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Why would straight CPAP be preferred over auto?
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Mosquitobait Offline

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Machine: Resmed AirSense 10 For Her
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Sex: Female
Location: Minneapolis

Post: #11
RE: Why would straight CPAP be preferred over auto?
Maybe the difference is not in the reporting but in how it handles RERAs?
05-25-2015 01:27 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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Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

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Location: California, USA

Post: #12
RE: Why would straight CPAP be preferred over auto?
(05-25-2015 06:38 AM)Riven Wrote:  My ResMed AirSense 10 AutoSet (for him) reports RERAs. They show up in both ResScan and SleepyHead. Did you mean to say - The AutoSet A10 for Her is not the only A10 to report RERA events.

Hi Riven. Thanks for your post. Your post is the first place I have read that the AirSense 10 AutoSet For Her model is not the only ResMed machine which reports RERAs.

If on your machine you have seen non-zero numbers reported for RERA, then either ResMed's website and the setup manual (Clinical Guide) for the AirSense series and other published materials were in error, or, reacting to complaints from users, perhaps ResMed's published materials are now out of date only because ResMed has added this feature recently, perhaps using your machine's wireless software download feature.

Please let us know whether your machine has ever reported a non-zero number for RERA.

If not, then perhaps your machine is not reporting RERA, even if ResScan and SleepyHead have placeholder spots to display how many RERA are occurring, placeholder spots which may be erroneously displaying zero because the machine might not be reporting RERA events if they occur.

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: 05-25-2015 03:14 PM by vsheline.)
05-25-2015 02:44 PM
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Riven Offline

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Machine: ResMed AirSense 10 AutoSet
Mask Type: Nasal mask
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CPAP Pressure: 8
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Ontario, Canada

Post: #13
RE: Why would straight CPAP be preferred over auto?
Vsheline:

The RERA numbers do not appear on the readout of my unit. They only show in ResScan and SleepyHead. Also the RERA numbers are in addition to the total AHI number - not part of it. They are all zero events in duration as you suspected. They do have an index value as shown on the detail screen and are shown in the pie chart with Sleepy Head. Starting to look more like a bug.
05-25-2015 03:32 PM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #14
RE: Why would straight CPAP be preferred over auto?
(05-25-2015 01:27 PM)Mosquitobait Wrote:  Maybe the difference is not in the reporting but in how it handles RERAs?

As far as we know from ResMed descriptions of its pressure adjusting algorithms, the suspected RERAs are only reported and are not used in its pressure adjusting algorithms.

But this does not mean that ResMed machines do not treat the condition (Flow Limitation) which is the root cause of RERAs, which are arousals caused by needing to exert too much effort to inhale, usually because of Flow Limitation. ResMed APAP machines, like most or all APAP machines, react to FL by raising the treatment pressure.

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: 05-25-2015 03:47 PM by vsheline.)
05-25-2015 03:33 PM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #15
RE: Why would straight CPAP be preferred over auto?
(05-25-2015 03:32 PM)Riven Wrote:  The RERA numbers do not appear on the readout of my unit. They only show in ResScan and SleepyHead. Also the RERA numbers are in addition to the total AHI number - not part of it. They are all zero events in duration as you suspected. They do have an index value as shown on the detail screen and are shown in the pie chart with Sleepy Head. Starting to look more like a bug.

I meant, do you ever see a non-zero count for how many RERA events occurred?

RERA numbers are never included in the AHI, because although RERAs are arousals (associated with needing to exert strong effort to inhale) RERAs are neither apneas nor hypopneas because the strong effort had been managing to keep the airflow too high to qualify as hypopneas. They are included in what is called the Respiratory Disturbance Index (RDI).

RDI = AHI + (average number of RERA events per hour)

Are you seeing RERA events flagged in SH but the events have zero duration? That would sound like RERA events *are* being reported (or SH thinks they are being reported).

Considering only ResScan (which tends to be bug free), do you ever see specific RERA events flagged in the Detailed Data in the Events timeline which shows when each apnea or hypopnea or CSR event occurred, or in the Statistics page a non-zero number for RERAs per hour, or anything like that?

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: 05-25-2015 08:40 PM by vsheline.)
05-25-2015 04:15 PM
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calusa Offline

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Location: USA

Post: #16
RE: Why would straight CPAP be preferred over auto?
(05-24-2015 09:14 PM)krelvin Wrote:  I'm curious as to why the tech talked to you at all? In both of my tests there was no discussion with the tech of anything other than basic process... nothing about what they would be doing the test on or how.


My tech was fantastic -- we talked a fair amount, and I learned more from that talk than I did from my quick appointment with the sleep doc!
05-25-2015 06:20 PM
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Riven Offline

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CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Ontario, Canada

Post: #17
RE: Why would straight CPAP be preferred over auto?
Vsheline:

Yes, I see a non zero count for the total number of RERA events that occurred each night.

Both ResScan and SH show separate RERA events on the time line ( I can see the exact time they occurred). The events always have a zero duration. SH tells me in the events log when they occurred as well.

In ResScan I see RERA events when they occurred in the time line.

BTW, I did a search on this forum and it looks like the issue was discussed in 2014. So I assume this is nothing new and these events have always been reported or miss reported as the case may be.

Sometimes I wonder how much time and money ResMed would save, if they just made one CPAP/Elite/AutoSetUnisex/AutosetforHer machine. Seems like they are tripping over themselves downgrading the firmware of their best model to please DMEs, insurance companies and government health programs. Imagine car companies making many different models and the only difference was software/firmware. Could this be the future?

Thanks for your interest and help.
05-25-2015 06:35 PM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #18
RE: Why would straight CPAP be preferred over auto?
(05-25-2015 06:35 PM)Riven Wrote:  Yes, I see a non zero count for the total number of RERA events that occurred each night.

Both ResScan and SH show separate RERA events on the time line ( I can see the exact time they occurred). The events always have a zero duration. SH tells me in the events log when they occurred as well.

In ResScan I see RERA events when they occurred in the time line.

Glad to learn that. Thanks.

That there are not time durations associated with RERAs does not sound like a bug. Unlike apnea or hypopnea which has duration, RERA is an arousal which follows perhaps 10 seconds or more of Flow Limitation but the reduction in breathing volume was too low to be considered an hypopnea by the machine.

If you are having RERA events, by zooming in on the detailed data (with about a minute filling the horizontal scale) you would be able to see examples of the type of pattern which ResMed considers indicative of a RERA, which is probably at least a certain duration and/or degree of FL followed by a sudden increase in Flow or Tidal Volume or Minute Volume which is suggestive of an arousal.

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: 05-26-2015 03:14 AM by vsheline.)
05-25-2015 08:45 PM
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Mosquitobait Offline

Advisory Members

Posts: 746
Joined: Apr 2015

Machine: Resmed AirSense 10 For Her
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10
Humidifier: integrated, Climate line tube
CPAP Pressure: 9-12
CPAP Software: ResScan SleepyHead

Other Comments: RLS and Bradycardia

Sex: Female
Location: Minneapolis

Post: #19
RE: Why would straight CPAP be preferred over auto?
(05-25-2015 06:35 PM)Riven Wrote:  Sometimes I wonder how much time and money ResMed would save, if they just made one CPAP/Elite/AutoSetUnisex/AutosetforHer machine. Seems like they are tripping over themselves downgrading the firmware of their best model to please DMEs, insurance companies and government health programs. Imagine car companies making many different models and the only difference was software/firmware. Could this be the future?

Actually, car companies do just that pretty commonly. They have a luxury model, a mid-priced and cheap - most of the parts are interchangeable.

I suspect the multiple models are not nearly as hard for Resmed as they are for patients to figure out what exactly they are getting. It becomes very clear with the postings on Craigslist how very few actually know what they bought.
05-25-2015 09:17 PM
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zonk Offline

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Post: #20
RE: Why would straight CPAP be preferred over auto?
(05-25-2015 06:38 AM)Riven Wrote:  My ResMed AirSense 10 AutoSet (for him) reports RERAs.
What color is your machine? A10 AutoSet for Her is grey and A10 AutoSet is charcoal

Another member from Australia said his rental machine "AirSense 10 AutoSet" report RERAs but when probed, we find out that this particular machine was for used for trials
05-26-2015 06:30 AM
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