Couple Questions on refurbished AirSense 10

[GreenScrew]

I picked up a refurbished AirSense 10 to trickle down/upgrade a machine at a second home and have two questions:

1) Reseller noted that MyAir may not work as machine might've been registered by previous owner. I wasn't bothered by this since the data is available via Oscar and figured I'd just turn airplane mode on. However, since using the machine I'm annoyed that I get repeated reminders asking if I want to turn airplane mode off. So my question is two fold: A) Is there any way to disable these reminders or otherwise disable wireless so they go away and B) Is it possible ResMed might be willing to reset the assignment of my machine so that I can register it? I'm feeling like it's a privacy concern that my data might be getting uploaded to someone else's MyAir account.

2) My prior machine was an S9 that was set for manual 14 pressure by the DME (EPR on always @ 3) after I used it for a month and therapist read the data to determine ideal settings. I've been very successfully using this machine/configuration for many years. With the same setting on the AirSense 10, the pressure feels way too high. Maybe the S9 has weakend over time, but I was not used to it. So I've been running it on auto which has gone very well so far (AHI-0.00, but only a few days on it). My only question here, is that I prefer no ramp set pressure rather than auto. Is it the right approach to use a manual setting that is based on the average pressure data while using auto? I'm going to give it a full month, but so far avg pressure has been 11.67 so I was thinking I'm headed for a 12 cmH2O setting. Is this the right approach for setting manual pressure level?

Here are my stats from the S9 (note, currently been using a very antiquated Fischer/Paykel unit at my second home which explains the low number of days for the past year. I'm unable to sleep without CPAP therapy. So I'm never without...

   

[Cpapian]

To disable modem, check YouTube. There are videos there.

[Gideon]

Your AHi says your settings can be lowered.
Min = 4+ EPR or 7
Mode = auto (actually provides more data)
Max = 14, ok based on your AHI.
Run this for a night and post the nightly charts. This will let us see what is really going on.

Then we will have the data we need to optimize your settings in either a varying pressure or fixed pressure. I prefer min=max=x in auto mode for fixed pressure

[RayBee]

I picked up a refurbished AirSense 10 to trickle down/upgrade a machine at a second home and have two questions:

1) .......... I want to turn airplane mode off. So my question is two fold: A) Is there any way to disable these reminders or otherwise disable wireless ...........

You can find a lot of great discussion on this thread:

Semi-permanently disabling modem in ResMed Airsense 10

The link above directs you to post #94 where you can watch a Youtube video on disconnecting the modem.

[GreenScrew]

Thanks for the responses and a quick update:
1) Today I was attempting to contact ResMed about the myAir account and decided to try to register while I was there and viola it worked! Not sure why it didn't work originally through the mobile app, but this resolves my issue/concern for data privacy and I'll no longer need to run in airplane mode

2) Thanks for the advice from Gideon I'll adjust settings on the AirSense 10 as proposed (Auto with Max=14 and Min=7) and run this way for a few nights to make sure consistency. The data I originally posted was from my former machine not the new AirSense 10. I've been running the AS10 for 2 days now on auto. Attaching the charts.

It does leave me curious to know why the preference for leaving on Auto yet adjusting min/max to the same value thus preventing any automated adjustments? Also, as I've been using EPR=3 for 10 years, is there any reason to change that now (which it seems auto w/ min=max would effectively eliminate)? Just interested to learn the logic behind the preferences...

Thanks again to the great community!!

   
   

[Gideon]

The min = max only impacts pressure. EPR still applies its -3 to pressure.

I'd have to check the data to be sure but spap mode has no need for flow limits because pressure is never changed with those settings. Flow Limits are very important in auto mode so they are recorded. Therapeutically there is no difference between CPAP mode and auto with min=max.

[GreenScrew]

Your AHi says your settings can be lowered.
Min = 4+ EPR or 7
Mode = auto (actually provides more data)
Max = 14, ok based on your AHI.
Run this for a night and post the nightly charts.  This will let us see what is really going on.

Then we will have the data we need to optimize your settings in either a varying pressure or fixed pressure.  I prefer min=max=x in auto mode for fixed pressure

Last night:
   
   



Stats after 3 days:
   

[Gideon]

This shows an improvement and with an AHI of 0 changes should be made for comfort only, so how do you feel?
This shows no need to go to a fixed pressure. I know you previously used a fixed pressure.

[cathyf]

I would put in a pitch for setting your min & max pressures to two slightly different values. Example-- 12 and 12.2.

This tells you what the machine algorithm thinks is going on... Spend the night pegged at 12.2? -- the machine thinks you need more pressure.  Spend the night pegged at 12? -- the machine thinks you need less. Meander around 12.1 all night? Sounds like just right!

Since you have EPR of 3 the actual pressure is continuously moving a lot more than that anyway. When you are "pegged" at 12.2 you are actually moving back and forth between 9.2 and 12.2 at every breath. Likewise a "constant" pressure of 12 is constantly oscillating between 9 and 12. So there is no way that you would experience the pressure as different -- it's just not big enough to matter.

You are not allowing the machine to move the pressure like it wants, but it is useful to know what the algorithm would want to do if you were to let it.

[GreenScrew]

First, I'd like to thank you both! Greatly appreciate your time to review and provide advice!! Thank you, thank you.. 

This shows an improvement and with an AHI of 0 changes should be made for comfort only, so how do you feel?
This shows no need to go to a fixed pressure.  I know you previously used a fixed pressure.

I feel great! My primary concern was for deviating from previous/long-term settings which might jeopardize my history of success (as reference; sleep study AHI=116.3 in 2012). Yet the previously successful pressure setting (14) seemed really extreme for some reason with this machine. 

That said, my only comfort issue might be that I take slightly longer to fall asleep and feel like a higher minimum pressure would help with that. This is probably mostly psychological, admittedly. But then, isn't falling asleep mostly psychological? In reality, 3 minutes versus 1 minute to fall asleep, I really can't complain. I'm fortunate this way, I know.

The other element is the upper pressure. It's visible in the chart that after I woke in the morning I laid back in bed but never fell back asleep for an hour. It's fine, I had slept a solid 6-1/2 hours which is perfectly adequate for me and I wasn't tired.. just not ready to get up yet. And OK if I did fall back asleep. Really indiferent. Yet, the pressure in this state remained at the upper end of max and was a little bothersome which will probably affect my ability to doze back off for a bit after I'm already well rested.

I would put in a pitch for setting your min & max pressures to two slightly different values. Example-- 12 and 12.2.

This tells you what the machine algorithm thinks is going on... Spend the night pegged at 12.2? -- the machine thinks you need more pressure.  Spend the night pegged at 12? -- the machine thinks you need less. Meander around 12.1 all night? Sounds like just right!

You are not allowing the machine to move the pressure like it wants, but it is useful to know what the algorithm would want to do if you were to let it.

This is an interesting approach that probably helps with the couple minor items I mentioned above, while providing some additional insight through an occasional look at the statistics to see if there might be a need to re-assess (whether the opportunity to lower, or need to increase, pressure) based on what the machine is suggesting should be done. If I'm seeing it constantly on one end of the narrow pressure spectrum or the other.

I think I'll give this a go tonight. Thanks for the suggestion!

Any final words of wisdom for this approach. If I happen to see a constant pattern for being pegged at either the upper or lower range, presumably reverting back to a wider range of min/max pressures would provide further data for analysis as to what the machine is recommending. Or I might consider whether it's time for another formal study (which, btw, was a horrible experience for me and I'll try to avoid at nearly any cost)?

Thanks again gang, YOUR ALL THE BEST!!!