Did I make a Mistake with Air Sense 10 for Her?

Good morning: Thank you EMK for your comment. Unfortunately after 2 hours of "struggling" with my new machine, Air Sense 10 For Her, I had to switch machines in the middle of the night to the S-9 and that worked perfectly. I was having breathing (lungs) problems with the Air Sense 10 as stated previously. On my S-9 I never had a ramp and never had problems with it going straight to 11. I took it off FOR HER, and it was on AUTOSET. I think also the humidity was set too high on the Air Sense 10, so I turned it down to 70, with 1 as the setting and I still had breathing problems. I don't know what the problem is. Also, is there a way to keep the climate line hose connected and is there a setting to turn the humidity OFF? And do I still need to have water in the humidifier if I turn the humidifier to off? I just felt like I was suffocating last night and won't try this machine again until the weekend. It is purchased and non-returnable because it is opened. I feel terrible because this was a very expensive birthday present to me.

I agree with palerider, you need to set up the new machine with the *same exact settings* as the old machine so you can compare apples to apples. If the S9 was running at straight pressure of 11, you need to start using the AirSense at a straight pressure of 11, not Auto 11-20, and not AutoSet for Her. Same humidity/heated hose settings, same EPR, everything, so you can start teasing out what it is about the new machine that's different for you. One or two bad nights do not mean that this was a mistake any more than one or two bad nights when you first started meant that Cpap wasn't for you.

The only time I've felt I had trouble breathing with the same machine is when I had ramp on with the starting pressure at 4 which was too low. I felt like I was smothering. But I've never felt like I could not get in synch with the EPR or like I had to breathe quickly to match it. The EPR has always seemed to follow my breathing cycle so naturally that I am not aware of it. Right now my summer settings are tube temp 80 and humidity level 1. You can turn your humidity to zero. I would think you wouldn't need water in the tank then. You can use the climateline hose even with the humidity off.

I had thought that the regular APAP mode was the same in the S9 and the Airsense 10. Since this is a brand new machine that came straight to you, could you double check everything such as the filter? Is there any chance there's still protective tape over something?

Thank you EmmaGoldman and others. I had to turn the EPR down to a "1" from a 3 which I use on the S-9. A "3" EPR on the Air Sense machine made me breath in and out too quickly and too shallow. Yet, it works perfect on the S-9 machine for me. No chemical sensitivities, same mask. The humidity did seem too humid for me at 70 and 1. Is there a way to turn the humidifier off? And if I do, do I leave the water in the humidifier or take it out?

YES, I believe the exhalation is too strong for me on this machine, too fast?. I don't need the ramp which I never used. I was in bed (horizontally) for 2.5 hours struggling with the breathing and had to disconnect the machine and go back to the S-9 and then fell asleep right away. I need help because I cannot take back the Air Sense machine online. It's been opened. Any way to turn off the humidifier even though I have the climate line hose? I did see the filter in there, AMK. Good suggestion. I didn't see protective tape. And this is not straight pressure actually, the auto set is from 11-20 and starts out at 11 just like the S-9 machine. Thanks so much for any help.

Since this is a machine that most of us who own it are using with great success, if I were you I would take the machine to my sleep nurse and ask her to examine it. There is no reason you should have an expensive, top of the line machine that is acting as oddly as you describe. Without being able to get our hands on the machine ourselves, I am not sure how much more help we can offer here. Yes, you can turn the humidity off by just turning it one more turn counterclockwise in the setting, from 1 to off. A humidity of 1, however, should not cause the types of breathing issues that you are describing. The EPR should be following your own natural breathing, not forcing you to breathe quickly and shallowly.

Thanks AMK: Again unfortunately, I did not go through my insurance or a provider or a sleep nurse. My boyfriend bought it off online and I can't ask them of course. They are just a medical supply house of CPAP machines/hoses, etc. My insurance would not cover it. It is a very strange issue and frustrating issue and to the point where I had to disconnect it last night and install my S-9 in the middle of the night after struggling (breathing) with the Air Sense for 2.5 hours. I will try again on the weekend when it would not be as bad for me to lose all this sleep. I will try readjusting the humidifier to OFF on the weekend and see if that does anything, but I doubt it? I can't imagine that this machine is broke? The Sleep Hours did state 0 on it when I received it, so it was brand new. Hmm, very frustrating that BF paid so much for this machine and I have no recourse now? Thank you for your help. If anyone else has any other ideas, please let me know. Thank you very much. One last question, if I turn the humidifier off, do I still need to fill the chamber with distilled water?

Do you have a medical professional who treats your apnea? I know that my nurse would be willing to look over a machine that I paid for that wasn't working for me. It doesn't matter who paid for my equipment to my treatment providers.

I would think that you would not need to put water in the humidifier if it was set to zero but it's not something I have specifically looked up.

You really need to get sleepyhead downloaded and lost some of the graphs so we can try to see what is going on, but it would not surprise me if your unit is defective, and if so the online seller should be more than happy to do an exchange.

TASmart wrote:You really need to get sleepyhead downloaded and lost some of the graphs so we can try to see what is going on, but it would not surprise me if your unit is defective, and if so the online seller should be more than happy to do an exchange.

That's a good idea. If the unit was used for 2.5 hours last night, then that's 2.5 hours of data that could be shared here.

I didn't realize SleepyHead can be useful when you are just lying there not sleeping at all? I was wide awake for 2.5 hours struggling to breath both inhaling and exhaling (as I had the same problem at my kitchen table as well) and then I finally "pitched" it at 12 midnight and put it away and took out the S-9. I thought Sleepyhead was only when sleeping? Also, the cpap internet company will not exchange it as they said it is already opened now and they could write out a requisition for me but most likely they will send it right back and I will have to pay the postage of course they said. I asked where my 2-year warrantee card is too. I asked to speak with a supervisor, so hopefully somebody intelligent will call me back. Does this sound like a defective machine or just something I have to get used to? Can this machine be defective?

A pic of your Sleepyhead would give the people here info that might be helpful, yes.

emmagoldman44 wrote:Hi Luthie,
I am a Autoset 10 user and will be getting a "for Her" version in a few days, so I will be sure to report in to you.

One question I have is, do you have any chemical sensitivities at all? If you are now using a new machine esp w new hosing, the plastic offgassing could be irritating your lungs??

I would suggest you try it again while horizontal and relaxed, and pay special attention to whether you are experiencing interference with your inhalation or your exhalation. I know this is different from what you are going through, but just as an example, I realized when I really tuned in to why I was having problems with the Dreamstation, it was because it was interfering with my exhalation due to the "pressure pulses" being too strong.

If settings of EPR3 worked for you on your old machine but now you feel like it interferes w your exhalation too much, well there must be something different about the actual pressure that you are getting, I would think (mask & tubing being the same). Do old CPAPs lose their umph?? Anyone know? Or is it an all or nothing thing, like either it works at the pressure or it doesnt. I don't know.

Is there a reason you are not supposed to use the ramp feature? Sounds like you could benefit from that - unless your medical professionals had a good reason to tell you "no ramp". It is worth asking.

I wanted to try and help a few different ways if possible. I'm actually a DME Respiratory therapist and commonly catch these questions. My initial reaction as to why Luthie feels different is that the claim of the "for her" machine, is that it hosts a different, more sensitive algorithm for women. This can be understood by the way the machine responds. Honestly speaking, and I don't mean to be discouraging, from a respiratory and home care stand point, we kind of think this is a bogus selling point instituted to drive revenue for companies like ResMed. My reasoning for this is, the sleep labs do not have a "for her" algorithm when they are testing people's airways. They simply do it. First night polysomnogram shows need. Second night titration finds what pressure best corrects the AHI. Pressure is pressure. You may not need as much as a male, or another female, but you still need it. A second reason I don't set my female patient's up on "for her" machines goes back to the clinical setting yet again. If this separate algorithm, or way of adjustment was so needed, we would see it in hospital settings on BiPAPs, NIVs and Ventilation, but we do not. It is non-existent in the clinical setting.

My suggestion would be to keep the machine, as the airsense 10 machine is a good high quality machine, but I would absolutely take it off of "for her settings" and change the settings back to the general auto prescription. I would then match it to your S9 in every way with the exception of the humidity as the Air10 options are different.

To answer your question, absolutely machine pressures can vary and fail. It's not common but it does happen. The CPAPs and BiPAPs are driven by electronic fan motors. So as they lose power, go through normal wear and tear, the motors can sometimes fail, be failing or not blow hard enough. You're local DME/HME CPAP provder should be able to test this for free. The prescription pressure of the machine must blow with in + or - 1cmH2O from the prescription pressure. Anything above or below this amount would be considered, need for repair, warranty etc.

Hope this helps! Sorry for the long response.

Luthie2006 wrote: I know Chicago Granny mentioned why get another one if the old one works?

Egad! I jinxed you! The AirSense 10 should work fine. So please, forget I ever said that. (Did I really say that?)

Luthie2006 wrote:making my breathing fast and shallow

Usually when this happens, it's "all in the mind". A CPAP machine, even with EPR, does not determine the rate and depth of your breathing. The machine only responds to how you are breathing. Try to do something with your mind for distraction. Think of some pleasant, quiet activity that you enjoy. Get your mind totally off breathing. You can breathe without thinking about it.

There is always a small chance that something is wrong with the machine or the settings are not the same as you are used to.

Finally, don't use the machine in the kitchen!

Luthie2006 wrote:Good morning: Thank you EMK for your comment. Unfortunately after 2 hours of "struggling" with my new machine, Air Sense 10 For Her, I had to switch machines in the middle of the night to the S-9 and that worked perfectly. I was having breathing (lungs) problems with the Air Sense 10 as stated previously. On my S-9 I never had a ramp and never had problems with it going straight to 11. I took it off FOR HER, and it was on AUTOSET. I think also the humidity was set too high on the Air Sense 10, so I turned it down to 70, with 1 as the setting and I still had breathing problems. I don't know what the problem is. Also, is there a way to keep the climate line hose connected and is there a setting to turn the humidity OFF? And do I still need to have water in the humidifier if I turn the humidifier to off? I just felt like I was suffocating last night and won't try this machine again until the weekend. It is purchased and non-returnable because it is opened. I feel terrible because this was a very expensive birthday present to me.

I still believe it would be worth matching exactly to your S9 machine. It's worth understand that a new model may feel different form a previous model due to a change in design and algorithms. If you have access to the clinical menu, I would change the ramp starting pressure to what you were used to starting at previously. 11. I would leave the auto prescription however. Next, in the patient mode, I would adjust the ramp time to "auto". This will allow you to start at the prescription pressure you're familiar with, still correct for AHI, but will not begin fluctuating within the auto range until the machine recognizes and airway obstruction. That's the perk of the auto-ramp and I use it constantly with my patients.

Secondly, I wanted to mention that the humidity setting on the new AirSense can be extremely confusing but that it was a good catch wondering if the heat was making it more difficult. Since the new machine has a wider range along with the auto-humidity settings, many patients tend to apply too much humidity or at least have a difficulty finding the sweet spot. Look at your S9 range. Find what number you are on and consider it's place within the range. EXAMPLE: 1-5 range. If you are on 3. Your place would be the "middle" humidity. On your Airsense the middle then would be around 4 because the range is 1-8. Now, with all that being said, what I commonly do with my patients is start off or on 1. Tell them to sleep with it and when they wake up the next day, ask themselves, "do I feel dry or was the humidity too much?" Based on how they feel, go up or down one at a time, each day until they hit the sweet spot. This is to keep people from overshooting or undershooting where their humidity should be. I also want to mention, this sweet spot changes with the seasons.

Lastly, NO, you do not have to use the humidifier, and if you turn it off, you do not have to fill it with water, but you can. To turn off the humidity, simply use your round knob on the front. Highlight, "my options". Select it. If humidity says "auto". Select it and switch to manual. Click to save. Then you can manually adjust your humidity. If you are already in manual mode and your "humidity level" just shows a number, then all you have to do to turn it off is to turn humidity to zero. If you do this, it is wise to also turn your heated tubing temperature off if you have heated tubing. If you do not, it will not give you the option. Don't over think the heated tube temp. If you're using it, set it to the around room temp. Remember this simple thought process. Cold tube means condensation. So if you have water in your tube, its too cold. Needs to be slightly warmer. Adjust up or down a few degrees each night depending on the need just like the humidity number. If no water, no need to mess with it, But again, if humidity is off, no need for it.

Sorry the response is so long. Hope it helps!

ArkansasLRCP wrote:

emmagoldman44 wrote:Hi Luthie,
I am a Autoset 10 user and will be getting a "for Her" version in a few days, so I will be sure to report in to you.

One question I have is, do you have any chemical sensitivities at all? If you are now using a new machine esp w new hosing, the plastic offgassing could be irritating your lungs??

I would suggest you try it again while horizontal and relaxed, and pay special attention to whether you are experiencing interference with your inhalation or your exhalation. I know this is different from what you are going through, but just as an example, I realized when I really tuned in to why I was having problems with the Dreamstation, it was because it was interfering with my exhalation due to the "pressure pulses" being too strong.

If settings of EPR3 worked for you on your old machine but now you feel like it interferes w your exhalation too much, well there must be something different about the actual pressure that you are getting, I would think (mask & tubing being the same). Do old CPAPs lose their umph?? Anyone know? Or is it an all or nothing thing, like either it works at the pressure or it doesnt. I don't know.

Is there a reason you are not supposed to use the ramp feature? Sounds like you could benefit from that - unless your medical professionals had a good reason to tell you "no ramp". It is worth asking.

I wanted to try and help a few different ways if possible. I'm actually a DME Respiratory therapist and commonly catch these questions. My initial reaction as to why Luthie feels different is that the claim of the "for her" machine, is that it hosts a different, more sensitive algorithm for women. This can be understood by the way the machine responds. Honestly speaking, and I don't mean to be discouraging, from a respiratory and home care stand point, we kind of think this is a bogus selling point instituted to drive revenue for companies like ResMed. My reasoning for this is, the sleep labs do not have a "for her" algorithm when they are testing people's airways. They simply do it. First night polysomnogram shows need. Second night titration finds what pressure best corrects the AHI. Pressure is pressure. You may not need as much as a male, or another female, but you still need it. A second reason I don't set my female patient's up on "for her" machines goes back to the clinical setting yet again. If this separate algorithm, or way of adjustment was so needed, we would see it in hospital settings on BiPAPs, NIVs and Ventilation, but we do not. It is non-existent in the clinical setting.

My suggestion would be to keep the machine, as the airsense 10 machine is a good high quality machine, but I would absolutely take it off of "for her settings" and change the settings back to the general auto prescription. I would then match it to your S9 in every way with the exception of the humidity as the Air10 options are different..

Your "expertise" isn't really wanted here.