Sierra

I can't make any recommendation because I don't understand why you need a BiPAP machine over a standard APAP. You said that your doctor recommended a BiPAP because your AHI is so high. A BiPAP will provide more pressure so I guess if the doctor has not done any kind of titration testing to determine your pressure requirements, I suppose it is a safer choice. If that is all there is behind it, then the ResMed model in North American terms that I would suggest is the AirCurve 10 VAuto. It can operate in the S mode which seems to be just a bilevel pressure mode with no auto adjustment up to 25 cm, or in the VAuto mode which gives you auto adjustment of pressure up to 25 cm, or in the CPAP mode which is limited to 20 cm and no auto pressure adjustment. You would have to do some comparisons to see which Lumis model offers that. This manual may be helpful. It details what the options of each machine are.

AirCurve 10 Manual

Masks tend to be very personal. What works for one person doesn't work for another. You have to watch the pressure as well. One person that uses low pressure may say a mask is great, but another person that has to use higher pressure will say it is awful.

Unfortunately the guy that does those annoying youtube videos is not the most credible. If you want credible information read that link I gave you a few days ago. Not only that, I believe he is not correct about how the DreamStation responds compared to the ResMed. Have a look at the SleepyHead report from a Respironics BiPAP machine. You can pick them out from a mile away based on the constant spikes in pressure (red trace in the graph). The machine seems to spend the whole night responding to events, and then quickly ramping the pressure back down. It is actually the more aggressive one. It is aggressive in spiking up pressure and then spiking it back down again. The key here is "responding". The DreamStation keeps needing the trigger events all night long. Each trigger event is another apnea that you must endure. The ResMed is smarter and says OK, this guy needs at least 8 cm of pressure to prevent an apnea. I will hold it there and see what happens. If nothing happens it then SLOWLY ramps pressure down. If another event comes along, it will notch up a little higher. At the end of the night, I believe the ResMed method achieves a lower residual AHI. That said, you can deal with a DreamStation and make it work. What you have to do is take away some control and set the minimum pressure higher. Both machines work, but I would suggest the ResMed is more sophisticated in the algorithm it uses to control pressure.

https://goo.gl/images/t7VAMh

You might want to consider making a brief summary post here on how you decided that a DreamStation was the best machine. It might generate some discussion. It is a good machine, but best? I'm not so sure...

I have a ResMed AirSense 10 AutoSet, but I do not use MyAir. It seems a bit too basic and as you have noticed is highly weighted to measure compliance, and not the machine effectiveness. You are correct in that your AHI seems too high. The normal guidelines is treatment to less than 5 for AHI.

My suggestion would be to download SleepyHead. It is a free software that is used to display your detailed data on a computer. From that you can see a lot of detail about what was going on during the night. I will include a screen shot below of my sleep last night which illustrates that. At 5:10 AM there is a cluster of obstructive apnea events (blue indicators). That could indicate a positional problem. And, it also happened when the pressure was at my maximum setting of 13 cm. It may mean I need to increase that maximum limit. In any case if you are interested here is a beginner's guide to SleepyHead to look at. I find SleepyHead key to understanding my apnea treatment, and in making the necessary adjustments. If you download this software and post your Daily chart, like the one below, I and others can give you some suggestions as to what might be going on.

Welcome JPC to the club that nobody really wants to belong to!!

I think NiceSilverBison has given you some good tips on how to get used to your mask. A full face mask can be difficult, but I think you were given one of the better ones. Main thing is to stick with it. I'm sure I got close to zero sleep the first night I used a CPAP. It takes some time. If you can't tolerate a full face mask there may be other options like a nasal pillow mask which tend to be less confining and more tolerable to wear. However they also are a bit of a problem if you tend to open your mouth in the night. In short masks take time to optimize.

I think it would be helpful if you were to share a bit more information about your situation, such as your AHI at diagnosis, and what pressures your machine is set at.

I'm not so sure you would gain all that much in using an O2 meter. The O2 will go down in response to apnea and hypopnea events. Your machine is quite capable of monitoring them already. And in the long term you really don't want one more thing waking you up.

My suggestion would be to download SleepyHead. It is a free software that is used to display your detailed data on a computer. From that you can see a lot of detail about what was going on during the night. I will include a screen shot below of my sleep last night which illustrates that. At 5:10 AM there is a cluster of obstructive apnea events (blue indicators). That could indicate a positional problem. And, it also happened when the pressure was at my maximum setting of 13 cm. It may mean I need to increase that maximum limit. In any case if you are interested here is a beginner's guide to SleepyHead to look at. I find SleepyHead key to understanding my apnea treatment, and in making the necessary adjustments.

My thoughts about setting up the AirSense 10 are as follows:

Set your Ramp on Auto Set the Ramp Start pressure at about 7 cm Set the EPR to 3 Set the EPR to Ramp Only

This will give you an inhale pressure of 7 cm during the ramp and 4 cm exhale. I find that very comfortable. When the machine decides you are asleep it ramps fairly quickly up to your minimum pressure which I would assume is 7 cm or higher. The EPR is turned off at that point so inhale and exhale are the same.

At least that is what I have found best in all my different combinations I have tried I think I am on about version 20 of my machine setup now...

I thought about this a little more and I also tried to make my machine act badly when I went to bed last night by taking sudden deeper inhales and exhales. Yes, I could hear the machine speeding up and slowing down following my breathing, but no really abnormal sounds. The normal sounds I hear from this machine almost sound like a second person sleeping a short distance away and breathing in sync with me. Have never felt or heard anything that sounded like pressure pulses.

My further thoughts were that you may have a defective machine. You said it is recent. Is it new or was it used? Has it done this since day one? About the only other things I could think of was some kind of flow restriction in your setup. I assume the filter is new and clean? Anything out the ordinary about the tubing? You could check the humidifier seals to see if they are located properly. There are some instructions in this Clinical Manual on how to inspect the humidifier seals. If you don't have this manual, it is worth downloading and keeping as a PDF.

If you find nothing, it may be worthwhile checking into what the warranty routine might be. There may be some time limits on getting a new exchange machine. I recently had a new ResMed DC to DC power supply go bad. The vendor was willing to ship me a new one immediately and gave me a return authorization to ship the old one back. They were very good about it. However, that may depend on your vendor...

Have you looked at your detailed data using SleepyHead? You can get a lot better idea what is going on during the night when you see the detailed data in SleepyHead. It is freeware.

SleepyHead Download

Basic SleepyHead Instruction Manual

There are two types of nasal masks; nasal, and nasal pillow. And there is the odd exception or two as to what setting you should use. Here is a link to ResMed's compatibility list and settings for masks. That is a long shot anyway.

For a reader I just use one of those small portable things that plugs into my USB slot.