[Equipment] trouble moving from RemStar Auto to AirSense 10

[DavePaulson]

How does the data look and how are you feeling?

[holden4th]

What concerns me about your SH graphs is the pressure readings. When a machine is well tuned you don't see all those spikes. Usually there is a flat line and then a response when needed. If you drew a line across the top of all of the pressure spikes it would give a flatline reading of close to 9.0. Also, at 3.00 am your pressure maxed out so your maximum pressure setting is too low. Set your max pressure back to 20 to give your machine some room to move if it needs it. As has been said before, it's the min pressure that is important.

If you have a look at your data then you'll see that your 95% pressure was 8.4 (the pressure AT or BELOW which you spent 95% of the night.) and you coped with it. Based on this I would set the min at 9.0 and the max at 20.

The other thing to consider is that the more pressure spikes you get the more likely you are to have disturbed sleep as they can wake you up without you realising it making for a very restless night. Looking at the last SH graph you could have been woken up at least 30 times. Setting the minimum to 9 could easily resolve this problem.

Leaks don't appear to be an issue but we don't know if you are mouth breathing or not.

You have a 5 minute ramp time. With a minimum pressure of 9 you probably don't need it so turn it off. Flex is set at the maximum which would take your exhale pressure down to about 7 which is OK.

Can I now suggest that you try the Resmed at the same settings. With a higher minimum it's more aggressive algorithm won't be that noticeable which is what I think you experienced. The machine had to suddenly make big increases in pressure because your minimum settings was too low. I've used Resmed and PR and found that I could set the Resmed a bit lower because of its response time.

[jim.evo]

Here are shots from the last 3 nights w/ the RemStar (I'm focusing on this one first and then will work on the AirSense once this is dialed in). Had a bad night sleeping on 8.9.17 due to an unrelated matter, trouble getting to sleep and staying asleep.  Slept like a rock last night!

Overall, the increased minimum to 9 feels good. I am confused that some of you suggest a range from 6-10 or 7-9 (if I read that correctly) and others say that to adjust just the lower and leave the top @ 20.

Again thanks for everyone's input.

[Gideon]

If you are not having any excursions to higher pressures it makes little difference to have your max at 20 or at 9.  With max at 9 you can see you need to see what's happening without going to a possible uncomfortable pressure.  I'm comfortable at any pressure but I'm very rarely going over 12, so my max is set at 25 (biLevel) and my current min is set at 10.

With a PR machine you need to set a tighter "range" but especially the min pressure, to quicken the response to events.  This is not near as critical with ResMed because ResMed responds much faster.

[DavePaulson]

Since no else has made any suggestions. Your results look pretty good if you're looking to experiment further I would either do a .4 cm increase in the minimum or reduce flex to 1. Then wait several days if you are sleeping OK. Keep posting charts as well as how you feel you are sleeping.

[jim.evo]

Since no else has made any suggestions. Your results look pretty good if you're looking to experiment further I would either do a .4 cm increase in the minimum or reduce flex to 1. Then wait several days if you are sleeping OK. Keep posting charts as well as how you feel you are sleeping.

Thanks Dave, have yet to look at last nights info. Can you explain your reasoning for your suggested changes? I'm trying to understand the nuances of this process!

I really appreciate everyone's help here.

Jim

[DavePaulson]

The minimum pressure increase is to see if it would reduce the number of hypopneas. The flex change will your not reduce exhale pressure as much which may help reduce them as well. If you want to get dialed in do it slowly and one thing at a time and watch your AHI and how you feel you are sleeping. Again your numbers look good and doing nothing is OK too.

[jim.evo]

Thanks Dave. Here is my data from last night. (I did have a time when the mask slipped off and I put it back on - doesn't happen too often).

Am I correct to focus on the AHI as an overall guide to how I'm doing? What then is the "ideal" AHI or range?

Thanks again everyone.

[DavePaulson]

How you feel is actually the most important factor. I find I feel I sleep much better now that I have my AHI as low as I can get it. Lower is better some people can not achieve an AHI as good as yours is now. Make little changes and use how you feel first and AHI second.

[jim.evo]

How you feel is actually the most important factor. I find I feel I sleep much better now that I have my AHI as low as I can get it. Lower is better some people can not achieve an AHI as good as yours is now. Make little changes and use how you feel first and AHI second.

Thanks Dave. Will fine tune this unit a few more days and then try the AirSense again!