Sierra

The A10 machines come with a 4 Gb card, and my wife's S9 has a 2 Gb. You are right in that cards that small are really hard to find now. I suspect the main reason dealers take them out is to prevent customers from looking at their own detailed data, and instead come back to them for support. The sad part of that thinking is that when there is no card in the machine then no detailed data get captured at all. Both the user and the supplier are in the dark. They can't even help you if you come to see them.

SleepyHead is now OSCAR, and needs a PC or Mac with a SD card reader. It saves the data on a hard drive and will not write over the MyAir data.

I have been doing it for nearly 2 years and my mouth has not been trained to stay closed. My wife did mouth taping for a couple of months with good success, and now claims she has been trained and doesn't need it any longer. Her results in SleepyHead seem to verify that, although she was getting more consistent lower leakage rates with the tape. Without tape she is averaging about 4.5 while I average 9 for leakage even while using tape. A study of 2! Not sure what one could conclude from that...

Every ResMed machine is shipped with a SD card in the slot. Some dealers take them out for I would suggest less than up and up reasons.

If you are really worried about what get sent wirelessly, there is a method to disable it. I have not done it, because I think if someone is so bored that they want to look at my sleep data, they can jump to it. In any case you can find the information in this forum post. However, if you damage your machine in the process you are on your own.

Semi-Permanently Disabling the Modem on an AirSense 10

The one thing to remember about MyAir is that the data being transmitted wirelessly is very limited. The real detailed data is only kept on the machine SD card. Your provider is not reviewing the detailed data unless you bring the card in to them to look at with the ResMed application. The data sent wirelessly is mainly for insurance compliance purposes. Some people have their machine taken away if they don't use it often enough.

I am out of suggestions, although you could try the Mefix tape alone to see if you like it better than the Micropore. I just lift my mask if I think I am not getting enough air. However, that almost never happens. Yes, you have to lift the Micropore tape slowly or it can damage your skin. I learned that from doing exactly that.

I don't actually use the MyAir app as it captures only limited high level data. Instead I use SleepyHead (OSCAR), which shows you all the detail during the night second by second. But, in general data is collected for the whole time the machine is on. The events are suppressed during the ramp period, but the time is counted as the total use time. So reading time in bed if the mask is on and the machine running is counted as usage hours. However if the machine is in the ramp period those events are ignored. After the ramp period, if you hold your breath for more than 10 seconds it will be counted as an OA event. Hope that helps some.

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.

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,

I have not tried the SomniFix strips, but from what they look like I suspect they would not keep my mouth closed. I started out using a 1" strip of Micropore tape horizontally, but found that was not enough for me. I suspect it might be better than the SomniFix though. Someone here suggested using Molnlycke Mefix tape cut off in strips 10 cm x 6 cm. What I found was that it didn't seem to hold up well to moisture. My last trick and current method is to use a 1" horizontal strip of Micropore first, with the Mefix patch over the top. That seems to hold up for me on most nights. You can get the Mefix at medical supply stores. I buy the 10 cm wide by 10 meter long rolls and cut it.

I would start with the Micropore tape which you can get at Walmart - 3M Gentle Paper. Then if that is not enough, then try the Mefix. And, as a last resort both.