Sierra

It is kind of hard to figure out where your configuration may be. Here is a quick guide to how I would set it up. See the detailed guide at the link below, and first page 14 where it tells you how to get into the Clinical Menu. It basically works like the user menu but has more setup options. See pages 15 to 17 for a list of the setup options.

First go down to the Comfort section and to Ramp Time - set that at Auto. This feature holds the pressure at the Start Pressure until you go to sleep. Start Pressure - that is the next setting, and controls what pressure you will get during the ramp. For example if your minimum pressure is 8 cm and maximum 10 cm, I would suggest at ramp Start Pressure of 7. But adjust it to what feels comfortable during the go to sleep period. You should feel no restriction from the mask to breathe in, or no resistance in breathing out. You can't set it above the minimum pressure. And if your minimum is 7 then it still makes sense to set the ramp to Auto and a start pressure of 7 cm.

The next section is EPR. I enable it, set it at 3 and for ramp only. If you use EPR during treatment it can reduce effectiveness. For most you will get a lower pressure during treatment if EPR is off. But when set to ramp only you still get the comfort of EPR before you go to sleep. I find it works well.

Next skip down to the Option section.

Essentials - Set to Plus. This will give you a bit more control and a more detailed sleep report from the user menu.

SmartStart - I set this to On so the machine will start and stop automatically when you put it on and breathe, or off when you remove the mask.

That is about it. I hope that fixes it, and there is nothing wrong with the machine. If you have any questions just ask.

A10 Setup Guide

My wife has been using a CPAP for almost 4 years now. We started out by using the RV batteries, an inverter, and one 70 watt solar panel. The trailer uses very little power as the lights are all LED, and we use propane for the fridge, cooking, and even outdoor lighting. What I found was that we were just keeping up to the CPAP drain with the one 70 watt solar panel. Then this year I got into the CPAP use as well. In theory we could have run both machines off the one inverter, but I was worried we would need another solar panel to do the recaharging. We also found is that it is hard to find an inverter that does not use a fan to keep cool, and that fan is much noisier than a CPAP. That is when I did some math and found we could run both CPAPs with the DC to DC converters (which have no cooling fans) for almost the same power as running one off an inverter. My plan was to try it this year and if it didn't work then buy another solar panel. It turned out to be not necessary as the one panel seems to manage. Using the furnace on 12 volts is a non starter though. It uses way too much power to recover the next day.

And you are correct that a CPAP battery/power supply solution is not really going to be ideal for camping, unless you only do one night stands without AC power. Although if a solar panel and inverter was used to recharge the CPAP battery during the day it might work if the solar panel was large enough.

One additional point. Whatever you choose, make sure it is well tested before your trip. I told my wife that she did not need to bring her normal AC adapter on a trip we made earlier this summer. We could always run off the 12 volt power from the trailer whether or not we were plugged in to AC. Well her brand new ResMed DC to DC converter lasted 4 nights and then quit. There was a bad connection in the power cord. Fortunately she ignored my advice and brought the AC adapter and was fine for the time we had AC!

Amp hours is a term which assumes the battery is 12 volts. 10 amp hours in a 12 volt is 120 watt hours. I would consider that the very minimum to survive a night at 15 cm average range without using the heated hose and humidifier. That Magnadyne unit in 24 volts looks like it should do it, but you were looking for actual experience (which counts), I don't have that.

For trailer off grid camping I think I would go the route of 12 to 24 volt conversion with the ResMed converter which is in the $100 range. That assumes you have a reasonable size battery in your unit. We use two 6 volt golf cart batteries in series plus a 70 watt solar panel to recharge. At about 150 lbs I doubt they will let you on a plane with that setup though! And if I was buying again, I would get a 100 watt solar panel, which seems to be the current Costco in store standard. Based on actual experience I think we could camp indefinitely with that setup while using two ResMed CPAPs.

I keep thinking that this thread has come to a conclusion, but as I thought about this more during the US Open tennis match today (excellent tennis by the way), I decided that there may still be a bit more to it.

If we make some assumptions which may or may not be true, there seems to be another conclusion that has not been identified so far.

Assumptions:

1. The Luna machine you are using behaves like the RESmart Auto machine tested in the study I posted earlier.
2. The sleep study you had done is accurate and your apnea is nearly 100% hypopnea

If the assumptions are correct what does that mean? First the machine may not be detecting hypopnea and as a result may not be responding to it. And further, it may not be including hypopnea in the AHI reported. What does that result in? Well, it would mean it would take minimal pressure to produce a very low AHI, which is your basic original question. Why? In fact it kind of validates what you have observed which is a high AHI at diagnosis, but almost no pressure to reduce it to a very low AHI.

If this is in fact true, what can you do about it considering that you bought this machine to minimize costs for a CPAP? The first thing to keep in mind is that while there are many different CPAP machines with all kinds of bells and whistles, at the end of the day, they only do one thing. That is to provide pressure to keep the airway open. This machine can certainly do that. Your only problem is making the machine do that, while at the same time, it may not be detecting your basic problem in Auto, which is hypopnea. Contrary to what I have said in previous posts, the easiest way to do that is to let it provide a higher pressure.

A second thing to keep in mind is that CPAP therapy operates on various pressure levels. In my opinion less than 10 cm is low pressure. 10-15 cm is moderate pressure, and 15+ is high pressure. The pressure you need to treat the condition that your CPAP may not even be detecting is likely in the low pressure range, with minimal if any side effects of using it.

So my conclusion (for today) is that you may be better to error on the higher side for pressure than on the lower side, when using this specific machine.

Without being able to see the actual flow waveforms in SleepyHead it is hard to say what the benefit of more minimum pressure would be. What I see in my wife's SleepyHead reports is that it takes more pressure to reduce flow limitation and snoring than it does to stop apnea and hypopnea events. I am kind of the other way around. When I have my pressure high enough to stop the apnea events my flow limitation and snoring is zero.

With your machine you are kind of flying blind. That comparison study of various brands of CPAP machine shows that your machine may be over reacting to snoring, and under reacting to hypopnea. Perhaps it does not even detect hypopnea and that is your main issue. Don't know. Just guessing. However it only reports snoring to you and not hypopnea, so it is really hard to tell what is going on. Probably the best you can do is limit pressure to the point where the snoring index is not further improved. On minimum pressure it would really seem to be mainly a comfort factor. If you feel comfortable and are getting enough air, then what feels good and keep the snoring index and AHI index in control, should be good too.

The other issue is just pressure variation during the night. Say for example you need a pressure of 8 cm to control snoring and going above that does not do any more good, it would make sense to set max pressure at 8. If you find that the machine is going up to 8 cm and back down frequently during the night you can minimize that variation by moving the minimum pressure up.

Hope that helps some,

I have some partial experience with my wife's S9 and my A10 machine running off battery power. However, it is with our 5th wheel trailer when running with no AC supply. We each have a ResMed 12 volt to 24 volt converter which we use in place of the normal 110 volt adapter. ResMed publishes a battery guide which gives the 12 volt current draw for an inverter solution (which we do not use) vs a voltage converter solution (which we use). The DC to DC converter is about 40% more efficient. From our trailer experience I would say that the ResMed guide is pretty accurate. We both draw about 1 amp at 12 volts. If you are using a battery solution and the DC to DC converter or equivalent you probably need a 10 amp hour 12 volt battery as a minimum. A motorcycle dry AGM would technically do it and would be reasonably cost effective, BUT I highly doubt you would get one on a flight unless it says it is a CPAP battery. And they are expensive. I believe the ResMed battery and adapter package is in the $700 range. Here is a link to the battery guide. The amp draw is quite dependent on the average pressure you use. A BiPAP generally operates at a higher pressure and the minimum draw may be over 1 amp, but you should be able to look it up. This low current draw is with the humidifier and heated hose turned off. That is one thing you should do before your flight as no matter which way you go, you may be limited on the plane for watts - figure out how to shut the humidifier off and the heated hose off. That is what we do when we operate on 12 volts from the trailer. We try to limit the current draw to the minimum because we depend on a solar panel to charge up the batteries each day.

ResMed Battery Guide

As for the British Airways 747 on board I thought I found an easy answer for you, with a power guide pdf. The problem is that I found two of them and they are not the same. The power options you get depend on the class of ticket you buy. If you are flying first class no problem with just using your standard AC adapter. If flying economy you may be out of luck and need a battery solution. In between those two extremes it is a bit of a mystery. In any case Here are some links I found. Probably what you should do is contact British Airways and find out exactly what power you are going to get at your seat.

Traveling with a Medical Condition - See Section on CPAP Machine

In Seat Power: Quick Guide - Version 1

In Seat Power: Quick Guide - Version 2

I don't see any easy way of using that 15 volt outlet that seems to be all that is available in some cases depending on the class of ticket.

Hope that helps some. I think your only problem is the flight over, as your existing dual voltage adapter and plug adapter should do just fine in Europe.

Welcome Adam. The ResMed A10 AutoSet is a good machine. You may find that after a while you might want to tighten up the minimum and maximum pressures some. As I suggested to Max in the previous post, you may want to download SleepyHead so you can see what the machine is really doing during the night. I have the same machine and started out with a wide range like that. Now I am at a minimum of 11.4 cm and a maximum of 12.6. If you need any help just post your questions in a new thread.

I suspect you only got a very slight amount of ozone if any at all. You will also smell ozone after a lightening storm, and people survive that. If you read the SoClean stuff they claim any smell is the result of ozone cleaning the mask and is not the ozone itself?? I would air dry it all day after it came out of the SoClean machine if it were me.

Welcome to the forum. Yes the AHI reported by your machine is reasonably comparable to a sleep study. If you want to look at your results in more detail I would suggest downloading SleepyHead. It is free software made to display and track your detailed data from the SD card in the CPAP. You will need a SD card reader to transfer the data from the card to your computer (Apple or PC).