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I have been on CPAP since Fall 2010. My first machine is my avatar, a PRS1 Pro. I have been proactive in my treatment, and CPAP has helped immensely. But now with the recall, I have a well used ResMed AirSense 10 Autoset and I’m trying to find the right range and see if I can get used to pressure changes. CPAP didn’t fall right into place, and I assume this won’t either. Hence this thread as I seek advice.

My first night was not great (for me) AHI just over 1, and I’m not feeling refreshed. Not totally out of line, but about twice my average compared to when I’ve got straight CPAP & leaks well tuned for success.

I’m starting with 8-11 cm pressure as a range, and “Soft” response set (I’m guessing that “For Her” would be better for me, but it isn’t on this machine). Here are a few OSCAR screenshots:

What were your settings on the machine you were using before this one?

What were your settings on the machine you were using before this one?

PRS1 “Pro” 460 straight CPAP at 10.0 cm pressure, no CFLEX, no ramp. Bleep mask, standard hose. 3M micropore taped mouth. Bio filter attached at hose in case of bits of foam. Here is the overview (2 weeks) with 13 nights on PRS1 CPAP, and the last night on ResMed APAP:

Second night on ResMed AirSense 10 Autoset (8-11cm, “soft”, no EPR, standard hose, Bleep mask, 3M micropore taped mouth). AHI now up to 1.27 (wrong direction! - remember I can average <0.5 AHI if I’m paying attention). This time I put my CMS D50+ oximeter on (up to 2am, then took it off for the night when I got up for the bathroom). I see the worst SpO2 level (90%) was during an unmarked event early in the evening, during a time of no leaks. Not sure why the machine didn’t at least call it an hypopnea!
Still not feeling refreshed, but better than last night.

It seems to me that the AutoSet is not being proactive during the lousy wave forms. I know I have it set to “soft response” to reduce disturbances, but still I would have thought it could be proactive. Would a “For Her” model be more responsive? On my old CPAP machine it would not record FL, but I did have RERAs so I’ve assumed the “For Her” algorithm would be best for me.

Any advice welcomed.

The soft vs standard choice is just for the transition between inhale and exhale if I remember correctly. It has nothing to do with the auto adjusting algorithm inner workings.

Hyponeas have specific definitions and if you see a reduction in air flow and no hyponea flag then the reduction didn't meet criteria for the flag. There has to be a certain amount of reduction and it has to last at least 10 seconds to earn a flag.
So either not enough reduction in air flow or didn't last 10 seconds...or both.
Your zoomed in flow rate without a flag...I suspect the air flow reduction was NOT enough to earn a flag...has to be at least 40/50% (different brands have different minimum reduction and I don't remember which gets 40 and which gets 50) for hyponea.


Add in a bit of EPR to see if it helps with your Flow Limitations a bit. You may or may not need to increase your minimum pressure a bit to compensate for the drop during exhale when using EPR.

And remember just because we talk about Resmed's more responsive auto algorithm doesn't mean it changes in the blink of an eye and the minimum pressure is still the most critical setting to think about...and everyone is different anyway.

If it were me going from Respironics 10 cm fixed with Flex and I wanted to go to auto mode....I would start with minimum of 9 and EPR at 3 and see what happens....and take a big dose of the patience pill because you are essentially self titrating and need to give things some time for your body to adjust.

Quit worrying about the AHI numbers varying slightly..that's going to happen no matter what even once you get things dialed in but right now your are in the dialing in process.
Besides an increase to 1.5 AHI isn't the end of the world....the one flagged zoomed in OA you posted...looks like you weren't asleep when that got flagged. I would call it SWJ sleep/wake/junk and all it means is you aren't asleep.
If you aren't asleep the flagged events don't count.
Your reduction in air flow that you thought should have hyponea flag...I think that is just some shallow breathing and you were probably awake during that as well. Hard to tell for sure because can't see enough of the flow rate going on prior to the reduction.

I would expect more awakenings for a bit while you are getting used to the Resmed.
It's a lot like learning to dance with a different partner.
IMO, a better "dancer".

chunkyfrog wrote: ↑

Thu Jul 29, 2021 11:05 am

I would expect more awakenings for a bit while you are getting used to the Resmed.
It's a lot like learning to dance with a different partner.
IMO, a better "dancer".

Per forum log in history....OP has NOT been back at all to see any of the responses.
So we don't know if they got it sorted out or not or maybe got lost and couldn't figure out how to get back here.
Heck, maybe 5 minutes after posting the question they got it all sorted out and didn't want to bother coming back.
Maybe something so simple they were embarrassed to admit it.

We just don't know when people don't come back why they don't come back.
Now sometimes I see they have been back but didn't post...but in this situation the last time the OP was here was with the original post and that's it. So unless using a read only app where logging in isn't needed...OP hasn't read any responses.
Certainly hasn't logged in.

Pugsy wrote: ↑

Thu Jul 29, 2021 11:23 am

Certainly hasn't logged in.

um, it's only been five hours.

perhaps s/he's one of those poor unfortunates that have to work for a living?

zonker wrote: ↑

Thu Jul 29, 2021 11:27 am

Pugsy wrote: ↑

Thu Jul 29, 2021 11:23 am

Certainly hasn't logged in.

um, it's only been five hours.

perhaps s/he's one of those poor unfortunates that have to work for a living?

That is certainly true but if I was ready for bed and I couldn't get my machine to work and I had to post on a forum about what I could do...I wouldn't be going to bed until I at least checked to see if there were any responses.
I wouldn't immediately log out without checking. The post got approved by me almost immediately after it was posted and the OP would received a private email notice that the post was approved. It's not like I didn't approve it until this morning.
I was online when the OP was online last night and the post was approved within a couple of minutes of it being posted.
New account posts always get a private email that their post was approved. It's part of what I do when I approve an new account first post.

Now spammers...I don't bother with private emails notifying them that their post was disapproved and they are banned...I figure they already know why their post doesn't show up and their account is blocked.

Yep, "Get that skunk out of our kitchen!"

Hi all,
Thanks for your concern that I dropped off the face of the planet during the last few hours. I am, as was guessed above, a working person and it is only just now 5:05pm where I am.

I very much appreciate the advice. I’ll reflect on that later tonight before I get to bed. I am deeply grateful. Perhaps one of the most reassuring pieces of advice is to remember it isn’t an instant thing, and my AHI isn’t a horrible thing either.

Please don’t worry - I am here. I’m going to sign off to heat up some dinner and get to my evening activities out in the community (yeah reopening … though back to masks on!). CPAP (now APAP) has kept me going and I have the stamina to do after-dinner events without falling asleep (at the event, or on the drive home)!

- SleepyCPAP (he, by the way)

Ooops...big screw up folks...I think we got confused as to who we were talking about and it only being 5 hours since posting.
The 5 hour person was the person who said they got a brand new machine and it wouldn't turn on and wanted "want to do" and somehow or other that discussion got into this thread.
I had a brain fart..and I wasn't the only one.
Big screw up all around...no wonder SleepyCPAP was confused. We messed up. We are human and we do make mistakes.

Pugsy wrote: ↑

Thu Jul 29, 2021 4:18 pm

Ooops...big screw up folks...I think we got confused as to who we were talking about and it only being 5 hours since posting.
The 5 hour person was the person who said they got a brand new machine and it wouldn't turn on and wanted "want to do" and somehow or other that discussion got into this thread.
I had a brain fart..and I wasn't the only one.
Big screw up all around...no wonder SleepyCPAP was confused. We messed up. We are human and we do make mistakes.

OK, so it wasn’t me and my thread. Oops.

I looked at the advice, and the whole-night screen shots. First I’m taking a deep breath and agreeing I don’t have to be rushed about getting APAP perfect “this instant” and get my AHI back down. What Pugsy said about the unmarked shallow breathing being likely while I was still awake gives me an insight. My breathing during that initial 17 minutes (both nights) kicks up the pressure. I’m used to starting bedtime at full-blast (no flex, no ramp) 10 or 10.5cm (on my travel machine I set it slightly off so I can see those nights it in the overview). My body _wants_ to be under full pressure as I drift off to sleep, and I’m guessing it messes up. It may do that for days.

It isn’t that I haven’t dealt with this low starting pressure before… but it was way back in the days I was trying the AutoIQ (AutoTrial) feature, maybe three days to a week now and then. In 2015 I tried it 7-11cm, and then the machine went back into single pressure mode at 8.5cm (CPAP-check slow float mode). I think my body just needs to relearn lower pressure falling asleep. Lower pressure later in the night seems to work for long stretches, as long as I’m asleep.

I went to set up ramp, to see if it could be set to 10cm. Nope - it won’t let ramp be over my minimum. So I turned ramp off again.
That would be so cool though - have ramp start strong, and then go to lower pressures when I’m asleep.

That means I have to change, since the machine won’t. I may try drifting off to sleep on my side. It has been a while, and not just because air gets in my belly that way (I’ve become mostly a back sleeper from my Swift FX days when I was really trying to keep the head gear steady so the pillows wouldn’t slide off my nose).

Pugsy, I won’t try EPR just yet. I didn’t use c-flex (my PRS1 felt like it was trying to make me breath on it’s own pattern, too annoying). I’m used to exhaling against full pressure. Later, after I’m used to this new machine, I’d like to try it, as the ResMed relief system is different and might work for me. In my sleep study the tech said it really helped my breathing when I was asleep - but I’ve gone nearly 11 years since without it.

Yes, Chunkyfrog, this machine is definitely a new dance partner. I think it will be worth learning the moves.

I’ll report tomorrow morning before work. Good night all.

Good morning all,

This will be a rushed update, as I am doing during my 9:00-5:00.

Last night was not a good night. I woke to use the bathroom and could not get back to sleep. Tried for at least an hour, then stayed up for hours, then finally felt ready for bed and slept a little more.

My oximeter would only download the first 20 minutes of the evening. It was recording all night (blinking light) but not giving me the data when I put it in OSCAR. That was a waste of a mashed fingertip.

We’ll see how I function today. Ugh.