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Getting used to APAP
#1
Getting used to APAP
Hi All,

Bottom line: I'm trying to get used to and figure out the best way to use my new Airsense 10 Auotoset after 6 happy & comfortable years with my Resmed S9.

Some history (I'll try to be brief - something I'm not always good at):
About 10 years ago, I was diagnosed with mild to moderate apnea and was given a Resmed S8 with some kind of face mask.  I don't think I used it more than 5 or 6 times before it got put in a closet.

In 2013, I was sleep-tested again and this time the apnea was moderate to severe. I remember that the AHI in that study was 43. I was given a Resmed S9 and nasal pillows. Somehow, this time I had very little trouble getting used to the machine and pillows and I have been happily using it since then. (It's probably not necessary to mention my wife's happiness at the absence of horrifying high decibel snoring.) I joined this board and visited for a while, but never really had enough issues to need much help. I fooled around with software, but stopped using it pretty quickly. The original SD card is still sitting in that machine.

The S9 pressure was set at 11 and I've never had any reason to change it.  Every morning I check the machine for the night's AHI and it's always been good: usually between 1.3 and 3.5 or so. Once or twice a month it'll hit 4+. Maybe 2 or 3 times a year it will go above 5. I think I hit 6 one time.

But the S9 has gotten old. It still works, but a couple of chunks of the plastic casing have chipped off during travel. I thought it might be time to get a new machine and maybe try an APAP. The current coronavirus situation somehow made this seem more important. I found a good price on [Commercial Link Removed] Supplier #1 and 4 days ago I received my new Airsense 10 Autoset. I've used it 3 nights so far and I definitely need help.

The first night, the machine was set to APAP with the default 4-20 pressure setting. This was an awful night. I usually stay up late have no trouble falling asleep once I'm in bed, but I had dozed on the couch and this time I lay in bed almost an hour before I slept. The machine seemed to stay at 4 and I found this uncomfortable and too much work to draw a breath. Before I fell asleep, I shut off the machine and saw that the AHI was over 10 - and I had not been sleeping! I woke up several times during the night and my brief looks at the screen showed the pressure at 11, 14, etc. In the morning, the AHI reported was 10.5.

The second night, I kept it on APAP, but changed the pressure range to 9-20. This was more comfortable, but I woke up several times from blowing air out my mouth - glancing at the pressure showed it in the 14-15 range. The AHI in the morning was over 7.

Last night, the third night, I kind of gave up on autoset and set the machine to CPAP mode with my old pressure setting of 11. I had a comfortable night. The AHI showed as 5.5. Still higher than my usual, but closer to normal. One thing I'm wondering is whether this machine is any more or less accurate than my old one in reporting the night's AHI.

For the time being, I'm planning to keep the machine set to CPAP and 11, but I'd like to be able to take advantage of the autoset feature. I'm wondering whether to try a chin strap or possibly a full face mask (I don't wanna!) to deal with the pressure causing me to blow air out from my mouth. I'm also not sure why the reported AHI has been so high those nights I tried autoset. I'm also considering keeping it on CPAP and upping the pressure a bit.

I'd appreciate any thoughts and suggestions. Sorry for being so long-winded. I'm glad you fellow apnea folks are there and hope you're all doing well and staying safe from this horrible virus.

Be well,
Paul (Discon)


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#2
RE: Getting used to APAP
I would highly recommend that you download OSCAR for a more definitive detail of your sleep sessions.  Since you were using 11 cm on your S9, I would set the AS10 to a pressure range of 10 to 14 cm. until you have some data in OSCAR to provide a more defined setting.  If you don't have an SD card for the AS10, you could reformat the S9's card, if you aren't currently using it.  If you need the S9's data, copy it to your PC in a dedicated directory before formatting it.

The pressure swings could be caused by either chin tucking (most probable) or flow limitations.  Don't worry about this until you have obtained a night's data for OSCAR.

Please review the formatting of the OSCAR Daily screen for posting here in my links below my signature.

Overall, your AS10 should perform as well as or better than your S9.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
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Useful Links -or- When All Else Fails:
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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.
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#3
RE: Getting used to APAP
Until you get an SD card, it would be good to check you S9 settings beyond just pressure and AHI.

You might find a mask or hose setting that is different.

I never liked the air feel of a slimline hose on my S9. I tried a slimline hose on my Aircurve 10 without issues. The machine was set to standard. I’m not saying that is a cause, but there can be odd quirks.

A few years ago I was “gifted” an S8 and decided it would be a good travel machine. It was horrible compared to my S9 and I never got good numbers.

As far as APAP, if straight 11 works, you can set an APAP range of 10-12.

John
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#4
RE: Getting used to APAP
Thanks for the replies, Crimson and John. I do have an SD card in the Airsense, I just haven't popped it out yet. I'm used to ignoring it from my S9, but I'll download OSCAR and see what it shows me. I'm pretty geeky for an old guy, but I don't have the patience with learning curves that I did in my old Commodore 64 days Smile

I did set the AS to "pillows" before I started. I haven't noticed a hose setting, but I'll check. Using the climateline now, but I never noticed any real difference on the S9 between that and the slimline. I'll experiment. 

I'll be back after I've built up some more data. Thanks again.
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#5
RE: Getting used to APAP
If you are using the climate line hose then the hose is auto detected and there is no need to make a hose selection
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#6
RE: Getting used to APAP
Thanks!
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#7
RE: Getting used to APAP
You have plenty of data on the SD card already. You just need OSCAR
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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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.
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#8
RE: Getting used to APAP
OK. I went back to APAP mode and set the range at 10-14, as suggested. This was the first night the AHI was below 5, though it was still above the usual below 3 with my old S9. I had numerous instances of waking up from blowing puffs of air out from my mouth, especially when sleeping on my side. It seemed better on my back. I tried to check the pressure when these puffs woke me up and it seemed to be around 12.5 at those times.

I believe I've formatted the OSCAR screenshots properly, although I couldn't get the bottom of the left sidebar to be included. I'm attaching each of my last 3 nights. The first night (10.5 AHI) was an outlier anyway, since I had it set for pressure of 4-20 and had such an awful night.

Again, thanks to all for help and suggestions. The members of this board are so generous with help and opinions and I really do appreciate that.

Be well, all
Paul


               
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