Sierra

I have looked at these machines, but have not been a user. We have a Z-1 travel machine that does not come out of the cupboard due to noise and other limitations. Here are my comments but I also would be interested in actual user thoughts.

"AirMini offers all of the following therapy modes: CPAP, AutoSet™ (with Response option) and AutoSet for Her. Unlike the AirSense™ 10 series, where different devices offer different therapy modes, the AirMini includes all three of these therapy modes."

This is a bit of "sales-speak". The ResMed AirSense 10 AutoSet For Her does all three therapy modes. It is just a mode setting change.

Will I be able to use this as a full time machine?

I think a more honest answer is that yes you probably could use it as a full time machine, but with some compromises:

1. There are many reports that it is more noisy. This may be the result of a narrower diameter hose, a smaller machine, and many also report that the humidifier device adds noise and is located close to your ears.

2. The machine requires special masks and does not accept the universal mask standard. Your only choice is a special ResMed N20 or P10. This is a big risk as your needs for a mask may change over time, and as new and better masks become available, you will not be able to use them.

3. The machine does not have a SD card to store detailed data like the standard AirSense 10 AutoSet does. That means you will not be able to use SleepyHead to monitor your results. That is a show stopper for me.

4. The humidifier seems to just recycle your own moisture from your exhale. I suspect it is not as effective as a real humidifier, is noisy, and has to be replaced every 30 days as an ongoing cost. There is a bit of a myth about using a standard humidifier in that you have to take special distilled CPAP water with you when you travel. This is not necessary at all. Just use ordinary tap water and then rinse your water container out with vinegar when you get home. Your humidifier acts like a distillation unit and you only get pure evaporated water to breathe in.

5. The AirMini does not accept the ClimateLine heated hose which makes temperature control and humidity control automatic while avoiding "rainout".

And, the final big factor that has kept me from seriously considering it, is that portability of the standard machine is very good. Once you add in your mask and power supply there is not much difference in the weight and size of the standard machine compared to the portable machine. The standard travel case for the AirSense 10 is very good for traveling and attaching to a rolling carry on bag. A CPAP is classed as a medical device by airlines and it does not count against your carry-on and personal item count.

I suppose there is some convenience in having a dedicated travel machine as you would not have to pack up the normal machine when you travel. But, packing it up is probably a 5 minute job at most.

Just my thoughts as a non user.

Another thing you can do with the software is zoom in on the detail of a small section of the night to see what is happening breath by breath. For example if you left click on the cluster of central apnea events in the events bar for October 25th at 11:50 and keep clicking or use the up down arrow keys you will get to see the detail. That can be quite revealing as to what type of central apnea you are having. But try to pick a time when you are sure you are sleeping and are having a cluster of CA events. Post that zoomed in screenshot and I will give you my comments as to what I think may be going on.

So here is my suggested method for setting up your Auto BiPAP. My thoughts are to start simple to establish a base treatment pressure, and then decide based on the results whether more adjustment is needed in a phase 2 of the adjustments. The SleepyHead reports indicate you are currently in a Fixed BiLevel Mode with IPAP at 20 cm, EPAP at 10 cm, and Presssure Support at 10 cm. This does not let the machine do anything, and you have reported that you believe the pressure is too high.

Phase 1

In order to see what pressure works best for you I would suggest switching the Mode from Fixed BiLevel to Auto BiLevel. See page 4-19 of the manual. This will allow your machine to adjust the pressure within a set range. With SleepyHead you will be able to see what pressure is needed to normalize the obstructive apnea, and at what pressure the central apneas start to appear. The DreamStation machine is able to distinguish between obstructive apnea events and central apnea. It should only increase pressure for the obstructive events and not for the centrals. In theory this should keep the machine from running the pressure up unnecessarily high.

The first step is to set the Mode to Auto BiLevel. The Menu should now change to display an IPAP Max, and EPAP Min (The manual says EPAP Max, but I think that is a misprint). See page 4-20. To start with I would set IPAP Max to 15 cm, and EPAP Min to 8 cm.

There should also be a display of PS Min and PS Max. This is the variable pressure support. For the first phase I would suggest setting both PS Min and PS Max to 0 cm. This will force the IPAP and EPAP to be the same. They will both go up and down together between the limits you previously set at 8 to 15 cm.

I would collect at least one night's data with this basic setup and post the results back here. That might suggest some further tweaks to the settings, but the main purpose is to collect some data to find out what pressure works and doesn't work for you.

Oh, and make sure you remove that filter material you were reducing the pressure with. It will mess up the numbers in SleepyHead and also keep the machine from automatically adjusting pressures correctly.

Phase 2

Depending on what comes out of Phase 1, the next step may be to try adding in some Pressure support. It may help with central apneas or it may hurt. About the only way to find out is to try it. But, lets not complicate things, and leave that aside for now to see what comes out of Phase 1.

How does that sound? If you have any questions, just ask.

I think the best way to decontaminate the ozone residuals would be to follow the ozone treatment with a vinegar wash, then another wash with water and a little bit of liquid dish washing detergent, and finally a thorough rinse with just water. Hang to dry thoroughly before use.

Sorry, I just noticed that SleepyHead is reporting that you have a DreamStation Auto BiPAP. Assuming that is correct I will think about some suggestions for a setup compatible with that machine.

It sounds like you have the ResMed AirSense 10 AutoSet machine? Is that correct?

If you want to take the next step in optimizing your machine for comfort and performance and you have a PC or Mac with a SD card reader, I would suggest downloading the free SleepyHead software. With it you can see what is going on during the night and what can be improved with the pressure and comfort settings available on the AirSense. Here are some links. Just post if you want help. Probably best to start a new thread though.

SleepyHead Download

SleepyHead Basic Instruction Manual

Assuming your machine came with a SD card all the detailed data since day one of use will be stored on it. You will be able with SleepyHead to go back and examine it all. I see you have already jumped into the Clinical Menu on it, and the next step would be to optimize all the settings.

While you are waiting you may want to do a bit of research on the type of sleep apnea test you want to get. The traditional method is to have you sleep overnight in a sleep lab while the current trend when there are no other complications is to set you up with a portable unit which you wear overnight at home. I think the basic difference is that the home test is less intrusive, but it does not give quite a detailed a report. But they are both quite adequate to diagnose sleep apnea. Here is a link that may help you out a bit if you are allowed that decision choice.

Home vs Lab Sleep Study

And you may want to think down the road a bit about a CPAP machine. Assuming you have bread and butter basic apnea there are two choices of machines. One uses fixed pressure and you will need a second in lab test to determine the optimum pressure that it is to be set at (titration study). It used to be they were much cheaper and insurance companies preferred them. Now, there are Automatic machines that determine the pressure themselves, thus eliminating the need for the titration lab test. That is now the more current method of going and the one I would recommend. There is minimal difference in cost to get the auto machines.

And last in my opinionated opinion I think the best automatic CPAP currently available for run of the mill apnea is the ResMed AirSense 10 AutoSet For Her. And yes even for males the "For Her" version is the better choice. It offers an optional automatic mode which is tuned for lower pressures. It may or may not work better, but it gives you two choices to try in the same machine "Standard" or "For Her". Your provider and/or insurance company may push for one machine or another, but I would push back and demand the "good one". I would also try to get a heated hose for comfort. Here is a link to learn a bit more about this model:

ResMed AirSense 10 AutoSet For Her

And last when you get the sleep study done insist on a full explanation of the results and a full written copy of the report with a copy of the prescription if a machine is provided. If you have any concerns about what they are recommending come back here for some input to help sort it out. Some providers are good, and some not so good. It really helps to go into this with your eyes wide open.

If you do not have insurance to cover the costs, then you may want to check on line prices for the machine. It should run in the $800-900 range for an initial setup. You will need a prescription to buy on line though.

Hope that helps some,

An AHI of 5.7 that is 75% central shows you have some room to move pressure down potentially without increasing obstructive apnea that much. Trying a night at 5 cm should verify this one way or the other. The trick will be to reduce CA without increasing OA too much, and get a total of less than 5.

Those graphs are helpful. They show that when you have major leaks (grayed out area) the events are not being flagged. That is probably the reason why you were getting better AHI's when you were using the poor fitting mask.

As for settings I think I have mislead you about being able to set the machine in Auto CPAP mode. That manual I gave you a link to seems to be a universal manual for several models, and you probably do not have the ability to change it to Auto CPAP.

To help clarify things which exact model of machine do you have? It is probably one of the two following ones:

DreamStation BiPAP Pro - May have a part number starting with INX600

Dreamstation Auto BiPAP - May have a part number starting with INX700

When we clarify which exact machine you have then I can give you some better suggestions for settings.

The ResMed A10 has some very good features to make going to sleep comfortable. First is switching the ramp to Auto as you have done. You can also set the Ramp Start pressure to a higher more comfortable level. I would suggest 7-8 cm. Base it on what feels like zero effort to breath in and out. I also set my EPR at 3 and for Ramp Only. That makes the breathing more comfortable before going to sleep and the pressure more effective after going to sleep.