First night with new Resmed Autoset

[Statsfreak]

Thanks for the advice regarding M-series Auto vs Autoset in a previous thread. I ended going with the Autoset mainly because of familiarity with Resmed. Good news is I got the H4i humidifier and the card reader. Will have the software soon.

This wasn't my first night with a CPAP device, as I've been using the S8 compact for about 1.5 years. Also sleeping next to the human snoremachine didn't help (she's sick this week, but an Alaska logger with a chain saw would have been more quiet).

My sleep studies have resulted in settings of 7 and more recently 6, but with the new Auto I was curious what would happen if I had it set between 6 and 10, I used a brand new Swift Mirage mask first and after two hours (at least 30 minutes to fall asleep) I had the follwoign results:

Leak 0.06, AHI 3.1 all HI's, and a setting of 7.8

After a short break I changed to a Mirage LT mask (which I quit using because it whistled out the exhaust port due to moisture and woke my up frequently). Again had trouble falling asleep, but after 3 hours the data showed:

Leak 0.00, AHI 2.1 all HI's, and a setting of 9.8 - I did sleep on my side though for this part, I assume that affects things

Again after a short break I switched back to my original (and 1.5 year old) Swift Mirage mask. This time I had teh following results after 3 hours:

Leak 0.24, AHI 3.4 all HI's, and a setting of 9.0 - the difference this time was my mouth felt dry, so I assume that means I might have been mouth breathing some

Bottom line is I am convinced this upgrade will make a huge difference. I've been living with a machine set at 7 and using a mask which seems to have a high leak factor (unless it was just mouth breathing) and the auto adjusted the pressure well above my titrated settings each time.

Finally, I also have some questions and observations about the new machine.

- It whines a bit and seems louder than the S8 compact (or is it quieter and now I hear the whining?).
- Do you keep the data card in the machine? If not, do you download to the card daily, weekly, ... ?
- Why can't I change the smartstart setting from OFF (I have access to the Clinician's Menu)?
- Why does the unit think I have a H3i humidifier? I do have an H4i, my old unit had the H3i and they are different.
- Why does the unit not completely turn off after you hit the start/stop button? What I mean is there is still some small airflow (actually it's a lot like when you hit the warming button).

[Slinky]

I didn't have the S8 II but I did have the S8 AutoSet Vantage and was very happy w/it. Until they switched me to the VPAP Auto which I was very happy w/until recently. I had some kids mess w/it when they were visiting w/their grandmother and things haven't been quite right since.

Anyway, allowing for possible differences between the AutoSet and the Vantage:
1] No, you only insert the data card when you want to do a download. You'll have to check your manual how often that would have to be to get the detailed results, instead of some nights just summary results, w/the AutoSet. W/the Vantage I only needed to do a download every 4th-5th day to retain the detailed results.

2] W/the Vantage you could turn SmartStart On or Off as you liked, the only restriction being you couldn't have both SmartStart and LeakAlert turned On at the same time. You could only use one or the other or turn both Off. EXCEPT for one or more of the full face mask settings. Since I'm not one to use a full face mask I don't remember which ones or all full face masks.

3] The Resmeds remain "active" at low "speed" for some time after turning them off for use. It is to "dry" any moisture out to protect the xPAP unit itself.

With the VPAP Auto (which came out in January 2008 and has been replaced already by the VPAP Auto 25 which came out in July 2008) we only get TWO days of detailed data before they roll over into the averages. I thought it was because the VPAP Autos were so much more complicated - but I'm not totally sure that that isn't unique to all the S8 IIs.

[Statsfreak]

W/the Vantage you could turn SmartStart On or Off as you liked, the only restriction being you couldn't have both SmartStart and LeakAlert turned On at the same time. You could only use one or the other or turn both Off. EXCEPT for one or more of the full face mask settings. Since I'm not one to use a full face mask I don't remember which ones or all full face masks.

The Resmeds remain "active" at low "speed" for some time after turning them off for use. It is to "dry" any moisture out to protect the xPAP unit itself.

With the VPAP Auto (which came out in January 2008 and has been replaced already by the VPAP Auto 25 which came out in July 2008) we only get TWO days of detailed data before they roll over into the averages. I thought it was because the VPAP Autos were so much more complicated - but I'm not totally sure that that isn't unique to all the S8 IIs.

Ahh, I have the leak alarm turned on. I'll turn it off and see if that activates the smart start. Cool.

I was thinking the unit might be doing a "drying cycle", but wasn't sure. Good to hear it isn't a defect.

Each time you tranfer data to the card (too keep detailed daily data) do you have to download to the computer, or can the card store many dumps from the machine before you have to go to the computer. This only matters right now for me because I don't have the software yet, only the data card and reader.

[riverdreamer]

My Autoset is only a month old. I don't hear any whining with it, and mine is running in a similiar range as yours. I don't know if yours is different, or if you are more sensitive to sound, but the only sound I hear is the venting on the mask. You might want to check just to make sure everything fits together right. There could be a tiny leak that is cauing the whine? I don't have an H4i, so I can't say anything about that. Maybe that changes the sound. I use the Swift LT.

I do think that switching back and forth like you were will give you less accurate data. I know you are adjusting, plus you have a new toy! The info on the LCD is averaging over the night, so the numbers you were seeing were not only for the brief periods you were running it. The pressure is the 95% number the machine ran at or lower for 95% of the night. The leak and AHI numbers are the average for the whole night. If you stop and start, as long as the stop is under and hour, it puts all the data together as one session.

Once you get your software, you will be able to see when the pressure went up, and when the AHI events occurred, as well as the leaks. Sounds like you are like me, and need more pressure than you were titrated for. Good luck!

[Statsfreak]

I even took the machine apart last night and used just the base unit to check if it was the connection between it and the hmidifier. It's definitely in the base unit. And yes, I am way to susceptible to noises unfortunately. I have learned to treat the gaussian noise of the air venting as a relaxing mask of other sounds, but I think on this unit that is quieter and thus I am hearing the machine run (fans or whatever). Will talk to DME and also try a more detailed comparison with the S8 compact to see if I am imagining this or not.

If I understand the 95% prssure for 95% of the night statement correctly, then my pressure at some time certainly went above (and possibly well above) the stated rates, right?

Interesting comments about the collection of data in one night. I think my breaks were less than 1 hour, so the 3rd mask really had more than double the reported leak rate (5 hours of 0.0 and then 3 more hours lead to a total rate of 0.24 for the entire 8 hours).

[Slinky]

You are NOT going to get any truly ACCURATE data UNTIL you stay at ONE SETTING for at least ONE ENTIRE WEEK. Our sleep vaires from night to night.

When you make a change in therapy, whether mask or pressure setting or whatever you should make ONE change AT A TIME and STAY at that ONE CHANGE for ONE ENTIRE WEEK. Then and only then are you going to really get any useful, accurate data.

I know it is hard to resist playing w/a new "toy". But CPAP isn't exactly a toy and they do have their limitations.

AND, if you check your manual it suggests that you should do an Erase Data between therapy setting changes so there is no influence on the data from one therapy setting change to another. I've had a Resmed Rep tell me that is not the case - but if not WHY do they put that in the manual?? Use your own discretion on whether to erase data or not.

[riverdreamer]

DO NOT ERASE DATA if it is required for your insurance to submit a data card. Sorry Slinky, didn't want to contradict you.

Otherwise, it makes sense, if you want to clarify things. I have not erased data because I have to prove to Medicare that they should pay for my equipment. I can still tell, on the monthly statistics, what impact various changes made in my therapy. However, switching things around in one night will make it hard to see what happened. I do agree with Slinky that you should not make too many changes at once. Find one mask that is reasonably comfortable, then figure out what it takes to make it more so, eliminate leaks, etc. If you keep switching, you won't see how much your sleep itself can change from night to night all on it's own. That is part of the advantage of an auto machine, it can respond to the changes in your sleep. But most people find that even on an auto, a smaller range works better than a wide open one.

If your machine is truly loud, there is a possibility that there is a problem with it. Hard to tell, from what you are saying. I'm pretty sensitive to whining sounds, though I have been sleeping with an air filter now for some time, and the fan no longer bothers me. Occasionally teh filter whines and I have to get up an push here and there to make it stop. But I didn't use the filter in my bedroom the first nights with the Autoset, and my APAP sits right next to my head on a side table. I've seen posts where some put the machine in a drawer, or other enclosed space to reduce noise. Make sure, though, that it has a good source of clean air, because that is what you will be having pushed into your lungs.

[dtsm]

What's the major differences btwn the S8 autoset vs vantage models? Large price difference and both have auto and EPR?

[riverdreamer]

I am not sure of all the differences, but the Vantage is an older model. If I am right, the Vantage does not have EPR in autoset mode, only in CPAP mode. It also does not have the Easy Breathe technology.

Easy-Breathe technology combines new software, a quieter motor and improved EPR for maximum comfort and a quiet night’s sleep. With Easy-Breathe technology, EPR is integrated with AutoSet™ technology for pressure relief that continually adjusts to patients’ pressure needs, breath by breath.

Featuring ResMed’s improved EPR with Easy-Breathe technology, the S8 AutoSet II offers pressure relief delivered in a smooth waveform that mimics patient breathing. With a choice of three different EPR comfort levels, the S8 AutoSet II with Easy-Breathe technology allows customized comfort for breathing that feels natural.

Resmed claims the Easy-Breathe software and motor also makes the Autoset II 75% quieter than any of their other machines. It is rated at 24 dcb, about 7 dcb quieter than any other machine I researched. YMMV, especially depending on your pressure.

You can look on cpap.com or resmed .com to see more details about what might be different.

[Statsfreak]

Yes it is obvious that changing too many (usually that's more than one) variable at a time is not a good thing. And I agree that you need more than one night to see how you react. Last night I was just kind of experimenting with fit and feeling, not too worried about in depth data analysis. It was definitely eye-opening too see my pressure go way above my titrated level from the sleep studies. Actually dissapointing in a sense as I believe this is probably far to common.

Regarding the 95%/95% pressure thing. Where is this defined?

Luckily I don't have to prove usage for anybody at this time, although as I will retire from active duty in a few years I will want to show usage (if anybody asks) as part of my disability determination. One question regarding deleting data: My clock is off by about 50 minutes and I was about to set it right, but got a warning that it would erase data. I was setting it back 50 minutes and had just used the machine, so that could be the reason. No matter though, if I insert the data card and transfer the data to the card and then change the time should I be OK even if the LCD display says I will erase data?

[riverdreamer]

I haven't done any data erasing so not sure. What you will have to do is transfer the card data to the computer before you put the card in again, as it will erase any detailed data that it saved. Seems like the cards only hold 3-4 days of detailed data, and it rolls over each day once you accumulate that much in the machine. The card is wiped and reloaded each time you insert it into the machine.

[Statsfreak]

I haven't done any data erasing so not sure. What you will have to do is transfer the card data to the computer before you put the card in again, as it will erase any detailed data that it saved. Seems like the cards only hold 3-4 days of detailed data, and it rolls over each day once you accumulate that much in the machine. The card is wiped and reloaded each time you insert it into the machine.

Damn, that is good to know. I need to get the SW ASPA then. I assume you can only transfer to the computer if you have ResScan installed.

[rested gal]

If I understand the 95% prssure for 95% of the night statement correctly, then my pressure at some time certainly went above (and possibly well above) the stated rates, right?

Right. The 95% pressure means the machine used THAT pressure AND pressures below that pressure, 95% of the time. It used pressure(s) above that pressure 5% of the time.

ResMed uses 95%.

Respironics uses 90%.