Sierra

For comfort I would also adjust the Ramp Start pressure up to 7 cm. My experience is that when you have EPR on, a bit more pressure is more comfortable than less.

Both my wife and I use an AirSense 10 and I see that when I check the User Options both Climate Control and Temperature Control are set to Auto. When I look at the device settings in OSCAR, I see that the Humidity also shows level 4, and temperature at 27. You could possibly go to manual and try setting at level 4 and 27 C to see if that helps. But, as far as I know it should work in Auto. In fact I recall that when you plug the heated hose into the machine it displays that it has set the climate control to auto.

I would have similar comments on what I made on your setup:

1. Set the minimum pressure to 7 cm. When you have the EPR at 3 cm full time it will be reducing the exhale pressure to 4 cm (green pressure line) with each breath. If you use a lower pressure nothing is going to change on exhale because the machine will not go below 4 cm for pressure. 7 cm on inhale and 4 cm on exhale should be as comfortable as it gets.
2. Put the Ramp Time to Auto. It appears to be off, but that may be just OSCAR not reporting it properly.
3. Set the Ramp Start pressure to 7 cm. This will hold the pressure at 7 cm inhale and 4 cm exhale until the machine decides you are asleep, and then it will increase pressure as needed. Your machine seems to be set to Auto, but this one does not appear to be in that mode.
4. I like the Smart Start to be on, but that is a personal preference. I use it to start the machine, but I stop it manually with the on off button.
5. I see the humidifier and temperature is in manual and set low. I guess that is fine if there is no rainout (water condensation in the hose). I prefer my machine to be in Auto Climate control like yours is. I don't find the air to be warm or cold, just right, when it is in Auto.

I do not have a Clinical Manual for the AirSense 11, but here is a link to a AirSense 10 Clinical manual. The interface may be a little different on the 11 but I believe most of the functions are the same. With the 11 I believe you touch the screen with two fingers to go into clinical set mode??

Hope that helps some,

Does it show a temperature setting?

Your results are pretty good with the machine set the way it is. The only improvements I might suggest are:

1. Increase the minimum pressure to 7 cm
2. Increase the Ramp Start pressure to 7 cm
3. I can't see what is driving the pressure up, but I suspect it is flow limitations. If you click and drag on the dividing line between the graphs you can scrunch the height of each graph down so more graphs will show. It would be helpful to see the Flow Limitation one. If you click and drag on the title of the graph you can change the order of the graphs.
4. If flow limitations are what is pushing the pressure up, you may want to try increasing the EPR from 2 cm to 3 cm to see if that helps reduce flow limitations and hypopnea events.

Hope that helps some,

I believe the heated hose and humidifier should be compatible. Do you have the Climate Control set to Auto?

The original versions of the AirSense 10 used 3G. My wife has a later AirSense 10 version and it uses 4G. The newest AirSense 11 machines are 4G. Due to the chip shortage and shortage of machines as a result, ResMed is now selling a non wireless (no G) version that does not support MyAir. The price is a little lower. If I was buying I would take the discount to get the No G version as I do not find MyAir to be very useful. OSCAR is much better.

Here is a link to the AirSense 10 model that does not have the built in cellular communication modem. It seems to be about $200 less than the AirSense 11. They call it the "Card to Cloud" version. Some that consider the automatic upload their CPAP data to ResMed an invasion of their privacy may prefer this version.

AirSense 10 Card to Cloud APAP

Yes, the Fitpack version of the mask should come with three sizes of inserts; Small, Medium, and Large. You may do better with the Large instead of Medium. You want it to sit more on the nose rather than inside the nose.

You may also want to check that there is a SD card in your machine. Some suppliers pull the SD card out. That prevents the machine from capturing the detailed data, and prevents you from looking at it with a software program like OSCAR. You could ask for the SD card as well if it is missing.

I currently use the ResMed AirFit P10 mask and like it a lot. I have tried about 5 different masks and this one is the most comfortable. It does have to be fitted properly. If you use a cushion insert that is too small it will go too far into the nostrils. You want to use the largest size of cushion that still seals ok. I use the Large. You should also check to see that the straps are not too tight. When I first started using it I did get some irritation of my nose from the cushion. I think one's nose needs to toughen up a bit to make it more resistant to irritation. When I was having the irritation I put some OTC 1% hydrocortisone cream on the nose just at the entrance to the nostrils to help with the healing. It should not be used internally. I put it on once a day first thing in the morning after taking my mask off. It should not be used for more than a week or so.

My wife uses a different nasal pillow mask called the F&P Brevida. She likes it better than the P10. It could be an alternative nasal pillow if you can't get used to the P10. It fits a little more on the nose and has a larger cushion.

The first thing I would do is check your settings to see if they have gotten changed somehow. Here is a link to a manual that gives the technical information on how to access the settings and change them.

AirSense 10 Clinical Manual

If there is nothing obvious the next thing I would do is download OSCAR. Providing you have a PC or Mac and a SD card reader you can download the data from the SD card in your machine if it is an AirSense 10 Elite or AirSense 10 AutoSet. This should give you a lot more information on what it is doing.