[CPAP] Switching from DS2 to Airsense 11 - Struggling

[tyler.durden]

I've been on CPAP for about 13 years. I started with a Remstar System One that was replaced during the recall with a Dreamstation 2. As my Dreamstation 2 was having issues with the humidifier, I was issued an Airsense 11 as a replacement by my new sleep specialist/DME. 

I was originally diagnosed with severe OSA with AHI 72.  My original prescribed pressure was 12cm and that crept up over the years to 14.5cm. Using the Remstar and Dreamstation, my AHI was reduced to 4 or less.

About 18 months ago I began a lifestyle change and have dropped over 100lb. I noticed that I was waking up with a dry mouth.  When I discussed it with my previous specialist they agreed that I might try auto to how my treatment needs changed. I set the Dreamstation to 5-15 Auto with flex setting at 2. My 95% pressure hovered around 7 and my AHI was typically about 1.
I have used  a Respironics Nasal Cushion mask for the last several years without issue.

Now that I've switched over to the Airsense, I haven't had nearly the quality of sleep that I was getting with the Dreamstation.  I set the Airsense 11 to Autoset 5-15 EPR 3 No Ramp.  I have a heated tube and both the tube and humidifier are set to Auto and am using the same Respironics Nasal cushion mask.

I have tried switching to CPAP at 9cm instead of Autoset. I've tried Austoset for Her. I've made many adjustments, but almost every night, especially with Autoset, my pressure increases and it blows the mask off my face or causes a mouth leak. In OSCAR, I can see episodes where my pressure builds to 10-12 cm while the leak rate is above the large leak threshold. This of course causes fragmentation of my sleep.

Anatomically, I have noticed that my right nostril stays congested and feels like there is some flow restriction. I'm trying to use a nasal steroid to open up that passage, but I do wonder it that flow restriction is part of the issue.

All that being said, my AHI numbers are very low (usually 1 or less) and there are very few incidences of snoring, yet I don't feel great in the morning. 

I wanted to call on the hive mind here to see if anyone else has transitioned from DS2 to Airsense 11 successfully and what made it work for you. The only other item I have on the table is to add a chin strap or mouth tape, but I've never needed that with the previous Phillips devices.

Thanks in advance.

T

[staceyburke]

we need to see OSCAR data.  OSCAR is completely free to download and use from the top of the site.  You will need a sd card no bigger than 32 gb... they can be found cheep, get the least expensive.  Then look at chart arrangement in my signature on how to post.

[tyler.durden]

I appreciate the responses.

I am a long time CPAP user and have extensive experience with masks and leaks, so I had already spent a good deal of time adjusting the mask, so that was not the culprit.

My new DME provider literally programmed the equivalent settings on the Airsense 11 as I was using on my Dreamstation 2: auto, 5-15 flex 3, no ramp.   

After starting therapy with the Airsense 11, I had  performed many trials making adjustments to pressures, Auto/CPAP, and pretty much every logical setting I could think of to see if I could find a trend toward even being close to the benefit of the Dreamstation 2.

Finally, just after starting this thread, and counter to what I would have at first expected, I disabled the Autoset and selected a constant pressure of 8cm. My sleep results in OSCAR showed the best night I'd had since switching to the Airsense 11.  AHI = 0.33, Total Time in Apnea = 00:00:29, and Time Over Leak Redline 0.000%.  My suspicion was that the Airsense 11 Algorithm was escalating too much and causing runaway pressure.  The next night I lowered my constant pressure to 7cm with similar results. I'm sticking with that for now.

I would assume that many of us have made or will make the transition from Phillips machines to other brands. I will say that the Auto Algorithm for Resmed is completely different and difficult to tolerate. Whether I had grown accustomed to the Phillips system over the years and Airsense is just different I am unsure. I do hope that this thread will help others who are struggling find some hope.

T

[Deborah K.]

As the machine brands work differently, the settings most likely need to be changed.  We can only help you if you post actual data, and the best way to do that is to download Oscar, our free apnea reporting program which creates great charts showing many aspects of each night's sleep.  With that data, we can advise you.  Without it, we are in the dark.