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[Equipment] trouble moving from RemStar Auto to AirSense 10
#1
Question 
trouble moving from RemStar Auto to AirSense 10
Thanks for hosting this forum. 

I’ve been using CPAP and now APAP for 20 years or so. My most current machine, is the 

System One RemStar Auto with A-Flex (550P) w/ pillows. Rx is 4-20. It’s been working well for many years.

I’ve been given the AirSense 10 AutoSet and am having major problems. (using pillows and Rx is the same). It seems that it over reacts to my events and pushes so much air that I wake up and or have air escape from my mouth. Also it is over drying my nose & mouth. I do NOT have these issues with the RemStar. (I’m not so concerned with the dryness, that is always a work in progress).

I want to be able to use the AirSense w/out waking myself or my wife up. I like the heated tube and getting reports online.

I have installed SleepHead and have looked at the reports from both machines but it’s a bit of greek to me.


I took the AirSense into the vendor. She initially suggested that I talk to my doc about getting the pressure level reduced. I said that doesn’t make sense as it matches my RemStar and there are no problems there - thinking the issue is with the unit or the settings.

She changed one setting in the clinical menu: 

Response was changed from standard to soft. This did help by letting me sleep longer before I had the “over pressure” waking me up. The MyAir report showed 7:37 usage (70/70); Good mask seal (11/20); 0.6 events per hour (5/5); 2 mask on/off (4/5) for a total score of 90/100. So the scores are OK but don’t reflect that I had to stop using it.


My current settings for the machines are:

RemStar

Mode: Auto
Auto Max 20
Auto Min 4
Flex Type: A-Flex
A Flex :2 (1-3)
System 1 Resistance: x1 (0-5)

AirSense 10

Mode: Autoset
Max: 20
Min: 4
Mask: Pillows
Response: Soft (Standard)
Ramp Time: Off
EPR: On (off)
EPR: Full Time (Ramp Only)
EPR Level: 2 (1-3)
Climate Control: Auto
Tube Temp: Auto
AB Filter: No
Essentials: Plus (off)
Smart Start: On (off)

Pressure Relief: Off

I was told if this unit doesn’t work for me I can try another and or they can give me the upgrade to the RemStar.

Thanks if advance for your help!

Jim
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#2
RE: trouble moving from RemStar Auto to AirSense 10
Down load sleepyhead software so you can install the sd card on resmed 10 , then post them so we can see them. . The peope here can read your charts . Fromwhat you are saying the settings are for you resmed it is factory settings right know. If i run mine at 4 i am starving for air. I need at least 6.
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#3
RE: trouble moving from RemStar Auto to AirSense 10
I see you use SleepyHead you should post data it would help to see whats going on. There are a couple of guides on how to post and organize your charts here. Posting an Image in 5 Easy Steps    Organize your SleepyHead Charts. If you need more help with any aspect of posting data don't hesitate to ask.

Best of luck,

Dave
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#4
RE: trouble moving from RemStar Auto to AirSense 10
Very rarely do you find someone working well at 4-20.

Post some SleepyHead charts and I'm sure we can help you out.
Is the AirSense 10 Autoset the for her model?  I don't think so,but it does have another mild auto setting.

The Dreamstation is the newer model of the Phillps line, you would want the 


Fred
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#5
RE: trouble moving from RemStar Auto to AirSense 10
I'll just add that if you have data or the card from your old 550, we can compare that to the Airsense 10 and give some suggestions. The much more aggressive pressure increases from the Resmed usually work better, but if it is increasing pressure above your comfort zone, we need to identify what you tolerate and limit the maximum pressure. An optimized auto CPAP should only change pressure by 3-4 cm. Having a CPAP on default wide-open settings of 4-20 is not a prescription, it a recipe for failure. We can help you identify where you need to be.

If you were comfortable with the System One, I'm curious why you did not opt for the Dreamstation which continues the same pressure behaviors and Flex pressure relief, rather than the Resmed which is quite different in both regards.
Sleeprider
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#6
RE: trouble moving from RemStar Auto to AirSense 10
I would suggest that the philips are a slow machine to react. If you had 4-20 for years, the noticeable pressure of the resmed suggests your apnea wasn't being properly treated. It doesn't go that much above what is needed.

the resmed also has 2 setting for how strongly it reacts. This is on the for her model and I think is being used in both the autoset models now. It's worth looking in the clinical manual for your model number to check

You have said you have mouth leak issues with the nasal mask, I have this too. I gave up on the tricks to get it to work and bought a full face mask f20 and haven't looked back.
The link below will help get the nasal mask working as best it can for you.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#7
RE: trouble moving from RemStar Auto to AirSense 10
Hi jim.evo,
WELCOME! to the forum.!
Good luck as you continue CPAP therapy and also with getting your new machine dialed in to meet your needs.
trish6hundred
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#8
RE: trouble moving from RemStar Auto to AirSense 10
thanks for everyone's reply.

i do not have mask leaks with either machine, rather the AirSense is pushing too hard, IMO, when I have an event. I'm attaching screen prints from recent use of both. (The RemStar did not show Flow Limit in Sleepyhead). The AirSense is not the Her version. In regards to moving to the AS 10, this is what my HMO has provided.

well now i'm told i can't post links until i've done 4 posts....

so here is number 2.

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#9
RE: trouble moving from RemStar Auto to AirSense 10
a question re pressure setting (and my 3rd post): it's been noted that 4-20 is to large a range? If so, I thought that given I'm using an APAP does not the unit automatically give me the pressure I need? So If I never need more than 10, for example, what is the harm in having it go to 20? (the 4-20 was the range given to me by the doc years ago and reviewed a few months ago).

thanks to everyone's welcome! (post 4). I'll put up the screen shots tomorrow.
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#10
RE: trouble moving from RemStar Auto to AirSense 10
the max pressure isn't normally an issue, it's the min pressure that is fine tuned for you apnea. Then the 20 max pressure is brought back to be a couple on cm above the max pressure you are getting. or 2 or 3cm above the 95% pressure.

Is this the old or new machine that you never go above 10?
If it's with the new machine, I would guess a rough setting of the max would be about max 12 and the min about 7. If you are feeling pressure at this, it will settle down in a week as you get use to it. On average it isn't that high a pressure. I had 15-20 on cpap. With my current machine, I get pressure spikes going to 25cm.

when you get some sleepyhead charts up, there will be a lot of help from the members to fine tune.

You can post a link if you put a space in the http or www. like w ww
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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