Sierra

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.

Happy New Year,

It looks like the three OA events were likely due to the pressure being lower. When you lower the minimum the ResMed slowly reduces pressure if you are not having any flow restrictions. Flow restrictions are not shown, but outside of the OA events it looks like they are keeping your pressure higher at times. I would guess that the OA event woke you up and the CA was just part of waking up.

All in all you have a pretty good balance of CA and OA events, with a reasonable total event frequency. If you are generally sleeping well, I think you are doing very well with your settings. You have made a very significant improvement from where you started with your first OSCAR posts. If the OA events start tending to be higher than the CA events, you might want to consider raising the minimum pressure some.

Overall your results are pretty good with an AHI under 1. It looks to me as if those CA events were most likely due to arousal events. You could consider lowering the minimum pressure to 12 to see if that helps. With not sleeping on your back, that may be ok.

Merry Christmas!

On that first event at about 4:10 I think just before the CA event you had a short OA event that did not last long enough to be flagged. When the machine determines that flow has stopped it starts a high frequency flow cycle. This is how it determines whether the event is a central or obstructive type. If it is obstructive then the pressure cycles up and down in response because the airway is blocked. If the pressure does not cycle up and down as much then it means the airway is open. In the 4:10 event by my eye the short period of cycling produces more of a pressure response than later when it gets flagged as a CA event. This would suggest you had a OA followed by a gasping and then drop of of breathing effort. While it appears to be a legitimate CA event, the trigger was probably the OA event. In both cases you can see the impact on the minute ventilation graph. It goes unstable prior to the CA event.

The second event is not quite the same. It looks like you just took a deeper breath and then the effort dropped off to another CA event. It is actually normal to take a short extra deep breath while sleeping. My wife does it on a regular basis every 8 minutes or so. I forget the name but it is considered normal. Your response to it was not quite normal though, and it ended up as a CA event. But, in the scheme of things not a real serious event. Here is what my wife's breathing looks like when she takes the periodic extra deep breath. In her case it does not result in any issue and the breathing carries on at a regular frequency with no events. The first event is right where the green cursor line is, and then you can see the subsequent periodic repeats of it. Notice that there is next to zero impact on her minute ventilation. It remains very stable. She has few issues with CA events (unlike me).