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ResMed Airsense 10 Autoset Problems
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ChaosTheorist Offline

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Post: #11
RE: ResMed Airsense 10 Autoset Problems
(09-20-2014 01:45 PM)Lahanna44 Wrote:  ....a ResMed Airsense 10 Autoset with the pressure settings at 8-14 and Humidity at 5.
Were those the settings of the S9? Seems like an A/B comparison is only valid if the two are set up as identically as possible. Especially for ResMed, with the much more aggressive pressure increase when breathing is interrupted.
09-26-2014 07:39 PM
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vsheline Offline

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Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
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Post: #12
RE: ResMed Airsense 10 Autoset Problems
(09-21-2014 11:50 AM)zonk Wrote:  
(09-20-2014 01:45 PM)Lahanna44 Wrote:  Everytime the machine increased the pressure it woke me up ( due to the force of the air blowing out of my lips) and I spent several mins trying to get back to sleep. Also each time the pressure was increased , my nasal mask would start whistling around the hose connection ( geesh) and that drove me nuts Sad I woke up enough a couple of times to check the pressure and It was at 10, then around 5:30 am I woke with my chest hurting, burping and had acid reflux, hose whistling and a feeling of having swallowed way to much air, checked the pressure and it was at 11.3
( OMG) So...... I got up and set my S9 back up and went off to a restful slumber for the next 3 hours.
That is exactly my experience with the AirSense 10 AutoSet, never had such problem with the S9 AutoSet. S9 AutoSet 95P pressure around 9-10, A10 around 14-15 and would go higher if allowed. Definitely would be going back to the S9 and the A10 going in the trash bin, where it belongs

Hi Zonk,

Did you try the For Her mode?

Despite the "For Her" name, the For Her mode just means the pressure increases and decreases will be slower and more gentle, and the machine will automatically raise the Min Pressure setting a little if it finds we are having obstructive events too frequently at low pressures.

I think ResMed should have named it something like "Gentle AutoSet Mode" rather than "AutoSet For Her" mode. I think most men might prefer the For Her mode, too, if we try it.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 09-27-2014 03:00 AM by vsheline.)
09-27-2014 02:57 AM
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zonk Offline

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Post: #13
RE: ResMed Airsense 10 Autoset Problems
(09-27-2014 02:57 AM)vsheline Wrote:  Did you try the For Her mode?
I did not get the 4Her version

Both AirSense 10 (A10) AutoSet and S9 AutoSet increase pressure in response to flow limitation (FL)
A10 see FL and increase pressure until the maximum reached, S9 also increase pressure in response to FL but FL is well controlled at lower pressure

Other people said the same thing about the S9 too, there is no one size fit all, matter of trial and error to see which algorthim works better
(This post was last modified: 09-28-2014 06:23 PM by zonk.)
09-28-2014 04:39 PM
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ChaosTheorist Offline

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Post: #14
RE: ResMed Airsense 10 Autoset Problems
(09-28-2014 04:39 PM)zonk Wrote:  Both AirSense 10 (A10) AutoSet and S9 AutoSet increase pressure in response to flow limitation (FL)
A10 see FL and increase pressure until the maximum reached, S9 also increase pressure in response to FL but FL is well controlled at lower pressure

Apparently the ResMed people disagree. I asked them about this. Their answers are in bold.

Message: I'm evaluating replacement hardware. I have seen multiple reports of problems with the A10 AutoSet, compared to previous experience with the S9; specifically, that it increases pressure too quickly and to too high a level in response to an event, waking the user. Are you aware of these issues? Not aware of these specific issues. The AirSense 10 uses the same autoset algorithm as the S9 autoset. Are they a problem with the hardware, or a user-education issue? No reported issues with the hardware or a user education issue. Does the A10 AutoSet really have that different a response behavior than the S9? No Does the "For Her" variant solve or mitigate this? The AirSense 10 For Her has a autoset For Her algorithm that delivers therapeutic responses tailored to the characteristics of female OSA patients.

Not that much to work with, but ResMed apparently isn't getting reports of these issues. If people are having these problems with A10 units that are configured the same as S9 units that don't have the problem (I never got an answer to my question about that in this thread), feeding that info back to ResMed would be good.
10-03-2014 11:25 AM
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Kadenz Offline

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Post: #15
RE: ResMed Airsense 10 Autoset Problems
That's a rather unhelpful response from ResMed to your question about the ForHer feature in ththe A10. I would have hoped for better from them.

What they should have explained is the way in which female OSA patients differ from from males, why that requires a different algorythm, and how the ForHer algorythm is different from the normal one.
10-04-2014 06:21 AM
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zonk Offline

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Post: #16
RE: ResMed Airsense 10 Autoset Problems
(10-04-2014 06:21 AM)Kadenz Wrote:  That's a rather unhelpful response from ResMed to your question about the ForHer feature in ththe A10. I would have hoped for better from them.

What they should have explained is the way in which female OSA patients differ from from males, why that requires a different algorythm, and how the ForHer algorythm is different from the normal one.
ResMed like to play the gender card, pink masks 4Her, pink S9 AutoSet 4Her and now AirSense 10 AutoSet 4Her (female-specific algorthim)

The study (funded by ResMed) sample is small and they conclude that there is no statistical difference between the algorthim of AutoSet and AutoSet 4Her for AHI and oxygen desaturation index (ODI) or number of RERAs

Study http://www.resmed.com/content/dam/resmed...S_2014.pdf
10-04-2014 03:32 PM
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ChaosTheorist Offline

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Post: #17
RE: ResMed Airsense 10 Autoset Problems
(10-04-2014 06:21 AM)Kadenz Wrote:  That's a rather unhelpful response from ResMed to your question about the ForHer feature in ththe A10. I would have hoped for better from them.

What they should have explained is the way in which female OSA patients differ from from males, why that requires a different algorythm, and how the ForHer algorythm is different from the normal one.

Yeah, parroting back what's on the Web site doesn't add any value. I've asked him to expand on *why* it's better for women and (especially) if/why it might *not* be better for men. We'll see what he says.
10-04-2014 03:39 PM
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zonk Offline

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Post: #18
RE: ResMed Airsense 10 Autoset Problems
(10-04-2014 03:39 PM)ChaosTheorist Wrote:  
(10-04-2014 06:21 AM)Kadenz Wrote:  That's a rather unhelpful response from ResMed to your question about the ForHer feature in ththe A10. I would have hoped for better from them.

What they should have explained is the way in which female OSA patients differ from from males, why that requires a different algorythm, and how the ForHer algorythm is different from the normal one.

Yeah, parroting back what's on the Web site doesn't add any value. I've asked him to expand on *why* it's better for women and (especially) if/why it might *not* be better for men. We'll see what he says.
From http://investor.resmed.com/phoenix.zhtml...highlight=
"We've known for a while that sleep apnea presents itself differently in men and women, and that physiological gender differences affect treatment responses," said McArdle. "With that in mind, we designed this trial, the first of its kind, to investigate the possibility of a new treatment algorithm to make APAP therapy more effective and comfortable for women with sleep apnea."

Using the principles of APAP therapy, researchers at the University of Western Australia, the Western Australian Sleep Disorders Research Institute, and the ResMed Science Centre developed the new treatment algorithm to proactively address female-specific characteristics of sleep apnea. The algorithm has been designed to reflect the fact that respiratory events in women are typically shorter in duration, that female apneas occur mainly in the rapid eye movement phase of sleep, and that air flow is frequently constrained but not altogether blocked in female patients.

From A10 clinical manual: AutoSet for Her mode
AutoSet for Her mode is based on key aspects of ResMed’s AutoSet algorithm and delivers therapeutic responses tailored to the characteristics of female OSA patients.
The AutoSet for Her is similar to ResMed’s AutoSet algorithm with the following modifications:
* Reduced rate of pressure increments designed to help prevent arousals.
* Slower pressure decays.
* Treats apneas up to 12 cm H2O and continues to respond to flow limitation and snore up to 20 cm H2O.

* Minimum pressure (Min. Pressure) that adjusts according to the frequency of apneas:
If two apneas occur within a minute, the pressure reached in response to the second apnea will become the new minimum treatment pressure until the next treatment session.
(This post was last modified: 10-04-2014 04:00 PM by zonk.)
10-04-2014 03:55 PM
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MikeBY Offline

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Post: #19
RE: ResMed Airsense 10 Autoset Problems
mask leak (whistle) would be the likely cause of the highest pressure being above the max. The apap will attempt to keep pressure at the mask in range, and if it detects higher than normal leak, it will attempt to compensate.

Good luck.. I've never used ramp myself. Would feel like suffocating with the mask pressure too low. EPR is the ticket for easier exhale.. max (3) is 3cm H2O pressure reduction. I'm surprised with an APAP test that they didn't start your min. pressure below your static 8, but perhaps that is because they were seeing too many AHIs in your data.

Send us an Update!!

I just got the A10 autoset, and had to adjust setting myself as well. Picked it up from the DME without their 'fitting' Same DME tried to deliver a S9 instead of the A10.. but since I was getting a new machine.. why would I want the older model?

Turning on Airplane mode until I figure out who is getting access to my data.
10-05-2014 04:29 AM
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vsheline Offline

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Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
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Post: #20
RE: ResMed Airsense 10 Autoset Problems
(09-21-2014 08:09 PM)Lahanna44 Wrote:  So.... I tweaked the pressure on the Airsense last night before bed, set to min 8 high 9.6 also turned the EPR on to full time instead of the Ramp only setting, also turned off the ramp totally. I had a much better night. Checked the readings this am highest auto adjustment during sleep was 10.4 ( not sure how it manage to override the 9.6 that I had it set on

I am not sure whether the A10 is reporting the max pressure at the mask (which, during a cough for example, could go momentarily higher than the setting for target Max Pressure) or is reporting how high the target Mask Pressure was adjusted by the machine (which should never be higher than the setting for target Max Pressure).

Also not sure whether the time period being reported was for both nights or for only the most recent night. The time period for the on screen sleep report is selectable.

(10-03-2014 11:25 AM)ChaosTheorist Wrote:  
(09-28-2014 04:39 PM)zonk Wrote:  Both AirSense 10 (A10) AutoSet and S9 AutoSet increase pressure in response to flow limitation (FL)
A10 see FL and increase pressure until the maximum reached, S9 also increase pressure in response to FL but FL is well controlled at lower pressure

Apparently the ResMed people disagree. I asked them about this. Their answers are in bold.

Message: ... I have seen multiple reports of problems with the A10 AutoSet, compared to previous experience with the S9; specifically, that it increases pressure too quickly and to too high a level in response to an event, waking the user. Are you aware of these issues? Not aware of these specific issues. The AirSense 10 uses the same autoset algorithm as the S9 autoset.

Regarding possible changes in the S9 "AutoSet" versus A10 "AutoSet" algorithms, I think one of the following may apply:

1. The seemingly different behavior between S9 and A10 may be coincidental. This would be the case if a more extensive back-and-forth trial between the two machines (switching each day between the two machines, one day on the S9 and the next day on the A10, until both machines have been tried 10 days each using identical settings) would show no statistical difference in their behavior. (I think this could be the case.)

2. Although perhaps there have been absolutely no changes in the AutoSet software algorithm used by the machines, perhaps the sensors on the A10 are more sensitive or have been calibrated differently, causing the two machines to behave differently. (I would guess this is probably a factor.)

3. The "AutoSet" software algorithm has been changed in some way and is no longer identical for the two machines. (I doubt this has happened, since ResMed has said this hasn't happened.)

(10-05-2014 04:29 AM)MikeBY Wrote:  mask leak (whistle) would be the likely cause of the highest pressure being above the max. The apap will attempt to keep pressure at the mask in range, and if it detects higher than normal leak, it will attempt to compensate.

I think no machine designed within the past 10 years would display its raw output pressure. The pressure it displays would be the estimated pressure at the mask after taking into account the estimated pressure lost across the hose.

A steady amount of mask leaking does not cause the machine to raise the estimated pressure reaching the mask. The machine increases its output airflow rate to compensate for the leak rate, while maintaining the target mask pressure unchanged.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 10-05-2014 07:55 PM by vsheline.)
10-05-2014 12:01 PM
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