The dilema [AirSense or DreamStation?]

[happyguardian]

I have been using ResMed AirSense 10 Autoset for the last 18 months.  I noticed that I was waking up a few times during the night and I would never get that "get a good night's sleep - get up refreshed" feeling from it. I believe it treated my apnea successfully (AHI<5).  I recently had a chance to try out for a month the PR Dreamstation.  I was feeling more energetic and refreshed after using it for a month, still not 100% but perceivably better than the Airsense 10. It seems the Dreamstation was treating my apnea somewhat less successfully as the AHI was between 5-7 on it, but nothing major.  Another thing I noticed.  I suffer from tinnitus when I use the Dreamstation, the tinnitus seems to be stronger when I wake up and also throughout the day.  I cannot explain why it is happening.  With the Autoset 10 I also had tinnitus but it was not so pronounced.    BTW I had virtually the same settings on both machines. 

What is your opinion or experience, is it anything like mine? I am gravitating towards the Dreamstation just because I feel better and more energized and this is something I was missing in the last little while.

[OpalRose]

I’m sure you will receive much advice leaning toward the AirSense, but in reality, the AirSense and the DreamStation are both good machines and will treat your Apnea if set up correctly.

The ResMed AirSense algorithm is more aggressive than the Respironics DreamStation. Therefore, you normally have to use a slightly higher minimum pressure setting with the DreamStation to achieve close to the same results as with the ResMed machine.

The advantage with a ResMed is that it offers EPR which is much more effective and helpful than the Respironics Flex system.

From your profile, it looks like you have used a ResMed machine in the past.  Was your Apnea well treated?  How was your comfort level?  What were your AHI readings?  More importantly,
what is the breakdown of your AHI?  Do you experience mostly Obstructive, Hypopneas, or Clear Airway events?  

Bottom line is go with your gut feeling.  What are you most comfortable with?

[happyguardian]

I’m sure you will receive much advice leaning toward the AirSense, but in reality, the AirSense and the DreamStation are both good machines and will treat your Apnea if set up correctly.

The ResMed AirSense algorithm is more aggressive than the Respironics DreamStation. Therefore, you normally have to use a slightly higher minimum pressure setting with the DreamStation to achieve close to the same results as with the ResMed machine.

The advantage with a ResMed is that it offers EPR which is much more effective and helpful than the Respironics Flex system.

From your profile, it looks like you have used a ResMed machine in the past.  Was your Apnea well treated?  How was your comfort level?  What were your AHI readings?  More importantly,
what is the breakdown of your AHI?  Do you experience mostly Obstructive, Hypopneas, or Clear Airway events?  

Bottom line is go with your gut feeling.  What are you most comfortable with?

Is there a way of knowing if the ResMed is working properly?  I don't know why but I have a feeling it may not be working properly.  My healthcare provider does not want to deal with it and just told me to contact ResMed directly.

[OpalRose]

Download the free #SleepyHead software and use the links in my signature line to organize the charts and use the attachment feature to post a screenshot here.

Folk here may be able to see if your machine is working properly or not.

Why do you think it’s not working?

[MitchS]

I have a ResMed A10 Auto and a DreamStation Pro CPAP. I used the DreamStation Pro on AutoTrial for several weeks. Both do a very good job treating my apnea. As stated by OpalRose, the DreamStation minimum pressure needs to be slightly higher than the A10 minimum pressure to obtain the same results.

Another option is to try the soft response with your A10 (Clinical Menu>Comfort>Response). While it’s not quite the same, I found the A10 soft response to be something like the DreamStation in the way it responds to events.  It may be worth trying if you still have the A10. 

Whatever you decide to do, it would be worthwhile to post SleepyHead charts and get advise on optimizing your settings for the best treatment.

[Twisticles]

The advantage with a ResMed is that it offers EPR which is much more effective and helpful than the Respironics Flex system.

Out of interest, what makes it more effective and helpful than the Flex system?  I have the Dreamstation and Airsense 10 Autoset, the relief on both machines seems (to my human senses) comparable.  Both allow very easy exhalation. 

[Fats Drywaller]

I have been using ResMed AirSense 10 Autoset for the last 18 months.  I noticed that I was waking up a few times during the night and I would never get that "get a good night's sleep - get up refreshed" feeling from it.

That last part makes me wonder whether the machine's settings were appropriate, because I don't know of any reason the A10 wouldn't do the job. Have you posted Sleepyhead charts for the chart-watching experts to critique? It could be that some tweaking would give better results.

[OpalRose]

The advantage with a ResMed is that it offers EPR which is much more effective and helpful than the Respironics Flex system.

Out of interest, what makes it more effective and helpful than the Flex system?  I have the Dreamstation and Airsense 10 Autoset, the relief on both machines seems (to my human senses) comparable.  Both allow very easy exhalation. 

When using ResMed’s EPR, you can receive a pressure relief equal to which setting you use, 1,2, or 3.
So you can receive up to 3cm pressure relief if needed.

When using Flex, you can only receive up to 2cm drop in pressure relief, regardless which setting you use.  
Flex settings 1, 2, and 3. for PR machines
You can receive up to 2cm pressure relief, which is flow based.
• C-Flex – Provides pressure relief upon exhalation.
• A-Flex/C-Flex+ – Provides pressure relief taking place at the end of inhalation and at the start of exhalation.

[SarcasticDave94]

Just bringing something to your attention happyguardian. Your opening post says "BTW I had virtually the same settings on both machines." If the settings are not the same (with a noted exception that the DreamStation does respond slower to events compared to the ResMed) then we're really not in a good situation to evaluate why the ResMed is not providing it's best support vs that the DreamStation is seemingly doing better for you.

I said all the above to build a case for it being a necessity to post SleepyHead charts from both machines. I would also strongly suggest posting every setting you can find on both machines as well.

[Hydrangea]

I had similar experiences. 

I started with a DreamStation, and loved it!  I had to adjust the exhale settings (decrease the exhale support so that the inhale and exhale pressures are closer to each other), to help my ear pain/clicking/issues.

I tried a ResMed for travel (using the exact same settings as I had on my DreamStation).  Despite getting better AHI #s, I felt worse - basically all of my sleep apnea symptoms came back (not feeling refreshed, etc.).

After some experimenting, and a TON of reading on here, I realized that ResMed's aggressive algorithm for stopping the obstructions was *disrupting my sleep*!  DreamStation's less aggressive algorithm intervened enough to improve my sleep apnea, but not so much as to disrupt my sleep.

Thankfully the ResMed has a "soft" setting.  And the "soft" setting is more similar to the DreamStation algorithm.  So now when I travel (with my ResMed), I make sure it's on the soft setting and with very little exhale relief/support, and I feel MUCH better!