Experimenting with a Resmed AirCurve 10

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robysue1
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Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Wed Nov 16, 2022 11:23 am

ozij wrote:
Wed Nov 16, 2022 2:16 am
robysue1 wrote:
Wed Nov 16, 2022 12:43 am
Here is the score card through Night 11:
Aerophagia: 3 nights worse than usual compared to the DreamStation; 8 night about the same (or better) as the DreamStation
Wakes & Arousals: 3 nights worse than usual compared to the DreamStation; 9 night about the same (or better) as the DreamStation
Feeling on Wake: 2 nights worse than usual compared to the DreamStation; 9 nights about the same (or better) as the DreamStation
You're so thorough that I dare ask you about the chronology of the score card.
Is there an indication that it's also a process, in which the first nights were more likely to be worse, and you figured out the settings and perhaps got more used to some things?
That's a good question.

The short answer to your question is that the first two nights with the AirCurve were the nights that were clearly worse than the DreamStation. And that yes, it took a few nights to figure out the settings and to get used to some things that Resmed does differently than PR.


Here's the long answer to your question:

In my Resmed AirCurve 10 experiment, the the basic question to be answered was: "Should I just get a new AirCurve 10 with my insurance benefits now instead of waiting indefinitely for PR to replace my DreamStation 1 BiPAP Auto with another potentially rehabbed DreamStation 1 BiPAP Auto of the same age?"

My husband is an applied mathematician (I'm a "pure mathematician"), and he's the one who suggested doing a Bayesian hypothesis testing experiment. In order to do this you set up two competing hypotheses, and gather data to see which hypothesis "fits" each data point best and collectively the data points to which hypothesis is most likely to be valid. So I had to recraft my basic question of whether I should get a new AirCurve or wait for my DreamStation to be replaced, as a pair of competing hypotheses that I could actually "test" and quantify.

The basic competing Bayesian hypotheses are:
  • H1: I will sleep worse on average with the Resmed AirCurve 10 VAuto than with the PR DreamStation BiPAP Auto.
  • H2: I will sleep about the same or better on average with the Resmed AirCurve 10 VAuto than with the PR DreamStation BiPAP Auto.
If the data supported H1, then I'd be better off just waiting for PR to send me another DreamStation BiPAP Auto, even if that machine turns out to be a refurbed machine that is the same age as my current one. If the data supported H2, then I'd be better off getting my insurance to pay for a new AirCurve 10 VAuto and use the PR replacement machine (if and when it finally arrives) as a backup machine.

And part of why I'm updating the score card each day is that I can, in fact, see the historical trend on which nights are "worse" and which nights are "better or about the same" as well as simply keeping a tally. But the data is clearly pointing to H2 as being the more likely true hypothesis. The evidence is so strongly pointing to H2 that I am now working with a DME to try to get an AirCurve 10 Vauto as a replacement machine with my insurance paying their 50% of the cost of the machine.

Here are some factors that made those first few nights worse, even though I've only made one modest change in the clinical settings.

1: Since a DreamStation has no Cycle, Trigger, Ti min, and Ti max settings, I had to make an intelligent guess (based on some information give to me by palerider) about those settings. And while breathing felt reasonably "ok" with my initial settings, something still felt "off" those first two nights. Changing the Trigger setting for the third night helped quite a bit. I'm not yet sure I have Cycle, Trigger, Ti min, and Ti max set in the best way for me, but my current settings are pretty good and I'm reluctant to change them when there are some other things that I want to make sure of first. (In other words, this is now a situation of "If it ain't broke, don't fix it.")

2. The fact that my nasal pillows were already problematic when I swapped the machine was an issue on the first couple of nights. On the DreamStation, which I was used to, the leaky, worn out pillows had not yet gotten to the point of genuinely interfering with my sleep. But the combo of "leaky, worn out pillows" with "brand new machine" meant that leaks that were trivial for me to fix without really waking up on the DreamStation suddenly were a big issue with the AirCurve. The fix for that, of course, was to change the pillows, which I also did for night 3.

3. Darth Vader breathing has not been a noticeable problem on my DreamStation with my Swift FX mask recently, but it was an immediate problem with the AirCurve. So back to the fix that I used on the PR System One BiPAP Auto way back when the jet exhaust from the FX was bothering me intensely: A homemade diffuser for the exhaust vents. That eliminated the Darth Vader noises and their contributions to extending the lengths of wakes because it was difficult to get back to sleep listening to them.

4. A major breakthrough also occurred when I found the answer to "How do I turn off the blower completely?" buried in the Clinical manual. Knowing that holding the power button down for 3 seconds will turn the blower off has made it much easier to deal with my expected, usual short middle of the night wakes when I want to just pull the pillows off the nose to wipe my nose or to cough or just reset them because there's been a small leak. The blower continuing to blow after the machine is turned off was really, really irritating me (because it was extending the wakes) before I learned the trick about Power Saver mode.

5. At this point, I've got the ClimateLine hose on the machine, but it's set so low (64F = 18C) that the air essentially feels like its not heated. (That's intentional.) The elbow on the ClimateLine has fixed the problem of the hose being too easy to pull off the back of the machine. The fact that I still have to orient the machine away from my face is not an issue for me, but I do still think where Resmed chooses to put the hose outlet is not a good design feature. (There's a reason that all the Resmed pictures seem to show the machine sitting on a nightstand without the hose attached.) Experimenting with the hose temp is probably the next set of changes I plan on making.

6. The dryness of my nose is still a bit problematic. I've got the humidifier set to 8 (its max setting). (On the DreamStation I used "Classic 5", which was a non-smart mode with the humidifier set as high as possible.) Rainout has not been a big issue for me on the AirCurve, although it was a minor one on the DreamStation: My nose was happiest on the nights where I would wake up to gurgling noises and have to raise the hose to get the water to run back to the humidifier. So far the nasal dryness is not a deal breaker, but long term I may need to pay more attention to nasal hygiene with the AirCurve than I've had to do in the last several years of using the DreamStation.

So, yes, in retrospect it doesn't surprise me that the worst nights were at the beginning of my experiment. Truth be told, I was hoping that whatever difficulties I had would tease themselves out and that the data would get better with time. But it's also why I didn't just dismiss those first two nights outright: Dirty data is worth something, even if it is dirty. And had the aerophagia or wakes continued to be issues after the few basic things I changed on night 3, that dirty data would have been more data building a case supporting H1.

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Re: Experimenting with a Resmed AirCurve 10

Post by ozij » Wed Nov 16, 2022 1:34 pm

Thank you, robysue!
robysue1 wrote:
Wed Nov 16, 2022 11:23 am
but I do still think where Resmed chooses to put the hose outlet is not a good design feature.
That, and all those nooks and crannies in the humidifier....

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Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Thu Nov 17, 2022 12:15 am

Night 12
Here's the data:
ImageOn paper a pretty boring night. One thing that's a bit unusual for me is that all of the events were CAs. The first two are likely sleep transition CAs. The other two? They're likely real. While this is unusual for me, it's not alarming in any way.

The number of wakes is a bit more than usual. And I'm still having trouble getting Oscar to show the individual sessions rather than glomming them together. So that's why this is another SleepyHead screenshot.

The very short (4 minute) session at the beginning of the night was caused by something being "wrong" with how the xPAP was sitting on the nightstand, the pillows in the bed, how the covers were, and how the hose was lying underneath the covers. It was easiest to turn the machine off, fix all the various problems, and mask up again.

But outside of that initial 4 minute session, there are two other short sessions---one that lasted 46 minutes and another that lasted 39 minutes. These short sleep periods usually do make me feel a bit more tired when I wake up in the morning, and that was true this morning. I really didn't want to get up.

I had enough energy during the day, but I would not describe it as a good day---merely an OK day. And I'm more used to good days now that "ok" days.

Other than getting to bed too late and having more problems than ordinary with sleep continuity, it wasn't too bad of a night.

I'm sleepy and I'm going to bed now.

Here is the score card through Night 12:
Aerophagia: 3 nights worse than usual compared to the DreamStation; 9 night about the same (or better) as the DreamStation
Wakes & Arousals: 4 nights worse than usual compared to the DreamStation; 9 night about the same (or better) as the DreamStation
Feeling on Wake: 3 nights worse than usual compared to the DreamStation; 9 nights about the same (or better) as the DreamStation

_________________
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Humidifier: DreamStation Heated Humidifier
Additional Comments: Also use a P10 mask
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Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Thu Nov 17, 2022 10:54 pm

Night 13
This was one of those weird days: Subjectively I slept pretty decently. I felt pretty good when I first got up. And then everything in terms of how I feel started to go down hill about an hour or hour and half after I got up. I've been cold all day long and I've had both some nasal congestion, a bit of a cough, and a sensitive stomach most of the day and I've had trouble concentrating today. So I'm a bit worried that I might be coming down with something.

The data shows that objectively it was a good night in terms of OSA events and a pretty standard in terms of 3 obvious wakes spaced far enough apart to believe that they're all at the ends of full sleep cycles:
Image

The only wake I vaguely remembered when getting up for the day was the last one at 6:36. There was a bit of rainout in the hose or mask and I had to lift the hose to let the water run back to the machine. It didn't take long to do that, but it did take a bit of effort to get the hose where I wanted it to be afterwards.


I also thought I'd show y'all the FitBit data for this night. It looks like this:
Image

While I'm not sure I really believe that my FitBit can accurately distinguish REM from non-Rem sleep, it does a good job at identifying the "major" wakes when I turn the machine off and back on. The really short wakes identified as red dots in the FitBit sleep graph almost always correspond to breathing patterns that resemble potential arousals in the flow rate graph. I can find out the time for all of the sleep stage changes (and the red dots) by hovering the mouse over the graph when I am looking at it on the FitBit webpage for my FitBit account. On this night the red dots in the FitBit data are at
  • 4:49:00 -- 4:50:00
  • 6:03:00 -- 6:04:00
  • 6:08:30 -- 6:09:30
And here are zoomed in views of the corresponding data from SleepyHead:

Image
Image
Image

I'm pretty sure the FitBit doesn't pick up every micro-wake where I don't wake up enough to turn the machine off and back on, but I am impressed that almost always if the FitBit says there was a short 30 second to 1.5 minute long "wake", there's usually something funky going on in the wave flow that usually looks like an arousal of some sort. In other words, I'm beginning to trust the FitBit data as providing a decent "floor" for the number of wakes and micro-wakes during the night.


Here is the score card through Night 13:
Aerophagia: 3 nights worse than usual compared to the DreamStation; 10 night about the same (or better) as the DreamStation
Wakes & Arousals: 4 nights worse than usual compared to the DreamStation; 10 night about the same (or better) as the DreamStation
Feeling on Wake: 3 nights worse than usual compared to the DreamStation; 10 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 18, 2022 10:56 am

Night 14
We have a snow day here in Buffalo, so my college campus is closed. (The main lake effect band is to the south of my house, so we've only picked up maybe 4 inches overnight. But the band is supposed to shift north again this evening and we're still under a lake effect snow warning through Sunday afternoon.)

So I thought I'd get today's report done early before I spend the rest of the day processing pictures taken on the trip to Europe that my husband and I did this past summer.

I feel pretty decent today, but I'll admit that I am procrastinating because I don't want to go out and shovel the bottom of the drive way. I woke up without an alarm at a few minutes before 8:00am feeling ready to get out of bed. And there was not even a hint of aerophagia.

Here's the AirCurve's data as shown in SleepyHead:
Image

Another pretty boring night of xPAP data with a grand total of 3 events flagged---one OA and two CAs. As usual in my data, there are 3 places where I wake up enough to turn the machine off and back on, but 3 of the four xPAP sessions are clearly long enough to represent full sleep cycles. On paper this is a good night of sleep, although again, it's a bit short. I'd like to be getting more like 6 to 6.5 hours of sleep instead of 5.5. But since I'm working on stabilizing my wake up times to be around 8:00 EST, but not getting sleepy until it's pretty close to 2:00 or 3:00, short sleep is what I'm getting right now on a lot of nights. Can't blame that on the machine I'm using.


The FitBit data looks like this:
Image

The most "bothersome" part of the FitBit data is that "double wake" between roughly 6:06 and 6:30. That's a real wake, and I do remember it. I woke up hot and the air in the hose felt over warm and stuffy. I had increased the hose temp from 64F to 66F last night, in part because I had been so cold during the day yesterday. So I thought it might be worth doing the experiment with increasing the hose temp last night. And there was a bit of rainout in the hose as well. And I wanted to turn over, but after turning over, my back got cold since it was no longer next to my warm hubby's side. So there was a lot of finagling with the covers and the hose and my bed pillows all in an effort to rebuild my "robin nest" so that I could get back to sleep.

The wave flow for this period looks like this:
Image

The red boxes are where the FitBit says I was awake. That first box is a very clear wake, which is longer than my usual wakes. But then again, I had a lot that I had to fiddle with at that wake between wanting to get some "fresh air" without the mask blowing at me as well as the bit of rainout and the need to turn over. My best guess is that the spike around 2:23 (near the start of the second FitBit wake) is a real wake where I started rebuilding the robin nest, but zooming in on just that second wake shows a lot of what looks to be normal sleep breathing after after about 2:25. I'm more inclined to trust the wave flow than the FitBit data when they don't agree, so maybe I was managing to snuggle into the recreated robin nest in a light sleep.


There's also one "short" xPAP session in the SleepyHead data (Oscar is still glomming the sessions together and I haven't bothered to see creating a new profile will change that problem yet.). The short xPAP session is the second session and it lasts about 42 minutes. The flow rate for that period looks like this:
Image

The red boxes are where the FItBit says I was awake. The last box is the start of the first "real" wake in the Fit Bit data, the other three red boxes correspond to the three red dots in the Fit Bit data.


Because I'm still procrastinating going out to shovel snow, it's also worth looking at the one OA that was flagged during the night. Here's a super zoomed in view with FitBit "Wake" data boxed in Red and the AirCurve's FOT oscillations boxed in blue:
Image

This sure looks to me like it might be a post-arousal CA that has been mis-flagged as an OA.

Now I gotta go shovel and be thankful I'm not living in the south suburbs of Buffalo since they're still getting pounded by the lake effect storm.

Here is the score card through Night 14:
Aerophagia: 3 nights worse than usual compared to the DreamStation; 11 night about the same (or better) as the DreamStation
Wakes & Arousals: 4 nights worse than usual compared to the DreamStation; 11 night about the same (or better) as the DreamStation
Feeling on Wake: 3 nights worse than usual compared to the DreamStation; 11 nights about the same (or better) as the DreamStation

Note on the heated hose: At 64F, I haven't woken up feeling like the air in the hose was too warm. At 66F, I did. I need to rethink whether to keep the hose at 66 for another night or to just reduce the temp back to 64 or 65.

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Re: Experimenting with a Resmed AirCurve 10

Post by Pugsy » Fri Nov 18, 2022 11:06 am

robysue1 wrote:
Fri Nov 18, 2022 10:56 am
This sure looks to me like it might be a post-arousal CA that has been mis-flagged as an OA.
I agree ....post arousal whatever event.


Been watching the news up your way....thinking about you....take care of yourself and be careful.
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Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Sat Nov 19, 2022 9:15 am

Pugsy wrote:
Fri Nov 18, 2022 11:06 am
Been watching the news up your way....thinking about you....take care of yourself and be careful.
For those who might be interested:

We live in the northern half of the Buffalo, NY metro area---about a mile from the city's northern border. The southern half of the metro area got socked with 3+ feet of lake effect snow yesterday; we had about 4 or 5 inches on the ground when we got up.

The band of snow moved north overnight and right now we've got a foot or more of snow on the ground. The band is just now moving out of our area and further to the north. But it is supposed to wind its way back through here starting sometime between 8-10 pm. The band seems to be slow moving, so we're likely to pick up another 6-12 inches overnight according to the current forecasts.

The really phenomenal snow pictures you may have seen on the news are most likely from south Buffalo and the near southern suburbs as well as the suburbs east of the city out by the airport. Phenomenal snow pictures are likely also coming from the Watertown/Tug Hill area at the eastern end of Lake Ontario, which is not close to Buffalo. But whenever we have lake effect off of Erie, Watertown and Tug Hill are going to get socked with lake effect off of Ontario.

Since its cold (mid 20s F), we're probably not going to shovel until tomorrow when this lake effect storm finally moves out of the metro area entirely and settles for a while in the Souther Tier and ski country before it breaks up.

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Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Sat Nov 19, 2022 11:52 am

Night 15
Another boring night in terms of sleep disordered breathing events, but with more wakes (5 total) than I like to see where I was awake enough to turn the machine off and then back on, but I also don't remember most of them. I'm feeling pretty good this morning, although I really do not want to go out and start the shoveling. Since the band has mostly moved to our north, it would be useful to do some digging out to make tomorrow's digging less onerous.

I woke up rested and ready to get up without an alarm at a few minutes past 8:00 AM. That's good. Really good. The SAD lightbox I use in the mornings is doing a really good job of helping to stabilize my wake up times. Bedtimes are still hit or miss. I'm happy I was sleepy enough to go to bed by 1:10 last night.

At this point, I've gathered the data I needed in order to make an informed choice about whether to have insurance just replace my 6 year old DreamStation with a Resmed AirCurve 10 Vauto. The answer to that is, "Yes" since I am sleeping at least as well subjectively with the AirCurve as I do with the DreamStation.

And so far aerophagia using the AirCurve has been a minimal problem---i.e. since those first 2 nights, it's not been any more of an issue than it's been with the DreamStation the past few years. Over the past few years of using the DreamStation, I have had random nights with significant, painful aerophagia, but those random nights have been few in number and don't cluster together like they once upon a time did. And at this point I think there's reason to believe the AirCurve won't be any worse in terms of random nights of significant, painful aerophagia.

So my new sleep doc has sent a script to a DME that is supposed to sell Resmed machines. I have had some phone tag with the DME prior to the big lake effect snow storm, but I have not yet gotten an actual answer concerning what brand and model of machine they intend to set me up with. I've informed them I will not accept anything other than a Resmed AirCurve 10 Vauto. (One person mentioned the machine might be a Luna, and I vetoed that.) I've also asked the sleep doc to send me a copy of my script; it's supposed to be in the snail mail. For some reason, the patient portal system used by the large neurological practice that includes the sleep doc (and my headache doc and the psychiatrist I used to see pre-pandemic) does not allow doctors (or patients) to attach a pdf to a message. The small practice my PCP uses does allow doctors and patients to attach pdfs, and it really saves a lot of silliness when you need to get the result of a test or you've misplaced the order for blood work that was not urgent.

At any rate, here's the AirCurve data as presented in SleepyHead (Oscar is still glomming individual sessions together.):
Image

And here's the FitBit data:
Image

The two big FitBit wakes correspond to the two longest breaks in the AirCurve data. The first one is a 5-10 minute wake that I really don't remember. The second one, FitBit says I was awake for 19 minutes, but while I remember this wake, I sure didn't think it was that long. My husband got up around 6:30 (that's his usual wake up time these days), but I do remember being restless before he got up.

FitBit says the wake was from 6:30 to 6:49. Here's a zoomed in view of the AirCurve data for the same period:
Image

It's pretty clear from the flow rate graph that I did wake up right around 6:30. And at this scale, it looks like that H that is flagged around 6:48:30 is a likely transition to real sleep that starts up around 6:49. Whether there's any sleep in that short 10-minute long session in the middle is a big question mark, but even if there is some sleep mixed in there, it's not really long enough to have done me much good.

What I suspect happened here is that the "brief" conversation I had with hubby as he was getting up may have been longer than I remember it being. And I also suspect that turning over and rebuilding the robin-nest and getting comfortable enough to get back to sleep also took a bit longer than I remember it taking. All in all, however, it's not a huge issue: I was able to get a final nice full sleep cycle in before waking up for good.

There is, however, another very short 15 minute session of xPAP use between (roughly) 4:45 and 5:00. And a whole series of red Wake dots in the FitBit data at 4:34, 4:43, 4:47, 4:58, 5:16, and 5:31 that are between the 2nd and 3rd "REM" periods. Here's are two edited screen shots of the flow rate data with the FitBit wake times in red boxes:
Image

Even at this level of zooming, it's clear that there is some kind of potential arousal/micro-wake in those red boxes. I don't remember any restlessness during the night, but clearly this hour long stretch is not my best sleep, even though there's only one OA flagged, and it's most likely a post-arousal event. (It's inside the second red box from the right.)

I also left the hose set to 66F last night. Unlike the night before, I don't remember waking up feeling like the air was too warm at any point in the night. After letting the machine do its cool down cycle with the blower gently blowing, there was still a teaspoon or two of water that came out of the hose when I took it off the machine to hang it up today. In spite of this, the rainout is not gathering in a low spot in a way that is triggering hose gurgling. And since my nose is happy and not too wet, I'm continuing to ignore the minor rainout problems. And at any rate, they're no worse than what I've been dealing with on the DreamStation with an unheated hose and the humidifier set to "Classic 5" in a bedroom that is typically around 60F during the night.

Here is the score card through Night 15:
Aerophagia: 3 nights worse than usual compared to the DreamStation; 12 night about the same (or better) as the DreamStation
Wakes & Arousals: 5 nights worse than usual compared to the DreamStation; 11 night about the same (or better) as the DreamStation
Feeling on Wake: 3 nights worse than usual compared to the DreamStation; 12 nights about the same (or better) as the DreamStation

And now I'm going to have some lunch and get ready for a Skype call with my son who is currently living in Equatorial Guinea. :)

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Re: Experimenting with a Resmed AirCurve 10

Post by Dog Slobber » Sat Nov 19, 2022 12:16 pm

robysue1 wrote:
Fri Nov 18, 2022 10:56 am

We have a snow day here in Buffalo, so my college campus is closed. (The main lake effect band is to the south of my house, so we've only picked up maybe 4 inches overnight. But the band is supposed to shift north again this evening and we're still under a lake effect snow warning through Sunday afternoon.)
Image

Omen for tomorrow's game against Cleveland.

You got this Josh!

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Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Sun Nov 20, 2022 11:12 pm

Night 16 EDITED TO CORRECT THE GRAPHS
The experiment continues because I'm still waiting to see what the DME is going to try to set me up with. And I don't want to lose my impressions. But at this point, I've pretty much established that the settings I'm using on the AirCurve 10 VAuto I have on loan from Pugsy are pretty much dialed in, both in terms of therapy and in comfort.

Last night's AHI was higher than it's been, but not high enough for me to worry about. Here's the SleepyHead data:
Image

Yes, there's an obvious, nasty cluster of OAs between 4:45 and 4:54. Close up they look like this:
Image
I see this kind of cluster a few times a month, but it's not a regular enough occurrence for me to worry about. And since I've felt fine today, I'm happy to write this cluster off to a visit from Pugsy's aliens.

There are some comments I do want to make about that cluster. First, the first OA follows what might be an arousal, although if it is, the FitBit missed it. The second thing is that the FitBit says I was in a REM cycle from 4:29:30 to 4:46:30. So if the FitBit's claim that I was in REM is at least partially correct, this might be a REM-related cluster. I'm not sure I believe in FitBit's claim that it can identify REM sleep with some degree of accuracy, and this cluster starts 45 minutes after the last time I woke up enough to turn the machine off and back on. Clearly, if I had a higher max IPAP, the machine would have increased the pressure some. (And on the DreamStation, the EPAP would have increased to 6 while the IPAP would probably have already been at 9cm since on a PR machine, the PS is not fixed.)

But I'm not ready to increase my max IPAP to 10 just so EPAP could increase to 6 during a cluster like this for fear that I'll have problems with aerophagia: The Resmed machines respond aggressively to flow limitations and I know from experimenting with my PR machine that my flow limitations do not always get "better" with additional pressure---i.e. when I've increased Max IPAP on the DreamStation, my 95% IPAP pressure increases to whatever max I've set (up to about 11 or 12 cm) and the aerophagia gets worse. And the AHI's are not any better with max IPAP = 10 (or higher) than they are with max IPAP = 9.

As for the second cluster of OAs that were flagged around 5:20? They're pretty clearly SWJ or transitional stuff since I turned the machine off and back on right before that cluster of 3 events happened. HERE IS THE CORRECT GRAPH:
Image

In terms of wakes, this was a pretty restless night---worse than usual in terms of the number of times I was awake enough to turn the machine off and back on. I fortunately don't remember all those wakes. I do remember waking up with a very dry mouth once or twice, and even thinking about getting up and going to get a drink of water. (In fact I may even have done that once.) I also do remember waking up feeling like the air in the hose was too warm---it's still set at 64F. And at least once, I thought I might be hearing some rainout gurgling in my mask (not the hose).

When I went to hang the hose after the "cool down" period was over, I got what is becoming the standard 1.5 teaspoons of water coming out of the hose when I unplug it from the machine. With the DreamStation, lifting the hose made that 1.5 teaspoons or so of water flow right back into the humidifier. This is not a deal breaker for the AirCurve, but I do think that Resmed's choice of where to put the hose attachment on the machine and how to route the air from the blower over the humidifier and on to the hose is a situation where "function" lost out to "fashion"---i.e. Resmed may be trying a bit too hard to make the machine look "cool" and non-medicinal.

I'm also thinking about trying to use the "mask fit" feature to see if that will dry the hose out better than the cool down cycle does.

I'm planning on leaving the temp at 66 for one or two more nights. Since I now have a hose elbow connector, I may just go back to the unheated hose and see if that's better than it was when I was attaching the hose directly to the machine's back.


Here is the score card through Night 16:
Aerophagia: 3 nights worse than usual compared to the DreamStation; 13 night about the same (or better) as the DreamStation
Wakes & Arousals: 6 nights worse than usual compared to the DreamStation; 11 night about the same (or better) as the DreamStation
Feeling on Wake: 3 nights worse than usual compared to the DreamStation; 13 nights about the same (or better) as the DreamStation

_________________
Machine: DreamStation BiPAP® Auto Machine
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Also use a P10 mask
Joined as robysue on 9/18/10. Forgot my password & the email I used was on a machine that has long since died & gone to computer heaven.

Correct number of posts is 7250 as robysue + what I have as robysue1

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robysue1
Posts: 554
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Location: Buffalo, NY

Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Mon Nov 21, 2022 10:57 pm

Night 17
The daily AirCurve 10 Vauto data is once again boring, except for the number of wakes, which is, alas, sort of standard for me:
Image

The FitBit data seems to confirm that there were a fair number of wakes and microwakes/arousals that were "big enough" for the FitBit to pick up on:
Image

There is a family matter concerning my alcoholic cousin who is living with us that may be getting ready to blow up. And I think that may be driving the wakes/restlessness that the FitBit is picking up. In going through the flow rate data to see if those FitBit red dots correlate with stuff that looks like arousals, the answer is most of them do. (I think there was one red FitBit dot that I could not identify what it might be associated with in terms of the flow rate.

While I felt reasonably fine when I woke up this morning, I also felt a little a bit tired and sleepy during the afternoon. That's probably the fact that I've not been getting quite enough sleep for a while now. I do best if I am managing to get at about 6-6.5 hours of sleep each night. I also do best when the FitBit sleep efficiency is much closer to 90% than 85%, like this night was.

I did wake up feeling like the air coming through the hose was too warm and stuffy at one point. So for tonight I've lowered the temp back down to 64F.

Here is the score card through Night 17:
Aerophagia: 3 nights worse than usual compared to the DreamStation; 14 night about the same (or better) as the DreamStation
Wakes & Arousals: 6 nights worse than usual compared to the DreamStation; 12 night about the same (or better) as the DreamStation
Feeling on Wake: 3 nights worse than usual compared to the DreamStation; 14 nights about the same (or better) as the DreamStation

_________________
Machine: DreamStation BiPAP® Auto Machine
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Also use a P10 mask
Joined as robysue on 9/18/10. Forgot my password & the email I used was on a machine that has long since died & gone to computer heaven.

Correct number of posts is 7250 as robysue + what I have as robysue1

Profile pic: Frozen Niagara Falls

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Posts: 554
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Location: Buffalo, NY

Re: Experimenting with a Resmed AirCurve 10

Post by robysue1 » Tue Nov 22, 2022 11:21 pm

Night 18
Last night was not a particularly good night, but it's not fair to blame it on the AirCurve. There's a significant problem brewing at home with my alcoholic cousin who has clearly started drinking again after several months on the wagon. She's hiding the booze by drinking while sitting in her car in our driveway supposedly smoking and talking on the phone to her Arkansas family & friends. And she's wasting gas running the car while she doing the drinking, the smoking, and the yakking.

I had started to suspect that she'd fallen off the wagon about a week or so ago. Hubby and I uncovered the evidence that she's drinking again during the big snowstorm when we dug her car out in order to move it so we could shovel some stuff more completely: There was a half glass of whiskey sitting in the cup holder. Since then, hubby has found (and dumped) whiskey in the water she keeps in the car, I've found beer in the water bottle (twice), and tonight I found a half-empty pint of whiskey in a bag she keeps in the car. We're currently pouring the booze out when we find it waiting for her to either figure out that we are onto her and admit she's drinking or we figure out when and how we want to confront her after Thanksgiving. We'd kick her out of the house, but then she'd be homeless and she'd probably head back to Arkansas and as a consequence lose her NY Medicaid, which is a far sight better than what she could get in Arkansas. And yes, she has multiple health conditions in addition to the alcohol problems. On the other hand, if/when she gets angry at me after a confrontation and decides on her own to move back to Arkansas, I ain't going to stop her. I just don't want to feel responsible for making her homeless by kicking her out of the only place she currently can live over Thanksgiving.

Last night, just as I was getting ready to head to bed, my cousin came downstairs (drunk) and started talking to me again about a contract nursing job that failed to materialize because of a snafu that the travel company should have informed her about. She was understandably extremely angry and upset, but it was my bedtime and I really did not want to have to talk all night with her about it. So I listened briefly and told her I really needed to get to bed and that she needed to call her outpatient alcohol counselor to set up a meeting to talk about the job falling through, her anger, and how this would put her at risk of falling off the wagon. Cousin lied and said she was on the wagon and that she wasn't worried about this latest crisis triggering a desire to drink. At that point, my husband got back up (early) for his usual middle of the night wakeful period and I told both of them I really had to go to bed because I was starting to yawn uncontrollably.

So the net result is that I had a rough night from worrying about my cousin and worrying (excessively) about how and when the confrontation is going to come and how to make it happen on my terms not hers. And as a consequence, I had a fair number of wakes last night.

Here's the AirCurve's data:
Image

And here's the FitBit data:
Image

While I managed to get some decent sleep at the beginning of the night (after a false start caused by mask problems), from about 3:30 on, I was restless: Two major wakes (the FitBit shows two groups of two wakes each) and there's evidence of some arousals that the FitBit didn't pick up as well as all those red dots in the FitBit data corresponding to things that look like wakes/arousals. And of course, there are the events scored near the end of the night, but in correlating the FitBit data with the AirCurve data, it's pretty clear that most of them occurred during SWJ periods.

I woke up with a severe backache for some reason and did not feel rested at all. While the back did start to feel better when I did some significant work taking care of my collection of plants in my florida room, my mood really didn't improve at all: My mood has been pretty sour today, but that's because of the situation going on with my cousin. And between the sour mood and the restless it's not been a good day.

I did, however, have the energy to make the cornbread for Thanksgiving dinner's "dressing" (stuffing to those of you who didn't grow up in the South) and I also made the homemade (mock) mincemeat for the mincemeat pie I will make for Thanksgiving. Mincemeat is my favorite pie and it's become very hard to find a kind of bought mincemeat that I like since all I can find these days are jarred mincemeat, instead of the boxed stuff my mother used that you added water to and then cooked on the stove.

I did turn the hose down to 64F last night. There was a bit more of a rainout problem and a more like 2 tsp of water in the hose when I disconnected it from the machine this morning. I am planning on swapping the heated hose out for an unheated one now that I have the proper elbow to connect a slimline hose to the machine more securely. It will be interesting to see if the elbow allows the slimline hose to rotate.

Here is the score card through Night 18:
Aerophagia: 3 nights worse than usual compared to the DreamStation; 15 night about the same (or better) as the DreamStation
Wakes & Arousals: 7 nights worse than usual compared to the DreamStation; 12 night about the same (or better) as the DreamStation
Feeling on Wake: 4 nights worse than usual compared to the DreamStation; 14 nights about the same (or better) as the DreamStation

_________________
Machine: DreamStation BiPAP® Auto Machine
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Also use a P10 mask
Joined as robysue on 9/18/10. Forgot my password & the email I used was on a machine that has long since died & gone to computer heaven.

Correct number of posts is 7250 as robysue + what I have as robysue1

Profile pic: Frozen Niagara Falls

lynninnj
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Joined: Mon Jul 25, 2022 8:56 am

Re: Experimenting with a Resmed AirCurve 10

Post by lynninnj » Wed Nov 23, 2022 1:39 pm

Robysue, I am sorry you are in a position to deal with this. The generosity of you and your husband to allow her into your home is very special.

I have been where you were at. I hope you don’t mind my off-topic sharing, but for you, may I suggest an Al-Anon meeting (different than AA in that it provides comfort and help for those dealing with alcoholics including some who are alcoholic themselves but not always). https://al-anon.org/al-anon-meetings/fi ... n-meeting/

I believe there are online meetings for both AA and Al-Anon. first and foremost, taking care of you, you would probably benefit from a meeting.

you might even want to insist that your cousin go to a meeting at the very least online.

At the end of the day you would not be forcing her to leave. You would be making a decision for yourself and your husband. And you would be putting the choice on her whether or not she wanted to remain or regain her sobriety, or whether she wants to go or she can do whatever she wants somewhere else.

It has to be HER choice to get help, to drink, to not drink, and where she wants to live with her complex health issues.

The only thing you can do is remind her she has choices and that if she continues to drink (just call her on it so there’s no reason pussyfooting) she will have to do it elsewhere. And if she chooses to stay direct her to online or in person AA meetings.

sorry if I have overstepped my bounds in anyway, but I have been where you were at in a slightly different situation so I get it. Good luck.

_________________
Machine: AirSense 11 Autoset
Mask: ResMed AirFit N30 Nasal CPAP Mask with Headgear
Additional Comments: Newbie who loves her machine!
Spare me the nitpicking. I have a serious health issue and I came here to learn to manage it by managing my OSA. Move along if you can’t be kind.