[Equipment] Resmed Airsense 10 CPAP-Excessive Mask Pulsing on inhale and exhale

[indiogoa]

I am new to this forum and website. I am a 15 year CPAP therapy user. 

Just recently picked up a low hour second hand Resmed Airsense 10, CPAP with no autoset feature. Pressure is 16.6, ramp is turned off, EPR is 3. At the start of the night, air pressure and exhale seem to start out ok, but within 2 hours the masking literally was pulsing when breathing in and out, my heart was racing, my BP was elevated . I immediately switched back to my old machine, a, Resperonics, Remstar M series with no mask issues. Myair indicated less than one AHI per hour, minimal leak issues. Sleepyhead software has this to say:

The last time you used your ResMed CPAP...
was last night (on Tuesday, April 24, 2018)
You had an AHI of 0.00, which is considered perfect
You machine was on for 4 hours, 22 minutes and 59 seconds.
You had no major mask leaks (maximum was 0.00 L/min).
Your CPAP machine blasted you with a constant 16.6cm H2O of air

All this is good news but I feel far from great, it was a rough night and the heart racing really concerned me.

Anyone else had this experience with the machine, are my setting wrong or is the machine malfunctioning?

Thanks in advance for your help..

[Ron AKA]

The EPR will make the mask pulse in and out because the pressure is changing by 3 cm from exhale to inhale. I would suggest reducing the set pressure to 14 cm and turning the EPR off. Try it there and see if it is any better. If your AHI is still zero or low, then try reducing the pressure in steps of say 0.4 cm until you start to see some indication of OA events. Then you should be close to a good setting.

[Hojo]

What kind of filter did you have in the machine, was it a standard screen filter or a hypoallergenic filter?  When I put in a hypo filter my machine acted like it was bucking me and it turned out the machine couldn't draw air in due to the filter.

[mesenteria]

What kind of filter did you have in the machine, was it a standard screen filter or a hypoallergenic filter?  When I put in a hypo filter my machine acted like it was bucking me and it turned out the machine couldn't draw air in due to the filter.

I was thinking along the same lines, pressure, faulty mask, faulty machine, filter problem, or even the exhaust vent on the mask/hose not being fully cleared of flashing or dust/hair/lint, etc.

[indiogoa]

Hmmm...interesting, never gave that a thought, will check the filter. Thank you for the suggestion.

[Sleeprider]

It would help a lot if you could download the free #Sleepyhead software and post a chart on the forum. There are several possibilities. If you are not accustomed to EPR, you may have had some central apnea that resulted in the machine using the Forced Oscillation Technique (FOT) that Resmed uses to determine the apnea type. FOT consists of small oscillations in pressure (1 cm H2O peak-to-peak at 4 Hz) added to the current device pressure during apena. Some users are sensitive to FOT and report the mask pulsing and other disturbances. Other just don't notice it. If you post some data we can tell for sure what happened, and maybe make some suggestions.

[indiogoa]

I think your onto something here. My data is sparse because i just started using the machine a couple of days ago and stopped using the machine. But I suspect I might of experienced some of the symptoms of central apnea. I will be meeting with a DME technician later this week to discuss, but as suggested by another post, the EPR may not be right for me.

[Sleeprider]

It's not for everyone, and sensitive individuals may experience a significant increase of events. You are using a fixed pressure of 16.6 with EPR at 3. This means your pressure is 16.6/13.6. The lower EPAP pressure may allow additional OA events to occur, especially since you are not using the Autoset function which would compensate by raising pressure if obstructive indicators like snoring or flow limitation were present. Second, in sensitive individuals the difference in pressure between IPAP and EPAP can trigger CA events. That is the reason we use the data and try to find a solution that solves whatever problem shows up. It's a good thing to have the data so you can figure these things out, and I think you will find your Resmed machine is very comfortable once we do that.

[indiogoa]

I agree with your comments on data, I just don't have much for this new machine. Hopefully i can start gathering data in the coming weeks once I meet with the DME technician.

[indiogoa]

Still trying to troubleshoot my Airsense 10 CPAP machine issues. So I took the advise, reduced the pressure, from 16 to 14, turned off EPR and the mask pulsing decreased on exhale but not totally, my breathing on inhale and exhale is just not smooth and fluid aggravated by the continued pulsing of the cushion. 

Next I took the machine into the local DME to have the pressure checked and make sure the machine was not malfunctioning. She hooked up a digital manometer, the pressure was set to 16, and the manometer registered 13, so she says the machine needs to be serviced. I have 100 hrs on the machine. 

I wasn't sure with her assessment so when I got home,  I checked the settings on the machine, setting was 16 but the EPR was on set to 3, that might explain the reading she got of 13. So is the machine really not functioning properly or should the EPR be turned off before checking the pressure on the machine? If there are any techs out on the forum familiar with pressure checking Resmed Airsense 10, I'd appreciate your thoughts on what the settings on the machine need to be when checking the pressure with a manometer.

Thanks all