Help with report(s) please

[acabgd]

Hi,
I'm about the get a new machine yet I'm unsure which one to get. It seems to me I have some exhale issues with my current setup but I'm not really sure. Somehow it seems as if things have gotten a tiny bit worse in the last few months but again - I can't really read the Oscar reports and don't know where to start so I'm looking for some help from you guys.
My AHI is mostly under 2.0 but my wife says I do have some "twitches" during the night where my stomach/chest seems to struggle. Me personally I have noticed sometimes just before fully falling asleep that my exhalation is blocked (large tonsils) but I never expected the exhalation part to be problematic.
Anyway, any help is appreciated. If some other screenshots are useful please let me know, I just selected random ones.

Furthermore, I thought about remaining with Philips and getting the DreamStation Auto CPAP. Would you maybe recommend something else based on these charts?
Thank you!

[Pugsy]

The ResMed AirSense 10 AutoSet would give you a little bit more options available for exhale relief than a Respironics machine offers with it's Flex exhale relief. It is also a bit more quiet overall in terms of motor/fan/blower noise.

Most of us who have had a chance to use both brands (myself included) ended up preferring the ResMed.

But based on the reports you share...I see no urgent need to change anything and I see nothing that might explain what your wife is reporting and you didn't go into much detail about your sometimes maybe problems exhaling.

If insurance is paying for this....it pays the same no matter which brand. Get the ResMed AirSense 10 AutoSet. I am 99.999999999% sure you will love it.

[Miss Emerita]

Another vote for the ResMed Airsense 10 Autoset. It will probably do a better job of cleaning up those flow limitations and hypopneas than a PR machine.

For me, the big plus was that the ResMed machine waits until you start inhaling to give you your little EPR pressure boost; the PR machine's flex uses recent breaths to try to predict when you'll inhale next, and that often led to my feeling it was "forcing" me to inhale when I wasn't ready.

[acabgd]

Thanks for the replies. I don't want to make this a Respironic vs Resmed thread. I'm from Europe so Respironics is a "natural" choice with Philips being more represented. I'm also paying myself for the machine and supplies so it's up to me.

I was mostly interested in hearing comments about my Oscar reports as I still have no idea what to look for in the charts. I posted a similar question about 2 years ago and one user commented that my inhale/exhale chart seems inverted. I have now "connected" this comment to the issues I might seem to be having while exhaling, hence my posting today.

Here the old thread with screenshots and the last comment relates to "inverted charts":
viewtopic.php?f=1&t=173233&p=1271317#p1271317

I would really appreciate if anyone can look at this in more detail as here is the only help I get and I just want to make sure I'm doing the right thing. Considering the above comments I suppose there's no reason to get any other machine, switch to Bipap or something like that - AutoCpap/Vpap would still continue to work for me?

Thanks a lot guys!

[acabgd]

And just to add about "problem exhaling"... I have very enlarged tonsils, so enlarged that a few doctors took photos and ask for a permission to possibly publish as they rarely see such an example. While the inhale part is solved by CPAP, it seems - maybe lately, I don't know, that I have some problems while exhaling. I have noticed that just before falling asleep while exhaling I myself can hear the blockage in the throat and basically cannot exhale without adjusting my head/throat position. Laying on my side I need to lower the head towards my torso, otherwise I seem to hear this throat gurgling blockage (don't know how else to describe) - and feel it obviously.

The wife says my stomach contracts as if someone hit me in the solar plexus but it happens only once. There is no louder sound from the CPAP machine and it happened maybe 3-4 times in the last month and a half, at least the ones she saw/heard.

I know this is far from ideal additional info but it's all I have.
Thanks again to anyone who contributes.

[Pugsy]

Now the greater exhale relief available with a bipap/bilevel machine might be of help with whatever exhale issues you are having.

With Respironics apap machines and Flex exhale relief the most it will ever give is 2 cm drop at the setting of 3 and you get that ONLY if you are a forceful breather. The amount of reduction and the timing is based on flow rate or breathing.
With bilevel it opens up more options in terms of exhale relief. Now would those options help or not...depends on whatever issues you might be having.

The ability to have more than 2 pressure support might be something worth thinking about with what you describe.
Pressure support is just the difference between inhale and exhale....the bigger the difference usually equals more natural feeling and easier to breathe.

I see nothing on the reports that might explain the weird thing your wife sees and we don't know when it happened to zoom in on that time frame.
Tell her the next time she sees it happen for her to reach over and turn the machine off and then right back on again. This will create a break in the therapy line and make it easy to know exactly when it happened and then be able to zoom right in at that time...might show something...might not but give you a known point of reference.

[acabgd]

Great idea and thanks for the detailed reply!