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ResMed Airsense 10 pulses as if something hit the hose?
#11
(03-19-2016, 08:41 PM)FrankNichols Wrote: It seems the only thing I got right in my post was that I was probably wrong Smile

The thing you got right was: you had the guts to try to help. Kudos

Just my personal opinion. My posts are not medical advice or a statement of fact. Please consult a qualified physician or other qualified medical personnel. Please comply with all applicable laws, codes, regulations, and protocols.
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#12
(03-20-2016, 12:00 AM)sdb7802 Wrote: [quote='FrankNichols' pid='154464' dateline='1458438094']
It seems the only thing I got right in my post was that I was probably wrong Smile

Frank, I appreciate your trying to help. We are all working to find a better solution to our problems and any input is valued highly. There are no useless opinions or answers as far as I am concerned. Thanks
It does not matter how slowly you go as long as you do not stop. --Confucius
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#13
(03-19-2016, 04:27 PM)OpalRose Wrote: If the pulse determines that the airway is partially closed, then it will start to raise pressure to help keep airway open.

That is my observation with SH data review. Since starting APAP on 8 Feb 2016, I have seen less than 20 OA total count. My Apnea are all shown in SH as Clear Air or H. However, sometimes the machine increases pressure on a cluster of CA so I assume the machine is preventing the OA or converting the OA to CA by increasing pressure. Not sure if this is a valid assumption. CAs have decreased dramatically in past 15 days, so assume I am becoming accustomed to the high pressure at 15cm.

My AHI has been consistently below 2.5 for the past month. I use the "Silent Night" liner and set the A10 EPR=3. EPR=off or 1 dramatically increases leaks (even =2 is more leaks). I tried ERP=1 and did not wake up with the "pulsing" but it is still there but much less intense. However, leaks wake me with this EPR=1 setting. I believe the problem is the anti-asphyxia valve is malfunctioning with the pressure changes as the "pulsing" seems to increase in intensity with increase in EPR (larger pressure variation).

I do not believe I detect the 1 hz pulses the A10 uses for determining if the airway is open. If I were, I do not think the "pulsing" would be random in nature and only one strong "shake the hose" type of event. The problem also occurs when I am fully awake. Strange that I do not seem to have the problem when first going to sleep only after being awaken? I do go to sleep rather quickly ( 8 min from Lights out to sleep in sleep study)

I will continue to use EPR=3 as it provides good <2.5 AHI and low leaks <10L/min on A10 with the liners. Whereas, lower EPR makes leaks progressively worse and wakes me more often than the "pulsing". Hope the problem goes away when I receive my next mask in early May.

It does not matter how slowly you go as long as you do not stop. --Confucius
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#14
(03-19-2016, 04:16 PM)justMongo Wrote: I do not know how the A10 "knows" I am exhaling. It's running a moving average on flow; and uses that average to set a zero crossing threshold. Could be some irregular breathing cause the SW to be fooled? Maybe I should see if I can fool the SW and make it generate the "pulse".

Ok. With a running average I probably cannot "fool" the SW. Tried EPR changes last night. "Pulsing" present at all ERP settings, but becomes less intense at lower values (lower pressure variation). For EPR=off, the "pulsing" is about the same as in machine pause mode with minimal air flow. This leads me to believe it is an Anti-Asphyxia valve malfunction which may cause the machine to incorrectly react to my exhaling. I did not notice this new problem in the first month but it is getting steadily worse over time. However, the slight pulsing when machine in pause mode has always been present.

Just a thought, could irregular breathing cause an issue with the EPR moving average threshold which would cause the machine to attempt to increase air pressure at the same time I am exhaling ... i.e., I exhale latter or earlier than the moving average predicted? The hose actually jumps when the "pulse" occurs almost like a jump felt with the abrupt valve shut off on a water hose.
It does not matter how slowly you go as long as you do not stop. --Confucius
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#15
(03-20-2016, 11:56 AM)Ed1101 Wrote: [quote='OpalRose' pid='154432' dateline='1458422826']
If the pulse determines that the airway is partially closed, then it will start to raise pressure to help keep airway open.


Just to clarify, I wasn't referring to Clear Airways, because the APAPs
don't treat Clear Airways and won't raise pressure in response to one.

Sometimes there are Hypopneas or Obstructives around the same timing as CA's, and you may see the pressure rise, but usually I notice the pressure rise slightly after the event.

Pressure also will rise in response to snores and Flow Limitations.


OpalRose
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#16
(03-19-2016, 07:25 PM)ehunter Wrote: Hi I have similar but less invasive issue. I use P10 pillows but have noted that when going to sleep on exhale sometimes, and this might be only 2 or 3 times a night, the hose does need jerk or bounce similar to how you describe. Ive mentioned this to me sleep consultant but with no response. Doesn't bother me as get to sleep ok but agree I have had similar symptoms to you. Sorry I can't solve!

Yes. The effect is a hose bounces like an abruptly shut-off water hose. Your description sounds very similar to mine. My DME made a conference call to ResMed and the Rep on the phone said that had not heard of the problem before. The problem does not occur many more times than you describe but when I am woken up I notice it may occur 2 or 3 times before I go back to sleep (maybe 5-10 mins).

I would not care if it did not seem to wake me up (think this is what woke me?). Maybe I will adjust to this as to everything else associated with APAP.
Thanks
It does not matter how slowly you go as long as you do not stop. --Confucius
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#17
My first thought from reading the original post was that the pulsing problem was due to the anti-asphyxiation valve. It would be worthwhile to check the installation of said valve (if that is possible with your mask) to make sure that it is correctly installed. another thing that I have had happen to me on occasion is to inadvertently cover the exit for the anti-asphyxiation valve and then when I uncover it, I get the hose pulse or, of course, I can cause it on purpose. This may be different for your mask.

Best Regards,

PaytonA
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#18
(03-20-2016, 12:39 PM)OpalRose Wrote: Just to clarify, I wasn't referring to Clear Airways, because the APAPs
don't treat Clear Airways and won't raise pressure in response to one.

Sometimes there are Hypopneas or Obstructives around the same timing as CA's, and you may see the pressure rise, but usually I notice the pressure rise slightly after the event.

Pressure also will rise in response to snores and Flow Limitations.

I have noticed on SH that the pressure increase does indeed occur slightly after the CA. Also the pressure goes up on Hypopneas. I very rarely see a flow limitation over 0.25 and have never seen one over 0.50 in SH even when OA shown. What would one expect to see in flow limitation numbers. I cannot tell any difference in the OA and the CA flow and OA flagged when flow limit is shown at essentially zero. Never seen a pressure rise just on flow limit alone (but my min pressure is 15cm). I am not sure that flow limit reveals much about my events?
It does not matter how slowly you go as long as you do not stop. --Confucius
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#19
One last thought. Make sure the machine is set (in its menu) for a FFM. If set to Pillows or? it could cause the airflow to transition to/from EPR at a rate that's noticeable.

My old S8 VPAP S had a fast risetime (300 milliseconds.) I could feel the mask cushion rise on my face when it switched from EPAP to IPAP.
Of course with my PS=5, the transition pressure was considerable.
My S9 has a feature called "easybreathe" -- the rise fall from IPAP to/from EPAP is smoother.

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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#20
(03-20-2016, 12:56 PM)PaytonA Wrote: My first thought from reading the original post was that the pulsing problem was due to the anti-asphyxiation valve. It would be worthwhile to check the installation of said valve (if that is possible with your mask) to make sure that it is correctly installed. another thing that I have had happen to me on occasion is to inadvertently cover the exit for the anti-asphyxiation valve and then when I uncover it, I get the hose pulse or, of course, I can cause it on purpose. This may be different for your mask.

The F10 Mask valve is built into the elbow that snaps into the mask. It is not accessable or adjustable So says the DME and does not look to be adjustable. It is replaced with each new complete mask replacement. Covering the valve has no effect at all. It seems reasonable if it is close under pressure. According to the DME the exhalation is via holes around the circular elbow attachment port.

The valve is a floating plastic plate that moves up or down according to flow (pressure). The plate covers the port when there is positive pressure and would, in theory, drop down and open the port if power is lost. When machine is in pause mode, there is some air flow per manual to ensure dry out of hose. There is a slight pulsing on exhaling in this mode which the DME says is normal but the hose does not "jump" or bounce. The plate only partially closes the port in the pause mode.

Notwithstanding, what the DME says the port does exhaust air on exhaling as I can feel it with my hand. I do not know if the drop of 3cm (EPR=3) from 15cm would allow the port to partly open. Actually the air coming out of the port feels fairly constant to me so I do not think the valve works as the DME states. I think it reacts to air flow and closes proportionally. I do not know if there is a minimum pressure (air flow) that fully closes the the port but certainly 15cm should fully close the port. Anyone know this value for the F10 mask?
It does not matter how slowly you go as long as you do not stop. --Confucius
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