Higher AHI and Leaks with replacement AirSense 11

I have used the Airsense 10 for 6 years. Recently, I was prescribed an Airsense 11 replacement (5 years and some pulsing issues). I have used the Airfit F20 FFM all this time. I tried other masks but with little success. My pressure has always been min 12 max 18 (cmH2O). My new pulmonologist wanted me to change to 6 -18. Lower min pressure did not work well so reset Min 12 Pressure EPR 3.

I use the Mask fit on donning the mask. I cannot hear air leaks with hearing aids off so they do not wake me up if the occur. I have never felt tired in the mornings, but I do now -sometimes. All Mask off are generally bathroom breaks (82 yrs old)

Link to Screenshots
https://imgur.com/a/wrETq9B

(1) Old AirSense 10 graph AHI 0.47 minimal leaks
(2) New AS11 first night at min 12 pressure
(3) Unexplained excessive leak
(4) Unexplained excessive leak
(5) Tried resetting to Min 10 EPR 2

Question [1]: At what pressure does the AirSense 11 lose therapy effectiveness? (Are these leaks making my therapy ineffective?)
Question [2]: Any thoughts on why the AirSense 11 is detecting more events? Was the AS10 defective?
Question [3] What is the pressure range for the built in Mask Fit on the AS 11? (Mask checks lying down are good, but often immediately experience substantial leaks in therapy ... without my hearing them even while still awake)
..

On 5/16, the leaks are very steady. I suspect your humidifier tank is not seated well. This is a known issue with the AirSense 11. In order to prevent air leaks from the tank, care must be taken to properly seat the tank.

Eddy wrote: ↑

Sat May 27, 2023 1:12 pm

Question [1]: At what pressure does the AirSense 11 lose therapy effectiveness? (Are these leaks making my therapy ineffective?)

It depends on what the individual's pressure needs are. According to the manufacturer, the machine can compensate for leaks up to 24 lpm. Most members here agree with that.

Above 24 lpm leak, the data the machine reports is suspect.

Make sure the humidifier tank is well seated and report back if that doesn't solve the problem.

BTW, your minimum pressure could probably be set lower. You notice at 10.0 and 12.0, the machine is barely raising the pressure. After you solve the leak problem, you might want to experiment with lower minimum settings. Take it down 1.0 cm/H2O and check OSCAR next morning. You can repeat this each night until you see the machine is often increasing the pressure 2.0 cm or higher. Members can help you judge from new OSCAR screenshots.

Thanks for the humidifier info ... although the DME Supplier claimed that there were no known or reported issues with the AS 11 humidifier .

Ensured the humidifier was seated on 05/26. Also on 05/26, Changed mask to the F&P Vitera because the F20 even with a remzz mask liner and chin strip made the bridge of nose sore.

ChicagoGranny wrote: ↑

Sat May 27, 2023 1:36 pm

BTW, your minimum pressure could probably be set lower. You notice at 10.0 and 12.0, the machine is barely raising the pressure. After you solve the leak problem, you might want to experiment with lower minimum settings.

I lowered the pressure to 10 before the post (05/26). The sudden rise from 10 to 17 pressure (last chart (05/26) at 3:45 due to hypopnea explosion woke me and I was up for a while. Apparently the algorithm does not raise pressure for Unclassified apnea vs Hypopnea as the pressure did not go up significantly around 12:00. My new pulmonologist wanted me to change to 6 -18. I started with 8 and moved it up by 1 every 4 days but with the F10 mask setup vs the F&P. I added the 05/27 chart to the mix so would appreciate additional insightful comments as I go forward. Also added stats for the AS 10 for month before switch (left side) for AS 11 a month after switch (right side). Significant increase in AHI and Average leak rate %. The 95% pressure is lower for AS11 than AS 10?

https://imgur.com/a/DBxbGjE
https://imgur.com/a/wrETq9B