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Factor's Treatment Thread
#1
Factor's Treatment Thread
As you can imagine due to the recall I chose to purchase a new AirSenses 10.  I do have some general questions.  For those who may have switched for one reason or another.  I will give a review later on the AS10.  

From what I have read here on the forum the RM AS10 is a much more efficient machine.  Also seems the settings are not one for one.

On the PR DS1 these setting give AHI of .33
Mode CPAP
Pressure 11.00 cmH2O
Flex Level 3
Flex Lock Off
Flex Mode C-Flex
Humid. Lvl 3
Humid. Mode Adaptive (System One)
Humidifier
Ramp Pressure 4.00 cmH2O
Ramp Time 15.00 Minutes
Ramp Type Linear

On RM AS10 these setting give AHI of 2.73 with centrals.
Mode CPAP
Pressure 11.00 cmH2O
Climate Control Auto
EPR Full Time
EPR Level 3 cmH2O
Humidifier Status On
Humidity Level 3
Ramp On
Ramp Pressure 4.00 cmH2O
Ramp Time 15.00 Minutes
Smart Start On
Temperature 27 ºC
Temperature Enable 2

So in general in reading on the forum it seems and from above.
EPR and Flex are not really the same?  So not a 1 for 1 setting, correct?
My DS flex setting of 3 is really only about .5 cmh2o
Compared to a full 3 cmh2o with RM AS10.

It also seems the Pressure is a really ( or perceived ) higher on the AS10 vs the DS1.  Could this be true if I have it set on 11 cmh2o on DS1 is this really more like 10 cmh2o on AS10?

The very first night I had the AS10 in auto mode like below my AHI was .83.  If I set the AS10 to the notes posted above I get centrals and my AHI is 2.73
Seems like I should use the Auto mode on the AS10
pressure 10 - 13
epr 1 (or not at all)?
no ramp

I have OSCAR but wanted general thoughts first.

Thanks.
Brent
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

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#2
RE: DreamStation to Airsense 10 autoset
OK I'll say the ResMed may feel like it blows more. My guess is because ResMed reacts much faster and therefore is acting on events more.

I'd consider edits as follows:
Nix Ramp entirely.
Change EPR to 1 full-time for the likely treatment emergent CA
Change to Mode AutoSet
Change static 11 to 8-15 and post OSCAR with your critical thoughts on feel and comfort on the changes.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: DreamStation to Airsense 10 autoset
Thanks Dave. I think we are on the same page

So can someone who has been on CPAP for 4 years get treatment emergent CAs?  I thought that was only for new people?  OR is it more around anyone who changes their treatment/ settings?
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

Got OSCAR?
Organize Charts
Optimizing Therapy

My Story
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#4
RE: DreamStation to Airsense 10 autoset
Your correct-er than I. I missed the data about your 4 year PAP career. OK, a maybe is ResMed is moving your respiration to higher efficiency, so TECA... Only a maybe not likely.

Do you have any diagnosic reports, full detailed ones? Yes, good, post redacted version here. No.. Try to get it maybe.

In the absence of that report, we may need to see by how CA reacts then instead.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: DreamStation to Airsense 10 autoset
Because centrals happen because the Cpap gets rid of CO2. If your NEW machine is doing a better job of getting rid of CO2 then your body will need to adapt to the lower CO2.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#6
RE: DreamStation to Airsense 10 autoset
(06-22-2021, 06:16 PM)SarcasticDave94 Wrote: I missed the data about your 4 year PAP career. 
Not your fault Dave.  It's not in this post.  I put it in my Personal story.  

Sadly like a dummy I forgot to put my card in the machine.  I do know my AHI was better 1.11.  I need to get me one of those Wifi cards.  I do have my SS report.  I can redact it and post it.
(06-22-2021, 09:46 PM)staceyburke Wrote: Centrals happen because the Cpap gets rid of CO2.

So the AS10 is blowing out more of my exhaled CO2?  I assume through the vent ports.  I would assume since the device makes my airway more open respiration happens more effectively.  I just never imagined one brand would be that much better than the other.
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

Got OSCAR?
Organize Charts
Optimizing Therapy

My Story
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#7
RE: DreamStation to Airsense 10 autoset
Higher breathing efficiency, the kind that causes treatment emergent CA, is a volume of airflow thing, the complete circulation of incoming oxygen rich air and expelling CO2 more efficiently. This increase is mainly due to our lowered efficiency from Apnea. But it's not about the mask ventilation directly.

Despite you were on PAP, a Respironics, for some time, the theory is that ResMed with faster attacking of events, yields an even higher efficiency than the Respironics. Your brain will reprogram itself for this higher efficiency with a bit of time elapsed. When your brain has redone its calculation, your CA will diminish.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: DreamStation to Airsense 10 autoset
Resmed's are considered by many to be more responsive to events than DreamStations.

To reduce the aggressiveness of the ResMed algorithm, set your Response to Soft from Standard in the clinician setup. This will provide a gentler pressure increase.

This may reduce your CAs and "feel" more like your DreamStation. Soft Response is not available on older AirSense 10 AutoSets, nor AutoSet for Her devices while in Autoset for Her mode.


You may want to set Ramp to Auto. This will switch you out of ramp mode to therapy mode, when it detects breathing patterns more consistent with sleep breathing than awake breathing, or if it detects events.

 When I was on an AutoSet, I loved the AutoRamp feature because it appeared to be very accurate for me, let me know how long I took to fall asleep and I could tell through out the night if there had been a power failure instead of data reporting problem because the pressure would lower to ramp pressure.

AutoRamp will switch to therapy mode under the following conditions:
  • 30 breaths of stable breathing (this is how it believes you're asleep)
  • 30 Minutes since starting machine
  • 5 consecutive snore breaths
  • 3 obstructive apneas or hypopneas within 2 minutes
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#9
RE: DreamStation to Airsense 10 autoset
(06-23-2021, 11:06 AM)SarcasticDave94 Wrote: Respironics, for some time, the theory is that ResMed with faster attacking of events, yields an even higher efficiency than the Respironics. 
So in CPAP mode its just the same pressure all the time.  I assume in theory no attacking just constant pressure.
In APAP mode when you say attacking do you mean. It sends pressure or more pressure into the airway sooner?  Which in turn leads me to believe the DS1 is not sending pressure as soon?  
(06-23-2021, 11:33 AM)Dog Slobber Wrote: Resmed's are considered by many to be more responsive to events than DreamStations.

To reduce the aggressiveness of the ResMed algorithm, set your Response to Soft from Standard in the clinician setup. This will provide a gentler pressure increase.

This may reduce your CAs and "feel" more like your DreamStation. Soft Response is not available on older AirSense 10 AutoSets, nor AutoSet for Her devices while in Autoset for Her mode.


You may want to set Ramp to Auto. This will switch you out of ramp mode to therapy mode, when it detects breathing patterns more consistent with sleep breathing than awake breathing. When I was on an AutoSet, I loved the AutoRamp feature because it appeared to be very accurate for me, let me know how long I took to fall asleep and I could tell through out the night if there had been a power failure instead of data reporting problem because the pressure would lower to ramp pressure.

I wondered what the Standard and Soft was for.  However It would seem Standard is better in the long run?  Seems like the better at attacking the obstruction is better for OSA in the bigger picture.  OR is the attacking the same but the force of the pressure just less. aka Standard =bam 10 Soft = 8,9,10.


I will check out the auto ramp.  I usually have no issue falling asleep.  Unless the Cat is running like a demon in the house...  

Power failures wake me up since I cant breathe. Bigwink
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

Got OSCAR?
Organize Charts
Optimizing Therapy

My Story
Post Reply Post Reply
#10
RE: DreamStation to Airsense 10 autoset
Yes, in Auto with a range of pressure, the ResMed senses pending events and it'll increase pressure in that range to head off the event. Sometimes the Respironics is too slow to respond in anticipation but starts to respond after the event when it's too late.

Most times the ResMed has increased pressure enough and results in less events and higher comfort as it need not stay at high pressure but the Respironics needs higher to start with, diminishing comfort and less effective at event combat.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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