01-09-2016, 10:08 PM
(This post was last modified: 01-09-2016, 10:13 PM by Dafod.)
My main machine has been a Resmed A10 (last 10mths). Over the past 18 days I have been traveling and I picked up a new PR560 (new) that I was able to buy relatively cheaply since its now a superseded model (for the trip and to be used as my backup machine). Contrasting the two machines my main observations have been:
The PR560 seems a lot more "gentle" than the A10 regarding changing pressure. On both of them I used the same P10 mask with a chin strap and essentially the same settings regarding the pressure ranges and EPR.
The result of using the PR560 is both positive and negative as I seem to have less disturbed sleep, have lower top-end pressures at the mask, which results in virtually no aerophagia (unlike the A10 which can be bad), and less mask/mouth leaks. The negatives is my AHI is higher, at around 0.5 to 3.5 with the PR560 picking up more hypopneas (although I get that the two machines are not necessarily directly comparable on incidents). While my noted hypopneas on the machines are not directly comparable the duration of the events with the 560 are typically 20-50 seconds while only being 10-12 seconds on the A10. Also, it seems that when I start to go to sleep the PR560 cuts off the end of my inhalation if I don't more forcefully inhale. Later when I somehow get in sypatico with the machine I don't notice this.
With the A10 I have had nights where I have mask/mouth leaks near and above 25. This didn't happen with the 560. Reviewing the occurrences in Sleepyhead I noted they virtually all occur when the A10 quickly ramps up pressure to manage or head-off an event.
The EPR on the A10 is 2 and my Flex A is 2 (I think) on the 560. Also pressure range on both machines is 6/7-16.
Just curious whether people have experienced similar things? Whilst both machines seem very good and manage my apneas they seem to go about it quite differently - more than I had expected.
Epr and aflex work differently
EPR is a straight pressure drop.
Aflex is flow based.
Try setting your aflex to 1to lessen the "air cutoff" feeling.
01-10-2016, 12:39 AM
(This post was last modified: 01-10-2016, 01:06 AM by vsheline.)
(01-09-2016, 11:38 PM)Ghost1958 Wrote: Try setting your aflex to 1 to lessen the "air cutoff" feeling.
ResMed EPR has only straight pressure drop which lasts the whole time between start of exhale to start of inhale.
A-Flex of 1, 2 and 3 all have 2 cm H2O of straight pressure drop but have different amounts of additional Flow-based pressure drop.
When actively breathing out, there is an additional amount of pressure drop based on how forcefully we are exhaling. This Flow-based additional pressure relief goes away as we stop actively exhaling, which makes it less easy to finish the last bit of our exhalation. But there is method in this madness, since the reduction in pressure relief as exhalation is ending reduces the pressure drop to 2 cm H2O just before inhalation starts; the most vulnerable time for an obstructive apnea to begin is just as inhalation starts, because of the suction created by breathing in.
With A-Flex of 1 (and even more so with A-Flex of 2 or 3) the pressure at the end of inhalation drops as our inhalation Flow is ending, which makes it less easy to finish the last bit of our inhalation. This means the high inhalation pressure will last longer (and finishing our inhalation will be easier) when A-Flex is 1. But the beginning of exhalation will be easiest when A-Flex is 3.
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.