Sierra

Click on the link I gave in the previous post and go to page 14. That will tell you how to get into the Clinical Menu. Then go to page 17 for the Options, Essentials configuration description. Then go to page 19 for a more complete description in the More Info description of the additional information you will get with the Plus configuration of Essentials.

If it is a AirSense 10 CPAP model do you actually get any detailed data on the SD card? My recollection is that the CPAP model does not capture detailed data, and only the Elite and Auto model do.

Another option you have is to go into the Clinical Menu, and under Options, set the Essentials item to Plus. It defaults to On. But, if you set it to Plus, then the Sleep Report on the machine is more detailed. It can then be set for a selectable amount of time, from one day to months. It gives a more detailed breakdown on the type of apnea events too. See page 17 of this technical manual for more details.

AirSense 10 Technical Manual

That said, all the detailed sleep data is stored on you SD card, and it is not transmitted with the MyAir very basic data. The only way you can see the detailed data is by removing the SD card and extracting the data with SleepyHead, OSCAR, or by having it read in the clinic with ResMed software like ResScan.

Are you using SleepyHead or Oscar to determine if the sleep onset apnea events are central or obstructive? If they are obstructive, then more pressure would be better than less. If they are central, pressure might make them worse, but that would be less certain. If you are sure they are central and they are happening before you go to sleep, then you may want to use the Auto Ramp, with a much lower ramp start pressure.

What specific model of AirSense 10 do you have? Auto, Elite, or CPAP?

No I don't see how a BiPAP could help with a sleep onset apnea. All it does is provide more than 3cm of EPR which would hurt more than help. It also provides a maximum pressure of up to 25 cm instead of 20 cm. Again would not help unless you are at 20 cm already and need more.

Have you read that manual on how to access your Clinical Menu on the machine? I still think you should be able to set it to ramp only. Turning EPR right off may be another option and then use no ramp at all.

I think the overall score is more of a compliance measure than a quality of treatment score. You should look at your AHI and leakage rate if you want to know how well your apnea is being treated. Using OSCAR is a better way of looking at the detailed data.

Yes, I suffer from central apnea more than most. I get an incidence of CSR perhaps on average once a month. My long term average in SleepyHead for CSR is 0.14%, so not a real big factor, but it is of some concern. For me it seems stable. If it gets worse I will talk to my doctor about it to see if there are any underlying heart issues I need to be concerned about.

The traditional sleep labs are finding the practice a big threat to their business. Many are lobbying the governments to not allow the practice of using home sleep studies, and then going straight to an auto CPAP.

Here a daily report from back when I started using the machine and the mode was in auto. You can see how the machine responds to events flagged at the top and increases pressure. It was set for a minimum pressure of 10.4 cm, and max of 15 cm.

And this one was from last night, and is actually a little better than my average. Pressure is fixed at 11 cm.

Starting in Auto is always a good idea. It may work fine in Auto, or it may not. Works for me wife, but not so much for me. The higher pressure cause central apnea for me, and I have to limit pressure to avoid that effect.

The nose only nasal pillow style masks tend to be the most comfortable, but I am not sure they are rated for pressure above 20 cm and perhaps not even that high. I have used one up to about 15 cm, but not higher.

Traveling with a CPAP is not really difficult. They come with a travel case and they are classed as medical equipment so you take them as an extra carry on without charge. The ResMed case in particular has a velcro strap that slips nicely over a two extension rod roller carry on. I just got back from Mexico and both my wife and I use a CPAP. No hassle at all.

Yes, the Auto versions adjust pressure themselves. A common route now used in our part of Canada is to do a home sleep study, and if it indicates obstructive apnea, then you go straight to a home trial with an APAP. That is what I did. They then look at the detailed data and if it looks good, you get the choice of buying the machine at a ridiculous cost... Part way through my trial I made my own decision and ordered an on line CPAP. I initially used it in Auto mode up to about 15 cm. However after a lot of testing and data analysis I have now changed to a fixed 11 cm pressure. I will post a couple of daily reports for you as to what my results looked like early on, and what they are like more recently. I suffer from central apnea so I can't get low sub 1 AHI like my wife can. I started with an AHI of 37, but have trouble getting it under 3. My wife was diagnosed at an AHI of 83 and now averages under 1. She still uses Auto mode with a minimum pressure of 13.6 and max of 14.4.

You really should request a written report from your sleep lab or doctor. They owe it to you, and should e-mail it or give you a hard copy. It should contain the detail of what pressures were used.