Airsense10; full, nasal or pillows settings--what do they do?

[tyrinryan]

I'm using a ffmask and a nasal mask alternately and am now experiencing a lot more Central Apneas and Flow Limitations. It is probably a coincidence. But: what is the effect of these Resmed Airsense10 settings for Full Face Mask; Nasal: or Pillows? Does a change in this setting affect pressure or operation of the machine in some way or perhaps just affect the Resmed calculation and resulting recording (as brought to life by Oscar) for breath volume, for example? What would be the effect of using a FFMask with a "Pillows" Airsense10 setting--or using a Pillows mask with a "Full Face Mask" Airsense10 setting?

[LSAT]

The settings have to do with the allowable leak calculation

[tyrinryan]

What about the settings for "standard" or "mini" hose and add-on "air cleaner" or not?

[Dog Slobber]

I agree with LSAT.

I believe the (Full-face, Nasal and Pillows) settings on the S9 and AS.10 has to do with leak rate calculations.

It's also worth noting that in the more modern ResMed masks, you do NOT set the CPAP mask type according to the actual mask type.

For example, on the ResMed Mirage FX Nasal mask, the manual instructs you to set the type to Nasal, as expected.

But on the newer Resmed N10 or N20 Nasal masks, the manual intstructs you to set the type to Pillows, even though the mask types are clearly Nasal.

At the back of all ResMed Mask user guides there is pressure flow graph, that displays vent flow rate (Leakage) against the pressure. The Mirage Pressure flow is:

Code: Select all

Pressure           Flow
(cm H2O)           (L/min)
 4                    19
 8                    28
12                    34
16                    40
20                    45

The Pressure / Flow values for the
N10, N20, P10, and N\P30i* are:

Code: Select all

Pressure            Flow
(cm H2O)           (L/min)
 4                    20
 8                    29
12                    37
16                    43
20                    49

This suggests that the CPAP mask settings are used for vent flow and leak calculations as the the settings match the masks vent flow and not the masks physical type.

* The P/N30i pressure flow curve matches exactly the values for pressure 4 and 20, but the interim pressures use a less granular scale, the flow values extrapolate to the same values.

The ResMed Full-Face masks has completely different Vent flow rate tables.

The different flow rates are likely necessary because the different masks designs have very different dead space volume and shape and therefore require different venting flow to reliably clear any CO2.

[tyrinryan]

So I'm thinking: I'm getting more centrals---perhaps because the co2 is getting washed out by the venting action of the new masks. Rather than try physically to extend the mask area, could you change one of the settings and accomplish the same thing? Just thinking!

[LSAT]

So I'm thinking: I'm getting more centrals---perhaps because the co2 is getting washed out by the venting action of the new masks. Rather than try physically to extend the mask area, could you change one of the settings and accomplish the same thing? Just thinking!

If you want analysis of your therapy......Fill in your equipment data...download Oscar and show us some data...YOU ARE OVERTHINKING
viewtopic/t172378/Sticky--Newbies-PLEAS ... STING.html

[TropicalDiver]

So I'm thinking: I'm getting more centrals---perhaps because the co2 is getting washed out by the venting action of the new masks. Rather than try physically to extend the mask area, could you change one of the settings and accomplish the same thing? Just thinking!

I would be extremely reluctant to treat apneas by increasing CO2 retention. The potential of hypercapnia is something treat with extreme respect.

[palerider]

What about the settings for "standard" or "mini" hose and add-on "air cleaner" or not?

While you'll hear other *opinions* on what the mask type settings do, I maintain (and I've measured this) that they adjust the calculations for compensation against the varying flow resistance of those different types of masks.

The *exact same thing* that the 'standard/slimline/3m' hose and AntiBacterial filter settings do (and, whether or not you've got a humidifier attached, but that, of course, is automatic.)

slimline hoses present more of a resistance to airflow, so the machine has to have a higher pressure in the machine in order to generate the desired pressure *at the mask*.

[palerider]

So I'm thinking: I'm getting more centrals---perhaps because the co2 is getting washed out by the venting action of the new masks. Rather than try physically to extend the mask area, could you change one of the settings and accomplish the same thing? Just thinking!

No. The mask type settings have a minor effect, much much less than setting the wrong type of hose.

[palerider]

So I'm thinking: I'm getting more centrals---perhaps because the co2 is getting washed out by the venting action of the new masks. Rather than try physically to extend the mask area, could you change one of the settings and accomplish the same thing? Just thinking!

I would be extremely reluctant to treat apneas by increasing CO2 retention. The potential of hypercapnia is something treat with extreme respect.

Well, you *say* that...

Added dead space or inhaled carbon dioxide

Added dead space by attaching a plastic cylinder of variable volume (400-800 mL) to a tightly fitting mask can act as a source of increased carbon dioxide concentration in the inspired air and can increase the carbon dioxide reserves above the apneic threshold. Such a treatment in an experimental setting was effective against both primary central sleep apnea and CSB-CSA. The increase in PaCO2 is miniscule (approximately 1.5-2 mm Hg) but can be effective in stabilizing the breathing pattern.

Minimizing hypocapnia, by adding 100-150 mL enhanced expiratory rebreathing space (EERS), was documented to improve CSA and is a potentially useful adjunctive therapy for positive pressure–associated respiratory instability and salvage of some CPAP treatment failures. [29]

Similar results have been obtained by adding supplemental carbon dioxide (5%), but safety and accuracy of carbon dioxide delivery devices remains a concern.

Another potential problem of added dead space or inhaled carbon dioxide is worsening of obstructive sleep apnea by the increased mechanical load. Hypercarbia stimulates sympathetic discharge with potential deleterious effects on the heart.

https://emedicine.medscape.com/article/304967-treatment

We have shown that keeping CO2 above the apnea threshold with the use of Enhanced Expiratory Rebreathing Space (EERS) is an effective adjunct to PAP therapy 22. Enhanced expiratory rebreathing space (EERS) is the dead space concept applied to pressure ventilation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3998090/