Question about AirSense 10 CPAP - Can I trust MyAir AHI data?

[mj277]

Hi everyone,

I'm writing from Argentina (mentioning this because my insurance/healthcare system likely works differently from the US). I recently switched from a rented AirSense 10 AutoSet to a purchased AirSense 10 CPAP, and I have some concerns about data monitoring.

My sleep study from March 2024 showed severe OSA with an AHI of 42.3. I started CPAP therapy in April with a rented AutoSet, initially using APAP (4-15, then 4-13), and eventually switched to fixed pressure at 10 with EPR 3. My AHI improved significantly, staying consistently below 1.

In October, following my doctor's recommendation, I switched to an AirSense 10 CPAP (non-AutoSet). Only after the switch did I realize that this model doesn't provide detailed data to OSCAR, which I had been using to monitor my therapy. My insurance covered 50% of both the rental and purchase, and getting a different machine approved isn't likely in the near future. I also only signed up to myAir with the purchase, didn't know about it before and not sure if I could have signed up with a rental device.

Recently, I've experimented with slightly lower pressure (9.4 cmH2O), and MyAir still shows good results (<1 event/hour). However, I'm concerned about the reliability of MyAir's event detection compared to OSCAR's more detailed data.

My questions:

1. How accurate/reliable is MyAir's AHI reporting compared to OSCAR's?
   
2. Would you strongly recommend trying to switch back to an AutoSet model, paying out of pocket, given the limited data from the CPAP model?
   
3. Any suggestions for monitoring therapy effectiveness without OSCAR data?
   
4. Any other suggestions on how to monitor my events? Watch? Ring? App?
   
   

For reference, my current settings are:

• Fixed pressure: 9.4 cmH2O
  
• EPR: 3 (full time)
  
• Average usage: ~7 hours/night
  
• Recent AHI (MyAir): consistently <1
  
• Humidifier: 3
  
• Using mouth tape and Xylimelts to reduce mouth dryness.
  

Please let me know if any specific report from OSCAR (from either my current period with the CPAP only machine or previously with Autoset) that would help answering my questions.

Thanks in advance for any insights!

+----------------------+----------------------+------|-------|-------|-------------------------|-------------------------|------|---------------------------+

| First Use            | Last Use             | Days | AHI   | FL    | Device                  | Pressure Relief         | Mode | Pressure Settings         |
+----------------------+----------------------+------|-------|-------|-------------------------|-------------------------|------|---------------------------+
| Oct 27, 2024 (Sun)   | Nov 4, 2024 (Mon)    | 9    | 0.00  | 0.00  | AirSense 10 CPAP (37149)| EPR Full Time, 3 cmH2O  | CPAP | Fixed 9.4 cmH2O           |
| Oct 2, 2024 (Wed)    | Oct 26, 2024 (Sat)   | 24   | 0.00  | 0.00  | AirSense 10 CPAP (37149)| EPR Full Time, 3 cmH2O  | CPAP | Fixed 10.0 cmH2O          |
| Sep 24, 2024 (Tue)   | Oct 1, 2024 (Tue)    | 8    | 0.53  | 0.00  | AirSense 10 AutoSet     | EPR Full Time, 3 cmH2O  | CPAP | Fixed 10.0 cmH2O          |
| Sep 6, 2024 (Fri)    | Sep 23, 2024 (Mon)   | 17   | 0.99  | 0.00  | AirSense 10 AutoSet     | EPR Full Time, 2 cmH2O  | CPAP | Fixed 10.0 cmH2O          |
| May 7, 2024 (Tue)    | Sep 5, 2024 (Thu)    | 116  | 0.76  | 0.00  | AirSense 10 AutoSet     | EPR Full Time, 2 cmH2O  | APAP | Min 4.0 - Max 13.0 cmH2O  |
| Apr 19, 2024 (Fri)   | May 6, 2024 (Mon)    | 17   | 3.18  | 0.00  | AirSense 10 AutoSet     | EPR Full Time, 2 cmH2O  | APAP | Min 4.0 - Max 15.0 cmH2O  |
+----------------------+----------------------+------|-------|-------|-------------------------|-------------------------|------|---------------------------+

[PeaceLoveAndPizza]

1. How accurate/reliable is MyAir's AHI reporting compared to OSCAR's?

They should give the same numbers, just finer detail with OSCAR.

2. Would you strongly recommend trying to switch back to an AutoSet model, paying out of pocket, given the limited data from the CPAP model?

I would recommend it. Cheaping out with a fixed pressure machine only benefits the manufacturers and DMEs.

3. Any suggestions for monitoring therapy effectiveness without OSCAR data?

Look at the machine report screen for AHI and 95% numbers, but the best indicator is how you feel in the morning. 

4. Any other suggestions on how to monitor my events? Watch? Ring? App?

OSCAR is the best source of all knowledge and there are plenty of rings/smartwatches that do some level of sleep monitoring. Apple Watch, Garmin, Oura, and many more seem to work for folks. They will not give any sleep apnoea data, but are effective in their own way.

[mj277]

Thanks for your quick response! A few follow-up thoughts:

In hindsight, I completely agree that getting the AutoCPAP would have been a better choice, mainly for two reasons:

1. The detailed OSCAR data for better therapy monitoring
   
2. The flexibility of having auto-adjusting capability to evaluate the impact of external interventions (like mandibular advancement, surgery, or other non-CPAP treatments)
   

However, now I'm in a situation where switching would mean paying about 3x more (full price + no insurance coverage for a second device). It wasn't about cheapening out - I followed the recommendation by multiple doctors (two suggested it directly and a third agreed with the recommendation), and I followed their advice without knowing about the data limitations and not understanding the full implications. I can be open to consider buying the AutoCPAP, but I would need to see more clearly the value. For that, could you help me understand:

• What specific interventions/changes/experiments am I missing out on without OSCAR data? Or is it more about having detailed data for analysis (I'm a bit of a data geek myself, so I understand the appeal!)?
  
  
• As I continue to optimize my pressure settings (currently experimenting with slightly lower pressures), how much of a limitation is it to rely on MyAir AHI and the machine's display data?
  
  
• Would my doctors have access to more detailed data through ResMed's professional platforms?
  
  
• Are there other important aspects to consider?
  
  

Thanks for the tip about checking the machine's display screen! They were not available by default and I didn't know they existed. I'll start monitoring those numbers. However, I don't think I have the 95 percentile AHI figures (but also I don't think I had that in OSCAR for my previous autocpap device) - I'm curious how these contribute to therapy optimization compared to averages? I recall my doctor used the 95th percentile pressure data from my AutoCPAP period to help determine my stable pressure, but I'm not sure about AHI percentiles.

I really appreciate your help in making the most of my current setup while I consider long-term options.

[PeaceLoveAndPizza]

OSCAR is a fab tool for sleep analysis as it allows you to see every breath if you would choose to do so. MyAir is a decent enough overview, but the detail is not there.

Using MyAir to analyze and make decisions on settings is possible, but not recommended as there is just not enough details to see why settings may need to be changed.

Doctors have access to the ResMed cloud data, but if you are relying on them to make granular setting decisions on your behalf, you may be disappointed. With OSCAR you can make your own decisions with real data.