New machine, feel worse. System One to Airsense 10

[plpauly]

[attachment=19566]Hello,
I've been on a Respironics System One for 6+ years.
Pressure 17 C-Flex 2
Use a nasal mask Mirage FX and feel great when waking up.  I was never really tired from what I remember but I had terrible headaches almost daily before starting cpap therapy years ago.
After starting to use the System One, feel really good, almost never have a headache.

Recently received a new Machine. Airsense 10 Autoset.  I am using the same nasal mask....also tried the N20 but went back to the Mirage FX.
Airsense 10 Pressure 17  EPR 3,  also have played around with this and humidity levels.

I wake up with a headache most days and just dont feel as rested as before.  Also on the System One my humidity level was set to 1 or 2 and did not use as much water daily as is being used by the Resmed.
Anyway, I've attached some screenshots from the last week
The screenshots from Jan 15, 16 were the third and fourth day I had used the new machine....Didnt have an SDCard in the first couple days.
Any suggestions based on the charts? - Hope I've done everything correctly with the charts.
FYI I probably wont make to many changes until after the 90 day compliance for my insurance company....not sure how that would affect compliance.
[attachment=19566][attachment=19567][attachment=19568]
           

[Sleeprider]

I see on your charts you are using fixed pressure at 17.0 and have tried EPR settings from off to 3. Even though that dropped your exhale pressure, you still have relatively few events. I think it would be interesting for you to try using Autoset pressure and perhaps the lower average pressure will relieve some of the symptoms you describe.

I actually think the charts suggest EPR has a mostly beneficial effect, so that is probably something to keep. Flow limitation is much higher without EPR at a steady pressure of 17, and your experience with EPR at 3 is consistent with what we have seen in other users, and flow limitation is negligible. If you want to try Autoset Pressure , I think we can start with a minimum pressure of 12.0, maximum pressure at 17.0 and EPR at 3. We can coach you on how to make setting changes, or you can request a copy of the clinician manual by following the CPAP Setup Manual link at the top of the page. Let me know.

FYI, Compliance means using the machine at least 4-hours per day, at least 70% of the time (21 of 30 days). Compliance is not contingent on settings or pressure. We can make you comfortable with auto-pressure and insurance will have no concern with that. Read this article and request a clilnician manual https://www.apneaboard.com/adjust-cpap-p...tup-manual

Here is a tutorial on settings, but you have already found EPR so you probably know https://www.apneaboard.com/resmed-airsen...setup-info

[plpauly]

Thanks for the quick response.  Like I said, I probably will not make changes until after the compliance period is over.  The only change I've made so far is the epr setting.  Originally it was set to 3 from the home health office.

I've poked around in the clinical menu and would probably consider going to auto once the compliance period is done and the machine is "mine".
Hoping I can continue using it for another 75 days and feel this way.

Also, these charts are from the first few days of using the machine, maybe day three and four after I got an SD card installed.
This was probably with the resmed N20 nasal mask
       

[Sleeprider]

I had edited my first comment to include your concerns on compliance. Take a look. An alternative is to request your doctor's office to change your prescription to allow you to use auto pressure. If he does so, it completely solves the problem.

You have outstanding results with the fixed pressure, so the reason for changing to auto pressure is to improve comfort. If you speak to the doctor's office, this is the reason for requesting auto pressure. You can let them know you are monitoring efficacy and will attempt to balance comfort and efficacy. If it has been quite a while since you had titrtion, or if you never had a sleep titration study, using auto pressure to update your pressure settings makes a lot of sense. The bottom line is, you cannot fail compliance by changing settings.

[plpauly]

OK thank you for the additional info.  

I really wish the Respironics System One had detailed data I could get off the SD card!  Because like I said, there is a huge difference in the way I feel after using the System One vs this Airsense 10 auto machine.

[Sleeprider]

The System One works with both Encore and OSCAR software. The SD card slot is in the center-top at the back of the machine. If a card was used, it will contain the data. If you insert a card, at least the summary data will be written when you turn the machine on.

[plpauly]

there is a card in that machine, here are some screen shots
           

Does this give any useful info?

[Sleeprider]

That shows the settings from the old machine, but unfortunately no detailed data to view. I have used System One maclhines and the detailed data did show in OSCAR. Anyway, there is nothing there that explains why you feel so different on the Resmed. The feel of C-flex is different from EPR.

I don't see anything specific in your current charts to explain your headaches and sense of not being as rested. About all I can suggest is that we try some alternative settings, but fixed pressure should not vary that much, even between the Philips and Resmed machines.

[plpauly]

I’ll try adjusting the settings a bit as suggested and see what happens. 

If my nose is getting stuffed up is that a sign of to much or not enough humidity?

[Gideon]

Humidity is a very personal thing. Stuffed nose can mean either too much humidity or not enough. You need to try both to see which you prefer. I prefer the higher humidities, others not so much.