ResMed AirSense 10 AutoSet specific questions

[OldLincoln]

After years of Respironics my VA retired the last one (14k hours and becoming flaky) for a new ResMed AirSense 10 AutoSet. Love this machine and have a "couple" questions about what is going on behind the settings. Under Comfort I have Response with Regular and Soft. I switched to Soft as the machine was too aggressive causing bloating. It's good but I wonder if it changed only the front and back end of in/ex-hale or the whole antilogarithm. Of course I just thought to compare graphs of before and after changing settings and I'm guessing it lowers the exhale pressure.

The Resmed time at pressure graph has a VERY faint line in the background that has me stumped (not difficult these days). Please explain. Also I don't recall seeing Mask Pressure before. It tends to move somewhat in correlation to pressure but not understanding what it means.

Request.. can we get a result for AVERAGE pressure (Not the same as Median)?

That's it for questions now my ramblings:
1. I know everyone has preferences but do they understand the ramifications? I live in the country a long way from the sub-power station. We frequently have brief power outages from 2-10 seconds and higher and average longer outages. At one time I didn't set my Respironics to autostart and woke up in the morning breathing through the mask but without the machine running and a bad headache. Now I'm an advocate for autostart as it can't hurt anything but can save your life. Also DMEs tend to default to off.

2. I get frustrated training DME techs about what 95% means. A couple days ago my new tech was all adither that my 95% pressure was 17. When I balked at that she swung her monitor as showed me a tiny bar graph that actually reported max (17), 95% (13) and median (9). She couldn't see the 95% until I used her pen tip (not touching the monitor) to show and explain the different results. She couldn't grasp it until I drew a line and a mark for 95% of it and 50% (median) and another for average. I explained how if that were minutes and 80% were at 10 or lower and an event popped up to 13 it would report 13. She finally understood what I was saying but not sure she's convinced.

3. AHI: A Hypopnea is a "partial apnea" where you still get air. When the obstruction is complete it is an apnea. I think of it as a close call when driving vs a collision, no big deal. I understand reporting the hypo but not in the same measure of a real apnea, indicating they carry equal weight. I doubt one or a series of them will kill me so I don't consider them in my results.

[palerider]

Request.. can we get a result for AVERAGE pressure (Not the same as Median)?

you can't change what the machine shows you, but you can change the readout in sleepyhead.

2. I get frustrated training DME techs about what 95% means. A couple days ago my new tech was all adither that my 95% pressure was 17. When I balked at that she swung her monitor as showed me a tiny bar graph that actually reported max (17), 95% (13) and median (9). She couldn't see the 95% until I used her pen tip (not touching the monitor) to show and explain the different results. She couldn't grasp it until I drew a line and a mark for 95% of it and 50% (median) and another for average. I explained how if that were minutes and 80% were at 10 or lower and an event popped up to 13 it would report 13. She finally understood what I was saying but not sure she's convinced.

maybe you can make 'em read Robysue's excellent explanation of it:
http://adventures-in-hosehead-land.blog ... de-to.html

3. AHI: A Hypopnea is a "partial apnea" where you still get air. When the obstruction is complete it is an apnea. I think of it as a close call when driving vs a collision, no big deal. I understand reporting the hypo but not in the same measure of a real apnea, indicating they carry equal weight. I doubt one or a series of them will kill me so I don't consider them in my results.

you shouldn't discount hypos, since they result in an increased breathing effort and disturbed sleep.

[SewTired]

I'm just going to address your power outages. My family member has frequent brownouts and brief power disruptions (also rural) and invested in an uninterruptable power supply to save her computer. I should think you could get a similar device for your cpap which would help for those brief outages.

FYI - if you download Sleepyhead and give her the full printout from a day, down at the bottom it shows how long you were at each whole pressure. That may help her understand.

[OldLincoln]

I "think I remember" seeing that in SH for my Respironics machines. I'm using SH 1.0.0 Beta-2 and cannot see it. Doesn't mean it's not there but it's like looking for my socks (yeah I'm old - so what!).

As for the backup power, I have on that worked very well when I had an external HC-150 humidifier plugged into ac power. The machine would run all night with the humidifier shut down. With the built in on my new machine it runs maybe an hour tops. It's old now and don't trust it anyway.

[OldLincoln]

"you can't change what the machine shows you, but you can change the readout in sleepyhead."

I have SH 1.0.0 beta 2. How do you change the readout?

[Pugsy]

You can change the type of average that SleepyHead offers you.

Preferences...CPAP tab...lower right side...Preferred Calculation Methods

[palerider]

"you can't change what the machine shows you, but you can change the readout in sleepyhead."

I have SH 1.0.0 beta 2. How do you change the readout?

I was gonna answer, but Pugsy beat me to it

[cands]

The Resmed time at pressure graph has a VERY faint line in the background that has me stumped (not difficult these days). Please explain.

If you move your cursor to where the faint line peaks, it will show you the number and type of event and the pressure.

For instance, last night I had 1 clear airway event at 13.2cm, 2 clear airways at 13.4cm and 1 hypopnea at 14.8cm. (My AHI for the night was 0.46 with machine use for 8hrs 36 minutes)

[esel]

"you can't change what the machine shows you, but you can change the readout in sleepyhead."

I have SH 1.0.0 beta 2. How do you change the readout?

I was gonna answer, but Pugsy beat me to it

Is that you ? "THE palerider" ??? The phrasing looks the same but what happened to your aurora ?

Nice rambling OldLincoln. Shouldn't you be happy to teach some nice young DME's ?

[OldLincoln]

Thanks folks! I changed the setting to true average and it's great. Love that Sleepyhead!! You should have seen the look by the tech when I pulled out my report . I suspect I have better software they they do. Deep down I don't mind sharing a bit as long as they are willing to listen and ask questions without being edgy. See a lot of "edgy" in younger techs nowdays.

[LSAT]

one apnea that lasts long enough will kill you

what is missing is the *results* of the AHI on O2 and heart rate that are important too

Since you are a brilliant engineer, why don'y you figure this all out and publish your findings?

[ajack]

if you post some charts, you will get opinions of the results. I would think your minimum would need to be raised with a 95% of 17cm. You could start at your current median of 9, the median will rise as you target in on the right settings for you. I would actually start with 12 - 18

have you got the way to get into your setting yet?
http://www.apneaboard.com/resmed-airsen ... setup-info

[OldLincoln]

Oh My.... I was asking a few technical questions and offered my opinions. My AHI is around 2 (OH! 1) so I don't consider it a problem. I have a recording OX but stopped using it after 6 mths or so of excellent readings. I figure the whole purpose of xpap is to keep the ox under control and mine is. I stick by my reasoning about how numbers are used. I used to produce corporate results in a corporate setting (Fortune 400 company) and found the misapplication of averages and misunderstanding of what results numbers actually mean (pun implied) bothered me. I'm not preaching here (no choir), so I'll leave it at that.

[Okie bipap]

If you're sleeping well and feel good, leave it where it is. If you feel you need to try to get a slightly lower AHI, then you can post a screen shot of Sleepyhead. Personally I can't tell much difference in an AHI of 3 or less than 1 in how I feel.

[robysue]

AHI is a compromise to create a convenient surrogate statistic

it does not care how long the hypopneas are as long as its over ten seconds
and it does not care how bad it is until it uses fuzzy logic to declare it a full apnea

one apnea that lasts long enough will kill you

what is missing is the *results* of the AHI on O2 and heart rate that are important too

xxyz,

SleepyHead and other software can only report what the machines record and data directly based on what the machines record. Your gripe is with the people who make the machines and who are the lead researchers in sleep medicine, not the folks here.

SleepyHead and other software cannot report the "results of the AHI on O2 and heart rate" if all you are using is a CPAP/APAP because there is no O2 monitor and there is no heart rate monitor.

If you are genuinely interested in tracking those things, you must have a device that records them all night long. SleepyHead is capable of working with many recording oximeters and correlating the oximeter data (O2 and heart rate) with the CPAP data (when the apneas occur and how long they last). It's easy enough to find the particular models of oximeters that SH can use and buy one of them on-line if you want to track how the apnea events affect the O2 and heart rate.

And it is also worth pointing out that you can have OSA and NOT experience O2 desats from the events; but the arousals caused by the events are disrupting to the sleep and over time can do much damage to the body.