Old CPAPer New Member hello & questions

[JOinPA]

So Glad to have found this forum! I've been using CPAP therapy for about 6 years now, with terrific success. Honestly, I took to it immediately and had a great night's sleep first night with it, never any issues, knock wood.

Name is John, live in suburban Philly area. Started with Airsense 10 Autoset in June, 2017, machine is still going strong at just over 17,000 hours. I have had an AirMini since they came out, as well, as I used to travel a lot, pre-COVID. I have not used software other than the Resmed myAir app, until now, when I downloaded OSCAR and got an SD card to play around with it. On the myAir app (I know, not highly regarded), my scores are consistently 96-100 every night, and if I get a lower score it's typically because I did not use it long enough. I'm learning a lot here, very helpful place, thanks to those of you who maintain it!

I don't need much in the way of help, per se, but I do have a few questions, if I may. They are:

1. Just ordered another Resmed Airsense 10 because they are becoming scarce, and I just love this reliable workhorse of a machine, and saw no reason to "upgrade" to the newer model with smaller blower motor. I've heard of people routinely getting over 20,000 hours out of an AS10 and my question is should I use my current machine until it dies, then go to the new machine (after testing it for a week for function)? Figured I'd get the longest run with this wonderful machine that way. Or is there a charity site that accepts used CPAPs to refurbish them for others? Maybe mine is too old.

2. My original prescription after the titration test night was 10-14 pressure. My weight has not changed, but my AHI has gone way down as I learned to use the machine and get consistent mask seal all night. But I'm consistently bumping up against the 14 pressure upper limit. The machine "auto sets". Should I raise my upper limit and see what it does? I've never fiddled with it in 6 years. My OSCAR screenshot is here:



3. Has anyone used the sleep consulting services at AXG sleep diagnostics? I'm considering it just to learn more about OSCAR and what to look for in terms of optimizing my sleep, although I have no complaints. Thoughts on this? May not be necessary. The guy puts out very informative content on YouTube, though.

Thank you again for this great resource! Again, I have no issues or complaints, just looking to up my knowledge level.

Cheers,

John

[Miss Emerita]

Welcome! It's great to hear you're doing so well with CPAP, and you're smart to get a second machine in place now. I'm sure others will comment on how to deploy your machines in the best way.

Your pressure goes up and down largely in response to flow limitations. These are what they sound like: limitations within your airway that fall short of being obstructive apneas or hypopneas. The FLs may originate in your nose or lower down, in your pharynx, where the tissues lining your airway can sag a bit. They prevent you from inhaling smoothly and easily.

FLs make no difference to how well some people sleep; for others, they can make a significant difference. If your FLs originate in your nose, you will have to address the nose problems directly, but if they originate in your pharynx, EPR might be helpful.

EPR drops your pressure when you exhale, by 1, 2, or 3, depending on how you set it. By the same token, your pressure increases when you inhale. That increase can be all it takes to support smoother, easier breathing, if the problem originates in the pharynx.

Because you're doing so well with OAs and Hs, I would suggest as an experiment that you leave your current pressure settings in place and set your EPR to 1 or 2. Try that for a week and see whether you're comfortable with it and whether it helps some with the FLs.

EPR will feel a little different. One of the really nice things about ResMed machines is that their EPR is very nimble. It won't try to hustle you into inhaling before you're ready, and when you start inhaling, it boosts the pressure that tiny bit very smoothly, then lets it drop down right when you start exhaling. A different feel, but one that a lot of people use simply as a comfort feature or as a way to lessen aerophagia (air in the digestive tract).

When you post your next chart, could you turn off the calendar so more of the information in the left panel will be visible? (No need to report this chart, though.) Just click on the little triangle next to today's date.

[JOinPA]

Thanks Miss Emerita! I'll try that.

[lazarus]

using CPAP therapy for about 6 years now, with terrific success.

Good to hear!

Name is John, live in suburban Philly area.

I am a descendent of an indentured servant named John from the Philly area, but that was in the mid-1700s, so you wouldn't know him.

On the myAir app (I know, not highly regarded),

I loved MyAir when I had access to it. But, yeah, you and I may be the only fans on this forum.

thanks to those of you who maintain it!

That would be Pugsy.

should I use my current machine until it dies, then go to the new machine (after testing it for a week for function)?

I believe many of us use the new machine while it is under warranty and relegate the older one to backup status or travel status. A number of us have multiple backup machines because breathing during sleep is considered by us to be mission-critical support for quality of life.

Should I raise my upper limit and see what it does?

Other than the air-swallowers and pressure-sensitive among us, I believe most leave the max at 20. But Miss Emerita always talks sense, so I will consider that answered.

sleep consulting services at AXG sleep diagnostics? I'm considering it just to learn more about OSCAR and what to look for in terms of optimizing my sleep, although I have no complaints. Thoughts on this?

Personally, I consider this forum the best place for those things. And it's free! Well, other than having to put up with the likes of me and Zonker, anyway.

Welcome!

-Jeff

[zonker]

Personally, I consider this forum the best place for those things. And it's free! Well, other than having to put up with the likes of me and Zonker, anyway.

[lazarus]

I was gonna say "me and palerider," but frankly I'm a little scared of him.

[ChicagoGranny]

my question is should I use my current machine until it dies, then go to the new machine (after testing it for a week for function)?

You should max out the hours on the new machine while it is under warranty. After that, it's a personal preference. My preference is to keep running the new machine. When the message appears that the machine has reached its lifetime hours, I might be able to get insurance to pay for another machine. I wouldn't want my newest machine to be five years old and only have one year's run hours.

I loved MyAir when I had access to it. But, yeah, you and I may be the only fans on this forum.

I dissed myAir until the head RT at my DME told me their patients' compliance hours shot up when they started using the app. People like the convenience of nearly effortless and quick feedback.

Overall, I think a patient population's compliance hours are more important than therapy fine-tuned with the help of OSCAR.

[JOinPA]

I can already tell I'm gonna love it here. Lots of experts, comfortable with a little self-deprecating humor. lol. Thanks, ChicagoGranny, I was leaning toward taking the top off the pressure and see what the AutoSet does. I think the lower limit is fine, considering my median pressure is 12. Also, maxing out the new machine hours, holding my current machine in reserve is a good plan, because the AS10 won't be available in 5 years and I'll be able to take my time and research replacements while using the old one. Thanks for pointing that out, I should have figured that out myself.

Also, the idea that the ResMed software helps boost compliance makes sense, but compliance has never been an issue for me. Literally from day one I loved the CPAP therapy, never any issues. This may sound odd, but the only two days in the last 6 years I did not use CPAP was when I forgot a nasal pillow for the AirMini on a trip to Chicago. In 6 years, I've only not used CPAP 2 nights. Honest.

And with regard to the EPR suggestion and lifting the pressure ceiling, I'm going to do the latter first. I've never had discomfort using CPAP. Maybe I'm weird, but I use no ramp, EPR is off, and I sleep like a baby. I will revisit the EPR later, perhaps, but don't feel the need for any 'comfort' settings.

Am I unusual? Or are there others here who took to CPAP therapy immediately and without any issues? Admittedly, mine was pretty bad, really bad. I probably would not have type 2 diabetes or AFIB if I got a sleep test ten years earlier, but once I figured out what was happening, I took to CPAP like a drowning man reaching for a life vest. But I've really been comfortable since day one. Just looking to up my game and play with OSCAR because, well, frankly, I'm a geek. lol

[JOinPA]

Wow!

Watching some of you coach others who are having a lot of problems! This place is awesome!

Because I had no issues getting acclimated to CPAP, I am going to stifle myself because I cannot relate to those having significant issues, so likely have nothing to offer.

But watching you folks coach them is a thing of beauty!

[ChicagoGranny]

Also, the idea that the ResMed software helps boost compliance makes sense, but compliance has never been an issue for me.

Note that I was careful to say, "patient population".

Overall, I think a patient population's compliance hours are more important than therapy fine-tuned with the help of OSCAR.

For many individuals, including me, myAir is not sufficient. Fine-tuning the therapy with OSCAR is very important.

[JOinPA]

Well, night two with OSCAR data. Left EPR off, but took the top pressure to 20 and it did go as high as 14.8. My original prescription was 10-14. I don't know what to make of the other data, though. The UA around 11:30 was me going to the toilet, sometimes the AS10 won't auto shutoff when I remove the mask (it's intermittent, another reason, I'm overdue for a new machine, I think). And, no,I don't sleep that much, I spent a lot of time reading and scrolling Instagram last night before going to sleep. I just put the mask on when I get in the bed.

I'm going in search of an OSCAR tutorial now.

[ozij]

For some reason, Auto Off doens't work reliably with Resmed's P10 mask. That's even mentioned by ResMed somehere.
It's the mask, not the machine. Let the machine blow into a maskless hose, and you'll see it turning off properly.

[Miss Emerita]

If you're sleeping like a baby, then I'd say FLs don't bother you. And zero reason to change any of your settings, as far as I can see.

[lazarus]

Am I unusual? Or are there others here who took to CPAP therapy immediately and without any issues?

Unusual for the planet? Unusual for forums? Or unusual for CPAPtalk.com?

All people are usually unusual in some aspects, one way or another. In that sense, I am not sure I've ever met a "normal" person. If I did, I'd probably find them strange.

People usually search out forums when they have problems. But once those problems are solved, they may find themselves grateful enough to stick around and try to help others. A few of us at this forum have chronic problems with making PAP work work for us, others of us have sleep issues that are are mostly peripheral to PAP, but I think the majority of us have settled into our therapy and just hang out in case we learn something new or in case a drive-by poster has an issue that we happen to know something about.

The people who take to PAP like a duck to water rarely have a reason to think in terms of looking for online help, unless they just happen to be attracted to online info in general. Some of them who happen by are surprised to learn that others actually have problems with PAP therapy. But even some of those people benefit from forums like this one, because everyone sleeps and because some of us get great benefit from improving our sleep even just a little bit. Sleep that is 99% effective instead of 98% effective can make the difference between a great day and an OK day, for some of us.

Some of the greatest benefits to sleep-related forums come from people becoming familiar with the principles of "sleep hygiene." (Well worth a google or three.) Those principles can be particularly helpful to people dealing with sleep disorders, but they are also very helpful to everyone else, too. Not everyone has experienced the joys of improved sleep and therefore don't even realize they have a problem. They may consider it "normal" to get a few hours a night of bad-quality sleep and then load up with artificial stimuli to stumble through their days.

And if that is what "usual" and "normal" is, I choose to be unusual and abnormal enough to prioritize the quality of my sleep.

https://youtu.be/p-1zr_wgC1E

[JOinPA]

The people who take to PAP like a duck to water rarely have a reason to think in terms of looking for online help, unless they just happen to be attracted to online info in general. Some of them who happen by are surprised to learn that others actually have problems with PAP therapy.

I think that would be me. The longest nights of my life were between my titration test and getting my machine, since then, I've literally used it every night for six years save two (a trip to Chicago where I did not have a nasal pillow for my AirMini), with no problem at all.

I popped in here because I need to re-establish a relationship with a sleep doctor to get the prescription for a new machine (moved away from old doc, never sought one out). Now I'm finding myself very intrigued and doing the learning I should have done years ago.

Miss Ermita, what are FLs? I'm like a complete noob, don't know the acronym. Thanks!

Cheers,

John