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Sierra

Sierra
Joined Jul 2018
Bio

CPAP: AirSense 10 AutoSet

Max Pressure: 13 cm

Min Pressure: 12.2 cm

Ramp: Auto

Ramp Start: 9 cm

EPR: 3, Ramp Only

Mask: ResMed AirFit P10 Nasal Pillow

Canada

Sierra
Joined Jul 2018
Bio

CPAP: AirSense 10 AutoSet

Max Pressure: 13 cm

Min Pressure: 12.2 cm

Ramp: Auto

Ramp Start: 9 cm

EPR: 3, Ramp Only

Mask: ResMed AirFit P10 Nasal Pillow

Canada

I use the AirSense 10 AutoSet machine with the SmartStart enabled, and have never known the machine to start by itself. My wife uses the ResMed S9 with the same feature turned on and no issues with it either. I turn my machine off manually in the morning, but my wife lets it turn off automatically. it seems to work. I have heard of some having issues with the machine not turning off. That I think can be related to the using a very low set pressure. The flow switch that turns the machine off must not see enough flow to trigger it. My thoughts would be that you probably have a defective machine. It should not just start all by itself. Is it still under warranty? You may want to try going that route. Here is a link to a technical manual for the A10. There may be some troubleshooting help in there that I have not thought of. As far as reliability goes my wife has been using the S9 for about 4 years, and myself the A10 for about 2 years. No problems experienced with the machines, but my wife did have a problem with a DC to DC adapter we bought for camping. It would trip out during the night. ResMed supplied three of them before I gave up getting it to work. It would work with the humidifier and heated hose turned off, but would trip out when they were turned on. I suspect the design was flawed. The auto cutout was set too low. I use the same type of adapter with my A10 and do not have the problem even with the heated hose and humidifier turned on. Other than that, the machines have worked well.

If you go with another machine brand, I would suggest the Phillips DreamStation Auto. They tend to be a little less expensive. The only thing I don't really like about them is that they do not allow you to set the Flex (like ResMed's EPR) so it is on during the ramp, and off during sleep. I also like the auto ramp feature on the ResMed. The DreamStation has something similar, but not as good in my opinion. Here is a link to a DreamStation technical manual. It gives you some idea of the features it has. The manual however can be somewhat confusing as it covers the whole range of DreamStation manuals, so you have to pick out what applies to the Auto version. One advantage of the DreamStation is that it uses 12 volts DC instead of the 24 volts that ResMed uses. So it can run with a simple power cord from a 12 volt battery without any expensive DC to DC converter.

The machine I would suggest you avoid is the Fisher & Paykel Icon+. I used one during my trial period and did not like it. The data from it cannot be read by SleepyHead, although OSCAR may have been updated to read it. It also does not distinguish between obstructive and central apnea. I think that is a significant limitation especially if you suffer from central apnea events. The machine should be smart enough not to increase pressure with a central event, but increase if for a obstructive event. The F&P can't do that.

Hope that helps some,

It is certainly not obvious that you are benefiting from the 9.5 cm minimum over the 9.0. I also see some CA events showing up. My thoughts would be to go back to the 9.0 minimum and perhaps a 10.5 maximum. I would try that for a week or so to establish an average which will be recorded in the Statistics tab. Then you may want to try try the Flex to see if it helps or hurts. I would go for the maximum Flex (3?) so the difference will be more obvious. When you set the 10.5 maximum you should check to see if there is any persistent pattern of events occurring when the pressure is limited to 10.5. If there are then it could be bumped back up a bit.

On the Periodic Breathing, that does not look like classic CSR. I would not worry about it unless it becomes persistent. CSR would have CA events between each breathing pulse, not OA.

The whole series of flow limitation events when at 12 cm pressure makes me wonder if you are having some head positional issues. Some claim significant benefits from using a soft cervical collar to keep the neck straighter during the night. You can get them at Walmart for $15 or so.

On switching mask types I have noticed some differences in that some masks seem to need more pressure to get the same results. I suspect that they really don't need more pressure, but the machine indicates that the pressure is higher. These machines do not measure pressure right at the mask, only in the machine. They only estimate mask pressure based on theoretical pressure drop calculation for the loss in pressure from the machine to the mask. So the bottom line is that in my experience anyway, a different mask design can change the required pressure that is indicated. It is a good idea to settle on a mask type and keep that part consistent during your testing for the optimum pressures.