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Why would straight CPAP be preferred over auto?
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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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Location: California, USA

Post: #21
RE: Why would straight CPAP be preferred over auto?
(05-26-2015 06:30 AM)zonk Wrote:  
(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

Hi zonk,

I think your machine is a standard charcoal A10 AutoSet running original software because it has not been in wireless contact with ResMed wireless servers.

If your Max Pressure of 12.4 is limiting the pressure so it is getting max'ed out part of the night you may be more likely than the average user to have RERA events.

On your ResScan statistics page, is a number for RERA shown, and in the Detailed Data are RERA events appearing in the Events timeline, like Riven reports?

If ResScan is not ever reporting RERA events, what version of ResScan are you using, and can you upgrade to latest ResScan?

Thanks,
--- Vaughn

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 08:39 AM by vsheline.)
05-26-2015 08:15 AM
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Riven Offline

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Machine: ResMed AirSense 10 AutoSet
Mask Type: Nasal mask
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Location: Ontario, Canada

Post: #22
RE: Why would straight CPAP be preferred over auto?
(05-26-2015 06:30 AM)zonk Wrote:  What color is your machine? A10 AutoSet for Her is grey and A10 AutoSet is charcoal

The colour is charcoal.
The only modes selectable are CPAP and AutoSet.
It was made in Singapore.
Purchased in Ontario, Canada in April 2015.
REF # 37208
Device # 886
Lot # 1107739
Device SW Ver. SX 567-0302

It is a (Unisex) ResMed A10 AutoSet and it does report the occurrence of RERAs and the time it saw them. Both ResScan and SleepyHead report the same information.

The wireless function is on and working, and I get the latest usage data at MyAir every day.

Anyone out there with an A10 Elite? Does your unit report RERAs as well?
(This post was last modified: 05-26-2015 08:45 AM by Riven.)
05-26-2015 08:19 AM
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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: #23
RE: Why would straight CPAP be preferred over auto?
(05-26-2015 08:19 AM)Riven Wrote:  The colour is charcoal.
The only modes selectable are CPAP and AutoSet.
It was made in Singapore.
Purchased in Ontario, Canada in April 2015.
REF # 37208
Device # 886
Lot # 1107739

It is a (Unisex) ResMed A10 AutoSet and it does report the occurrence of RERAs and the time it saw them. Both ResScan and SleepyHead report the same information.

What version of software is your machine running? (On my S9 machine the software version is shown in its Information screen, with no need to get into the Clinician Menu area.)

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 08:49 AM by vsheline.)
05-26-2015 08:48 AM
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Riven Offline

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Machine: ResMed AirSense 10 AutoSet
Mask Type: Nasal mask
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Sex: Male
Location: Ontario, Canada

Post: #24
RE: Why would straight CPAP be preferred over auto?
vsheline:

I updated my post with the SW # just when you were posting your question. The SW is SX 567-0302.

Looks like I got the Model number wrong too. It should be 37028 not 37208.
(This post was last modified: 05-26-2015 09:07 AM by Riven.)
05-26-2015 09:02 AM
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macbob Offline

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Machine: AirSense™ 10 AutoSet For Her
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Post: #25
RE: Why would straight CPAP be preferred over auto?
(05-24-2015 10:40 PM)vsheline Wrote:  
(05-24-2015 09:28 PM)macbob Wrote:  I have an A10 Autoset For Her, and have tested it in both APAP and Autoset for Her modes.

The difference in the modes appears to be the straight APAP mode ramps up in larger increments, and then decreases pressure quicker. The For Her increments in smaller amounts, and then decreases pressure more gradually.

Having the Min Pressure too low is a common problem with APAP settings. ResMed machines treat the Min Pressure as a target which they are always slowly trying to return to, with a "time constant" of about 20 minutes for the legacy AutoSet algorithm.

In the new AutoSet For Her algorithm, if the Min Pressure is obviously too low the machine will increase the Min Pressure for the remainder of the night.

From the AirSense 10 Clinical Guide:

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.

Offering a separate For Her machine with a friendlier look is fine, but because ResMed does not include the For Her treatment algorithm as one of the therapy options included in the standard A10 AutoSet model, I think ResMed is doing a disservice to its customers who buy the standard A10 AutoSet model not realizing that they are getting significantly less with regard to treatment options.

Thanks! The info on the differences in the algorithms helps me better understand what the machine/treatment is doing. It also matched my observations from looking at the pressure charts (reduced increments/slower pressure decays).

I couldn't agree more on ResMed's not offering the For Her algorithm on all of their models. It doesn't make any sense to me at all. That mode has definitely worked better in my case.

My pressure range is 7-13; with my average pressure and max pressures decreasing as I get used to the new machine/mask/modes.

When I started, my average pressure was 10.5+, with max pressure around 12.5. Now my ave pressure is below 9.5 (and occasionally below 9) and my nightly max pressure is around 10 (and increasingly below 10).

There were a lot more up-and-down movements with the APAP mode and, for whatever reason, SleepyHead was reporting my ave and max pressures higher than with the for Her mode (not quite 0.5 cm higher).

I'm giving any changes I make a week try to see if the changes help or hurt. If things hold steady for another week, I'll drop the max pressure from 13 to 12.
05-26-2015 02:34 PM
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Mosquitobait Offline

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Post: #26
RE: Why would straight CPAP be preferred over auto?
(05-26-2015 02:34 PM)macbob Wrote:  
(05-24-2015 10:40 PM)vsheline Wrote:  
(05-24-2015 09:28 PM)macbob Wrote:  I have an A10 Autoset For Her, and have tested it in both APAP and Autoset for Her modes.

The difference in the modes appears to be the straight APAP mode ramps up in larger increments, and then decreases pressure quicker. The For Her increments in smaller amounts, and then decreases pressure more gradually.

Having the Min Pressure too low is a common problem with APAP settings. ResMed machines treat the Min Pressure as a target which they are always slowly trying to return to, with a "time constant" of about 20 minutes for the legacy AutoSet algorithm.

In the new AutoSet For Her algorithm, if the Min Pressure is obviously too low the machine will increase the Min Pressure for the remainder of the night.

From the AirSense 10 Clinical Guide:

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.

Correct me if I'm wrong - the 'flow limitations' would be the same as RERAs right?
05-26-2015 06:03 PM
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quiescence at last Offline

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Post: #27
RE: Why would straight CPAP be preferred over auto?
not really. the detection of an arousal in addition to flow restriction constitutes a RERA (respiratory effort related arousal).

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
05-26-2015 11:17 PM
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zonk Offline

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Post: #28
RE: Why would straight CPAP be preferred over auto?
Hi Vaughn

Yes, as you guessed correctly, my machine shipped from overseas, otherwise would cost an arm and leg if bought from one of the pricey locals, so called "accredited suppliers". ResMed, is one step or two ahead of us on this one

I've not undated to 5.4 version yet, still using 5.1 version, but really lately become lazy and not caring much about too much data. Hours and AHI matter to me most and also do pay attention to leak and pressure

At the end of the day, how I feel, matter the most to me, something like 7 hours or over will do

Thanks
Coffee
05-28-2015 06:30 PM
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AlanE Online

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Post: #29
RE: Why would straight CPAP be preferred over auto?
(05-26-2015 09:02 AM)Riven Wrote:  The SW is SX 567-0302.

Looks like I got the Model number wrong too. It should be 37028 not 37208.

I have the same model number, made in singapore, batch code 1104208 and running the same software version. Mine doesn't report RERA. There isn't any mention of it in either ResScan or Sleepyhead. In ResScan, what machine did you select for your device?



Using FlashAir W-03 SD card in machine. Access through wifi with FlashPAP or Sleep Master utilities.

I wanted to learn Binary so I enrolled in Binary 101. I seemed to have missed the first four courses. Big Grinnie
(This post was last modified: 05-29-2015 07:34 AM by AlanE.)
05-29-2015 07:17 AM
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Joanster Offline

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Post: #30
RE: Why would straight CPAP be preferred over auto?
this just happened with me. @ nights ago i had a titration done at the sleep clinic [overnight] and my pressure was changed from auto 7-12--after one month on a trial machine which was auto, to a straight cpap machine, with setting of 11 with ramp. [I ask at the clinic if i would qualify for funding for the auto, he hinted no as my one number was 3 rather than 4, but it was up to the dr.] I could not sleep at all or use the straight cpap and setting of 11- I emailed the clinic at about 3 a.m to let them know, my blood pressure was way too high also [stressed] i went that night without a machine. The next day i was back on exactly what I had before the titration, auto , and settings 7-12,[blood pressure back to normal, and a great nights sleep] I see the sleep dr. June 9th.------no way can I tolerate or use the cpap with out auto, or just set at 11. I also have great concerns because I have high eye pressures, [glaucoma] and I have been reading the auto is the best device for that as well] its a learning experience, and I am sure learning fast. Its my health that is at stake, and thank goodness for this great forum. --I want what is best for my health, and I will get it, even if i have to pay for it myself.......I love my Remstar Auto A Flex--one night without it was enough for me......
05-29-2015 07:36 AM
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