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[CPAP] I want my Dreamstation back
#21
RE: I want my Dreamstation back
No problem. BTW here's the screenshot of pressure ranges for AirSense and AirCurve units. All AirSense are 4-20, most AirCurve start at 3 except ASV which is 4. Most then stop at 25, but the COPD and ST-A hit 30. And none go above or under these as you mentioned.

   
Dave

OSCAR
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#22
RE: I want my Dreamstation back
Flex is a tool PR uses to help you breathe better and more relaxed by dynamically lowering your exhale pressure based on how hard you are breathing, the harder you breathe the greater the change and the higher the setting the more the reduction that occurs. Unfortunately, while on the surface you would expect the same event reduction that occurs with a similar setup with Pressure Support this doesn't happen. We see a very specific reduction in events with ResMed's EPR (which is considered the equivalent of Flex) hat is comparable to a BiLevel operating with similar settings. By hook or crook, you now have what most of us consider to be the best of any and all CPAP/APAP machines.
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#23
RE: I want my Dreamstation back
Thank you for the explanation... 
Hoping that I will get to feel like using it is not a struggle, and I do appreciate your input.
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#24
RE: I want my Dreamstation back
Coming late to the party, I have some slightly different suggestions.

I would suggest changing your minimum pressure progressively, starting at 7 for a week or two, then 8 for a while, until you end up about a cmH2O below your median pressure (which will change as you go). This gives your body a chance to acclimate.

Regarding the Ramp setting, you should change to to Automatic, rather than a fixed time, or turn it off . If you use the Ramp at all, you should set the Ramp Start pressure to 6 to make inhaling easier. I found I had to add effort to my breathing when my Ramp Start was at 4.

With regard to your relatively high and consistent flow limitations, the EPR of 3 is definitely recommended, but you may find that a soft cervical collar will help to hold your jaw and head up and your throat more open.
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#25
RE: I want my Dreamstation back
That's OUR task, Sally, to both optimize your therapy AND (very importantly) get you to feel like using it is not a struggle. Your comfort is paramount, it is part of the end goal.

Without question, we will ask you to try things that seem counterintuitive. If you don't understand just ask.
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#26
RE: I want my Dreamstation back
I’m very appreciative of your kind assistance and will try whatever you think might be an improvement. Thanks, Gideon.
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#27
RE: I want my Dreamstation back
   
So I think last niight was kind of a good news/bad news night... with all the different suggestions I sort of combined them and ended up using 8-20 with Ramp on Auto at pressure 7 which I think was kind of a waste so I will change that and go to 9-20 tonight as suggested with the Ramp off.  Some things look better -- like the snore graph -- and the flow limits are slightly lower but the bad news part is that I had 3 separate sessions.  After the first roughly 5 hours the machine woke me up as it does every night and I could not get back to sleep, so I shut it off.  There was a short 2nd session but it was still too noisy.  This kind of shoots my theory, though, that the noisy machine is due to higher pressures because it wasn't all that high when I had to shut it off. Between the 2nd and 3rd session I switched the slimline hose to a standard one and that seemed to help some but 1hr and 40 minutes later I had to turn it off again, this time for good, because it was just too loud.  I'm starting to think there isn't going to be a way to keep the machine from getting noisy in the middle of the night, and it's definitely not helping my sleep.  Is this common?  I am pretty noise sensitive but I don't know why it changes from being perfectly quiet early on to being so noisy that it wakes me up.

(p.s. I notice that the report has the wrong time zone hours... is that something I need to change on the machine?  I haven't seen that setting yet... thanks)
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#28
RE: I want my Dreamstation back
I'm only guessing on the noise issue, it could be it gets a bit louder later, like when you actually are asleep or maybe when you change to a different sleep stage. Getting louder indicates it has to work to combat events. And it looks like the PAP did an excellent job of event combat. Hypopnea at .15 total. Nothing else.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#29
RE: I want my Dreamstation back
   
I'm back...I've tweaked a number of settings, covered the tube with a cloth cover and am sleeping better, but am still wondering if there is anything more I should do to work on the flow limits...  Respironics never even reported those so it's new to me.  Am showing the results from my worst night recently... now that I've lowered the max pressure to just above 15 it doesn't even get that high anymore.  I don't have frequent apnea events but I can see that the flow limits are still pretty constant.  I ordered a soft cervical collar but the measurements were screwed up so it was too large...still working on that.  Is there anything else I can do with settings?  Thanks for your advice.
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#30
RE: I want my Dreamstation back
If your machine was a BiLevel I'd have you increase your Pressure Support (EPR on your machine). Your AHI doesn't warrant getting a BiLevel.
Your symptoms might by proving that your treatment is not working because you are retaining many of your symptoms.

That said try raising your min pressure as that is the tool that is left.
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