Sierra

An oxygen monitor that tracks O2 during the night is fairly inexpensive, and will give you some more information on what is happening in the night.

There will only be an auto option if you use the heated hose. With the standard hose it reverts back to manual control of humidity and no control of temperature.

Bill, I am going to be away for a couple of weeks, and may not be checking in. Lately I have been trying a fixed CPAP mode to see what it can do compared to giving the Auto mode a range and letting it adjust pressure. My pressures run about the same as yours do, and in the past I have gone as high as 15 cm. But when I have done the fixed pressure testing I have gone as low as 8 cm. It didn't turn out real well (AHI 6+), but with 9 cm, 10 cm, 11 cm, and 12 cm, there is not a huge difference in AHI. It seems to be a bit of a mushy range where the proportion of central, obstructive, and hypopnea events show no real clear trend, and the total does not change much. But one of the things I have learned is that you need a lot of data to determine what pressure is best. 2-3 days is not enough. My thoughts now are that you need 2 weeks minimum at one fixed pressure to try and evaluate what it can do. So it would take a long time, but you may want to consider trying two weeks at each single fixed pressure for 8 cm, 9 cm, and 10 cm to see what may work best for you. I think there can be some comfort as well as AHI advantages of using a single pressure over an automatic range. For example if all of those pressures give you basically the same total AHI, then why not use the lowest one, and get more comfort?

Do you have a breakdown of the obstructive events you are having compared to central events? At least in theory the base EPAP pressure should be dealing with the obstructive events, while the pressure support should be dealing with the central events. If your residual AHI of 5 is mainly central events, then you might even gain by lowering the base pressure and giving the pressure support more range. Just my thoughts based on using an APAP and trying to use it to control mixed apnea. My central events are like 2/3 or so of the total, but I do not have an ASV machine to deal with the central events. But, I can generally average under 3 for AHI, so probably not time to consider an ASV necessary.

I'm not a doctor, but my quick look of the info on line would suggest there should be a benefit in treating OSA when you have atrial fribillation. Is this a recommendation of your sleep doctor or your cardiologist. The article at the link below suggest both conditions need to be treated.

Sleep Apnea and Atrial Fibrillation: How They’re Connected

I suspect your original CPAP prescription would do if you have it. Or, just order the parts.

Welcome to the forum.

My personal experience is that the machine happy face is not very critical. Only once in 6 months have I seen the red unhappy face. When I checked the actual leakage rates with SleepyHead, it was terrible. You get the happy face if 70% of your night is below 24 L/min leak rate. That is pretty high leakage. If you enable the more detailed reporting on the ResMed machine you can get an actual leakage rate number. It gives you the 95% leak rate number. Ideally you want it under 15 l/min. See page 19 of this technical manual for more information on the detailed report numbers. To enable the more detailed report, if it is not enabled now, you need to go into the clinical menu. To do that push the home button and round Set button together for 5 seconds. This will bring up the clinical menu option. It works the same as the user menu. Go into it, and scroll down to the Options section, and the first item should be Essentials, press on it, and set it to Plus instead of On. Press the Home key and exit out of the clinical menu. The more detailed sleep report should now be available to you. You can set the time interval that it averages readings over from 1 day to 1 year.

As far as opening your mouth during the night, I have that issue and have solved it by using tape on my mouth. I think there are advantages to doing that, and it is way more comfortable than it sounds. See this video:

Mouth Taping for a Better Sleep

Based on my experience it should be hard to hear the AirSense 10. I can hear mine slightly when I first go to bed and my breaths are deeper, and you can hear the machine respond as it tries to keep pressure constant. As I relax the noise pretty much goes away. The machine is on the bedside table right beside my head. I don't hear my wife's machine which is a ResMed S9, but I do hear her mask leaking sometimes if it dislodges. She uses a nasal mask, and I can also hear the air leak out of her mouth if she opens it in the night. I've now got her convinced to do the mouth taping trick like I do and that noise source is gone for both of us.

Do you have an option to locate the machine a bit further away? I would think most noise would come from the air intake which is on the left side. If you could face the machine toward the bed so the air inlet faces the wall it may be a bit quieter. I see from the comparison charts that the AirSense is rated at 27 dB compared to the DreamStation which is 26 dB. However, the human ear usually needs a 3 dB difference minimum to detect a difference. So the noise should be essentially the same.

Did you change mask types when you got the new machine? Some masks are definitely noisier than others. I tried the AirFit F20 for a while, and it was not a real quiet mask. I see now that ResMed has released a different mask elbow for it with what they call a QuietAir vent system. Unfortunately it seems it only fits the two F20 masks though. I use the AirFit P10 nasal pillow mask and find it very quiet. I believe it is rated at 21 dB like this new QuietAir vent. Other masks can be 24 dB or higher...

I think there may be a bit of a push by some vendors to keep the users away from the detailed data, and coming back to them. I don't agree with it. But, I think worse than that if the SD card is removed then the detailed data is simply lost. You can't get it and all they get transmitted daily is the summary or compliance data which is very limited. If you have the SD card installed you can view it with SleepyHead, or if you take the SD to your provider they should be able to view it with the ResMed ResScan software. But with no SD the data is simply gone. I don't think it is ethical to take the card out as all machines come with one from the factory. If you want to learn a little more about it, have a look at the technical manual at the link below. See pages 28-29. This is a very good manual to keep for yourself as a pdf.

Technical Manual

One last thought. Assuming you are in the US there is a strange regulation there that you need a prescription to buy a mask. You can get around that issue by buying parts and assembling the mask yourself. It usually comes in two parts, and the total prices is the same as a full mask assembly. They know the game...