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UARS and Autoset?????

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Yvette +0 points · about 2 months ago Original Poster

I was diagnosed with UARS in 2012 and started cpap treatment right away. The insurance did not accept UARS as sleep apnea so I paid for everything out of pocket. I remember the very smart doctor told me I couldn’t get an autopap because it wouldn’t recognize the UARS (RERAs?). I have used cpap successfully for 13 years. This year I wanted a new sleep study to see if apnea got worse. It had and now I have a small amount of obscructive. Insurance paid for new machine and mask. This new sleep doctor says autoset pap will work for UARS. After 4 months I feel more tired, less able to concentrate, and less motivated. I don’t have ability to work hard at my job. Has anyone else with UARS been told not to use an autopap? I’m going back to cpap to see if I feel better. Thanks, Yvette

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Sierra +0 points · about 2 months ago Sleep Patron

What machine do you have now? A ResMed AirSense 10 AutoSet? There is a variation of that machine called the "For Her" version. It has an optional special algorithm which in ResMed's words:

"The AutoSet for Her algorithm has increased sensitivity to flow limitation and optimized response gain. It is driven predominantly by flow limitation and snoring rather than apneas and has an adaptive minimum pressure."

Here is an article about it. Obstructive Sleep Apnea in Women: Specific Issues and Interventions

It is supposed to respond more quickly to upper airway resistance and avoid RERA events. It is the more appropriate machine for UARS issue. However keep in mind that at the end of the day, all it is doing is increasing pressure. When a machine is in CPAP mode, pressure is manual, and it is essentially already increased. So if the manual pressure is set properly, it may simply avoid the RERA issue. And even in Auto mode if the minimum pressure is increased appropriately it can avoid the issue too.

I have the standard AutoSet machine, but I find it works better for me in manual CPAP mode. It is easy to switch between CPAP and Auto.

Have you considered using OSCAR to display the data on your SD card in the machine? It requires a PC or Mac and a SD card reader. With it you can display the pressures during the night and see how your machine is reacting and when you are having RERA events. You can compare what pressure it is using to what you used with the CPAP. The Auto machine may be keeping the pressure too low and letting you have RERA events that the CPAP was avoiding.

My thoughts would be to leave the machine in Auto mode and ask about increasing the minimum pressure. Or you could just switch it to CPAP mode and set the pressure to what it was on the CPAP machine.

Hope that helps some,

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Yvette +0 points · about 2 months ago Original Poster

Thanks for answering. It is what I thought, and the smart first doctor said... I need a cpap not autoset. I was set up with the standard AirSense 10 not for her. I’m mad at the new doctor.

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Sierra +0 points · about 2 months ago Sleep Patron

I would not dismiss the use of the AutoSet machine. Running in auto gives you the potential to have an average lower pressure during the night. My thoughts would be to increase the minimum pressure some to see if the RERA events reduce. The AutoSet should identify them. The Auto machines are a little oversold in what they can do. Most who follow their results in OSCAR and adjust their own machines end up with a pretty narrow band between minimum and maximum pressure. The advantage of the auto machines combined with OSCAR is that you can see what lower and higher pressures do for you. There is not much difference between a machine running in Auto with a narrow pressure band and a machine in CPAP mode.

One thing you should look at is the use of EPR on the AutoSet. It typically gets turned on full time by default. While it may feel initially a little more comfortable it can end up with higher pressures and worse AHI than if it is turned off. I run my machine with the EPR at 3 but set for Ramp Only, and on AutoRamp. Then it only cycles the pressure during the AutoRamp and stops when I go to sleep.

Here is a link to a technical manual for the AirSense 10 machines.

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