Resmed Slimline vs. standard tubing - how it works, settings

Hi, everyone.

I've been using standard tubing with my Airsense 10 Auto and am considering trying Resmed Slimline tubing. I really like the idea of a lighter weight tubing. And because my tubing is in a snugglehose fleece cover, it's a bit hard to jam into my Airsense 10 case when I travel. The slimline would be a little easier to travel with.

But I have some concerns. I'd be grateful for any information or thoughts that might be helpful.

First: I'm guessing that the machine has to push more air through the narrower tube to achieve a given pressure. Cpap.com's product page for the slimline hose states (under "important tips") "On any other machine [besides resmed 9, 10, 11], the SlimLine™ Tubing will significantly reduce overall pressure at the CPAP mask and may produce erratic pressure outputs for Auto CPAP machines." That makes sense.

So my question here is: can the Airsense 10 detect when you're using the Slimline and adjust pressure accordingly? Or do you have to go into the settings and make a change?

I looked in the clinical settings and, indeed, there's a tubing setting that can be set at standard or slimline.

But does everyone know this? Most folks on this forum know about the clinical settings. I suspect many others do not. And ResMed doesn't go out of its way to tell you. For example, Cpap.com's page for slimline does not state that you have to change settings, even on the "important tips" page. The machine doesn't come with any instructions stating that you have to change the machine's settings: the basic User Guide that comes with the AirSense 10 states in several places that the machine is compatible with ResMed SlimLine tubing but does not state anywhere that settings much be changed to use it. Lastly, though I haven't read all 224 of the Slimline tubing user reviews at cpap.com, I've read a couple pages' worth of them and nobody has mentioned a need to change settings.

So people who use slimline tubing but don't know about the clinical settings are probably getting less pressure than they think, UNLESS their machine can detect the slim tubing and make the adjustment on its own. But the latter doesn't seem likely given there's a clinical setting to specify standard or slim.

One more concern:

If the machine has to work harder with slimline tubing, it seems that might reduce its lifespan a bit. I bought my AirSense 10 Auto in 2016 and it's still working like new. I'm hoping to get 3 more years of life out of it. If I switch to Slimline tubing, maybe I won't?

This concern about machine lifespan and pressure seems to come down to question whose answer might be well-known:

Does lifespan of a machine depend on the pressure it operates at? Suppose two patients each use an AirSense 10. The first patient's average pressure is 8, the second patient's average pressure is 11. Is the first patient's machine likely to have a longer lifespan?

Thanks in advance for any thoughts, ideas, or information.

Warm regards to you all,
Ron
Kenosha, WI
USA

The Climateline heated hose is set automatically, when the hose is inserted;
while any non-heated hose must be manually set. The setting is under "options."
The effect of pressure on machine life is not significant.
Your body needs whatever pressure gives the best results--on YOU.
Consistently failing to change a dirty filter may be worse for the cpap.

LSAT wrote: ↑

Sun Jan 15, 2023 2:17 pm

There is a very small difference in pressure if someone failed to make the setting change,...I think it would be less than 1/2cmH2O.

Oh no, the increased flow resistance with a slimline tube is significant, so much so that when I first switched to the S9 VPAP Auto, I thought it had to be broken, because the pressure was so much higher than normal.

What I'd not done was select the proper tube size, it was set on slimline, and I had a standard hose.

It was way more than 1/2cmH2O, how much more, I don't know, maybe one of these days I'll drag out the manometer and check. Tube type setting is important.

Now, mask type setting, that one is near imperceptible, on the order of 1/2cmH2O at most.

If you go for the ClimateLine heated hose you won't need your fleece hose cover and travel will be that much simpler. Also humidity control will be better. Additionally, the ClimateLine hose is automatically detected by the machine.

I leave my Climateline Air tubing set the same year around.
It automatically found the right temperature in my icy hospital room.

chunkyfrog wrote: ↑

Sun Jan 15, 2023 4:13 pm

I leave my Climateline Air tubing set the same year around.
It automatically found the right temperature in my icy hospital room.

I haven't had to use it in a hospital room, but I use the ClimateLine and have humidity set to Auto on my AirSense 10 and I have never had reason to complain. Works a treat!

nelamvr6 wrote: ↑

Sun Jan 15, 2023 3:44 pm

If you go for the ClimateLine heated hose you won't need your fleece hose cover

Using a hose cover will make the unit use less electricity because the heater won't need to heat as much, (if any).

palerider wrote: ↑

Sun Jan 15, 2023 7:43 pm

nelamvr6 wrote: ↑

Sun Jan 15, 2023 3:44 pm

If you go for the ClimateLine heated hose you won't need your fleece hose cover

Using a hose cover will make the unit use less electricity because the heater won't need to heat as much, (if any).

Granted. But the OP is looking to save bulk and complications to make travel easier. The use of a cover will be advantageous, but is not required.

Thanks, everyone, for your comments! I'm grateful!

I wrote CPAP.com (from whom I buy all of my cpap gear) with the same questions. In case anyone might find it helpful or interesting, here is their reply (signed by Daryl C):

The Airsense series machines can handle any diameter of tubing, and the reason to adjust the setting is so that the machine can calculate your leak rates correctly and does not affect the life of your machine at all or the actual therapy pressures that you receive. You can confirm this with usage of a Gauge Manometer. The thing that makes the biggest difference in the life of your machine is to ensure you change the air intake filters out on the 30 day recommended guide and NEVER pump Ozone or anything else through the machine to clean it.

Machines should last about 5 years at the lowest pressure of 4 or the highest pressure of 20 and should not generally affect the life of the machine, but technically higher pressure may mean a slightly less life, but is not something we are able to measure or generally advise on since most machines will typically need replacing after 5 years regardless due to new technologies so you can stay the most up to date on your therapy.

Daryl says the tube diameter "does not affect...the actual therapy pressures that you receive. You can confirm this with usage of a Gauge Manometer." That's surprising and counterintuitive, unless he means that I can adjust the settings to insure that I get the same therapy with the smaller tube diameter.

Daryl says higher pressure shouldn't affect machine life, but on the next line says "may mean a slightly less life," but brushes this off because he wants us to replace our machines every 5 years "due to new technologies so you can stay the most up to date", in other words, if it reduces machine lifespan from 10 to 9 years, that won't matter if you're replacing your machine every five years. But I don't buy his reason for replacing the machine every 5 years - new technology to stay up to date - because in 2022-23 they are still selling AirSense 10 units, which have been on the market for 7 years.

--

I want to say, I highly value CPAP.com and I've been a loyal customer since I went on cpap therapy in 2007. Though I'm pointing out some questionable parts of Daryl's reply, I appreciate the time he took to reply to me and I don't expect their customer service people to all be experts in the physics of air pressure.

--

After all of this, I'm still not sure whether tube diameter affects machine life due to how hard the machine has to work to push air through slimmer tubing.

But it was more of an academic question I'm curious about, rather than a practical one: Lots of ResMed users on this and other sleep apnea forums use slimline tubing and nobody is complaining about their machines dying prematurely, so I'm going to go with the convenience of slimline tubing.

Warm regards and thanks again!
Ron

roncron wrote: ↑

Sun Jun 11, 2023 10:04 am

Thanks, everyone, for your comments! I'm grateful!

I wrote CPAP.com (from whom I buy all of my cpap gear) with the same questions. In case anyone might find it helpful or interesting, here is their reply (signed by Daryl C):

The Airsense series machines can handle any diameter of tubing, and the reason to adjust the setting is so that the machine can calculate your leak rates correctly and does not affect the life of your machine at all or the actual therapy pressures that you receive. You can confirm this with usage of a Gauge Manometer. The thing that makes the biggest difference in the life of your machine is to ensure you change the air intake filters out on the 30 day recommended guide and NEVER pump Ozone or anything else through the machine to clean it.

Machines should last about 5 years at the lowest pressure of 4 or the highest pressure of 20 and should not generally affect the life of the machine, but technically higher pressure may mean a slightly less life, but is not something we are able to measure or generally advise on since most machines will typically need replacing after 5 years regardless due to new technologies so you can stay the most up to date on your therapy.

Daryl says the tube diameter "does not affect...the actual therapy pressures that you receive. You can confirm this with usage of a Gauge Manometer." That's surprising and counterintuitive, unless he means that I can adjust the settings to insure that I get the same therapy with the smaller tube diameter.

Why is it 'surprising and counterintuitive'?

If you use a climateline tube, then the settings are made automatically, if you use a regular tube then you set the tube diameter (and length if you're on an aircurve/VPAP, this tells the algorithm how much flow resistance the tube adds, so it can compensate by raising pressure at the machine to give you the exact desired pressure at the mask.

Daryl is wrong in that the tube settings has *nothing whatsoever* to do with leak calculations.

roncron wrote: ↑

Sun Jun 11, 2023 10:04 am

After all of this, I'm still not sure whether tube diameter affects machine life due to how hard the machine has to work to push air through slimmer tubing.

In theory, a slimline tube would reduce the lifespan of the motor, because it has to turn a little faster to generate a little higher pressure at the machine to overcome the added resistance of the slimline tube. How much would depend on your pressure needs, I've never seen anybody even guess as to how much.

I want to throw something into this conversation, maybe there’s an explanation.

I’ve had an Airsense 10 for 8 years, it has been great! I sleep comfortably and consistently. Recently I got a new Airsense 11, I’m having one heck of a time sleeping with it! I’ve tried different settings, different masks, and different mask sizes, all bad! I’ve tried my tried and true mask, my tried and true settings, and even other settings, all bad.

Yesterday, after 2 months, I’ve got it figured out. I got rid of the slimline heated hose and went to my old unheated hose, and I’m now sleeping perfectly again! The pressures and resistance of the new equipment has never been comfortable. Now with the old hose, it’s nearly perfect! Prior to swapping hoses I had chest muscle pain in the morning, and I’ve woken up feeling like I’m panting.

Can anyone give me a reason why changing to the larger diameter tubing has made my sleep comfortable again? It has got to be related to flow and/or pressure. And BTW, I have not changed the slimline setting on my 11 as of now.

Standard tubing is 19mm Diameter
SlimLine is 15 mm
ClimateLine is also 15mm

the narrower Slimline (and Climateline) adds a lot more resistance to the pushed air. This means there's a lot more fan speed and air flow to achieve the same pressure with a Slimline than Standard tubing.

When you use the ClimateLine, the device is aware of the hose type and sets the "calibration" correctly. However if I understand you correctly when you say, "And BTW, I have not changed the slimline setting on my 11 as of now."

Thus means your device and hose are misconfigured. Your running a Standard on a Slimline config. The Device is pushing more Air, believing you have the higher resistance SlimLine.

Sounds to me, like your previous Air 10/Standard was also misconfigured, and you got accustomed to the resulting increased Air Flow/pressures.

You can continue with the misconfiguration, or set it properly and compensate by increasing your ramp/minimum pressure.

There also might be a little placebo effect going on.

Thank you for this, I missed it previously, I didn’t have email reply turned on. It makes sense, I’ll give it a try. I am however concerned if the heated tube auto sets the machine and I couldn’t sleep with it, setting the machine for slimline now with the non heated tubing may be a fail too.

I had a lot of changes when changing machines, I also went from a nasal mask to a new nasal mask, to a new full face mask, to a memory foam face mask. I’ve m gotten used to the full face mask now, except for yawning in the darn thing, I don’t like that.