmed on the following basis:

- $500 cheaper
- A little more compact
- Better AHI results

Any thoughts?

here's a comparison based on the previous generation resmed and respironics machines. the airsense 10 autoset is pretty much the same as the s9 autoset (except the extra mode in the as10 autoset for her model). I don't know if respironics has changed the behavior of the dreamstation from how things were in the system one machines... however, as I understand it, they've always been slower to react, which some people say they like.

anyway, here's the comparison:
https://www.youtube.com/watch?v=lzCCgNLya_g

add "currently supported by SleepyHead" to the resmed side of the list... though the dreamstation should be supported at some point in the future.

[jagzoo]

Am I the only only one that thinks that YouTube video was a ResMed info? It was a "bit" over the top!

Seems like all the poor Respionics clients should/would be dead or at least brain damaged!

[bellab]

Am I the only only one that thinks that YouTube video was a ResMed info? It was a "bit" over the top!

Seems like all the poor Respionics clients should/would be dead or at least brain damaged!

i was thinking the same but its posted by a cpap supply store with many different videos about different supplies....not just resmed stuff.
i was leaning towards a dreamstation, but now ill have to think twice.

[palerider]

Seems like all the poor Respionics clients should/would be dead or at least brain damaged!

not at all, just perhaps with a little higher AHI, but still treated acceptably.

don't exaggerate.

[BanjoPaterson]

Seems like all the poor Respionics clients should/would be dead or at least brain damaged!

not at all, just perhaps with a little higher AHI, but still treated acceptably.

don't exaggerate.

It's an interesting video and I think demonstrates two different approaches to treating apneas. From the video, I understood they use a breathing simulation machine that can simulate apneas and responses to treatment, so I didn't perceive bias per se. It does demonstrate that Resmed use a more "aggressive" approach to increasing pressure, which may or may not be ideal for some patients. Heck, even during one patient's CPAP usage things change - for example, when I started it felt that my titrated pressure (a measly 10. from the sleep study blew my face off and I set my APAP to start at 7.8 with EPR at 3... and even then I still felt as if I was falling asleep in a wind tunnel. Fast forward a few years and now I start at 10 with an EPR of 2, and I find it a mild zephyr that lulls me to sleep. No doubt things will change, and so I suspect there's no "perfect" machine for all people. You just have to try things over time. What's good is competition is forcing all the manufacturers to develop better and better machines, which benefits us all.

[marcus10]

Thanks for the replies all. Last night's AHI was 3.6, still high I think.

I honestly have to say I felt better on the ResMed so, although I'm sure my pharmacist would prefer I go for the DS, I'll likely end up going for that. I certainly appreciate the AHIs might not be totally comparable.

I did see that Airsense v PR video before, I appreciate it can seem a little biased but to me at least it seemed to make a lot of sense.

[AcedDublB]

DreamStation is not currently supported by Sleepyhead software.

You need Encore Pro software instead, not as easy to use as Sleepyhead.

[zorki1c]

Been using a ResMed S9 for five years and my AHI consistently below 1.0. All other data low,too.
Just got a new dreamstation. My AHI for the first three nights were 27.7, 12 and 26.3. Using the same mask as was used with the S9 and the same pressure setting (6.0). On night 4, I switched back to the S9 and had a .6 AHI and virtually no Obstructive Hypopnea. I had a used Respironics System One that I used for camping the gave me pretty much the same data as the S9. I'm telling my DME that either there's something wrong with the Dreamstation or if there isn't, I want a ResMed A10. So far they have been really slow in responding.

[palerider]

Respironics machines are slower to respond and often need higher pressures. Check the settings on your old prs1... But, push for abresmed... It's what you're used to.

[zorki1c]

Followup. Was convinced Dreamstation was giving false readings compared to S9. But tried the ResMed Autoset 10 and got similar readings to those from the Dreamstation. Apparently my old S9 was fibbing or calculating data differently. Gonna stick with the A10. May have to make some pressure settings.