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Introduction

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JasonLarsen +0 points · 4 months ago Original Poster

Hi

I have taken all of the surveys, and the only one I have scored remotely satisfactory on was the one asking about my impact of sleep on daily activities. I have had no impact on any of my daily activities except work.

I received my first APAP machine on my last birthday (incidentally, my next birthday is coming up this year) so I have known about sleep therapy for just under a year now.

I have mixed sleep apnea, but my OSA is more severe than my CSA. I had my APAP machine until a few months ago, when my sleep apnea company insisted that I give it back to them. I ended up owing them a lot of money as a result. I stopped using my APAP machine because I have sensory issues. I do not like the feeling of distilled water in my mouth and I couldn't stand my APAP machine trying to work itself too hard when I had severe OSA episodes. It made a lot of noise while I was trying to sleep also.

My sleep doctor suggested that I use an APAP machine during the day and I will do that for more and more minutes a day until I am used to it. However, the problem is that I have so many outlets in my residence that I don't know which one to plug my machine into in my common area.

Do any of you relate to me?

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Sierra +0 points · 4 months ago Sleep Patron
  • A CPAP is really only effective on obstructive apnea, and not CAS. Mixed apnea requires careful machine setup
  • Water should not carry over to your mask if it is set up properly. Be sure to use a heated hose, and put the humidity control on auto.
  • When a machine is set up properly the pressure will not go too high
  • Ideally use the machine while watching TV, or reading a book to get used to it
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PutSleepApneatoBed +0 points · 4 months ago

Welcome, Jason!

Successful Sleep Apnea treatment can often be more of a journey than a destination. What machine do you have? Are the ramping and expiratory assist features set up properly? Properly implemented, they may both help you adjust..

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Randall95 +0 points · 3 months ago

hi, Which machine do you have?

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JasonLarsen +0 points · 3 months ago Original Poster

Hi

I will be getting a new APAP machine soon, and I have another appointment with a sleep doctor tomorrow.

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Sierra +0 points · 3 months ago Sleep Patron

The ResMed AirSense 10 Autoset is a good APAP machine if you can manage to get it. The AirSense 11 Autosense is now out and should be good too from a machine perspective. If you plan to monitor your results on OSCAR then the AirSense 10 may be the better choice as I am not sure that the AirSense 11 is compatible with OSCAR yet.

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JasonLarsen +0 points · 3 months ago Original Poster

I don't know what APAP machines my insurance will cover.

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PutSleepApneatoBed +0 points · 3 months ago

I use the RESMED Airsense 10 for Her and have had an excellent experience with it. I’m on my second Airsense 10 (primarily because the old one was more than 5 years old) and my residual AHI is always well under 1.0 and sometimes it is 0.0. But the average is probably about 0.3.

People think that reducing their residual AHI to below 5 is enough, but I have to tell you that in going from 3.0 with my gen 8 machine to 0.3 with my first gen 10 (I skipped over gen 9) I noticed a massive improvement in how I felt.

However, that may be due to the fact that I desaturate badly.

IMHO treatment should not be reserved for those with an apnea of 15 or above and 5 with a co-morbidity, but rather should consider both the maximum AHI (during REM my AHI was 83) and minimum desaturation levels. ( I regularly desaturated below 60.)

Why are we looking only at the average? When the damage is undoubtedly done at the margins?

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JasonLarsen +0 points · 3 months ago Original Poster

The medical supplier responsible for giving me my new APAP machine may not have anything as good or better than that machine. If this is true, that will be most unfortunate.

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Sierra +0 points · 3 months ago Sleep Patron

Just don't let them give you a Phillips DreamStation machine that has been recalled. See this post which is pinned at the top of the forum page as well.

https://myapnea.org/forum/philips-issues-a-recall-on-a-number-of-cpap-bipap-machine

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PutSleepApneatoBed +0 points · 3 months ago

JasonLarson:

As good as or better than WHICH machine? The RESMEDs, even at gen 10 are very, very good. They have an excellent proprietary algorithm that adjusts very quickly as your pressure needs change throughout the night. They even have a gender specific version of the machine to provide for the different pressure needs of women.

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PutSleepApneatoBed +0 points · 3 months ago

It’s hard to imagine what improvements could be made on the gen 10 machines, which may be why it has taken RESMED so long to come out with the gen 11. When the gen 10 can get you to a residual AHI under 1.0, or in my case, close to 0.0, where can you go from there?

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Sierra +0 points · 3 months ago Sleep Patron

The only improvements I would like to see are relatively minor. Providing both the standard and For Her algorithms in one machine that is the standard model is a good idea. I would like to see a one external hardware button to start the prewarming cycle when I am going to bed. It is a pain to go through the menu system to start the prewarm each and every night. I would also like to see the SD card sitting in a more obvious visible spot. I'm sure that goes against the aesthetics designer's wishes, but each night I have to check to see if I have remembered to put the card back. It is not easy to see. I am almost always going to bed after my wife so it is dark in the bedroom. I would also comment that it is not real easy to see the water level in the reservoir. I used to keep a small light beside my machine so I could look in and check the level. Then I discovered if you jiggle the machine from side to side the water level becomes visible. I have no issues with the functionality of the machine. It does the job very well, even though I think it works better in fixed CPAP mode than it does in Auto.

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PutSleepApneatoBed +0 points · 3 months ago

Agree that providing both algorithms in a single standard machine IS a worthwhile improvement.

I don’t think I’ve ever used the prewarming cycle. I assume is just preheats the water in the humidifier? Is it that that important? How long does it take? I would think there’s SOME humidification from just the air flow running over even unheated water. Although I suppose there could be a timer setting, that would start the preheating cycle, but you would also want something to turn it off, should the humidifier water reservoir be empty.

And it sounds like you’ve removing the card every day. Why? To run it through Oscar? I can’t imagine many people bother to do that. Doesn’t the card maintain many weeks or months of information? What’s its capacity? Are you analyzing it daily? That DOES sound like a LOT of work.

Agree it is sometimes hard to see the water level, but I empty it every morning, let it dry, and then refill it sometime later in the day, when it is still light and I can easily see the water level. I don’t leave the water in the reservoir from one night to the next…and don’t think anyone should.

My wish list would include an alarm for power outages. I don’t like the idea of having the mask on and being asleep while losing power.

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Sierra +0 points · 3 months ago Sleep Patron

Yes, the prewarming cycle just preheats the water in the reservoir. It takes about 15 minutes and then it keeps it on hold warmed up for another 15-30 minutes. It gives you full humidity air right away when you are going to sleep which is more comfortable. There is essentially no humidity added from unheated water. When we camp in our RV with no external AC power and run off the batteries, I turn the humidifier off to reduce the drain on the trailer batteries. Also turn the heated hose off. I do keep the reservoir full of water thinking it will provide some humidity. But, essentially the water usage is negligible over a whole night. The humidifier seems to be totally dependent on the heating effect under the reservoir.

I have had lots of issues with getting a good setup on my machine, and seem to be finally "there" now. In the process I got in the habit of checking the data daily. I also maintain my wife's machine which is an older S9 ResMed. It is true that the A10 can hold lots of data on the card - probably months. The S9 has less capacity for detailed data even if you use a larger card. I think it may be a week, or at the most two weeks of detailed data. And, after that the detailed data is lost. This screenshot gives you some idea what my journey to my current settings looks like. It does not include all setting as some of my earliest data somehow got lost in a "hickup" with SleepyHead.

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Sierra +0 points · 3 months ago Sleep Patron

From what I can see the ResMed AirSense 11 is functionally the same as the AirSense 10 AutoSet For Her. The AutoSet for Her includes both the standard and For Her modes. You just pick between them. The AirSense 11 does the same thing and comes in perhaps a more gender neutral package. ResMed no longer offers the standard machine. The only issue with the AirSense 11 is that if ResMed changed the data format it may not be supported by OSCAR. My Wife's ResMed 9 has worked well, but is now displaying the warning about the motor life being exceeded. My plan is to hope that the AirSense for Her or the standard AirSense 10 goes on sale when the AirSense 11 becomes more available. She can't really take advantage of the For Her mode as she needs more than 12 cm of pressure.

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PutSleepApneatoBed +0 points · 3 months ago

Sierra: Are you certain that the AirSense 10 Autoset for her doesn’t exceed 12 cm? I think mine is doing that, although not by much, because I think I recall that my average and median pressures are a little above that according to a report from my sleep lab….

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JasonLarsen +0 points · 3 months ago Original Poster

I hope that my new machine is as good as or better than any of the machines mentioned in this thread.

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Sierra +0 points · 3 months ago Sleep Patron

I am not aware of an APAP machine that is better than the ResMed AirSense 10 Autoset.

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PutSleepApneatoBed +0 points · 3 months ago

Nor am I. It is really quite effective. Improvements at this point are likely to be only at the margin. `

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JasonLarsen +0 points · 3 months ago Original Poster

Just so you all know, my old DME company does not take my current insurance anymore, so I will be involved with a new DME company. Therefore, I have to do another sleep study all over again, and it is scheduled for two weeks from today.

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PutSleepApneatoBed +0 points · 3 months ago

Why won’t your new DME accept your LAST study? How old is your last study? And what is their reason for not accepting it?

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