Airfit P10 settings for Respironics REMstar Auto One

[stube40]

I've just invested in a Resmed Airfit P10 nasal pillow and using it on my Philips Respironics REMstar Auto One.

I think the Resistance setting should be set to 0, however I'm not sure about the tubing setting - there are two options 15 and 22.

Previously I had the tubing setting on 22 because I was using the standard hose that comes with the REMstar Auto One and it's definitely 22 (I think I actually measured it once). However, the Airfit P10 comes with it's own tube that is noticeable smaller in diameter and, hence, I suspect the setting needs to be lowered to 15 since the air will be restricted by the smallest part of the travel path.

Saying that, I left the tubing setting on 22 and slept fine last night, but that's not to say it's correct. Ca anyone shed any light on it?

Other than that, I can't recommend the Airfit P10 enough - great product!! I'm using it with A-Flex on setting 3 and pressure set to between 4 and 14. Last night's sleep was 6 hours, AHI 4.2, 90% pressure of 6.2 and 0% major leaks. Previously with my Philips Amara and Resmed Quattro FX, i couldn't get more than 2 hours sleep and would struggle to see AHIs of 7 or less, with usually 5% - 20% major leaks (certainly, never 0%!!!).

[strigiformes]

You would keep the 22 setting as long as you're still using your standard diameter main/long hose. The 15 setting is for using "slimline" tubing as your main hose.

[stube40]

Thanks for that - but I'm a bit confused. The Airfit P10 has 30cm or so of 'slim-line' hose attached to it. So in the end, you have a hybrid hose with both normal and slim-line portions. Wouldn't the air flow will be restricted by the smallest hose - in this case the 30cm of slim-line?

[strigiformes]

Thanks for that - but I'm a bit confused. The Airfit P10 has 30cm or so of 'slim-line' hose attached to it. So in the end, you have a hybrid hose with both normal and slim-line portions. Wouldn't the air flow will be restricted by the smallest hose - in this case the 30cm of slim-line?

Yes, but see the discussion this thread:

viewtopic/t85953/hose-diameter.html

And I hope your therapy continues to go well!

[palerider]

Thanks for that - but I'm a bit confused. The Airfit P10 has 30cm or so of 'slim-line' hose attached to it. So in the end, you have a hybrid hose with both normal and slim-line portions. Wouldn't the air flow will be restricted by the smallest hose - in this case the 30cm of slim-line?

doesn't matter, as far as the machine calculations are concerned, it's part of the mask, not part of the hose.

[stube40]

Perfect. Thanks for the feedback - I'll leave it on 22 (especially gratifying since I slept so well with it on this setting last night)

[hyperlexis]

The issue is not the diameter of the short length of hose -- the issue is the resistance control setting.

Because this is not a PR mask, you will need to determine the correct setting for that if you want to take advantage of the benefits of the resistance control setting.

As a pillows mask, it would most likely be close to the x2 setting, but perhaps someone on here has more accurate data if they have investigated this mask for volume, resistance numbers, etc....

#0 just shuts the resistance control option off altogether.

[Guest1]

I use X1 setting on my PRS1 60 series Auto with Large Pillows of Airfit P10. It works well and I feel its easier to exhale on X1 than on 0 setting.

I would imagine X2 will work for Medium Pillows.

[stube40]

Very interesting!!

I read somewhere that all masks that are not Philips should use the '0' resistance setting on the REMstar machine. However, maybe that advice is only for full face masks?

Certainly, I find exhaling that hardest part so possibly the '0' setting is wrong for the Airfit P10.

I use the Medium pillows and will give X2 a try tonight - thanks ever so much for the feedback, really appreciate it!!!

[Pugsy]

I read somewhere that all masks that are not Philips should use the '0' resistance setting on the REMstar machine. However, maybe that advice is only for full face masks

No, it's for all non Respironics mask types and not just full face,
I doubt that you will be able to notice any difference in exhale with Resistance setting adjustments but it wouldn't hurt to try.
It has nothing to do with exhale.

For exhale relief you need to play with the Flex settings that are available depending on which cpap/apap mode you are using.
There's a demo available on the Flex screen and that would enable you to test each setting to see how you like it without going to a lot of trouble in the clinical setup menu.
If this feature doesn't show up in the Flex box....that feature needs a little setting adjustment in the clinical setup menu to make it accessible to the patient. Easy to do.

[Sleeprider]

I tried this for a while. Personally didn't feel a difference with X1 for large (Airfit) pillows, but quantitatively ended up with a slightly higher AHI than using the 0 setting. I don't think my results are applicable to anyone but myself, so go for it I know the theoretical changes in the pressure at transition, but I just don't personally sense much difference or advantage to the System One resistance settings.

[palerider]

Very interesting!!

I read somewhere that all masks that are not Philips should use the '0' resistance setting on the REMstar machine. However, maybe that advice is only for full face masks?

Certainly, I find exhaling that hardest part so possibly the '0' setting is wrong for the Airfit P10.

I use the Medium pillows and will give X2 a try tonight - thanks ever so much for the feedback, really appreciate it!!!

I imagine that the 'set it to zero for non respironics masks' is because respironics couldn't be bothered to come up with something to accommodate other brands of mask.

[stube40]

Before bed last night I experimented with the X2 and '0' resistance settings and I felt that the X2 setting was easier to exhale - of course, whether I was imagining it or not, I don't know.............

Anyway, I tried sleeping the X2 setting last night and had a poor night's sleep, taking the mask off after only 2 hours. Comparing that to the 6 hours I slept the night before on '0' setting makes it look like X2 is wrong. However, I've only had the Airfit P10 for 2 nights so I can't really call it conclusive results. Will post back when I learn more.

BTW, I'm using the Medium pillows............

[Guest1]

System One resistance control settings raise the IPAP and lower the EPAP closer to the nominal number. Its explained on the respironics website with a diagram. So, at resistance control of 0, your actual mask IPAP is lower than the pressure that the machine is showing in its display by a small amount AND if you are using Aflex or Cflex, your mask EPAP is higher than what the setting wants it to be (in Aflex, the EPAP is 2 cm lower than IPAP).

So once you set resistance control to any setting (X1, X2 ....), your EPAP will be lowered a bit. This may expose you to more Obstructive events. This also explains why its easier to exhale.

[stube40]

Oh, I see - that makes a whole lot of sense now.

Hence, I can't see any reason not to go back to the '0' resistance settings that worked well for me on the first night and persist with them for now to see how they go long term.

I've read so much about the resistance settings and various contradictory statements - but what you've just explained has concluded it once and for all. Thanks so much!