[Equipment] Much worse sleep with ResMed?

[Jookia]

On the 7th of February I did an at home sleep study test and found out I had a pAHI of 21.5/hr, which wasn't great. I rented a DreamStation Auto CPAP and started to sleep really well: I had energy, I wouldn't wake up during the night, things were doing pretty well. After a month I bought a ResMed 10 Autosense and started using it, and over the past 10 days my sleep has felt worse. I've woken up throughout the night, and each day I've felt less and less energetic. I've kept the same mask and sleeping habits. Last night I slept for around 12 hours and I still feel pretty bad.

Looking at the OSCAR data, I don't really see any major differences. When I switched machines my AHI dropped from 4.3 to 1.5 overnight which I found a little strange. Looking at the flow graph I don't see anything really different either. I'm happy to post parts of it, I'm just not sure what I'm looking for.

Looking at graphs my minimum pressure is 4 and my maximum is around 20, on both machines. The biggest difference I see is that the ResMed seems a lot more aggressive with pressure increases. Events wise I don't see anything really correlated with hypoapneas outside a VS2 on the DreamStation.

The only other thing I can think of is that I do sleep in a somewhat noisy area and I stopped using earplugs due to pain. I'll resume using them if I can, but I'm not sure that's the problem at the moment.

Has anyone else had an experience like this? Apologies for a brief thread/lack of introduction, I don't have the energy for it at the moment.

[srlevine1]

I suggest you post your data for review to obtain better informed comments and suggestions. Without more detailed data, it is impossible to know what may going on and to suggest appropriate settings.

[Jookia]

I really don't feel comfortable uploading 2 months of raw data, sorry.

[Sleeprider]

No one wants 2-months of data, just a typical daily details screenshot. The instructions for organizing and posting a screenshot attachment are in the links in my signature. If you really felt better on the Dreamstation, there are tons of them on the market that no one wants after the recall and discontinuation of the product line by Philips. Just try to get one with a re manufactured white foam or the DS 2.

[PeaceLoveAndPizza]

It sounds like you are using the default settings as typically set by DME or sleep docs. With a night or two of OSCAR data we can help fine-tune things.

A few screenshots of the main screen showing the entire night as described in the “Organise your OSCAR charts” link in my .sig explains how to do so. Two nights should be plenty to get the ball rolling…

[OpalRose]

As others stated, post some data. Great advice is given here, but not by guessing.

Please don't upload 2 months of data... we only need to see a couple, daily charts.

Ideally, you can post one chart from your DreamStation, and one from the AirSense 10 for comparison.

If you liked the way your DS worked, then set the AirSense 10 to Auto Mode and set the response to "soft" setting vs. the "standard" setting. This way, it won't be so aggressive.

[Jookia]

Sorry for the misunderstanding, the only data I could think of was all the data I've collected.

Here's two days (I zoomed one in for slightly obvious reasons)

Thanks for your patience so far!

[SarcasticDave94]

I would try this on the ResMed AutoSet, increase min pressure from 4 to 6. Edit EPR to 2, make sure that's full time. I can't see Ramp info, only that it was on, which I'd turn off. Recap min to 6, EPR 2 full time, no ramp. Alternate is min pressure 7, EPR 3.

The ResMed has a different therapy key response than the Respironics. This plus the Respironics is a slow responder will make them feel different.

Again in EPR, this setting guide will give EPR ability to work always:
Min press. 5 EPR 1 = exhale at 4 & up
Min press. 6 EPR 2 = exhale at 4 & up
Min press. 7 EPR 3 = exhale at 4 & up
The CPAP cannot physically reduce below 4.

Another factor on both, default settings like this will fall short in long-term successful therapy on either. Default is 4-20 pressure like these are set up with.

ResMed's EPR will be more useful to most users. EPR is Exhale Pressure Relief, and the number 1-3 stands for actual cmH2O of exhale reduction. Respironics flex is rather arbitrary in value for settings, like differing levels of suggested power. They're supposed to be comparable, but to the user it's very different in feel and result.

You could try similar with the Respironics. Not trying to be biased, but Respironics didn't feel as capable to me when I had one versus a ResMed. Caveat my needs are unique. Even so I don't like Respironics as well for their shenanigans.

[staceyburke]

Setting that Dave gave you is a good place to start. You also have some positional apnea. . You can see positional apnea where either H or Oa events are clustered together.

Getting rid of as many as you can will lower your AHI. Positional apnea can NOT be controlled by pressure changes. You have to find out what position you are getting into and cutting off your own airway. Have you changed your sleep position? Sleeping on your back? Using more (or new) pillows? These things can cause positional apnea by chin dropping to your sternum and cutting your airway. Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar. I have a link to collars in my signature at the bottom of the page. It shows people who are not wearing a collar and the SAME person wearing a collar. There is a huge difference between the two.

[Jookia]

So just as an update: I haven't implemented any changes to the machine as I couldn't convince myself that it was actually the machine being the problem. I have found my energy improving independently so it may just have been some kind of lifestyle issue.