Switching cpap machines

Hello all,

So I just bought a secondary machine(airsense 10 autoset) and I have 2 questions.

1) Is there going to be a big adjustment period? (I've been sleeping with the elite version this past year) I woke up today feeling pretty good, but tired. Like my body wanted more sleep because it was enjoying the new auto pressure.

2) I'll have to call my doctor to give them the serial number for the new machine so they can track my data?

Thanks,

Vinny

When you have time please correct your equipment profile. You are showing the AirSense 10 CPAP machine and that's not the AutoSet.
Look down in the R's for the AutoSet. For some reason they stuck ResMed on the front end of AirSense 10 AutoSet so it is down in the Rs all by itself.

Shouldn't be much of an adjustment depending on what machine you were using before this new machine as long as there isn't a big difference in the settings.
What were your Elite settings and what did you use with AutoSet last night?

Thanks Pugsy. Just upadated my equipment.

My settings for the Elite were 8 and 14. And for Autoset there 8 and 20. I got a 4 on the AHI last night. My EPR was 2 for both machines. And I'm using autoramp.

I need to see detailed reports from the 2 machines.
Something doesn't add up in terms of your settings. The Elite can't do 8 to 14 unless you are talking about starting ramp of 8.

As far as different results...could also be simply normal nightly variables at play. We don't sleep the same each night and can have quite different results without ever changing anything.

Ok. The first 2 pictures are from the Elite. The last pic is the autoset from last night.

The Elite is set at 15 cm fixed pressure. The ramp starts at 8 and looks like takes about 15 minutes or so to work up to 15 and then you use 15 all night unless you turn the machine off and then back on again.
You are using 2 EPR...
The time spent going from 8 to 15...fairly brief.

With the AutoSet you have set the minimum pressure to 8 and this isn't the same thing as ramp.
The machine can roam around all night long between 8 and 20.
And it's doing just that.....nothing wrong with it except you need more pressure and the travel time for all the roaming around is making it so the machine can't do an optimal job holding the airway open.

There are times during the night when you need a higher pressure and other times not so high of a pressure is needed.
When you were using the Elite you were getting a higher pressure all night long...and even then you needed a little more (evidence by the clustering of OAs/hyponeas/flow limitations). When we see this happen it's usually related to a person either being on their back some or in REM stage sleep...both of which will worsen OSA and cause a potential need for higher pressures during those times only.

Go down to the lower left corner below the graphs where it says "flags" and click on the little arrow to expand the menu....you have turned off some flags...you need to turn them back on. Look to see any that are red in color...click on them to turn them to green in color. You are having OAs but your events graphs aren't showing them...you turned them off by accident I suspect.
Everything in that Flag area should be green...no red. Red turns off the flagging and you want the flagging.


So....your variances in results...simply caused by the settings not being the same.

I think these settings if using the Auto mode.....minimum of 12 and max of 20 and ramp of your choice with EPR of 2...something to consider trying.

Thanks Pugsy. I really appreciate it! I wish the doctor would have taken the time to help me fine tune the settings after my last visit.

I reposted with all the flags green.

So why is the Autoset more effective the the Elite? Why would they have prescribed me the elite, because of the high pressure needed?

vincec2019 wrote: ↑

Sun May 26, 2019 9:54 am

So why is the Autoset more effective the the Elite?

Properly set it can auto adjust as pressure needs might vary. It's no so much as it is more effective but it allows people to not always have to use high pressures all night long. At 15 cm fix the Elite was still allowing some events to happen in clusters. Not horrible results but could be better. I suspect either you were on your back or during REM or maybe a combination of both caused the special circumstances.
You could get the same better results with the Elite that you can eventually get with the AutoSet but with the Elite you are going to need even more pressure all night long than the 15 cm. It can be done but it sure isn't much fun and higher pressures all night long come with the increased chances of aerophagia issues cropping up plus additional potential issues with leak management as well.

Everything has pros and cons with it and that includes using the auto adjusting mode that the AutoSet has available.
Some people don't do so well with pressure changes during the night...and some people make the mistake of thinking that if it will auto adjust they don't have to worry about the minimum pressure. Actually it's the minimum pressure that is the most critical setting of all settings. It has to give the machine a good enough head start to where it needs to go and it can't go from 8 cm to 16 cm in the blink of an eye. It takes several minutes to go up (and down) and while it is roaming around all sorts of bad stuff can happen. The optimal setting is to have the minimum high enough to do a decent job preventing the bulk of the airway issues and close enough to what might be needed when special circumstances happen so it can get there quick enough to stop the airway from collapsing.

My OSA is worse in REM. Supine sleeping never has been a big trigger for me but REM sure is. My OSA is 5 times worse in REM than in non REM. In REM I might need 15 to 18 cm pressure to prevent the airway collapse. The rest of the night when not in REM (and REM is usually only 20% of our sleep) I get by quite nicely with pressures around 9 ish. I could use fixed pressures and prevent those REM events but I would need to use around 16 cm all night long if I did the fixed pressure thing. It's doable but not much fun for sure and I just don't see any advantage to use 16 all night for just 20% of the night's real needs.

vincec2019 wrote: ↑

Sun May 26, 2019 9:54 am

Why would they have prescribed me the elite, because of the high pressure needed?

You would have to ask them that question. Some doctors don't understand how apap mode works and some don't care and are stuck in the dark ages and just don't want to take the time to learn about new technology. Some don't know just how much "fun" using 15 cm all night long isn't.
Sometimes it's the DME just dispensing the Elite fixed pressure machine because the doctor just wrote a single pressure on the RX and the Elite costs less wholesale...so they make more money with the Elite than they do with the AutoSet and they can legally make more money. Can't really blame them I suppose. They could have supplied you with an AutoSet set to cpap fixed mode and still satisfied the RX requirements but they wouldn't pocket as much profit.

Actually with your higher pressure needs a bilevel machine would have been a better choice than the Elite if you needed 15 cm all night long....for several reasons.

So either the DME was greedy or your doctor uneducated on how auto adjusting might actually benefit you.

vincec2019 wrote: ↑

Sun May 26, 2019 9:54 am

So why is the Autoset more effective the the Elite? Why would they have prescribed me the elite, because of the high pressure needed?

fwiw, a fellow forum member said this recently-

dojiscalper wrote: ↑

Tue May 21, 2019 6:03 am

Your support network of doctors don't realize that this isn't like a prescription for a pill. It's like a prescription for an exercise program. It will take time and even a lot of time to get used to it and get the settings and gear right. Once you get it all working and comfortable you'll never want to sleep without it.



It took me nearly a year but I'm very sensitive to anything bugging me.

i think this may apply in many cases.

good luck!

vincec2019 wrote: ↑

Sun May 26, 2019 7:41 am

Ok. The first 2 pictures are from the Elite. The last pic is the autoset from last night.

Echoing what Pugsy said, the Elite was set (and can only be set) to 15, flat, all night, (except for the ramp), it doesn't react to your needs.

Since you're used to 15, you should set the autoset close to that.

12-13 min, 20 max, and see what it can do.

Thanks all. I was happy just to start feeling rested again. And Pugsy that is interesting to here about the REM sleep. I take an anti depressant and I think that cuts down on ReM sleep. But, it’s definitely less restful. But, I’m glad I can come hear and try to fine tune it.

I’m going to call the doctors office and insurance Tuesday to have them link the new machine to their system so I can continue to have insurance pay for the accessories.

Does anyone know how that works when switching machines? And I’m full of questions. I can’t upload my avatar, it says it’s too large, help!

You need to resize the picture you are wanting to use as your avatar.
Just look for any of the free image resizing online tools available. That's what I did with mine.
Resize it...save it to your desktop...then upload it per forum links for avatar uploads.

I don't know what your insurance needs to keep you in supplies. I have had well over a dozen machines and my insurance has never even bought me a machine so my insurance doesn't have a clue what machine I am using...and apparently doesn't care.
I think all they care about is if your doctor says you are using it.

Thanks Pugsy! You’re the best. Sleep well everybody

Hi All. Could you please take a look at last nights data. I feel kind of tired today. I'm not sure that I slept all that well. I changed the min pressure to 10, and max is 20. I'm really getting up there in terms of pressure. I'm seeing alot of 19's on the graph. Just a reminder my set pressure on the elite was 15. I might need some time to get used to the new pressure. I'm also an thinking about taking my ssri in the morning so it has less effect on my sleep. Thanks, Vinny

vincec2019 wrote: ↑

Mon May 27, 2019 9:35 am

Hi All. Could you please take a look at last nights data. I feel kind of tired today. I'm not sure that I slept all that well. I changed the min pressure to 10, and max is 20. I'm really getting up there in terms of pressure. I'm seeing alot of 19's on the graph. Just a reminder my set pressure on the elite was 15. I might need some time to get used to the new pressure.

Why didn't you do what was suggested?

You were used to 15, a pressure of 10 is a huge drop.

Also, get rid of the useless ahi chart, and the right panel. {F10, I think)