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Different machine (Devilbiss-Resmed) different results
#1
My therapy has been on a Devilbiss AutoCPAP with Nuance pillows for a while. The results have been consistent over time as seen on SH. AHI under 5 in general. I did get a Resmed Airsense A10 autoset as a second machine with the P10 mask. I thought it would be fine as a backup system or even as a primary if I found it to be a better fit. However, during a one week usage I find that it tells me my AHI is between 0.5 and 1.5, significantly better. The settings are the same. The P10 fits better but I get the feeling of a moderate headache during the night which might indicate a co2 problem. By sensation the Resmed seems to be less forceful for the same pressure setting. What am I to believe? I would have expected results within a similar range but this is not the case. Not sure what else to look at to get a better idea of what's more credible. Where can I find reference points for respiration rates, etc? AHI I can easily find. Suggestions?
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#2
It is not just a matter of air pressure. The two machines use different algorithms and you might be responding better to one than the other. Mask changes can make a difference too. And one machine could be out of calibration so the set pressure is not the actual delivered pressure. And EPR vs whatever DV calls their exhalation relief can also make a difference. Did you get large leaks with the Nuance but not the P10? The list is almost endless.
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#3
the list is endless...but guess I can always enjoy the challenge. Mask leaks with the nuance pillows was something I fought with and could end up with the mask off knowingly or unknowingly. My doctor gave me the solution, but only after I explained the problem in more detail (I think she could have advised me earlier). Basically - at the beginning the fit is good because my face is clean and there is no moisture in the tube yet. As the night progresses a face tends to get oily, from perspiration and whatever. Plus there may be some moisture in the system. This all makes for a worsening fit and when you are "asleep" you just try to adjust without much success in general. The solution, as suggested, is simply to be slightly more awake...enough to remove the mask, wipe the pillows of any residue, and do the same with the nostrils and face in general, even a hand wipe is sufficient. It won't make it 100% efficient, but certainly maybe 80% which is more than good enough. Anyways, what I will now try is the Devilbiss and the P10 to see if the combination provides a third scenario for comparison. Is there is absolute value for leak levels? ie. under x is considered no leak or low?
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#4
Your idea of swapping the masks is a good one. There is a machine dependant leak rate at which therapy stops being effective. All masks leak by design so that the CO2 from your exhalation is released not re-breathed. The Respironics machines record both total and unintentional leak. The latter is what you should be concerned with. Lower is better. I think above 24L/min is generally considered to be in large, unintentional leak territory.

I know nothing about how the DV machines work, but the Resmed are known for quickly and aggresively increasing the pressure in response to events. If your events are tightly clustered, that could explain the difference if the other machine's algorithm responds more slowly and gently.
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#5
Hi thepadol,
WELCOME! to the forum.!
Good luck to you with your CPAP therapy.
trish6hundred
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