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Need set-up help for ResMed Airsense 10 for Her
#1
Need set-up help for ResMed Airsense 10 for Her
I just found this forum this morning and have read a lot of threads.  I've also waited all day for my doctor's office to call without success.

I have been using a Respironics System One for five years and love it.  It worked well from day one, and I never miss wearing it (barring things like power outages).  My new insurance will only supply me with a ResMed Airsense 10 as a replacement, though, without a fight.  I picked up my new machine and tried using it last night and only made it about 15 minutes before I went back to my Respironics.  I believe the settings are my problem -- or perhaps I do better with Respironics (and my doctor wanted me to get a Dreamstation).

I was hoping you could help me set up my Airsense 10 to mimic my Respironics.  I want to give this machine a real try before fighting for a Respironics.  I don't believe the Airsense 10 went past a pressure of 4.  At least that's what I saw when I turned it off.

My problem is muscular-skeletal.  When I tried to use it last night, I really struggled to exhale.  I also had what seemed to be excessive amounts of air blowing out of the airholes in the mask elbow.  Breathing was difficult.  When my chest wall starting hurting, I switched machines.  I'm still sore today.  The Respironics was far quieter with less air blasting me with the same hose/mask.  It was just far easier to breathe with.  I wasn't fighting the machine.

I tried to read my Respironics settings and Airsense 10 settings so hopefully you can help me know what to change.

Respironics System One
A Flex = 2
Ramp  =  0.2  (20 minutes)
Ramp Start = 4
Tubing Type = 22
A-Flex = 2
A-Flex Demo = 2
Therapy = 7 (pressure set from 7-12)
AHI 30 day 0.1
30 day pressure = 8
Mask alert = off
Mask resistance = off
Opti-start = On

Air Sense 10 For Her
Mode = Autosense for Her
Pressure 7-10
Mask = Full Face (ResMed F20)
Ramp Time = Auto
Start Pressure = 4.0
EPR = On
EPR Type = Full Time
EPR Level = 3
Humidity Level = 4 (not using humidity)
Tube = Slimline (don't use the narrow heated tubing)
AB Filter = No
Essentials = Plus
Smartstart = Off

If there are other settings you need, I will do my best to find them.  I only know what some of these are but figure you guys will understand them all.

Thanks!
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#2
RE: Need set-up help for ResMed Airsense 10 for Her
G'day duncanblizzard. Welcome to Apnea Board.

I think the majority of members here would say you got a better machine in the Resmed. Resmed machines tend to respond more quickly to events and head off apneas before they happen (when everything is set up right). However, not everybody is the same, and some people prefer the way the Philips works. They're obviously both good machines and between them they dominate the market.

Looking at your settings, they are very similar between the two machines, so you shouldn't experience such a difference in "feel". The EPR on the Resmed works somewhat differently to the Flex on the Philips, so maybe changing that would make a (small) difference. You could also try setting the ramp to manual and reduce the ramp time (or turn it off). The fact you only used the machine for 15 minutes would indicate it never got out of the ramp, so you didn't experience the proper therapy pressure.

I'm having some difficulty understanding what the underlying problem is. You believe that the pressure was too low (which it could have been if ramp was still on) but at the same time you talk about air "blasting" you. You say you struggled to breathe - were you getting too much air (from the blasting) or too little (from the low pressure)?

I wonder if your old Respironics was still producing its rated pressure. After some years there may be internal leaks or other defects so that it's blowing less than the set pressure.

If you don't already have it, you can obtain the clinical manual for your Resmed at the address below. Read and follow the instructions exactly, as there ae hundreds of different manuals available, and we need to make life easy for our back-room elves. Smile

https://www.apneaboard.com/adjust-cpap-p...tup-manual
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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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: Need set-up help for ResMed Airsense 10 for Her
(01-17-2019, 10:18 PM)duncanblizzard Wrote: I just found this forum this morning and have read a lot of threads.  I've also waited all day for my doctor's office to call without success.

I have been using a Respironics System One for five years and love it.  It worked well from day one, and I never miss wearing it (barring things like power outages).  My new insurance will only supply me with a ResMed Airsense 10 as a replacement, though, without a fight.  I picked up my new machine and tried using it last night and only made it about 15 minutes before I went back to my Respironics.  I believe the settings are my problem -- or perhaps I do better with Respironics (and my doctor wanted me to get a Dreamstation).

I was hoping you could help me set up my Airsense 10 to mimic my Respironics.  I want to give this machine a real try before fighting for a Respironics.  I don't believe the Airsense 10 went past a pressure of 4.  At least that's what I saw when I turned it off.

My problem is muscular-skeletal.  When I tried to use it last night, I really struggled to exhale.  I also had what seemed to be excessive amounts of air blowing out of the airholes in the mask elbow.  Breathing was difficult.  When my chest wall starting hurting, I switched machines.  I'm still sore today.  The Respironics was far quieter with less air blasting me with the same hose/mask.  It was just far easier to breathe with.  I wasn't fighting the machine.

I tried to read my Respironics settings and Airsense 10 settings so hopefully you can help me know what to change.

Respironics System One
A Flex = 2
Ramp  =  0.2  (20 minutes)
Ramp Start = 4
Tubing Type = 22
A-Flex = 2
A-Flex Demo = 2
Therapy = 7 (pressure set from 7-12)
AHI 30 day 0.1
30 day pressure = 8
Mask alert = off
Mask resistance = off
Opti-start = On

Air Sense 10 For Her
Mode = Autosense for Her Recommend that you do not use the for her when trying to mimic your Respironics The normal Auto will be closer
Pressure 7-10
Mask = Full Face (ResMed F20)
Ramp Time = Auto set to 20 to mimic your Respironics   OFF is generally recommended
Start Pressure = 4.0
EPR = On
EPR Type = Full Time
EPR Level = 3 set to 2 to best mimic your Respironics
Humidity Level = 4 (not using humidity)
Tube = Slimline (don't use the narrow heated tubing) It is important to set this to the tubing size you are using this IS the wrong setting
AB Filter = No
Essentials = Plus
Smartstart = Off

If there are other settings you need, I will do my best to find them.  I only know what some of these are but figure you guys will understand them all.

Thanks!

The recommendations above are to mimic your Respironics as close as possible.

My suggestions are to start with what I have suggested above.  The big difference is that the AutoSet will respond faster to your events.
Once you have made these changes I strongly suggest you post your detailed nightly charts using Sleepyhead (free) software.  This will allow us to view what is happening down to a breath by breath basis when necessary.  See my signature for how to download sleepyHead and, very important,  organize the charts to present the more important ones (Organize link).  


Fred
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 

New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Download SleepyHead
Organize Charts
Attaching Charts

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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#4
RE: Need set-up help for ResMed Airsense 10 for Her
You mentioned air blowing out the elbow did you change masks as well ? You can use your old mask with your new machine if it’s what your used to
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#5
RE: Need set-up help for ResMed Airsense 10 for Her
I think you got the better machine, and I agree with the changes suggested by Bonjour above. I would also recommend you set the pressure range from 7-12 as you had with the Respironics and let things move if needed. I especially think you should turn off Ramp as this is what you're feeling when you turn on the machine. With the Philips you used Opti-Start which immediately starts at a higher pressure last used for therapy. Finally you will like SmartStart which turns your machine on automatically when you put on the mask, and off when you remove it. It works much better than the Philips variant. If you will post a SleepyHead chart we can quickly determine how to help you improve results and comfort. Good luck.
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#6
RE: Need set-up help for ResMed Airsense 10 for Her
Thank you for all of your help!  I made the following changes per your feedback.

Turned off "for her"
Turned off ramp
Set EPR to 2
Changed tubing to standard
Changed pressure to 7-12
Turned SmartStart on
Turned humidity off

I tried it for a few minutes, and it seemed good.  I'll try the new set-up tonight.

As far as masks, I've always used a nasal mask (mostly F&P Zest and then Zest Q which is standard issue for Kaiser So Cal).  I have become increasingly less happy with it.  I've been pressured to use other nasal masks since moving, and they keep getting smaller and smaller.  I was getting them oversized to ease breathing which isn't ideal.  I borrowed a couple of masks from my doctor including the full face ResMed F20 to see if they made breathing easier.  I used the F20 for a week and liked it.  It also solved the problem of that hard structure going to my forehead which gave me trouble when traveling and using different pillows (and I travel a lot for work).  I even broke the structure once while re-positioning it and still had to wear it for a week, and it doesn't work well without an intact structure.  So with my new machine I got the F20, and it gave me no trouble with my Respironics, and with the trial I just did, it seems to work fine with the Airsense 10.  I'll keep the Zest Q and other trial nasal masks as back ups.

More tomorrow once I try a night with these settings.

Thanks again!
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#7
RE: Need set-up help for ResMed Airsense 10 for Her
For the F20 you can get a more diffused elbow that reduces the blast of air from the vent, [Image: attachment.php?aid=7053]
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#8
RE: Need set-up help for ResMed Airsense 10 for Her
Many of us use the Resmed Airfit P10 nasal pillows. It is the quietest and smallest of the nasal interfaces. Use a larger nasal pillow than you think you need. Resistance is futile...try it you'll like it.
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#9
RE: Need set-up help for ResMed Airsense 10 for Her
(01-18-2019, 12:18 AM)bonjour Wrote:
(01-17-2019, 10:18 PM)duncanblizzard Wrote: Tube = Slimline (don't use the narrow heated tubing) It is important to set this to the tubing size you are using this IS the wrong setting
I disagree with setting the Tube to Standard.
The standard tubing supplied with all Resmed AirSense 10 Devices is SlimLine (15mm), unless the optional heated ClimeLine is ordered (in which case the device knows sets it to ClimateLine automatically).
I'm not sure you can even get Standard size (19mm) from ResMed any more.
https://www.resmed.com/us/en/consumer/pr...ccessories
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#10
RE: Need set-up help for ResMed Airsense 10 for Her
No, I have the 19mm.  It may not be ResMed brand, but my doctor specifically requested it with my prescription.   It was the first thing the guy told me when I picked up my machine, but apparently he didn't bother to change my settings to match what he gave me.  I've had nothing but problems with this DME, but it's the only one my insurance will allow for a CPAP.


We're working the chest wall issues, but for now I can't use the narrow tubing or nasal pillows.  And thank you for the info on the elbow.  I'll try what I have with the new settings and see how I do.  At least I have the Respironics machine as a back up until this one is set up properly for me.

Does the DME get data from my machine?  I'm curious if they'll know that I changed the settings.
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