Setting up a new Airsense 10 Autoset

[ajack]

mate, you are on a decent machine, trust it. you will get use to the pressure, Use the EPR, that will make breathing feel more natural.
I would lift the min to 8 and leave max where it is, if you want to. Review in a few days.
When you are ready, I'd use epr 3 because it will work like a mini bpap and see if that increases your tidal volume and lowers your breathing rate a bit.

[KLAussie]

ajack - thanks for your input on this!

I totally agree with your comment about trusting the machine, and will do so. I wasn't overly impressed with the Apex machine, which is why I went to the trouble of getting this reputable one from the USA to Malaysia (without a prescription, and shipped via Canada... not any easy process).
Tidal volume and breathing rates aren't factors that I have even considered yet, and hadn't even been looking at these on SH.
I am still focusing on trying to get basic pressures optimised, and a mask to fit without waking me up too often with leaks. Once I can get those sorted, and am feeling more comfortable with actually sleeping with a mask on then I will get into finer details like these

I tried swapping my wisp mask from the XL one to a L last night, and certainly achieved a better leak rate, but also felt that the smaller size was squeezing the sides of my nose a bit more, leading to a more resticted flow. I have been diagnosed with a deviated septum, and often find I am only brething through one nostril, which I can tolerate, but any additional side pressure on the nose starts the old brain into anxiety mode.

I will try the smaller mask (L) again tonight, and increase the min pressure up to 8 (and probably slowly increase to 9 or 10 over a few nights). I turned off the ramp last night, as a starting pressure of 4 was just too low. I also turned EPR back on, with a setting of 2. Will try leaving these like this again tonight...

I do trust the ResMed machine, I just thought it was very interesting that I could get very similar AHI results with such different max and 95% pressures.
I guess it's also a possibility that the APEX machine wasn't as fine tuned in recording or responding to minor events??

I really want to try an Airfit P10 mask, but trying to source one of these in Malaysia has only led to frustration so far. I started with the F20, then moved to the wisp and now hoping to try a pillow mask. It's costing me over US$200 for each mask here, but I'm determined to keep trying until I can get a comfortable nights sleep without the apneas!
I might need to throw my net a bit wider, and see if I can find a distributor in Singapore or Thailand that is willing to ship here.

FYI - to buy the AirSense 10 machine here in Malaysia would have cost around US$2,500....

[Pugsy]

We really don't know much about the auto adjusting algorithm on the Apex machine.
Perhaps the difference in pressures is just the way the 2 different brands respond to whatever the algorithm they are using is telling them to.
I know that the ResMed is fairly aggressive in response to snores and Flow Limitations as well as OAs and hyponeas. Perhaps it is increasing the pressure because of snores or FLs and the Apex maybe wasn't so aggressive.
FLs and snores aren't part of the AHI but they can grow up to be a full blown OA or hyponea and thus that's why these auto adjusting machines have "let's go killing FLs and snores" in their algorithms.

I see your snore graph and it's a bit active.
I don't see your FL graph but I am betting it is fairly active also.
I suspect those 2 things are the reason for the higher pressures.

[KLAussie]

I believe my treatment is going well, with consistently low AHI numbers. I just need the kids to sleep through the night now!

I have noticed when reviewing my data on SleepyHead that I have periods where my flow rate chart shows cyclical patterns, which is also the same in my tidal volume charts - see attached.
This is very rarely leading to a central apnea event (so not CSR by the medical definition). I can see similar cyclical waveforms at some point of the night on all my days of data.

My question: Is this perfectly normal, or something that I should be keeping an eye on?

Thanks again!