Questions about my new AirSense 10 Autoset For Her

[barry15]

I recently bought a Resmed AirSense 10 Autoset For Her (AS10 hereafter).  I used a Resmed S9 Autoset (S9) for the last 8 years, and I found some big differences with the AS10.  It's very early days yet, and I plan to try changing some things, but to start, I used the Standard algorithm, pressure of 7.0 to 9.0, and no EPR.  That corresponds to what I have been using with the S9 recently.  After one night, I increased the max pressure to 10.0 because it was bumping up against the 9.0 limit.
 
Here are the main differences I found:
 
1.  My AHI was higher with the AS10, mainly because of an increase in hypopneas.
 
2.  There is much more Flow Limitation being reported by the AS10.
 
3.  My average pressure was significantly higher with the AS10.
 
4.  After rising, my pressure came down much more slowly with the AS10.
 
I suspect those are all connected, and I suspect it has to do with how the AS10 defines or measures hypopneas and Flow Limitations.  I don't much like seeing my pressure go higher and my AHI also going higher (due to more hypopneas).
 
I'll attempt to attach SleepyHead screenshots of two nights - Dec 1 with the S9 and Dec 8 with the AS10.
 
I'd appreciate any insights or ideas or suggestions, to help me understand what's going on.  I'd especially like to understand the Flow Limitation differences since Resmed brags that the AS10 is "more sensitive" to flow limitations.  I fail to see how that is a good thing in my case, but I have a lot to learn, which is why I'm asking.
 
Thanks very much.
 
Barry

[Walla Walla]

I think I'd switch to Soft mode and see how it reacts.

[barry15]

Thanks, Walla Walla.  I plan to try the other two modes for sure.  I didn't mention it, but the Flow Rate waveforms look terrible with the AS10, compared to the S9, and I had read something about increasing EPR to make the waveform better.  I tried that last night, and the AHI was lower.  I also found I liked the feel of the EPR (set at 2 last night), which I had never used with my S9.  I haven't looked at the full graphs for last night yet, but seeing the AHI lower on the machine's screen was encouraging.

My main questions are about whether Resmed changed the way they measure or define Flow Limitation or hypopneas in the AS10, compared to the S9.  Maybe that answer isn't known, but I thought I'd ask.  It bothers me that the AS10 reports so many more Flow Limitations than the S9 did, and also so many more hypopneas.

The other possibility, of course, is that the machine's response is enough different (from the S9) that it is actually CAUSING the Flow Limitations.  Trying the other two modes might fix that for me.

I'll keep trying things, including the other two algorithms, and I'm sure I'll have more questions.

Thanks for your response.  This board is really a great asset to apnea sufferers.

Barry

[yankees123]

Just an aside note,WallaWalla what happened to your avitar I have gotten used to seeing?

[Sleeprider]

Looks like Walla has acquired my warm, fuzzy scenic avatar approach, or perhaps he has morphed from an oil spot to a more enlightened state...or a global warming gas

I have a different take on the therapy question. At pressure 7-10 with no EPR we see mainly hypopnea. I think adding EPR into the mix makes a lot of sense, but it may be necessary to increase pressure slightly to compensate. I'm thinking pressure 8-12 with EPR 3 will show us something. It should stop the flow limits and hypopnea, and if CA does not replace it, then I think it will be a more comfortable and effective solution. I don't think soft mode will be needed once EPR is turned on full time, but whatever feels best to you is fine by me.

[Walla Walla]

I missed that you weren't using EPR before. Good move on your part to start using it. I would follow Sleeprider's advice and disregard mine.

yankees123, I got tired of him grinning at me.   

[car54]

Barry15,
 I went from a PR system 1 to a RESMED 10 auto just like you and I had the same problems with flow limitations. The RESMED would see the flow limitations and would increase the pressure to the maximum setting which would cause many leaks. It did not improve my hyponeas or apneas. It got to the point where I  was not sleeping good and I switched the Resmed out with a PR Dreamstation which is less sensitive to flow limitations. I tried all types of changes on the Resmed and it didn't seem to help. This is just my experience.

car54

[barry15]

Thanks very much, sleeprider.  I used an EPR of 2 last night, with the pressure still at 7.0 to 10.0.  That experiment was based on an old post I saw here, to someone else with similar questions about Flow Limitations.  Just as you indicated, my hypopneas were significantly less, there were a lot fewer flow limitations, and my average pressure was less, only briefly hitting the limit of 10 a few times, then coming down again.  The Flow Rate waveforms looked a lot better, too.  I had no idea that EPR could have that effect; I thought it was simply a matter of comfort, so I had never experimented with it before.

My plan is to try an EPR of 3 tonight, and I think I'll leave the pressure range at 7 to 10 for now, just keep the variables under more control.  I might very well end up increasing the pressure; I was surprised the other night when a pressure of 10 didn't seem to bother me at all.  I'll watch for an increase in CA's, as you indicated.

I was really encouraged today when I saw the results of adding an EPR of 2.  We'll see if an EPR of 3 is better or worse.

Eventually I'll try the "soft" For Her mode, just to see if I notice any difference, but for now, I am encouraged.

Barry

[barry15]

car54,

Thanks for sharing your experience.  One reason I'm pursuing this aggressively right now is that I have a 30 day return period for the AS10, and I was out of town when it arrived (it was a great Black Saturday sale, 25% off, but it meant I lost a week of the 30 day return period).  I want to make this AS10 work, and if you look at my last post, you will see that I made some progress last night.

It is very obvious to me that the AS10 uses some different definition of Flow Limitation than the S9 did, and that seems to be what is causing my problems.  At least, that it how it seems to me at this point.  On the other hand, maybe my sleep wasn't as good as it could have been with the S9, regardless of the AHI numbers, so I plan to work hard to figure out the best I can do with the AS10.

Barry