Experimenting with a Resmed AirCurve 10

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: Experimenting with a Resmed AirCurve 10

Post by Pugsy » Tue Nov 08, 2022 5:48 pm

robysue1 wrote:
Tue Nov 08, 2022 5:38 pm
I don't always want to take my mask off and then wait for the machine to decide I'm no longer wearing the mask.
Probably wouldn't turn off anyway at your pressures.
The Auto off part of smart start doesn't work so great with nasal pillows (Swift FX or P10 and maybe some others) and low pressures like you are using.
It's so well known that it's mentioned in the manual.

BUT...it's funny...it works great with the Bleep/Eclipse. Shuts off like it should but with my P10 it would run all day if I let it. Go figure.

I still got my fingers and toes crossed that you will find a way to make this model machine work well for you.

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Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Tue Nov 08, 2022 6:56 pm

Pugsy wrote:
Tue Nov 08, 2022 5:48 pm
I still got my fingers and toes crossed that you will find a way to make this model machine work well for you.
I appreciate the crossed fingers and toes.

I'm cautiously optimistic that things are working out pretty well. Yes, the first two nights were rough. But I think a large part of that was using a worn out set of pillows. So while I'm not tossing those two nights out of the data set, I do regard the "subjective data" as dirty---i.e. the explanation of why those nights were rough may be impossible to tease out between the contribution of the worn pillows and the possible problems with the Resmed machine's Auto algorithm.

I'm fully planning on keeping the same settings for a few more days since I'd like a full week's worth of data to look at.

I'll likely make adding the ClimateLine hose the next variable to play with as long as painful aerophagia does not rear its ugly head.

I played around with the PR heated hose shortly after I got my DreamStation and discovered I didn't particularly like it. So I stuffed the thing in my CPAP supplies drawer as a "hose of last resort" when every other hose was in my "to be washed" pile. After returning from our 45 day trip to Europe this summer, I did have to put the heated hose on my DreamStation for while because we were down to two clean hoses, and the unheated one had to be put on hubby's System One Series 60 APAP. I rediscovered that I didn't like the "Auto" setting for the hose, but I didn't bother going through the manual to figure out how to change it since I washed a bunch of hoses and I knew I'd be swapping it out in a few days.

I would like to ask for advice from you since I know your nose is like mine and would drink water if it could: Would you recommend that I start a heated hose experiment in Auto mode and let the machine choose both the temp and the humidity setting? Or would you recommend Manual mode where I set the humidity setting and hose temp separately?

Keep in mind: I've currently got the humidifier set on 8 and until last night the nose was complaining of being a bit dry in the morning. Last night I had a tiny bit of rainout which didn't bother me (in terms of sleep interruption) and my nose was much happier this morning.
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Re: Experimenting with a Resmed AirCurve 10

Post by Pugsy » Tue Nov 08, 2022 7:34 pm

The ClimateLine hose and Auto mode will very likely be totally useless for you especially with your ambient room temps.
I wouldn't even go there if it were me. I have tried auto mode for both humidity and hose air temp and I didn't like less humidity for sure and auto mode for humidity gives about a middle of the road setting around 4 to 5 if you compared it to manual.
I tried it...while not as dry as yours...it left me wanting more moisture.
Auto mode for heated hose and rain out prevention...useless when the ambient room temps fall below 64 degrees or so and that's with auto humidity which is that 4 or 5 equivalent. If it can't stop condensation with humidity set to 4 or 5....it sure can't manage a setting of 8.

Bite the bullet and just go with manual settings for both. I think you will be a lot happier.

Side note....go ahead and at least plug the heated hose in....I am hoping you will find that it doesn't come loose for you as easily and the hose positioning is more adjustable....it rotates. You can turn the plug in circles and change the hose routing. You might like it.
And remember just because it is a heated hose doesn't mean you have to use a lot of heat with it if you don't want to. In the summer/spring before the need for air conditioning I have set the hose temp to 60 degrees and not have rain out (hose cozy on the short hose and sometimes a barrel cozy)....I prefer to breathe in the cooler air if I had a preference. In the winter I have learned to be happy with the really warm air of the 86 degrees because while I don't really like it....it is preferable to getting a cold shower or a train going down the hose noise. I learned that while I don't like the warm air ....I like the cold shower waking me up even less. :lol:

Unlike you with your condensation whenever I get it I usually end up with a real shitty night's sleep. Not so much from the water but from the fact that the least little thing that causes me to wake up will general trash the rest of the night's sleep for me but from the other problems that I have. The least little thing wakes me up and then I just can't get back to sleep. Not cpap or hose or whatever cpap related but to other life's stressors. So I try really, really hard to eliminate anything that might disturb my sleep.

I had another RFA procedure done today...will see how that does with the pain that disturbs my sleep.
They say allow 4 weeks to see how much it helps or not....it will be a long 4 weeks. I don't have much patience. :lol:

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Re: Experimenting with a Resmed AirCurve 10

Post by Pugsy » Tue Nov 08, 2022 7:37 pm

What I found out about the auto settings....works great if someone is using 4 or 5 (or equivalent) with ambient temps around 70ish but anything less than 70ish ambient temps I get way too much condensation.

I also get quite a bit of moisture only in the mask and that's from my own exhaled breath...hence the short hose cozy and sometimes the barrel cozy and I even modified a P10 barrel cozy to work on the Bleep/Eclipse.

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Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Wed Nov 09, 2022 11:52 am

Pugsy,

I'll keep all those tips and information about the ClimateLine hose in mind when I do my next hose swap, which will probably be Friday night or Saturday morning.

I'm off to teach my Calculus I class right now. I'll write more in my office hours if no-one shows up.
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Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Wed Nov 09, 2022 8:04 pm

Night 5
Outside of a very delayed get-to-bed time because of staying up most of the night watching election results on my computer (No, I won't talk politics with anybody around here.)

For those who want to see the data, here's a view of the whole night in SleepyHead (since Oscar continues to mess up the sessions):
Image
It's important to note that I am not using the ramp. So all those long stretches where the pressure is staying constant at 8/4? The machine was just really, really happy with my breathing. You can also pick that up from the total lack of anything being shown on the Flow Limitation and Snore graphs. The red dotted line is a feature I have turned on in both SleepyHead and Oscar: It's the "Leak Rate Upper Threshold" which is drawn at Resmed's "Red Line" of 24 L/min, which is their definition of a "Large Leak". As you can also see the leak line is just about perfect. The AHI = 0.22 represents one event all night long. On this night, that one event was an OA towards the end of the night.


But how was the sleep itself?
Pretty good. Yes, I only got 4 1/2 hours because I went to bed sooo late. When I finally got to bed, I got to sleep within 5 minutes. That impression is backed up by both the AirCurve data and the Fit Bit.

I woke up enough to turn the machine off and back on twice during the night. But the two wakes appear to be at the ends of full sleep cycles. I vaguely remember one of them only because I remembered that if I put the AirCurve into "Power Saver mode" by holding the on/off button down for three seconds, the machine would turn the blower off completely. I also think I turned over during one of the wakes. Between the wakes it felt like I got some really high quality sleep, and getting back to sleep after them took almost no time.

When I woke up, I did feel rested, but not particularly refreshed---that's because this is the second night in a row where I got to bed too late and still got up at a halfway decent time. There was no aerophagia at all, and any night with no aerophagia and no real restless periods it a good night's sleep for me.

And I've felt pretty good most of the day as well. I've certainly had enough energy to do the things I needed to do. And I'm now relaxing, watching TV and blogging at the same time. Clearly

In other words, I feel pretty good about this night's sleep because I felt good when I woke up and I've continued to feel good all day long.


Here is the score card through Night 5:
Aerophagia: 2 nights worse than usual compared to the DreamStation; 3 night about the same (or better) as the DreamStation
Wakes & Arousals: 3 nights worse than usual compared to the DreamStation; 2 night about the same (or better) as the DreamStation
Feeling on Wake: 1 night worse than usual compared to the DreamStation; 4 nights about the same (or better) as the DreamStation
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Re: Experimenting with a Resmed AirCurve 10

Post by lynninnj » Thu Nov 10, 2022 4:00 pm

robysue1 wrote:
Wed Nov 09, 2022 11:52 am
Pugsy,

I'll keep all those tips and information about the ClimateLine hose in mind when I do my next hose swap, which will probably be Friday night or Saturday morning.

I'm off to teach my Calculus I class right now. I'll write more in my office hours if no-one shows up.
-omfgihatedcalculussomuchimsorrybutomgcalcsucked-

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Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Thu Nov 10, 2022 4:51 pm

lynninnj wrote:
Thu Nov 10, 2022 4:00 pm
robysue1 wrote:
Wed Nov 09, 2022 11:52 am
Pugsy,

I'll keep all those tips and information about the ClimateLine hose in mind when I do my next hose swap, which will probably be Friday night or Saturday morning.

I'm off to teach my Calculus I class right now. I'll write more in my office hours if no-one shows up.
-omfgihatedcalculussomuchimsorrybutomgcalcsucked-
For what it's worth: I got B's in Calc I and Calc II and they almost made me a geology major. :)
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Re: Experimenting with a Resmed AirCurve 10

Post by Jlfinkels » Thu Nov 10, 2022 4:58 pm

robysue1 wrote:
Wed Nov 09, 2022 11:52 am
I'm off to teach my Calculus I class right now. I'll write more in my office hours if no-one shows up.
Based on your posts I would bet that your students leave your class understanding Calc. I wish some of my post-grad students had you as a teacher for math, it would have made my job much easier.
Sometimes it is the very people who no one imagines anything of who do the things that no one imagines

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Re: Experimenting with a Resmed AirCurve 10

Post by lynninnj » Thu Nov 10, 2022 6:24 pm

robysue1 wrote:
Thu Nov 10, 2022 4:51 pm
lynninnj wrote:
Thu Nov 10, 2022 4:00 pm
robysue1 wrote:
Wed Nov 09, 2022 11:52 am
Pugsy,

I'll keep all those tips and information about the ClimateLine hose in mind when I do my next hose swap, which will probably be Friday night or Saturday morning.

I'm off to teach my Calculus I class right now. I'll write more in my office hours if no-one shows up.
-omfgihatedcalculussomuchimsorrybutomgcalcsucked-
For what it's worth: I got B's in Calc I and Calc II and they almost made me a geology major. :)
That’s because YOU ROCK Robysue!

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Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Thu Nov 10, 2022 10:08 pm

Night 6
Night 6 was neither a big disaster nor a big success. A lot of this is that I went to bed early on Night 6 because I'd got only about 4.5-5 hours of sleep the last two nights. And going to bed early for me (as in at 11:00 pm) is always problematic for me. What tends to happen when I go to be early even when I'm really sleepy is that I'll typically sleep pretty well for the first part of the night, and then I wind up having trouble staying asleep---and getting back to sleep after the wakes--during the second part of the night. And that was true on Night 6 and I can't blame that on the AirCurve since this is a very old pattern in my sleep. In other words, given when I went to bed, I think I would have had the same not very good night if I had been using the DreamStation instead of the AirCurve.

Here's the data:
Image
This is still from SleepyHead because Oscar is still not displaying the sessions correctly. In particular, Oscar shows four sessions (which is better than 1, like on the other nights), but Oscar's 2nd and 3rd sessions combine 2 or 3 individual sessions together.

I woke up at least 6 times. I remember at least 3 or 4 of those wakes. Two of them, I actually got out of bed to go to the bathroom, which is unusual for me and to get a drink of water. I also woke up with a dry nose and even checked to make sure the humidifier was not out of water (it wasn't.)

But I don't think any of that restlessness is directly due to the machine---as I said earlier, when I go to bed because I'm exhausted, I often don't sleep very well.

The AirCurve recorded some snoring during a 21 minute long session that starts at 2:15 and ends at 2:36. While I don't remember any snoring, it sure looks to me like I must have woken myself up with the snoring. And I remember the 2:36 wake because that's the one I went to the bathroom and also got myself a drink of water because my nose felt dry.

After I came back to bed, I also had another short period of sleep between roughly 2:46 and 3:12 (with a probable very short wake/arousal at 3:04.). These short 30 minute sleep periods with wakes between them do play havoc with how I tend to feel and function the next day. I feel much better during the daytime when all of the xPAP sessions are at least about 90 minutes long---i.e. if I only wake up at the end of full sleep cycles.

While the FitBit shows that I got some actual sleep after the 6:10-6:20 wake, it didn't feel that way. Or more correctly, I remember waking up and tossing and turning for a bit before I got up at 7:40. That's an early wake-up time for me, but since the time has just changed, it's not excessively early.

The aerophagia was noticeable this morning, but not painful. Still to be honest, it was a bit more noticeable that I usually have with the DreamStation. Because of the snoring there are also some periods where the pressure is maxed out at 9/5. So it's no surprise that the 90% pressures are 8.9/4.9. But the fact that the median pressures are only 8.32/4.32 is probably why the aerophagia was not painful. (On the DreamStation, my median EPAP is always 4.0, and the aerophagia starts raising its ugly head when the 90% EPAP is close to 5; if the snoring gets bad when I'm using the DreamStation, my EPAP can get as high as 6, but that does not happen hardly at all because the DreamStation can increase the IPAP to 9 without dragging the EPAP up with it..)

The data hounds will notice there's one cluster of events shortly after 1:00AM. Zooming in, that cluster looks like this:
Image
That looks to me like this is all post-arousal SWJ. The Fitbit also says I had a brief wake right around 1:04:30, just as this cluster of OAs is starting.

The OA at 1:12:30, however, probably did occur shortly after I got back to sleep around 1:08 or 1:09. Here's what that one looks like:
Image
The breathing before this OA is nice and regular and looks like sleep breathing. You can also see the recovery breaths that follow this OA.

Here is the score card through Night 6:
Aerophagia: 3 nights worse than usual compared to the DreamStation; 3 night about the same (or better) as the DreamStation
Wakes & Arousals: 3 nights worse than usual compared to the DreamStation; 3 night about the same (or better) as the DreamStation
Feeling on Wake: 2 nights worse than usual compared to the DreamStation; 4 nights about the same (or better) as the DreamStation
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Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Fri Nov 11, 2022 11:21 pm

Night 7
This was another night where I was up too late and got up earlier than normal. Can't blame the machine for not getting enough sleep if I'm the one who didn't get myself to bed in a timely fashion.

Night 7 was a pretty good night even though it got off to a rough start. When I woke up this morning at 8:20 I was ready to get up in the sense that I was rested and no longer sleepy. And it's been a pretty good day too in terms of daytime functioning.

Here's the data:
Image

The rough beginning of night 4 started with me pulling the hose off the machine. And it took a while for me to get the hose attached to the back of the machine. You can see that happened just a few minutes after I turned the machine on at the beginning of the night with that gap in the wave flow.

I plan on starting to use the ClimateLine hose that Pugsy included with the machine tomorrow. And, of course, it's machine end is designed to attach to the pivot ring in the back of the machine. Curtesy of Pugsy, I've also learned that there is a pivot piece that can be bought from cpap.com that allows an ordinary unheated hose to attach to the pivot ring on the back of the AirCurve 10. The elbow costs all of $6.50. That's a small investment that is well worth making, in my opinion, since it should fix two of the big problems I've been having with the design of the Aircure---namely the lack of a pivot that allows the hose to move and the fact that I've pulled my unheated hose off the back of the machine twice without really yanking it that hard.

As for the rest of the night? Well as you can see, there were only two scored events:

A CA scored just as I was falling asleep at the beginning of the night that is most likely a normal sleep transition CA that would not be scored on a PSG:
Image

And a OA scored about 15 minutes after I turned the machine off and back on around 6:44. The OA looks like a post arousal event since there are big, irregular breaths before the OA happens as you can see when I zoom in on it:
Image

The rest of the night? There's hardly any reason the machine finds to increase my pressures from 8/4, and I'm pretty sure that's part of why there was no hint of aerophagia this morning.

In terms of actual wakes, this was a pretty good night as well: It looks like I woke up enough to turn the machine off and back on only at the ends of full sleep cycles. The Fitbit data also shows a 5 minute wake starting at 7:00, which corresponds to the large breaths that precede the OA. Since I don't remember this "wake", I suspect I may have woken up enough to turn over in bed and the breath holding may have been connected with concentrating on managing the hose in such a way as to not pull it out of the machine. But the truth is I don't remember any of those wakes.

Here is the score card through Night 7:
Aerophagia: 3 nights worse than usual compared to the DreamStation; 4 night about the same (or better) as the DreamStation
Wakes & Arousals: 3 nights worse than usual compared to the DreamStation; 4 night about the same (or better) as the DreamStation
Feeling on Wake: 2 nights worse than usual compared to the DreamStation; 5 nights about the same (or better) as the DreamStation
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Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Fri Nov 11, 2022 11:53 pm

Week One Conclusions

I've been happy enough with the AirCurve 10 that I have contacted my sleep doctor and had him forward a script for a replacement machine to a local DME that I know can set me up with an AirCurve 10 Vauto, and I've got confirmation from his office that they have faxed the script to the DME today.

That's not to say everything has been perfect or great. There are several things that I still don't particularly like about the design of the AirCurve 10, but none of them are deal-breakers. And except for the first two nights, the aerophagia has been much less of an issue than I was worried it would be. Clearly my AHIs are nice low as well, so that means I don't think I'll have much need to experiment with the clinical settings.

The good things:
  • The painful aerophagia has not reared its ugly head after those first two nights.
  • I've clearly got the therapeutic settings dialed in pretty good. My treated AHIs are better on the AirCurve than on the DreamStation, but to be honest, I think the DreamStation may score some things that the AirCurve doesn't when I'm in the process of getting to sleep.
  • I can apparently get a Resmed AirCurve 10 Vauto with my insurance now instead of continuing to wait on PR to replace my 6-year old DreamStation BiPAP Auto with a potentially refurbished DreamStation BiPAP Auto of roughly the same vintage. Given that I started seeing black foam bits in the humidifier tank for the first time a couple of weeks ago, that's a big, big plus.
  • The available information on the AirCurve's Sleep Report on the LCD.
  • The fact that you can tell how much water is left in the humidifier without having to open the machine up.
The bad things, none of which are deal breakers:
  • My nose is just on the edge of being too dry with the humidifier set to 8 (the max) and using an unheated hose. PR's "Classic 5" setting gives more moisture, in part because in that mode the humidifier is not "smart" enough to adjust for the ambient humidity and air temperature. I've had almost no rainout with the AirCurve, but the bit of rainout I get with the DreamStation is not a huge issue for me. It's going to be interesting to see if I can find an sweet spot for the hose temp/humidity settings that I like any better than the unheated hose with the humidity set to 8.
  • I still don't like the fact that turning the AirCurve off does not turn the blower off. However, the fact that if you just hold the off button down for 3 seconds, the blower does turn off, is turning out to be a perfectly decent work around.
  • The on/off button is too small. When you're flailing around in the middle of the night trying to find that button, it can be hard to locate it.
  • I really don't like the fact that the hose comes directly out of the back of the AirCurve. It's also quite difficult to attach a unheated hose if you don't happen to have the elbow thing that allows an unheated hose to be attached to the pivot.
  • The weight of the machine is so light that I'm worried about pulling it off my bedside table.
  • The AirCurve seems more fragile than my Dreamstation, which in turn seemed more fragile than my System One. I have pulled the DreamStation as well as the System One off the night table a couple of times having gotten seriously tangled in my hose. I just picked those machines back up off the floor and they seemed fine in the sense that I really don't think water was able to go from the humidifier tank back to the blower unit. I'm not so sure the AirCurve's design is as good at preventing water from getting into the blower as the PR DreamStation or the System One was.
  • The humidifier tank is a bit tricky to mount and unmount from the machine. But at least it opens and is easy to fill.
  • The weight of the machine is so light that I'm worried about pulling it off my bedside table.
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Re: Experimenting with a Resmed AirCurve 10

Post by ozij » Sat Nov 12, 2022 12:54 am

robysue1 wrote:
Fri Nov 11, 2022 11:53 pm
My treated AHIs are better on the AirCurve than on the DreamStation, but to be honest, I think the DreamStation may score some things that the AirCurve doesn't when I'm in the process of getting to sleep.
The companies have different criteria:

Resmed:
Glossary of Sleep Apnea Terms
Hypopnea is a partial blockage of the airway (shallow breathing). During a hypopnea, breathing is reduced by 50% for 10 seconds or longer.

Philips
https://www.philips.com/c-dam/b2c/ko_KR ... report.pdf
Hypopnea(H): defined by a 40% reduction in airflow for at least 10 seconds.

We know that ResMed flags more flow limitations than does Philips and responds to them rather aggressively.

[edited to correct the company name, with thanks to robysue and palerider, who caught my "slip of the keyboard" (or is "slip of the fingers"?)]

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Last edited by ozij on Sun Nov 13, 2022 12:05 am, edited 2 times in total.
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Re: Experimenting with a Resmed AirCurve 10

Post by booksfan » Sat Nov 12, 2022 8:46 am

robysue1 wrote:
Fri Nov 11, 2022 11:53 pm

[*]The on/off button is too small. When you're flailing around in the middle of the night trying to find that button, it can be hard to locate it.
Just a thought, could you add one of those little silicone buttons that are used on the back of picture frames or cabinet doors on top of the on/off button to make it easier to find? They come in flat or domed versions.

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