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ResMed S9 to A10 "upgrade" - Huge jump in AHI, CA, H, OA events - battling machine
#51
RE: ResMed S9 to A10 "upgrade" - Huge jump in AHI, CA, H, OA events - battling machine
Sweet deal. I'll just go with the settings I outlined in my previous post. EPAP min 6.0 Max pressure 15.0, PS 4.0. Other settings at default: Ti Min 0.3, Ti Max 1.8, Trigger Medium, Cycle Medium. The humidifier settings and mask can be as set in your Airsense 10.
Sleeprider
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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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#52
RE: ResMed S9 to A10 "upgrade" - Huge jump in AHI, CA, H, OA events - battling machine
(01-25-2020, 10:02 AM)Sleeprider Wrote: Sweet deal.  I'll just go with the settings I outlined in my previous post. EPAP min 6.0 Max pressure 15.0, PS 4.0.  Other settings at default: Ti Min 0.3, Ti Max 1.8, Trigger Medium, Cycle Medium.  The humidifier settings and mask can be as set in your Airsense 10.

Done, machines swapped and settings are set. 

Below are my two OSCAR charts for the last two nights, and the last nights with the ResMed AirSense 10 AutoSet.

The Leak Rate stats doesn't make sense as there is absolutely no leakage anywhere that I can detect. Weird.

Otherwise it is clear that I didn't have the soft collar on correctly on 1/23 (groups of events again) and did on 1/24 (no obvious groups of events).

   

   
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#53
RE: ResMed S9 to A10 "upgrade" - Huge jump in AHI, CA, H, OA events - battling machine
It help to see the charts, and I had forgotten just how bad your flow limitations are. We can see that on the Resmed Airsense 10, your pressure immediately rises out of ramp to the maximum setting of 12/10. There are apnea and hypopnea as soon as the machine exits ramp suggesting the ramp is far too low to prevent events. I think the minimum EPAP pressure of 6.0 will have to be raised, but I'm certain the pressure support will make an impact on how you feel, and should reduce the hypopnea. The collar makes a difference and you will need to continue with that.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#54
RE: ResMed S9 to A10 "upgrade" - Huge jump in AHI, CA, H, OA events - battling machine
(01-25-2020, 04:57 PM)Sleeprider Wrote: It help to see the charts, and I had forgotten just how bad your flow limitations are.  We can see that on the Resmed Airsense 10, your pressure immediately rises out of ramp to the maximum setting of 12/10. There are apnea and hypopnea as soon as the machine exits ramp suggesting the ramp is far too low to prevent events.  I think the minimum EPAP pressure of 6.0 will have to be raised, but I'm certain the pressure support will make an impact on how you feel, and should reduce the hypopnea.  The collar makes a difference and you will need to continue with that.

I completely agree. Also in comparing the pressure graph and Events, there is nearly a 1:1 correlation between the Airsense 10 dropping pressure (because it thinks I like that?) and then hypopnea or RERA events, which then causes the Airsense to raise pressure. Seems that a higher minimum pressure is in order as you suggest, but I want to give the settings you've recommended above (for the AirCurve VAUTO) a few nights just to see the difference between the Airsense and Aircurve machines especially the added pressure support.

Thanks Sleeprider.
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#55
RE: ResMed S9 to A10 "upgrade" - Huge jump in AHI, CA, H, OA events - battling machine
Public Service Announcement: If you move your SD card from your Airsense to your Aircurve, the machine will wipe it.

Glad I've got all my data saved in both ResScan and OSCAR!
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#56
RE: ResMed S9 to A10 "upgrade" - Huge jump in AHI, CA, H, OA events - battling machine
If you move your card from any Resmed machine to another the data gets wiped it’s what they do
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#57
RE: ResMed S9 to A10 "upgrade" - Huge jump in AHI, CA, H, OA events - battling machine
nteresting first night with the AirCurve 10 VAuto.

First thing I'll say is that Expiratory breathing is MUCH easier compared to the AirSense 10 Autoset. I've always felt (and the subject line of this thread proves it) that I was "battling" the machine to breathe (Expiratory breaths), not so with the AirCurve. 

Other observations:

-Hypopnea average for me was 18 per night, last night I had 10
-I woke up multiple times starting at 3:10am (probably the OA) but forced myself to get back to sleep
-I had nothing going on this morning so I let myself sleep until whenever... 9H:36M !!!
-Only one group of events (compared multiple groups per night) but that group had 4 of my 6 OAs for the night. It was within the first 10 minutes of sleep. Weird.

Question regarding EPAP: If my median EPAP pressure is 9.34 and my 95th percentile is 11, does that indicate that I perhaps should try increasing my my Min EPAP from 6.0 ?

Below are the both the daily and a zoomed portion of the event group which I find interesting comparing the events and Flow Rate to Tidal Volume, Int./Exp. Time, Time at Pressure and Mask Pressure. 

                  
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#58
RE: ResMed S9 to A10 "upgrade" - Huge jump in AHI, CA, H, OA events - battling machine
I see a number of times the machine reached your max pressure of 15 trying to treat snores,You may also do better with a higher min EPAP of 8 or 9 but if you increase Min EPAP also increas max IPAP to give the VAuto room to move with the pressures
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#59
RE: ResMed S9 to A10 "upgrade" - Huge jump in AHI, CA, H, OA events - battling machine
Total disaster. That's the headline.

Changed min. EPAP from 6 to 8 and everything is off the charts compared to the previous (Saturday) night.
- CA went from 3 to 10 events
- Hypopnea went from 10 to 36 events
- OA went from 6 to 29 events

I'm also having mask issues with the ResMed AirFit F20. I doesn't seem tight but I now have broken blood vessels on either side of the bony dorsum (sidewall) of my nose. It's pressure, not rubbing. I've used band-aids and last night soft sport tape across the bridge of my nose. I don't think I'll be able to use the machine for a couple nights.


Attaching the standard zoomed-out chart from last night. 

Also attaching charts from Satruday night and last night with Flow Rate pinned, and Resp. Rate, Tidal, Insp. Time, and Minute Vent charts visible. Shocking difference in two nights' sleep.

   

                  
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#60
RE: ResMed S9 to A10 "upgrade" - Huge jump in AHI, CA, H, OA events - battling machine
I didn't expect the results you got from the increase in EPAP. I think based on what we're seeing here Vauto mode min EPAP 8 max pressure 18, PS 5. We don't know what is driving the flow limitation and snores, but they are impressive and long-lasting. This looks a great deal like positional apnea.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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