A Tale of Two CPAP's - DS2 & AS10 Auto Differences?

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Grumpy48
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A Tale of Two CPAP's - DS2 & AS10 Auto Differences?

Post by Grumpy48 » Fri Jun 24, 2022 1:43 pm

I've had the recalled DS1 which was replaced with a DS2. Both were pretty much 'plug n' play', did what they were supposed do and got mostly good AHI numbers without any tweaking of settings. I recently bought a preowned AirSense 10 Auto to have as a backup and possible travel machine. I set up the AS10 with pretty much the the same settings as the DS1/DS2 had. I'm using the same FF mask, an F/P Vitera on each machine. The AS10 has a Climate Line hose attached. The AS10, despite settings which are the same or at least close, acts much different in use and during the night has pressures sufficient to blow out the side of the mask. Even the mask check will cause blow out unless I hold the mask firmly to my face. I can get a good mask check with the DS2. To note I checked the mask check pressure of each machine with a digital manometer. The DS2 was 14.3 cm/H2O and the AS10 was 19.0 cm/H2O, so that may account for the mask fail on the AS10. The meter reads of therapy pressure match the display pressure on each machine, so the machines are delivering what the display shows. The AS10 has been delivering higher pressures during the night than the DS2. I believe a Flow Limit in the AS10 triggers the pressure increase which then results in the leakage. I've tried EPR 3 on the AS10 and last night EPR 2. Both about the same for pressure increases at night.
I understand the algorithms for each machine are likely different, but shouldn't therapy pressures be closer? Typically the DS2 is at around 10.0 or less and for the times I've used the AS10, it's been around 13.0 for the 95% value.
A couple recent nights. If a different part of the graph is needed I'll grab it. DS2 first chart, AS10 second...

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Machine: DreamStation 2 Auto CPAP Advanced with Humidifier
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Additional Comments: Resmed AirSense 10 Auto with Humidifier

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palerider
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Re: A Tale of Two CPAP's - DS2 & AS10 Auto Differences?

Post by palerider » Fri Jun 24, 2022 8:32 pm

So, without going into too much tedious detail, the AS10 conducts it's mask fit at the highest pressure that it could get up to, that way you can get your mask adjusted so you won't have any leaks if it gets up to that pressure during the night.

As to the machine getting to higher pressures, that's because the algorithm doesn't suck like the philips machine does... if you look at the pressure strip for the philips machine, all those spikes are when the machine thinks your breathing is *great*, but when it thinks your breathing is bad... it does nothing..

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ozij
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Re: A Tale of Two CPAP's - DS2 & AS10 Auto Differences?

Post by ozij » Fri Jun 24, 2022 11:25 pm

Resmed's Auto algorithm responds very aggressively to what it identifies as flow limitations. You have a lot of them in Resmed speak, hardly any in Respironics speak. Which is why you're getting more pressure (and more leaks) on the Resmed machine. The "Resmed defined flow limitations" appear on the separate "Flow Limitations" graph, are driving your machine to give you high pressure most of the time.

Philips Respironics does not respond like that, its algorithm understands your breathing differently , and therefore responds differently. The "FL" in the event chart shows how very few "Respironics type" F(low) L(imitations) the DS2 indentifies in your breathing.

If you were to cap the A10 auto at the DS2's max, you'll find yourself spending most of the night at that maximum pressure.

Since its a backup machine, and you want to make sure it gives you good therapy when the need arises comes, I suggest you play around with it now to find out the best setting on this machine that will give you the same subjective results you get from DS2.

It's the quality of your sleep and how you feel that you want to focus on.

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palerider
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Re: A Tale of Two CPAP's - DS2 & AS10 Auto Differences?

Post by palerider » Fri Jun 24, 2022 11:42 pm

Additionally, you're spending a considerable amount of time with leak rates that are too high.

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