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Need set-up help for ResMed Airsense 10 for Her
#41
RE: Need set-up help for ResMed Airsense 10 for Her
(01-30-2019, 01:38 PM)lynneat Wrote: 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.

I always send my doctor a message when I change my settings and tell him why I changed it.  I figure they're a partner in helping me improve my health.  I've never had a DME that I considered any good and don't inform them.

Let me ask a further question on my data.  And I'm looking for help in how to read the data not just an answer.  For example, when I was told "what it will take to stop decapitating all of the inspiratory breaths,"  that gave me a picture of what I need to look at in my data to see what you're seeing.

Last night I had six events -- all CAs.  That's a lot for me.  I'm trying to understand what precedes them because to me the flow rate data is very different on different events.

Data 1 shows erratic flow rate data right before.  Can I tell from the data if that's an arousal, turning over, etc.?  Data 2 shows a long, "fuzzy" horizontal line, and I thought that fuzziness was snoring, but it's not in my case.  What can we understand preceded that event?

Maybe I'm trying to get more out of my data than I really can, so you can tell me if it doesn't clearly indicate something.  And I think you've said high pressure increases CAs, but I haven't increased my pressure at all recently (just the one night to 13 instead of 12).

And thanks to whoever writes the primers.  The mask fitting one has really helped me reduce mask leak.



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#42
RE: Need set-up help for ResMed Airsense 10 for Her
The "fuzzy" you see before the CA event is the machine send a testing "FOT" pulse to see if the airway is open (Central event) or blocked (Obstructive event).

FYI, I wrote the Mask Primer, among a number of other Wiki articles.

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

New to Apnea? Helpful tips to ensure success
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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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#43
RE: Need set-up help for ResMed Airsense 10 for Her
The doctor is super nice! Her staff...SUPER well I can't say it here :Smile You have to wait 2 weeks even though you call several times before they respond. AND the office manager told me if THIS DME doesn't work for me that they will give me her records and I'll have to go to another doctor.  I don't think they can legally do that.  We changed from what they first sent stuff to because of online reviews.  Bad move.  This DME wouldn't respond to calls...would make appts after a week or so.....so I requested a change.  Trouble is our whole family goes to this doctor....can't expect all to change doctors.  Great doctor!  I hate it when docs think they are gods.
ANYWAY thanks for all the info.  Can't say it enough.
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#44
RE: Need set-up help for ResMed Airsense 10 for Her
I really don't care how the machine scores these events. I see a lot of flow limitation followed by arousal and a CA event, then flow limits with a CA event. This is obstructive in origin.

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#45
RE: Need set-up help for ResMed Airsense 10 for Her
question: You say re: nasal pillows (in the Mask Primer doc) Generally these masks are for non-mouth breathers. There are ways (chin strap, cervical collar, tape) which may eliminate mouth breathing and allow you to use this type of mask
My daughter's nose stuffs up and then she mouth breathes.  The first DME said she had to have a full face mask because of this.  the second said the script was for a NASAL pillow mask.  I'd call the doctor but they don't return messages before 2 weeks!!!  Yea I need another doctor.  Thanks for the info there...re chin strap.  But if her nose is stuffed....God help us.  Hard to do this with no access to the doctor.  I WILL ask to see the script but either DME OR the office could have made a mistake.  How awful! Newbies.....get a doc who isn't so busy!!! returns calls. Sad
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#46
RE: Need set-up help for ResMed Airsense 10 for Her
(01-30-2019, 04:55 PM)bonjour Wrote: FYI, I wrote the Mask Primer, among a number of other Wiki articles.

(01-30-2019, 06:48 PM)Sleeprider Wrote: I really don't care how the machine scores these events. I see a lot of flow limitation followed by arousal and a CA event, then flow limits with a CA event. This is obstructive in origin.

Thanks for clearing up that these are obstructive.  I can see the indicators for obstructive and was a little concerned if I need to raise pressure for obstructive and lower pressure for CAs.

Thanks for all the effort you guys have put in and continue to put in to help educate those of us who are learning as we go!
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#47
RE: Need set-up help for ResMed Airsense 10 for Her
I returned my ResMed machine yesterday while awaiting the results of my sleep study.  I'm using my old System One with a nasal mask.

I am surprised how different the data seems to be.

1.  Is the System One more sensitive to snoring?  And do I need to do something due to the snoring data?
2.  Why does my pressure stay so low on this machine (other than the early snoring) compared to the ResMed?
3.  What triggered the flow event on Data 2?  The flow rate appears pretty much equal.

Thanks!


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#48
RE: Need set-up help for ResMed Airsense 10 for Her
You should turn off the VS2 graph on your System One. These snores are often over stated, and the machine only adjusts pressure based on VS snores. The Respironics Auto machines are very poor at raising pressure with flow limitation which is a main feature of your sleep. We mentioned flow limitation before. Resmed increases pressure much faster on flow limitation, and the For Her model specifically targets FL. It will be interesting to hear about your results, but I'm certain you will be better treated on a Resmed than Philips.
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#49
RE: Need set-up help for ResMed Airsense 10 for Her
The Respironics Auto machines are very poor at raising pressure with flow limitation which is a main feature of your sleep. We mentioned flow limitation before. Resmed increases pressure much faster on flow limitation, and the For Her model specifically targets FL.

Are you saying that the Respironics AUTO machines raise pressure is poor but RESMED is better?  I was considering asking for the For Her model but not if air flow is limited.  Sorry to be so dumb....I THINK I want to ask 'what is flow limitation?'
Thanks. Lynneat  
Newbie question:
You wrote:
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#50
RE: Need set-up help for ResMed Airsense 10 for Her
(01-20-2019, 11:28 AM)bonjour Wrote: Here are the definitions.  For obstructive events the cause is identical.  To have "Clinical Significance" they need to have either an arousal or an Oxygen DeSAT associated with them.
We do not believe that your Flow Limits are causing either
  • Apnea: 80% to 100% reduction in airflow for >= 10 seconds

  • Hypopnea: 50% to 80% reduction in airflow for >= 10 seconds

  • Flow Limitation: <50% reduction in airflow for >= 10 seconds
As you see the difference is in the amount of flow reduction associated with them.
In short, your assumption about not needing increased pressure is correct.

I will add that this is not necessarily the case with everyone.

Fred

(01-20-2019, 11:34 AM)Sleeprider Wrote: You should read the Flow Limitation wiki http://www.apneaboard.com/wiki/index.php...Limitation

If you zoom in on your flow rate chart in Sleepyhead you will see the signature flattening of the inspiratory wave-form of flow limitation. This is caused by an upper airway restriction that may or may not respond to higher pressure, however it will respond to higher pressure support. That is why people with Upper Airway Restriction Syndrome (UARS) do very well with bilevel machines. http://www.apneaboard.com/wiki/index.php..._and_BiPAP  

In your case, everything looks pretty good at this point. Good tidal volume, respiration rate, minute vent and very very low AHI. Without much doubt, most of your events in a diagnostic sleep study was hypopnea arising from UARS. You fortunately got one of the best CPAP machines for treating this. You would probably have better results with the Aircurve 10 Vauto because you could use more inspiratory pressure support.  My recommendation is that you simply keep the current settings for a while and don't worry about it.  If eventually you want to evaluate the comfort and efficacy of higher pressure, you're free to use a higher maximum pressure. The machine will increase pressure to whatever setting you set because of the FL.  This is pretty common on the forum and most people that have chronic FL prefer to use the EPR to minimize it, and restrain maximum pressure.

(02-04-2019, 12:50 PM)lynneat Wrote: Are you saying that the Respironics AUTO machines raise pressure is poor but RESMED is better?  I was considering asking for the For Her model but not if air flow is limited.  Sorry to be so dumb....I THINK I want to ask 'what is flow limitation?'
Thanks. Lynneat  

The above two messages found earlier in this thread helped me understand flow limitations.  I view them as mini-hypopneas -- obstructive events of less magnitude.  From my understanding, you can see them in my data in the flow rates on the zoomed in charts.  You can see that the expirations (negative flows) go straight down to points, but the inspirations go up and level off before going down in a table top manner or as someone said in "decapitated" inspirations.  So I assume my inspirations would be of higher magnitude if the flow was not limited.

Others can speak better to the different machines.  I'm a newbie too.  I didn't find the ResMed Airsense 10 auto very comfortable and am hoping to have a bi-level prescribed.  My sleep study was last night, and although they didn't say much about it, I struggled to sleep and mostly tossed and turned until they started bi-level in the second half of the night.  She said I hit REM sleep three times in the second half of the night, and I'm sure I didn't hit it in what little sleep I had in the first half.  If they don't prescribe a bi-level (and I think they will), I will buy one myself.  Last night proved to me that it's better for my health.  The contrast for my specific situation was stark, but your situation may be different.  Others can better help you assess your data.
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