Resmed Airsense 10 - Pressure Adjustment/Setup

Hi,

I hope everyone is well. I have recently (two weeks) started on a CPAP machine after being diagnosed with Sleep Apnea.

I have a Resmed Airsense 10 with Full Face F20 Medium Mask. Settings on machine were all set to auto and pressure range of 4 to 20 by Resmed.

My initial response to the machine was that although I was struggling to sleep through the night I was able to notice a positive difference, especially in the morning after the first night.

My goal is to try and get the most out of the machine and getting my Sleep Apnea under control as best as possible, while also trying to improve my physical fitness and weight.

My main questions is around getting some advice on dialing in the pressure range and any other settings. I have done a fair bit of research and gotten my head around Oscar but would greatly appreciate any advice given.

My local doctor refers me to Resmed who then recommend that I leave everything set to Auto and pressure range of 4 to 20 and to let the machine do the rest for best results. I am skeptical.

I have posted two nights of screenshots from Oscar. I have a young family and sometimes struggle to get through the night without getting up so I tried picking two nights which I slept for longer periods.

I have also posted my sleep test results, if it is of any value. Again, I greatly appreciate any advice given and I apologise if the images provided aren't suitable.

Kind Regards,

Photos: https://imgur.com/a/uyIp46q

Qwerty1234 wrote: ↑

Wed Sep 28, 2022 3:42 am

My local doctor refers me to Resmed who then recommend that I leave everything set to Auto and pressure range of 4 to 20 and to let the machine do the rest for best results. I am skeptical.

You are right to be sceptical - the wide open setting is not making best use of the machine's capabilities. A lot of docs start with 4-20 with the intention of narrowing the range after a week or two once they see where the machine wants to settle. In your case, I'd suggest raising the minimum to around 10.0. With your EPR of 2, that will give you an effective exhale pressure of 8.0, which is where the machine is trying to settle. Doing this will allow the machine to react faster to events (apnea and hypopnea) as well as precursors (snore and flow limitation).

You'll see that a lot of your apneas are occurring in clusters - this is often caused by your body position. In particular, your chin can drop forward to your chest, putting stress on the windpipe. Make sure your pillow supports your head and neck so that the airway is straight, like a lifesaver giving CPR but not so extreme.

From an untreated AHI of nearly 100 down to 5 or so is a great start! As you get more accustomed to the machine this will no doubt improve further and you'll feel the benefits over time.

Overall, I agree with Respirator99: It does look like you need to increase the minimum setting. If starting with a min pressure setting of 10cm winds up creating a lot of discomfort from the feeling of too much air coming through the hose, then increasing the min pressure to 8 cm would still help.

You also write:

Qwerty1234 wrote: ↑

Wed Sep 28, 2022 3:42 am

My initial response to the machine was that although I was struggling to sleep through the night I was able to notice a positive difference, especially in the morning after the first night.

It does take time to teach yourself how to sleep well with a mask on your face. But I think that you'll probably adjust pretty quickly since you are already seeing a positive difference.

If you can tease out what kinds of things that create struggles other than the novelty of having a six-foot hose attached to your nose with a mask on your face and air being blown down your airway, then post them: No matter how crazy the problem sounds, someone around here has probably dealt with the same issue and can give you things to try.

My goal is to try and get the most out of the machine and getting my Sleep Apnea under control as best as possible, while also trying to improve my physical fitness and weight.

You've got a positive attitude and that's a huge bonus on starting your adventures in the Land of the Hoseheads.

Qwerty1234 wrote: ↑

Wed Sep 28, 2022 3:42 am

Hi,

welcome to the zoo!

you are already in capable hands, so i won't bother chiming in on that. i just wanted to thank you so very much for taking the time to read the tutorials here before posting. it really helps out the experts when they can just start in with dispensing their advice straight away.

i'm hoping you'll stand as a good example for others to follow.

good luck!

Qwerty1234 wrote: ↑

Wed Sep 28, 2022 3:42 am

My goal is to try and get the most out of the machine and getting my Sleep Apnea under control as best as possible,

Even at the factory settings, your CPAP therapy appears to be working well on the night posted.

Your median pressure is 9.7. I would change the minimum pressure to 8.0 and see how that goes for a couple of nights. You might eventually set the minimum to 10.0. You are unlikely to have problems with a minimum of 10.0 because your machine is already running at 10.0 or higher for much of the night.

Are you using EPR 3? It's hard to tell exactly from the graph. If not already, I would change the EPR to 3. It might clear up some of the Flow Limitations.

Qwerty1234 wrote: ↑

Wed Sep 28, 2022 3:42 am

while also trying to improve my physical fitness and weight.

That's great. Also, think about good sleep hygiene.

Your attitude and intelligence seem to set you up to be a successful CPAPer.

Hi,

Thank you all for your kind words and great advice. I found the Newbie FAQ/How to Post Guides very clear and concise, which made it easy for me as a new user to post my query.

I have changed my minimum pressure to 9 and ERP is set at 2. I will see how this goes over the next week or two and report back.

I also have an unrelated question in regards to the SD card data. I am actually returning the machine I have and picking up another new unit (exact same model).

If I copy the contents of the current SD card onto the new machines blank SD card does anyone know if the new machine will continue to register sleep data on top of the existing data?

I guess it is not a huge issue because I have it saved on my desktop and loaded into Oscar.

Thanks again for everyone's prompt/great advice. Who would've thought a bunch of Sleep Apnea plagued CPAP users would form one of the more active/vibrant forums on the internet!

It's great for us new CPAP users to have such a valuable resource in everyone's shared experiences to help us along.

Cheers,

Qwerty1234 wrote: ↑

Thu Sep 29, 2022 4:21 am

Hi,

Thank you all for your kind words and great advice. I found the Newbie FAQ/How to Post Guides very clear and concise, which made it easy for me as a new user to post my query.

I have changed my minimum pressure to 9 and ERP is set at 2. I will see how this goes over the next week or two and report back.

I also have an unrelated question in regards to the SD card data. I am actually returning the machine I have and picking up another new unit (exact same model).

If I copy the contents of the current SD card onto the new machines blank SD card does anyone know if the new machine will continue to register sleep data on top of the existing data?

I guess it is not a huge issue because I have it saved on my desktop and loaded into Oscar.

Thanks again for everyone's prompt/great advice. Who would've thought a bunch of Sleep Apnea plagued CPAP users would form one of the more active/vibrant forums on the internet!

It's great for us new CPAP users to have such a valuable resource in everyone's shared experiences to help us along.

Cheers,

I can’t answer your specific question.

However, I use sleephq. I upload my data there from the machine that I use daily. I used an alternate machine one day. when I uploaded that data from a different card, it still had the same data available but there was a pull down tab with each machine. The data wasn’t combined but also wasn’t lost.

If you’re worried about losing what you have you might try sleephq. ( unless someone has a more appropriate answer)

If you put your existing card in a new machine the serial numbers won't match, so the new machine will format the card and lose the old data. Tell Resmed to stop being a tightarse and give you a new card.

Respirator99 wrote: ↑

Thu Sep 29, 2022 5:41 am

If you put your existing card in a new machine the serial numbers won't match, so the new machine will format the card and lose the old data. Tell Resmed to stop being a tightarse and give you a new card.

So saving a copy elsewhere on a computer or different card od sleephq sound like viable options to have a copy available?

Assuming you only want the older data for your own tracking, simply create a second profile on OSCAR for your new machine. Then you can go back to your older machine data on the first profile and have all the new data on the newer profile.

See OSCAR's "settings" for that.

I tried copy over the folders to the new machines SD card but no luck.

Will do as suggested and start a new profile on OSCAR.

How often to people generally replace their masks? I have the f20 full face silicone type mask.

I want to second Chicago Granny’s suggestion that you increase your EPR to 3. That might help with hypopneas as well as the flow limitations. That may or may not make a difference to your sleep, but it’s a good experiment to try.

You’re off to an excellent start. As you get more and more used to the whole strange business, you’ll get better and better sleep, I predict.

Mask replacement should be on an as needed basis. My previous F20 cushion lasted exactly a year. My current one look like it will give up before then, so once leakage becomes too bothersome I'll replace it. The little frame part will last more or less forever and the headgear needs to be replaced if it stretches too much or the Velcro wears out.

There is a lot of nonsense spoken about replacing these things at some accelerated schedule, but that's just designed to enrich Resmed's shareholders.

Thank you, I have changed ERP to 3.

Good to hear to simply replace mask as needed. I agree, Resmed tried to sign me up for 6 month replacement.

One final question (for now). Everything is going pretty great with the mask except that I am finding drooling to be an issue. Does anyone have any tips on mitigating drooling throughout the night?

Thanks again for everyone extremely helpful responses, it's much appreciated.

Qwerty1234 wrote: ↑

Fri Sep 30, 2022 4:38 pm

Thank you, I have changed ERP to 3.

Good to hear to simply replace mask as needed. I agree, Resmed tried to sign me up for 6 month replacement.

One final question (for now). Everything is going pretty great with the mask except that I am finding drooling to be an issue. Does anyone have any tips on mitigating drooling throughout the night?

Thanks again for everyone extremely helpful responses, it's much appreciated.

ask as many questions as you wish! it gives us something to do.

ny solution may give you inspiration to try something similar. i use scuncis (hairbands) to help keep my yap shut and my lips pressed together. scunci method here-

viewtopic.php?p=1089718&f=1&t=112758&p= ... s#p1086296

i do two modifications. i use those thinner ribbon-like bands, the kind women may use to tie up a pony tail. this keeps those scuncis tight. the other modification is, i use a glasses cleaning cloth or two, folded up. these i put over my mouth, then the scuncis and finally those thin bands.

i don't know if you happen to be an eyeglass wearer. i have been since i was seven years old. every time i get a new prescription, along with the new glasses, i also get new lens cloths. so i'm almost drowning in the suckers and never throw them away.

i hope this gives you some inspiration to try other things that you may have to hand.

good luck!

p.s. not sure how this would work with a full face mask, but works a treat with my p10 nasal mask.