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Poor sleep after switching from DreamStation to AirSense10
#1
Poor sleep after switching from DreamStation to AirSense10
FWIW:  This is all about my wifes Apnea treatment.  She asked me to post and follow up on her behalf.  We are dealing with multiple health issues that are being complicated by not sleeping well with the AirSense10.

Background:  She was diagnosed in 2018 with an AHI in the 50s.  Got a DreamStation and settled on the Eson2 nasal mask.  In scanning through the 900+ days of data in Oscar(sleepyhead) Her treated AHI was 2.5-5 .  She felt rested while using the DreamStation, didn't fall asleep during the day etc..  DreamStation stats attached.   No settings were changed from what i remember.  Note.. this is data from 2 DreamStations



AirSense10:  written as Min 4, Max 20

She was overwhelmed by the aggressiveness of the default AirSense10.  I poked around on the ApneaBoard and found mention of the 'soft' setting to calm it down a bit and that did help.  We also tried titrating the max pressure in hopes of getting the AirSense10 to use a lower pressure.  This may have worked to some degree but the AirSense seems to like to be around 10cm while the DreamStation ran 2-3cm lower for what we thought was effective treatment.  Summary of AirSense10 attached.

The other AirSense10 issue for her is she swallows a lot more air with it.  This complicates other health issues she is having and makes life pretty miserable for her.

Masks used with AirSense10:
-  She has used her Eson2 nasal primarily.  Large Leaks 20-60% of the time.

-  She recently got a DreamWear Full Face to try.  She's switched back to the Eson2 each time she's tried the DreamWear because she doesn't feel like she ever gets to sleep.  The data during the times using the DreamWear are different in 2 ways.  1. Pressure tends to be higher and 2. No large leaks.  However, the last time she tried the DreamWear she had 8 OAs in 10-12 minutes.  It was a night we tried capping pressure at 11.6 and it was at max when the OAs happened so that was a failed attempt.  She does change the mask type when switching masks.


I don't put a lot of confidence in the computed AHI for the AirSense10 as she takes awhile to get to sleep and tends to wake up and leave it on for an hour or more hoping to get back to sleep.  Also, I assume the AirSense10 isn't accurately assessing treatment when Large Leaks are happening.

Most recent details from AirSense10 attached.  The gaps represent times when machine was off for a bit.  She went to sleep sometime after 3am and woke up sometime around 06:15.


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#2
RE: Poor sleep after switching from DreamStation to AirSense10
Your flow limits are high and they can cause sleep disturbances. Your EPR is set at 2 BUT it can’t work fully because your min is 5. 

EPR is exhale pressure relief, it subtracts from the inhale pressure to make it easier to exhale. Your inhale (min) is set to 5. The absolute lowest the machine can go is 4. So min 5 - 2 cannot be 3 so it as you have EPR 1. 

Your min is to low and your EPR is to low. 

I would suggest

Min=8
EPR=3

That will help the flow limits and allow the machine to react quickly to events.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Poor sleep after switching from DreamStation to AirSense10
She tried setting Min setting to 8 and start pressure at 6 with EPR of 3.  She also had a neck pillow backwards to act like a cervical collar (actual collar should be here tomorrow)

She was awake several times during the night and got me up to help her get up or fix her bed(her needing help with getting in and out of bed is normal)  This was the worst night on the ResMed so far.  She was not able to settle down and get to deep sleep.  She kept feeling like she stopped breathing.

The last session had an AHI of 2.37  with 4 CAs in under 8 minutes early on.  Overvall AHI for night was 1.42 but that was with little sleep happening.

The detail of the whole night and a zoomed in view of the H-CA-CA-CA-CA sequence in the last session are attached.


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