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Help transitioning from Dreamstation to Airsense 10 Auo-set
#1
Help transitioning from Dreamstation to Airsense 10 Auo-set
Hi,

I started CPAP therapy in 2019, using the Dreamstation. My pre-therapy AHI was 13 and I averaged around 4.5 AHI with the Dreamstation. With the Dreamstation in recall, I got an Airsense 10 Autoset.

The Rx is the same, and the mask/headgear are the same (I had been using Resmed F20 Full-Face all along). It's only been a few days on the Airsense, but my AHI has averaged around 1.2, I am getting bloated during the night, and I'm getting more leaking. It would seem that the Airsense is providing higher pressure (resulting in lower AHI, higher leakage and bloating) than the Dreamstation -- but I'm unclear as to why that is, whether it's overall better for me, and how to resolve the bloating issues.

I see from reading other threads that I should turn on the EPR. Any other advice much appreciated!

I've attached Oscar screenshots.

Thanks!
PT


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#2
RE: Help transitioning from Dreamstation to Airsense 10 Auo-set
Yes, you need to set the EPR to 3.  FLOW limitations are driving your pressure up and EPR can help control that.

But note, a minimum pressure of 4cm isn't doing you much good.  With your median pressure hanging around 8cm, your minimum pressure should be at 8cm.  In order to keep Aerophagia at bay, bring your max pressure down to
14cm.

Summary:  pressure range 8 minimum - 14 maximum, with EPR set to 3.  

If you are uncomfortable with a Min of 8 or the Aerophagia is still prevalent, then back the min pressure down to 7cm. Any less than 7cm, you will not receive the full benefit of EPR.

If you must use ramp, set it to start at 6cm for 5-10 minutes.  In time, try to eliminate ramp.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy




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: Help transitioning from Dreamstation to Airsense 10 Auo-set
100% agree with Opal.
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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#4
RE: Help transitioning from Dreamstation to Airsense 10 Auo-set
Thank you both.

Any insight as to why my results (AHI, Aerophagia, leakage) are so different on the Airsense vs Dreamstation?
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#5
RE: Help transitioning from Dreamstation to Airsense 10 Auo-set
The ResMed pressure is driven by flow limits. EPR controls flow limits. The ds uses other readings to raise pressure. The low of 4 is to low of a starting point, the ResMed acts quicker to apnea so starting so low means it hits a higher pressure quicker causing leaks. Starting the ResMed at 8 will stop that and as you get the mask set for the higher pressure you will have less mask leaks.
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: Help transitioning from Dreamstation to Airsense 10 Auo-set
ResMed machines are more aggressive than Respironics, so you will usually see higher AHI numbers on a Respironics.

Aerophagia is simply swallowing air. Even with a full face mask, you are either gulping or swallowing air.
Your mouth could be dropping open when sleeping and allowing this to happen.

The fixes for this are lowering pressure, using EPR, and being more aware if you are mouth breathing.
Sometimes sleeping slightly elevated is helpful.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy




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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#7
RE: Help transitioning from Dreamstation to Airsense 10 Auo-set
I am definitely a mouth breather (my nasal passages are too narrow to breath consistently through the nose). In any case, I'll follow your recommendations and post a followup after a few days of trying the new settings. The info you've provided about the different mechanisms of the different machines is very helpful.

thanks again
PT
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#8
RE: Help transitioning from Dreamstation to Airsense 10 Auo-set
Look at your charts, As flow limits are high, so is your pressure. So you need to better treat the slow limits. This is done with EPR. The settings above should be pretty good but may not be your final settings.

PR machines elevate pressure based on snores, there is a very high correlation between pressure increases and the VS2 chart, similar to ResMed and Flow Limits.

Every brand is different and you need to individually optimize each one.
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#9
RE: Help transitioning from Dreamstation to Airsense 10 Auo-set
Want to post an update -- I've applied the settings recommended by @OpalRose: pressure range 8 minimum - 14 maximum, with EPR set to 3, no ramp. No more bloating or leaking. AHI is ok, but I've attached screenshot of last night to ask if there are any recommendations to improve.

Thanks again.
PT
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#10
RE: Help transitioning from Dreamstation to Airsense 10 Auo-set
(07-11-2021, 04:46 PM)PillowTalk Wrote: I am definitely a mouth breather (my nasal passages are too narrow to breath consistently through the nose). In any case, I'll follow your recommendations and post a followup after a few days of trying the new settings. The info you've provided about the different mechanisms of the different machines is very helpful.

thanks again
PT

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