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Another new AirSense user with a couple questions
#1
Another new AirSense user with a couple questions
I didn’t want to step on anyone else’s thread so I started this one.

Switching from DreamStation to AirSense 10:

Scrip is for 7-10.  On my reports from Sleepyhead and Oscar, someone here recommended bumping up my DreamStation low limit to 8.5 so it would be closer to my 95% value of about 9 or so.  My AHI went immediately from around 1.5 to regularly <0.5.  I haven’t changed that for a few years now, no need.

My understanding is that AirSense adjusts differently.  Is 8.5 still a good starting point?  I turned off all ramp and EPR to match my DreamStation settings.

And how do I disable the internal modem?  I can put it in airplane mode but it keeps reminding me and asks if I want to switch it back.  I didn’t see anything in the clinician mode to disable it.

Finally, I have been losing weight, almost 25lb this year so far.  I might not need the higher pressure anymore.  Should I set it back down to 7 as a starting pressure and see what happens after a few days?

Thanks.
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#2
RE: Another new AirSense user with a couple questions
The modem can be disabled if you're willing to open the PAP up. I think there's a YouTube on it. Your choice in doing or not.

I'd try this to see what happens, EPR 3 and pressure 7-10. You did say you now have 8.5-10? I think you might be able to get away with a bit less on the ResMed. It's faster to respond.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Another new AirSense user with a couple questions
Thx.

I had 8.5 - 10 set on the DreamStation.

For the Resmed I opened it back up to either 7-10 or 7.5 - 10.

I turned EPR off because I wasn’t using it on the DS, I’ll try the Resmed on 3.

I will be using it tonight for the first time.
If I don’t disable the modem, will it do anything?
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#4
RE: Another new AirSense user with a couple questions
The modem only uploads data to ResMed if data is needed for things like compliance. It would have to been registered. That's how I've understood it anyway.

EPR is your choice. It acts the same as BPAP pressure support but limited to 3 cmH2O. EPR is the reverse of PS in that it reduces pressure while PS adds it. It may make it more comfortable.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Another new AirSense user with a couple questions
Basic BiLevel 101 for OSA
EPAP/Exhale pressure treats OA
The difference between inhale and exhale pressures is Pressure Support or PS. EPR on ResMed machines is the same as PS.
PS or EPR is used to treat hypopnoea, Flow Limits, RERAs, and UARS. Thus EPR is therapeutic, not just a comfort tool.
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#6
RE: Another new AirSense user with a couple questions
A first night report:

1) That Resmed Airsense 10 is quiet, really quiet. It's so much more quiet than my Dreamstation ever was that I'm kicking myself for not getting it a long time ago (if I had known).

2) I turned off the EPR on the Resmed so the settings would match what I had in my Dreamstation -- except for the pressures.

My prescription is 7-10.

On my Dreamstation: When I had it set to 7-10 I was getting around 1.5 or so AHI. Someone on this site suggested changing the low limit to 8.5 so it would start closer to the average pressure the DS ended up using (about 9.something.) After I did that, I saw an immediate drop to about 0.5 AHI or even lower.

On the Resmed: So that I had a baseline to work with, I set the pressures to 7-10 to see what would happen. This morning I saw 0.7 AHI. And the average pressure overnight was about 9.x (pretty much what the DS would settle on.) It does look like the RM finds that sweet spot much faster than the DS.

Overall, I'm very happy with it. I do not use the humidifier, so I got a side piece that plugs in where the humidifier would normally go.

And one more big plus: The carrying case for the RM is way better than any case I've had before.

I'm going to pull up the SD card and see what Oscar can show me about last night.

The only thing left for me to do is figure out what that modem will do if I leave it on - I don't have anything setup for remote monitoring, and I'd rather not have it trying to dial out since there's no need. Leaving it in airplane mode means it will pop up reminder messages.
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#7
RE: Another new AirSense user with a couple questions
If this is a new unit under warranty or being paid for by insurance etc I would not mess around with the modem unless you want to potentially void your warranty or insurance coverage.

Everyone gets paranoid about this modem, all it does is send your basic apnea data to supplier/insurer so they can monitor results. Nobody cares about your results, heck your supplier and insurers probably don't even care...
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#8
RE: Another new AirSense user with a couple questions
I bought this mail order through
 a supplier on the list.  I’ve used them for years, but I don’t think they do anything with their machines besides ship them to customers the same way they get them from the factory.  I have no way to know if they registered the modem or not.

Question about the EPR:

It allows for settings of 1-3.  What setting is mildest?  And what pressures are associated with each value?  My understanding is that EPR will drop the exhale pressure by a small amount.  But is 1 the smallest or is 3?

I might use this tonight and see what happens.
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#9
RE: Another new AirSense user with a couple questions
Your pressure setting on autoset is IPAP (inhalation pressure). EPR subtracts from IPAP and a setting of 1 is 1 cm subtracted, 2 is 2 cm etc.

So if your pressure is 7 cm and EPR is off then EPAP is 7 cm, if EPR is 3 then EPAP is 4 cm.

The autoset is much more responsive then PR so you can try just setting EPR to see what is comfortable and then review your data. If you are having apnea or pressure are regularly being held higher by obstructions/flow limitations then try raising min pressure to see if it improves.

You can get an idea of what feels comfortable by adjusting the settings while awake with mask on and machine running. One of the most obvious ways is to set EPR to 3 and then turn it on/off to see the difference it makes. From there you can fine tune to what feels most comfortable to you (no EPR, only a little or a lot).
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#10
RE: Another new AirSense user with a couple questions
One more little tidbit about using the EPR option. The lowest your AS10 will go is 4 cm. This means that your EPAP pressure will be 4 cm until the IPAP pressure equals a calculation of any pressure that is greater than 4 cm + the EPR value.
Crimson Nape
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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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