Problem with New Resmed Airsense 10

[dcg494]

A block tubing with an 1/8" hole is used during calibration on the CPAP. But you want to see if the pressures and flow remain stable as the unit is running at a steady state. If the calibration is off it can cause the bouncing you are talking about.

Interesting! I see from your profile you're experienced in this stuff. I'd like to give that a shot. Have you ever done this, and how could I try, using what ? First thought was drill a 1/8" hole into a cork, but probably won't work too well ?

Also, you have an airsense 10 as well. Do you have a humidifier ? I don't HAVE to put water in it, right ? As in, having an empty humidifier wouldn't make a difference to the pressure delivered or the machine's sensing of pressure ? It shouldn't..

As to resmed vs philips.... Philips don't *have* mask pressure data.
...
The extra data the Resmed provides is just one of the things about it that I believe is superior.
...
Again, do you have all the relevant settings set up properly? Mask type, tube type, ab filter (I don't remember off hand if your machine has that setting).

Thanks Palerider. Yeah, i was wondering about that, does phillips just simply not record the data but does have a sensor for it and act on it ? Or does both not record it AND not adjust pressure according to mask pressure -- i.e. is dumb to the actual pressure ?

If so, I'd say that's a huge difference between the two, and just seeing how mask pressure can vary by 0.5cm pressure or more from breath to breath (if my device isn't broke), seems like a big deficit of the phillips machines.

And yep, all the settings are correct, including the ab filter setting (no, don't have)

[palerider]

A block tubing with an 1/8" hole is used during calibration on the CPAP. But you want to see if the pressures and flow remain stable as the unit is running at a steady state. If the calibration is off it can cause the bouncing you are talking about.

Interesting! I see from your profile you're experienced in this stuff. I'd like to give that a shot. Have you ever done this, and how could I try, using what ? First thought was drill a 1/8" hole into a cork, but probably won't work too well ?

Also, you have an airsense 10 as well. Do you have a humidifier ? I don't HAVE to put water in it, right ? As in, having an empty humidifier wouldn't make a difference to the pressure delivered or the machine's sensing of pressure ? It shouldn't..

I *believe* that he's saying to plug the hose with it, and then let it run for a bit, to see what the pressure trace looks like... Unless I'm guessing wrong, you can't *use* the thing with that... it's a test plug. (could be wrong, cuz I'm guessing). Basically, you're creating a steady state amount of leak.

As to resmed vs philips.... Philips don't *have* mask pressure data.
...
The extra data the Resmed provides is just one of the things about it that I believe is superior.
...
Again, do you have all the relevant settings set up properly? Mask type, tube type, ab filter (I don't remember off hand if your machine has that setting).

Thanks Palerider. Yeah, i was wondering about that, does phillips just simply not record the data but does have a sensor for it and act on it ? Or does both not record it AND not adjust pressure according to mask pressure -- i.e. is dumb to the actual pressure ?

If so, I'd say that's a huge difference between the two, and just seeing how mask pressure can vary by 0.5cm pressure or more from breath to breath (if my device isn't broke), seems like a big deficit of the phillips machines.

And yep, all the settings are correct, including the ab filter setting (no, don't have)

There are only two sensors in the cpap, both resmed and philips, (not sure about other brands, because I haven't taken them apart), one is pressure, and the other is airflow. It calculates all the rest of the data based on those two readings. The Philips has a pressure sensor, without it, the machine would just be a dumb thing blowing at a set fan speed (like machines from 20 years ago, where you had to adjust it with a knob and a manometer.... but they don't provide a readout of the high rate pressure data like Resmed does.

I'll ask *ONE MORE TIME*.... do you have all the settings *correct* for the hose, mask, and filter?

[dcg494]

Thanks Palerider, yep, all the settings are correct. Triple, quadruple, quintuple checked. And rigght, of course the philips has to measure pressure and air flow. Maybe a difference is the resolution of the sensors ? I.e. the sensitivity. In the resmed manual it says the airsense measures pressure at increments of 0.1ha, wonder what it is with philips.

Yep, figured he was talking about a test plug. I'm wondering how I could make that plug..

[palerider]

Thanks Palerider, yep, all the settings are correct. Triple, quadruple, quintuple checked. And rigght, of course the philips has to measure pressure and air flow. Maybe a difference is the resolution of the sensors ? I.e. the sensitivity. In the resmed manual it says the airsense measures pressure at increments of 0.1ha, wonder what it is with philips.

Yep, figured he was talking about a test plug. I'm wondering how I could make that plug..

Well, if you'd filled out your equipment listing, showing your mask type, then we could perhaps make a mask specific suggestion...

[chunkyfrog]

Just out of left field, could the jagged breathing be an indication of a tremor in the diaphagm?
Some neurological disorders affect breathing.
Parkinsons patients sometimes experience shaky speech.

[palerider]

Just out of left field, could the jagged breathing be an indication of a tremor in the diaphagm?
Some neurological disorders affect breathing.
Parkinsons patients sometimes experience shaky speech.

You can sometimes see people's heartbeats in the flow trace too.

[chunkyfrog]

That would be waaaay better . . .
--or would it?

[RonS]

On my BiPAP machine I could see my heartbeats on the graphs.

On my "new" (just over a year) ResMed AirCurve 10, unlike your graphs I get smooth lines but they do change to the little jagged peaks (Those are called FOTs?). I can feel those easily but I am no longer even aware of them, so I've acclimated to the sensation.

I use a Dreamwear mask. When I run "warmup" the airflow is smooth; if I partially block the nasal slot with my thumb or palm it goes into that gentle whoosh woosh woosh pulsing.

Note.... my set is a BiLevel machine so it may be different than something with EPR turned on. Etc., etc.

[palerider]

On my BiPAP machine I could see my heartbeats on the graphs.

On my "new" (just over a year) ResMed AirCurve 10, unlike your graphs I get smooth lines but they do change to the little jagged peaks (Those are called FOTs?). I can feel those easily but I am no longer even aware of them, so I've acclimated to the sensation.

I use a Dreamwear mask. When I run "warmup" the airflow is smooth; if I partially block the nasal slot with my thumb or palm it goes into that gentle whoosh woosh woosh pulsing.

Note.... my set is a BiLevel machine so it may be different than something with EPR turned on. Etc., etc.

FOT is very easy to see, it starts about 4 or 6 (can't remember off hand) seconds after an apnea begins, and then runs till the apnea ends. You can see it clearly in the mask pressure trace if the apnea is obstructive, and somewhat in the flow trace if the apnea is central.

None of the stuff in this thread is FOT, because it only happens during an apnea.

[palerider]

That would be waaaay better . . .
--or would it?

Well, I don't know about it being better, or worse... and from what I've read, it's not even a problem... it's just a thing that shows up occasionally. Something about the way the person is laying, and the heart beat applying enough pressure to modulate the airflow either on a lung or bronchus.

[RonS]

FOT is very easy to see, it starts about 4 or 6 (can't remember off hand) seconds after an apnea begins, and then runs till the apnea ends. You can see it clearly in the mask pressure trace if the apnea is obstructive, and somewhat in the flow trace if the apnea is central.

None of the stuff in this thread is FOT, because it only happens during an apnea.

Are you defining apnea without a requirement for 10 second duration?

If not, it took me about 3 seconds to find multiple examples of tiny pressure spikes in between breaths. There's clearly two types of these spikes in my graphs. The ones that begin after 6 seconds have a frequency of 4 Hz, the others 6Hz. Which is interesting because I do recall reading many years ago that essential tremor and Parkinson's frequencies are 4-6Hz

[palerider]

FOT is very easy to see, it starts about 4 or 6 (can't remember off hand) seconds after an apnea begins, and then runs till the apnea ends. You can see it clearly in the mask pressure trace if the apnea is obstructive, and somewhat in the flow trace if the apnea is central.

None of the stuff in this thread is FOT, because it only happens during an apnea.

Are you defining apnea without a requirement for 10 second duration?

If not, it took me about 3 seconds to find multiple examples of tiny pressure spikes in between breaths. There's clearly two types of these spikes in my graphs. The ones that begin after 6 seconds have a frequency of 4 Hz, the others 6Hz. Which is interesting because I do recall reading many years ago that essential tremor and Parkinson's frequencies are 4-6Hz

I'm not defining anything. I'm telling you how FOT works, it's a very regular 4 hz 1cm pressure wave. and they only happen when there's no breathing, because the machine thinks you're in apnea, not simply between breaths. Sometimes you will see FOT kick in but no flag if the breathing resumes before the 10 second minimum passes.

[RonS]

Are you defining apnea without a requirement for 10 second duration?

If not, it took me about 3 seconds to find multiple examples of tiny pressure spikes in between breaths. There's clearly two types of these spikes in my graphs. The ones that begin after 6 seconds have a frequency of 4 Hz, the others 6Hz. Which is interesting because I do recall reading many years ago that essential tremor and Parkinson's frequencies are 4-6Hz

I'm not defining anything. I'm telling you how FOT works, it's a very regular 4 hz 1cm pressure wave. and they only happen when there's no breathing, because the machine thinks you're in apnea, not simply between breaths. Sometimes you will see FOT kick in but no flag if the breathing resumes before the 10 second minimum passes.

No need to get miffed.
"Apnea" as I understand the term as defined by Resmed has a minimum duration of 10 seconds.
You used it in a different way and I was trying to clarify.
There are no adversaries here.

So when I see these FOTs show up after 6 seconds, I then see jagged lines in the pressure, though not to the extent of OP's graphs.

Can you explain these? If not, that's okay.

[zoocrewphoto]

Any chance there is something in the hose or the air intake that would cause a blockage to move? Recently, the air was blowing harder than normal and going up and down in pressure. I could hear it changing. She said it was blowing harder than she had ever felt, and she was use to used to 10-15, and the machine said 10. It turned out that the filter and cover were missing, and the machine had sucked in some pet hair. The hair would block and unblock. I removed the hair, and the machine is back to normal.

[palerider]

Are you defining apnea without a requirement for 10 second duration?

If not, it took me about 3 seconds to find multiple examples of tiny pressure spikes in between breaths. There's clearly two types of these spikes in my graphs. The ones that begin after 6 seconds have a frequency of 4 Hz, the others 6Hz. Which is interesting because I do recall reading many years ago that essential tremor and Parkinson's frequencies are 4-6Hz

I'm not defining anything. I'm telling you how FOT works, it's a very regular 4 hz 1cm pressure wave. and they only happen when there's no breathing, because the machine thinks you're in apnea, not simply between breaths. Sometimes you will see FOT kick in but no flag if the breathing resumes before the 10 second minimum passes.

No need to get miffed.

I'm not.

"Apnea" as I understand the term as defined by Resmed has a minimum duration of 10 seconds.
You used it in a different way and I was trying to clarify.

I didn't. "apnea" means "not breathing". To be scored for sleep apnea statistical purposes and count in your AHI, it has to last 10 or more seconds.

What I said was:

FOT is very easy to see, it starts about 4 or 6 (can't remember off hand) seconds after an apnea begins, and then runs till the apnea ends.

An apnea does not begin 10 seconds after you stop breathing, it begins when you stop breathing. It is scored as an apnea if it lasts at least 10 seconds.

Resmed starts testing to see what kind of apnea it is before the 10 seconds have elapsed, and that's what I was talking about.

Make sense?

So when I see these FOTs show up after 6 seconds, I then see jagged lines in the pressure, though not to the extent of OP's graphs.

Can you explain these? If not, that's okay.

Not without you showing what you're you're talking about. Also, it's just one FOT, the motor starts oscillating the airflow and continues till the apnea ends. Forced Oscillation Technique. https://www.youtube.com/watch?v=4GW97Xk06N8