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How reliable is APAP on Resmed Airsense 10?
#1
How reliable is APAP on Resmed Airsense 10?
OK, so I have been using CPAP therapy now for approx. 4 months. Still very droopy and tired every morning, independent of how much I sleep. I have been going into Clinical settings and tweaking the pressure settings (and some other of the settings). I now have a minimum setting of 7 and a max of 8.4, which results in an AHI of approx. 1 on average. It seems in the brief and rare times that I have allowed for the machine to adjust the pressure on it's own,  it goes to much higher pressures. Should I just set the pressure range wide open and let the machine do it's thing in setting the needed pressure at any give time? How good is the APAP feature? Thanks in advance for your thoughts.
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#2
RE: How reliable is APAP on Resmed Airsense 10?
APAP is excellent for the correct user that has more of a vanilla Apnea, which is most.

I suggest getting your free copy of OSCAR, looking at the OSCAR wiki, then posting a standard screenshot. If your pressures go up, you either have Apnea events or flow limits the PAP is going after. Supposing it's true, then this explains your continued tiredness. No offense, but twisting dials without seeing where you're going with OSCAR is akin to driving blind. The MyAir info or the PAPs own display are basic data, OSCAR will surprise you with how much data your PAP produces.

Get OSCAR and make sure an SD card is in your PAP before you sleep. Use the SD to upload the sleep data into OSCAR, take a standard screenshot, post here, and we can help you drive with your eyes open.
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: How reliable is APAP on Resmed Airsense 10?
Thanks for your suggestions and input. I have been adjusting the pressure to try to lower the AHI as much as possible, without causing any central apneas. I found that I can set a maximum pressure of approx. 8-8.4 and have an AHI of ~ 1, while having virtually no central apneas. Unfortunately, I am still super sleepy and awake with a headache.
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#4
RE: How reliable is APAP on Resmed Airsense 10?
You're welcome. Since you're in the US, did your request your detailed copy of the sleep study, that's the diagnosic? HIPAA law permits you to request it. I'd suggest doing so, for your personal health file and posting a redacted version here.

The diagnosic will tell us what exact Apnea you're dealing with. The PAP you have may be the right one for you, but there's numerous times here on Apnea Board we've seen that Dr. McQuack gets it wrong and scripts the wrong PAP machine.
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: How reliable is APAP on Resmed Airsense 10?
I have seen flow limits to cause sleep problems and just a very tired feeling. We could look for that or other problems by looking at your OSCAR charts, without that all we would be doing is guessing.
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: How reliable is APAP on Resmed Airsense 10?
Thank you both for your suggestions. I will download Oscar and post data from my machine from last night. Slept fairly well, but not rested.
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#7
RE: How reliable is APAP on Resmed Airsense 10?
Here are 3 screenshots from last night from Oscar. My apologies for posting them all, but not sure which are most important.


Attached Files Thumbnail(s)
           
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#8
RE: How reliable is APAP on Resmed Airsense 10?
It appears the pressure is being driven by significant flow limitations. Your median and 95% pressures are both at the max setting of 8.6. I suggest you increase the max pressure to deal with the flow limitations which are probably disrupting your sleep. Increasing the max setting to 20 should not be harmful since the machine will only go as high as necessary to deal with the flow limitations. Once we see additional data the max can be readjusted if indicated.  A screen shot showing event flags, flow rate, pressure (not mask pressure), leak rate, and flow limits will provide a more clear picture of what id happening and provides the most important information for those trying to help you. Please see the link on how to organize your chart.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

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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#9
RE: How reliable is APAP on Resmed Airsense 10?
OK another bit to chew on as well, what's your EPR set to? I'd suggest full time at 3 unless your Central/CA go up a lot then back EPR to 2. EPR will help with flow limits as well as what Melman suggests.
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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#10
RE: How reliable is APAP on Resmed Airsense 10?
Yes you need to try EPR=3 and a higher max. The epr fights flow limits the trade off is a possibility of centrals. You need to try and see if the centrals increase.

If you had therapy related centrals you have been on Cpap therapy long enough to having gotten rid of them.
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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