Autoset for Her, RERAs and CSRs

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Dog Slobber
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Autoset for Her, RERAs and CSRs

Post by Dog Slobber » Thu Apr 12, 2018 4:14 pm

I was going through the clinical manual for the Resmed AirSense 10 and noticed the following differences between the AutoSense model and the AutoSense for Her model.

AutoSense:
  • Black
  • No female algorithm
  • Doesn't detect RERAs
AutoSense for Her:
  • Beige with vine pattern
  • Female "for Her" algorithm
  • Detects RERAs
I am male, but own the For Her Model. Yes, I probably would have chosen the black model if I could have, but in all honesty, why would anybody get the regular model over the "for Her" model?


Respiratory Effort Related Arousals (RERAs)

I have read what RERAs are, but I really don't have a good grasp what their significance is? I typically get 2 or 3 RERAs a night. I haven't been all that concerned about them.
So:
What exactly are they?
Is their a particular wave or occurrence pattern to differentiate them from SWJ?
Can focusing on them and when they occur help improve other areas of Therapy or Sleep quality?


Cheyne-Stokes Respiration (CSR)

Similar, I read about these in the the clinical manual, saw that the AirSense 10 reports them, but but SleepyHead doesn't seem to report them.

I've seen them on non-ResMed SleepHead charts posted by members, but never on ResMed charts.

If anybody could expand on what CSR is I would appreciate it as well.

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palerider
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Re: Autoset for Her, RERAs and CSRs

Post by palerider » Thu Apr 12, 2018 4:46 pm

Dog Slobber wrote:
Thu Apr 12, 2018 4:14 pm
I was going through the clinical manual for the Resmed AirSense 10 and noticed the following differences between the AutoSense model and the AutoSense for Her model.
That's AutoSET, a part of the AIRsense line.

I am male, but own the For Her Model. Yes, I probably would have chosen the black model if I could have, but in all honesty, why would anybody get the regular model over the "for Her" model?


Respiratory Effort Related Arousals (RERAs)
Dog Slobber wrote:
Thu Apr 12, 2018 4:14 pm
I have read what RERAs are, but I really don't have a good grasp what their significance is? I typically get 2 or 3 RERAs a night. I haven't been all that concerned about them.
So:
What exactly are they?
Is their a particular wave or occurrence pattern to differentiate them from SWJ?
Can focusing on them and when they occur help improve other areas of Therapy or Sleep quality?
A RERA is an arousal that appears to be caused by respiratory effort, as opposed to a spontaneous arousal, which isn't caused by anything to do with sleep breathing effort. RERAs in a cpap are guesses, based in what appears to be unstable airflow followed by some larger recovery breaths... but no other quantifiable event (flow limitation, snore, hypopnea, apnea). I wouldn't worry about 2 a night.

Dog Slobber wrote:
Thu Apr 12, 2018 4:14 pm
Cheyne-Stokes Respiration (CSR)

Similar, I read about these in the the clinical manual, saw that the AirSense 10 reports them, but but SleepyHead doesn't seem to report them.

I've seen them on non-ResMed SleepHead charts posted by members, but never on ResMed charts.

If anybody could expand on what CSR is I would appreciate it as well.
If your machine had flagged them, then SH would report the flags.

I can't explain what they are more than what any decent web page would say... It's a characteristic waxing and waining of breathing with central apneas in between, often caused by neurological issues, or heart failure.

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Re: Autoset for Her, RERAs and CSRs

Post by SewTired » Thu Apr 12, 2018 5:30 pm

Dog Slobber wrote:
Thu Apr 12, 2018 4:14 pm

I am male, but own the For Her Model. Yes, I probably would have chosen the black model if I could have, but in all honesty, why would anybody get the regular model over the "for Her" model?
Availability for one. Many DMEs do not stock the For Her model. You have to order it special and it may take 2-3 weeks before you have a machine. If I didn't already have a used machine, I might have caved - glad I didn't. Second, many DMEs don't actually understand that the algorithm can help men as well, and figure that if you aren't a man, why would you want it? Third, there are flowery things on there, and YES, there really are men who will not get something that looks even marginally feminine (yes, I know they are vines). Finally, if you had great usage from your S9, why change? Why consider another algorithm?

FWIW, at the time I bought the For Her model (it had just come out a month or two before), I was told that they included the RERA count because women were more likely to have low AHI and high RDI. That is true for me. My AHI is typically .6 or lower whether I use the standard or the For Her algorithm. However, I am less likely to wake up with the pressure change on the For Her.

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Ron AKA
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Re: Autoset for Her, RERAs and CSRs

Post by Ron AKA » Thu Apr 12, 2018 7:02 pm

The standard AirSense 10 does actually report RERA events. I have experienced a couple in the last week. See the SH chart below for an example, and a close up of what it looks like. It seems to be associated with a flow limitation and the A10 responds to that by increasing pressure. My understanding is that it is a slow weakening of the breathing followed by some big breaths that indicate arousal.

I have not experienced Cheyne-Stokes events but I recall 3 showing up on somebody else's posted SH chart. They are in a bar at the top above the Large Leak if I recall correctly.
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Re: Autoset for Her, RERAs and CSRs

Post by Pugsy » Thu Apr 12, 2018 7:13 pm

When the AirSense 10 AutoSet models were first released the only model that reported RERAs was the for Her AutoSet.
That was apparently changed at some time by ResMed. Unsure when, where or why and we really never got any official notification that I saw. I just started seeing the regular AutoSet reporting a few RERA...at first it was machines in other countries but now seems everywhere.
The manual mentioning RERAs only being reported in the For Her model...I think those are just old manuals from back when that was what it was. I never could quite understand limiting RERAs to just the for Her model but apparently someone else couldn't either and it got changed.

CSR is reported by all machines if it gets flagged...AirSense Elite, AutoSet regular or for Her and the bilevels.
If someone isn't seeing it in SH...it's not being flagged by the machine.
SleepyHead doesn't do the deciding about anything that gets named or flagged ...SH just reports what the machine reports.

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Dog Slobber
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Re: Autoset for Her, RERAs and CSRs

Post by Dog Slobber » Thu Apr 12, 2018 9:11 pm

I'm glad that the AirSense 10 AutoSet now reports RERAs. I guess I'm working from an old manual, or they aren't very proactive about updating their manuals.

From Page 9 of the ResMed AirSense Clinical Guide.
Screen Shot 2018-04-12 at 10.57.15 PM.png
This following is probably only of interest to Canadians living in Ontario but it'sone of those bureaucratic things regarding the standard AutoSet and the for Her models.

OHIP has an Assistive Device Program ADP where they partially fund (75%) prescription xPAP machine for supported devices. If your prescription is for APAP the AirSense 10 Autoset is on the list of APAP devices, but the for Her model is not, so you have to get the standard model.

If your prescription is for CPAP than the for Her model is on the list of supported CPAP devices because it has CPAP mode. But the standard AutoSet is not.

I found this out because my DME wanted to sell me an AirSense 10 Elite and I wanted an AutoSet so that I would have APAP as an option. This is how I ended up with the for Her model.

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Ron AKA
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Re: Autoset for Her, RERAs and CSRs

Post by Ron AKA » Fri Apr 13, 2018 7:46 am

For sure the newest AirSense 10 AutoSet reports Cheyne Stokes Respiration. I got one event last night. It started with one OA, followed by three CA events. The A10 only responded by bumping up pressure in response to the OA. Just as they say it acts. The whole CSR event gets highlighted in green and is reported in the top line of the event summary bars. First time that I have seen it actually flagged in my data, but I have seen the breathing pattern before and identified it myself manually. It is on my list of things to talk to my doctor about at the next visit...

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