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First week result plus change from Dreamstation to Resmed Autosense 10
Hi all,
I just had my sleep study and result 10 days ago. I been told I have very severe sleep apnea. My AHI is 60.3, RDI at 61.3 and ODI at 56.4. Rem at around 17% with zero deep sleep which I was told is bad. I was provided a trail unit of the Philips Dreamstation and although I had the best sleep ever and been waking up basically before my alarm even rings. I found that I been waking up a 3-4 times without realising why. I also found it hard to breath with the philips. As such when a Resmed Autosense 10 for her came up, I bought it and been using it for the last 4 days. So total of around 3 days with the Philips then 4 days with the Resmed.
Please see the 2nd day on the Philips and the latest day with the Resmed. I was initially using the nasal mask then the pillow most recently as it seems to leak the least. Let me know what I can do to improve my therapy.
RE: First week result plus change from Dreamstation to Resmed Autosense 10
Welcome to the forum. Congratulations, you appear to be doing very well. The consensus here is that the Resmed is the better machine for most. Do you find it more comfortable than the dreamstation? My only suggestion is that you increase your minimum pressure to 7 to take full advantage of the pressure support provided by the EPR setting of 3. You shouldn't feel much difference since your pressure increases almost immediately to 7 or more.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-16-2019, 01:27 AM (This post was last modified: 12-16-2019, 01:30 AM by oliverpool.)
RE: First week result plus change from Dreamstation to Resmed Autosense 10
(12-15-2019, 11:57 PM)Melman Wrote: Welcome to the forum. Congratulations, you appear to be doing very well. The consensus here is that the Resmed is the better machine for most. Do you find it more comfortable than the dreamstation? My only suggestion is that you increase your minimum pressure to 7 to take full advantage of the pressure support provided by the EPR setting of 3. You shouldn't feel much difference since your pressure increases almost immediately to 7 or more.
Thanks for replying!
With the dreamstation, I have this feeling that I am trying to adapt my breathing to the machine. Its almost like I am breathing out of sync many times on the dreamstation. I also wake up 3-4 times every night with the dreamstation and not knowing why. Not gasping or anything but just strange. And then it takes awhile to go back to asleep due to the breathing out of sync feeling. Don't get me wrong. That first night was amazing as I felt so rested and actually woke up before my alarm rang which has not happened for a long time. I was up without feeling or falling asleep in the afternoons like I have been feeling for the past few months. My dark eye bags pretty much disappeared just after this week on Cpap.
But the Resmed just totally eliminated that out of sync breathing problem and I had not woken up in the middle of the night pretty much since using it.
Good point on the min 7 pressure. I recalled having difficulties going to sleep the first night I was using the Resmed. The EPR was off and the autoramp was on full. It felt like I could not get enough air from breathing. I saw that it pretty much stayed at 4 pressure before I was asleep. I changed the autoramp off and the EPR on to max the next day and that problem went away. (I didn't change it on that day as I could not find out how to go into the clinical menu and didn't want to search for it with my mask on.)
I would say that since that first 2 days, there are one or two days where I felt tired in the afternoon but its early days yet. Definitely not like last time where I would struggle to keep awake after lunch of late in the afternoons.
One other thing. I do not seem to find any snore graph using the Resmed. Is it not supported on the Resmed machine?
RE: First week result plus change from Dreamstation to Resmed Autosense 10
After the first 5-6 days of use, it seems I am now starting to wake up feeling tired. I understand that Cpap therapy takes time and it could even be months before a effect is felt. Is it normal to get a boost in the initial use for Cpap then flatlining or feeling like before? Its good that I dont feel like I have to fight to keep awake in the afternoons but the feeling of being filled with energy and waking before the alarm rings or not need to snooze is gone. This is my latest report as well. I move my min pressure to 7 with no other change. Last night seems rough. I feel like it was hard to breath at times again. Not sure if my sinus was stuck as it almost seems like at 7 pressure, when I opened my mouth there was almost no "wind" coming out of my mouth as per previous. I almost thought my machine was down or something was stuck. Only felt this yesterday though.
RE: First week result plus change from Dreamstation to Resmed Autosense 10
Hi Oliver.
oliverpool Wrote:Is it normal to get a boost in the initial use for Cpap then flatlining or feeling like before?
Yes, it's very common. Some people get quite dispirited when that happens, but PAP treatment can be a bit of a roller coaster sometimes. With more experience, your body will adapt and your overall health will feel the benefits.
Quote:One other thing. I do not seem to find any snore graph using the Resmed. Is it not supported on the Resmed machine?
Yes, but Resmed treats snores differently. I suggest you turn off the mask pressure graph (you don't need both pressure and mask pressure) and reduce the height of your flow rate graph (use your mouse to drag up the horizontal dividing line between flow rate and pressure). The snore graph should then be visible at the bottom of the screen. If not, scroll down and find it. Also check the graph selector (pop-up menu at right bottom) and make sure Snore is turned on (green).
Looking at your most recent chart, I see that the obstructive apneas are much the same but there are more central apneas. I'd try raising the minimum pressure to 8 (which will help prevent the obstructives) and reduce EPR to 2 (which will help address the centrals). It might be necessary to tweak these a little, but try these numbers for now.
oliverpool Wrote:Is it normal to get a boost in the initial use for Cpap then flatlining or feeling like before?
Yes, it's very common. Some people get quite dispirited when that happens, but PAP treatment can be a bit of a roller coaster sometimes. With more experience, your body will adapt and your overall health will feel the benefits.
Quote:One other thing. I do not seem to find any snore graph using the Resmed. Is it not supported on the Resmed machine?
Yes, but Resmed treats snores differently. I suggest you turn off the mask pressure graph (you don't need both pressure and mask pressure) and reduce the height of your flow rate graph (use your mouse to drag up the horizontal dividing line between flow rate and pressure). The snore graph should then be visible at the bottom of the screen. If not, scroll down and find it. Also check the graph selector (pop-up menu at right bottom) and make sure Snore is turned on (green).
Looking at your most recent chart, I see that the obstructive apneas are much the same but there are more central apneas. I'd try raising the minimum pressure to 8 (which will help prevent the obstructives) and reduce EPR to 2 (which will help address the centrals). It might be necessary to tweak these a little, but try these numbers for now.
Thanks. I made the change of pressure to 8 and the EPR to 2. Cant say I noticed any change although it seems like 95% pressure went down with this change. I woke up once not knowing why. Still a little tough waking up this morning but my throat does not seem that dry. I have my humidifier on at 4 but it seems like the water level never drops from what I put in the night. I now put water till the lowest level and it does not drop as well. So not sure if I really need the humifier or can I increase it without any problems? Same thing with the philips when I was using it. I sleep with the aircon on at around 24 degrees C. I believe the humidity level should be around 45-60 with the aircon on.
Can I ask how do you see which is OA and which is CA? I have attached my last night numbers with 2 of the highest OA data. Can you tell me what you see in those so that I can learn to read them in the future? Thanks again.
RE: First week result plus change from Dreamstation to Resmed Autosense 10
I have checked my 3 days of cpap use with the Philips and the Resmed. Although I have overall lower AHI with the resmed then the Philips. I seem to have more CA (clear airways/Central Apnea) with the Resmed then the Philips. I also notice that in all three of the days I was using the Philips, I had a higher inhalation index vs when I was using the Resmed where my inhalation seem to be equal or lower then my exhalation. Is this something to take note of? Or I should go back to trying my Philips with the same settings since I have the trial unit still with me?
RE: First week result plus change from Dreamstation to Resmed Autosense 10
There is no difference in the "respiration index" whatever that is. Tidal volume and minute vents are all within a small range between the two machines. If you're asking about I:E ratio, the Philips statistics are an error in all Philips machines due to the fact this is not a metric actually calculated by Philips and OSCAR has not revised (until the next release) and error where inspiration trigger is assumed to be when the flow rate crossover at zero flow happens...this will be changed to a positive inspiratory flow. Any error is compounded because you are breathing around the mask and exhaling orally. There is no expiratory flow in many places in the graphs, and this results in expiration time errors, even with the Resmed.
AHI is pretty comparable for you between the two devices and it is notable that you have low flow limitations which are a condition Resmed uses to increase pressure ahead of obstructive apnea and hypopnea. I think both machines do pretty well for you and the best advice is to go with the one that feels best and gives the best rest. The events will eventually be reduced as you adapt to the therapy, resolve the leaks and breathing around your mask and optimize the pressure.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: First week result plus change from Dreamstation to Resmed Autosense 10
This is 2 weeks in. Yesterday result which seem to indicate large leak. I think it happens sometimes when I sleep on my side. There is some leak on my nasal pillow which I am trying to solve. And another night a few days back with a great AHI and no large leak whatsoever.
Any suggestions on how to improve this? I am trying out another mask and another size of pillows to see if the leaks continue.
RE: First week result plus change from Dreamstation to Resmed Autosense 10
Hi Oliver. The results are looking pretty good, and an AHI of 0.59 is about as good as it gets. Could I suggest you re-post the chart for last night, but turn off the tidal volume graph and turn on the leak graph - we need to see exactly how the leaks are behaving.
