Hating My New Autosense 10

[hschlossberg]

I just finished Night #2 with my new A10 Autoset machine, "upgraded" from an S8 Autoset.

First the superfluous:
• controls and screen are on the front instead of the top; I have to get down on the floor to read or control anything;
• the hose comes out the back, which means I can't just stand the machine on its back to be able to read the screen (putting aside the issue of water leaking out if I did so);
• the hose comes out the back, which stretches the hose an extra 8-12 inches from the machine to my bed;
• the buttons on the machine can't be used quietly; any adjustments in the middle of the night make loud clicks that wake up my wife; the S8's buttons were very quiet;
• the humidifier is on the wrong side of the machine for me to have easy access for refills
• the machine is huge compared to the S8 (I had no humidifier), so doesn't fit in the old carry bag, and the new carry bag is huge (too big to just throw it into my dufflebag/carry on); I'll definitely continue using my S8 for travel, and especially for camping trips.

More importantly:
• I started the first night with ramp and pressure relief on, because that was how the S8 worked. I quickly learned that on the A10 I can't breathe with either of those on -- not enough air and the warm air of my exhalation stays in there because there's not enough air to blow it out the exhaust holes. I ended up turning those off and the min/max pressure up from 6/12 to 10/13. The min of 10 when turning it on feels about right when compared to the S8 (which btw was set for 6/12; go figure).

• Every time I come back to bed after waking up for the bathroom, the machine seems to start right back at the beginning. The S8 seemed to remember where it was before the bathroom and came back on at that same pressure. I don't need to start back at my minimum when I'm already half asleep, but the A10 thinks I do.

• The machine is very quiet (that's good). But whether at 6 or 10 or whatever, the mask too is very quiet. How can this be if it is the same mask as used with the S8?!? This makes me think that the A10 isn't really giving me the pressure that I think it should be giving me. Even at a pressure of 10, with EPR and ramping turned off, and humidifier set at 2, the mask isn't filled with cool air for me to breathe while I'm trying to fall asleep (as it was with the S8 at a min pressure of 6.

• The humidifier makes no sense to me. I've never had a humidifier before, but decided I needed one if I was going to go to pressures higher than about 11 or 12. But I do NOT want it heated (why would I WANT it heated; my nose has never, ever felt cold in my mask, so why would I want that suffocating feeling of being in a sauna?!?). I have therefore kept my old tubing, even though the ClimateTube came with this machine. I had the humidifier set at 2 the first night and didn't feel any relief from that. But when I set it to 3 or 4, the heater icon went on. Can't I get more humidity without the thing heating up? At a 2 setting, it has a blinking snowflake icon, so why can't it create a cold mist at a higher setting?!? Isn't there a way to get humidity without the heat?

• More data? That's what everyone has said is a benefit to the S9 or A10, but the machine's screen only gives me the same numbers as the S8. And Resmed's online service gives me even less info (though in bar graph form). I know, Sleepyhead will be my next step once I decide this machine is worth keeping. But at the moment, and after two nights of terrible sleep in front of a busy work week, I am thinking of just going back to the S8 (having seemingly just thrown away $900 of hard-earned cash on this new machine that was supposed to help me).

Thoughts?

Thanks,
Howard

[chunkyfrog]

On the other hand, I love mine.

[Gasper62]

I hate that ice cream isn't a full half-gallon anymore ! ! FWIW, an S9 is a top read machine with very quiet buttons & knob. Still rear exit for the hose, though.

[chunkyfrog]

My heated hose rotates; and in the 12 o'clock position, it comes up over the top of the machine.
You cannot get that with the unheated hose.
When I changed from my S9 to the Airsense 10, I had to move it up to a higher shelf. No prob.

[Sheriff Buford]

Consider using the humidifier in the passover mode. I, too didn't use my humidifier for years. Then Den turned me on to the passover mode. Put the water in the humidifier, but don't turn up the humidifier temperature. It gives me just enough moisture to help the dry mouth issues, but not enough to deal with the hot air issues.

Sheriff

[BlackSpinner]

Humidifier and hose are totally controllable by you. Get the full manual and adjust it to your liking and check all your settings.

Since "everything feels different" I suggest the first thing you do is install Sleephead software and look at where your AHI sits with this machine. Maybe your S8 was dying and not providing the right pressure anymore.

As far as the noisy buttons are concerned - middle of the night is not when adjustments are made. It gets turned on when you go to bed and off when you get out of bed.

[palerider]

I can't even guess at where to being with that list of bitching....

[bobmc]

I also had a stuffy feeling with the A10. I turned the temperature down on the climateline to the same temperature as my room at night. That was the biggest thing that got away from the 'sauna' feeling. That also caused me to turn down the temperature on the humidifier, as I was going to get rainout bigtime otherwise.

I have also noticed a difference depending on what mask I'm using.

[Thatgirl]

I haven't touched a button on my A10 in 6 weeks, much less in the middle of the night... I also never look at the screen. I touch the machine around every 3 days to fill the water chamber and grab my card for sleepyhead.

[englandsf]

I think you will find humidity and maybe heat are the problem, not pressure. Go back to your original pressure and start from zero heat or added humidity then work up from there. Good luck

[Wulfman...]

Consider using the humidifier in the passover mode. I, too didn't use my humidifier for years. Then Den turned me on to the passover mode. Put the water in the humidifier, but don't turn up the humidifier temperature. It gives me just enough moisture to help the dry mouth issues, but not enough to deal with the hot air issues.

Sheriff

Hi Sheriff.

Been wondering how you were getting along with your experiment with "passover" humidity.
Glad to hear it seems to be going well.


Den

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[robysue]

hschlossberg,

Since you never used a humidifier with your S8 and your nose was happy with that, why are you trying to use the humidifier with the new A10?

Just because most people seem to do better with a heated humidifier and many people do better with a heated hose, that doesn't mean that you will do better with either of them.

And going from no humidifer at all to a heated humidifier set to 3 is a pretty significant change and it sounds like it's a change that your particular nose does not like.

So why not try the A10 with the humidifier (and the heated hose if you've been using it) turned completely off? If you decide that you really don't need or want any humidification, there is an optional ($20) side plate that can be put where the humidifier tank slips into the side of the A10. That will also reduce the footprint of the A10 at least a bit.

I had the humidifier set at 2 the first night and didn't feel any relief from that. But when I set it to 3 or 4, the heater icon went on. Can't I get more humidity without the thing heating up? At a 2 setting, it has a blinking snowflake icon, so why can't it create a cold mist at a higher setting?!? Isn't there a way to get humidity without the heat?

It is possible to turn the humidifier off and put water in the tank. That adds a small bit of humidity to the air but it should not add any heat at all to the air in the hose. It won't add much additional humidity because it turns out that blowing room temperature air over a bowl of water is not very effective at evaporating the water in the bowl. The easiest way to increase the rate the water is evaporated into the air is to heat it up a bit.

And that's what the CPAP manufacturers have decided to use in designing the CPAP humidifiers: To add more water to the air in the tube, they've added a small heating plate under the humidifier thank. When the humidifier is turned on, it heats the water and more of the water evaporates and that increases the humidity of the air in the tube. But there is a trade off: When you heat the water up to make it evaporate more quickly inside of a semi-closed system, like an APAP, the air will also be warmed by the heat applied to the water by the humidifier heating plate.

To create a genuinely cool mist, like a cold air room humidifier creates, requires a whole different approach to getting the water vapor into the air. For example, the old fashioned (and very loud) cold air room humdifier that used to be commonly used when people had head colds worked by sucking the water up with a wick and spinning it around with moving air enough to break the water into small enough droplets for some of them to become suspended in the air. The newer ultrasonic cold air humidifiers use a small metal diaphragm that vibrates at an ultrasonic frequency to break the water up into fine droplets that can be suspended in the moving air.

Neither of these approaches to adding extra humidity to room temperature air is incorporated into current CPAP design. My guess is that CPAP manufacturers have rejected both of these possible approaches to humidifying the air in the tube because of some combination of size, cost, and patient preference for heated humidification. It's important to understand that through the years, many CPAP patients have complained of cold air blowing on them making it difficult to sleep along with cold, dry air drying their noses and sinuses. Hence the addition of a small heater plate under the humidifier tank was probably seen as the most cost effective way of adding moisture to the air, while simultaneously starting to address the fact that many PAPers complain about cold air blowing on them when they're still trying to adjust to CPAP.

More data? That's what everyone has said is a benefit to the S9 or A10, but the machine's screen only gives me the same numbers as the S8. And Resmed's online service gives me even less info (though in bar graph form).

As you have observed, the data available on the A10's lcd is the same as that on the S8, with the following exception: The S8 does not try to distinguish between OAs and CAs, whereas the A10 does. The A10's detailed sleep report should break down the AHI into both an AI and a CAI. That may or may not be important to you.

Where the real wealth of extra data is found, however, is when you load the SD card's contents into either ResScan or SleepyHead. The S8 was considered a full efficacy machine when it was new. You do get a lot of detailed graphs in the S8's data---if you have the proprietary card reader needed to read the S8's data card into ResScan. But what you don't get is the flow rate (or wave flow) data, which provides a trace of every breath you took all night long. Again, this may not be of any interest to you. But the flow rate data can be very useful in trouble shooting.

[hschlossberg]

Thanks, robysue, for the detailed explanation on cpap humidifiers. The reasons I changed from the S8 is that I wanted to be able to get more data out of it, AND I needed to boost my max pressure a little but was already at the limit of dryness my mouth and throat could take. My first night with the A10, I tried it with the humidity set at 2, but that provided no noticeable improvement on dryness. So it was only after boosting it to 3 that I saw the heat icon come on and it felt like a sauna inside my nasal mask. I'm going to try '3' again tonight, but with the minimum pressure set high enough that it should be blowing the warm air out right from the beginning.

[BlackSpinner]

dryness my mouth and throat could take.

Dry mouth means you are mouth breathing. What kind of mask do you use? Even if you use a full face mask no amount of humidity produced by the cpap humidifier will solve your problem.

[Wulfman...]

dryness my mouth and throat could take.

Dry mouth means you are mouth breathing. What kind of mask do you use? Even if you use a full face mask no amount of humidity produced by the cpap humidifier will solve your problem.

+1
And, the higher the setting, the worse it will probably be.
Too much heated humidity has been known to cause more nasal congestion which can mean your mouth-breathing will increase to get air.


Den

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