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Need set-up help for ResMed Airsense 10 for Her
#31
RE: Need set-up help for ResMed Airsense 10 for Her
Duncan, I think the comments about persistent flow limitation continue to apply. Your auto-CPAP pressure will always move to the maximum of the set range due to flow limitation. The real solution for this is bilevel pressure support beyond what your Airsense 10 can provide; in other words an Aircurve 10 Vauto. It is possible you can obtain a prescription based on your complaints of discomfort. That mostly depends on the knowledge of your doctor and if he support you having the best possible therapy for your condition which seems to involve a very persistent flow limitation or restriction in the upper airway. More pressure support during inhale will allow your inhale effort to be easier, more restful and will probably improve your sense of having better quality sleep. The articles I linked to before may be good discussion points between you and your doctor. My first bilevel machine, I purchased myself without a prescription. It was the ability to compare the therapy quality and my sense of feeling better that helped me to get the prescription. There is more than one way to approach this, the traditional one depending on your doctor to look out for your best interests, and the second being to just take things into your own hands and solve the problem.
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#32
RE: Need set-up help for ResMed Airsense 10 for Her
I saw my new sleep doctor today. He thought either a bi-level or a greatly reduced pressure (8) with this machine might be best. He's ordered a CPAP titration to Bi-level sleep study next week. When I saw the cost, I wondered why he just didn't give me a bi-level to try. I guess I'll see what the sleep study shows. He said I could also try out different masks which I'd like to do.
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#33
RE: Need set-up help for ResMed Airsense 10 for Her
It's really odd that we spend $2K to see if a bilevel that costs $1000 will work. Life in the medical world.
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#34
RE: Need set-up help for ResMed Airsense 10 for Her
I knew my doctor put my machine in "for her" mode two days ago, but he also fixed my pressure at 12 with EPR 3.  I slept poorly last night tossing and turning.  I'm trying to understand from my data what triggered my event. 

Questions
1.  What does "for her" mode do?
2.  Is each inhale at 12 and each exhale at 9 when there's a fixed pressure instead of a range?
3.  What do the blue shaded areas in my data mean?
4.  Was I turning over at 5:45:50 when my flow rate goes out of pattern?  And then that led to the mask leak and hypopnea?  Or am I misunderstanding the data?

Thanks for you help!


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#35
RE: Need set-up help for ResMed Airsense 10 for Her
You machine is now in CPAP mode (Fixed pressure of 12) inhale pressure 12 exhale pressure 9 as you are using EPR of 3 the shaded areas are Large Leaks a Leak over 24L/M. But your numbers look great how do you feel
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#36
RE: Need set-up help for ResMed Airsense 10 for Her
First, there is no 'For Her' mode with fixed CPAP. For Her is an Autoset mode that adjusts pressure differently from standard autoset mode. It automatically adjusts pressure in response to flow limitation, snoreand obstructive apneas along with an increased sensitivity to each flow-limited breath, providing a more comfortable therapy for women. Increases sensitivity to each flow-limited breath, providing a more comfortable therapy for women I'm including an image below describing the difference.  To be in for her mode, you need to select that mode and an appropriate range of pressure i.e. 10 to 14 cm with EPR 3.

You had a single hypopnea event and it was preceded by flow limited breathing.  Your event was the result of a restricted upper airway that caused enough flow reduction to flag a hypopnea.  Everything else on this chart suggest very good tidal volume respiratory rate and minute vent.   In other words, this single event is not very significant over a 7-1/2 hour session, and your results are excellent.  I think you should stick with it for a while.


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#37
RE: Need set-up help for ResMed Airsense 10 for Her
I know my AHIs are low, but some nights I toss and turn from side to side and don't sleep well.  Some nights I sleep soundly and hardly turn over.  I'm trying to understand the cause of the tossing and turning.  I don't think it's leaks.  I think leaks are a by-product of turning.

Last night I slept well.  The night before, I didn't.  I've included three graphs from last night.  The previous night are in the last post.  And I switched my settings back to auto and 8-12 last night.  I want some stability in settings to try to sort things out.

I zoomed in on the two events last night, one CA and one Hyp.  I also uploaded the overall night.

Can anyone help me understand why nights like last night went smoothly without tossing and turning and the previous night resulted in tossing and turning?  What data would help in determining that?


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#38
RE: Need set-up help for ResMed Airsense 10 for Her
I see persistent flow limitation. The solution may be higher pressure or pressure support. Pressure support requires a bilevel machine like the Aircurve 10 Vauto and with your results, insurance isn't going to buy it. That leaves higher pressure settings or getting a quote from someone like Supplier #33. If you want to try something ike a minimum 9.0, maximum 16.0, keep EPR 3 it might make a difference. Clearly, your results do not make a compelling argument for higher pressure, but that is probably what it will take to stop decapitating all of the inspiratory breaths.
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#39
RE: Need set-up help for ResMed Airsense 10 for Her
I was told the DME and doctor get results from the machine of your breaths....but I too would like to know if they know you changed settings.  If you change them and have a complaint will they blame you (when it may not even be the change you made that brought on the complaint?...and will insurance penalize you somehow for that scenario?) THAT is my concern.
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#40
RE: Need set-up help for ResMed Airsense 10 for Her
The DME and Doctor only get summary results unless the utilize the SD Card.  They DO NOT get detailed records like we look at without using the SD Card.  They do get settings so they can tell they have been changed.  They will very likely tell you that you cannot, should not change the settings.  The usually accept the settings when they work updating their records to your settings when they see that they work.  The issue with insurance is compliance, do you use the machine, otherwise they are fine.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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