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Changed Pressure. Have a Few More Questions,
#1
Hi All. With your help and that if this great site, I was able to change the bottom pressure on my DreamStation from 5 to 6.5.

I wanted to do this because I was waking up as soon as I hit deep sleep feeling like I wasn't getting enough air, even while stomach sleeping where I have only mild OSA. Snoring might have caused this. My apnea is moderate-high while back sleeping.

- I tried machine just now at 6.5 while awake and it feels fine for incoming air, but I still feel that breathing out isn't easy. Is that the "trade-off" for having to use CPAP - or should I look into whatever this exhalation relief is I hear about and change those settings too somehow? If so, where are they in the machine? I didn't see them.

- Also, I know in a snorer. How does the machine respond to snoring? Could it be doing something that is making me feel I'm not getting enough air as I described, and if so, will changing my bottom pressure as I just did, actually help?

Thanks
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#2
Hopefullady, welcome to the forum. Increasing your minimum pressure was probably a good idea to head off events that would occur with lower pressure. Snoring is one of the events that will cause an auto machine to increase pressure. It also detects flow limitations and changes in breathing volume and makes pressure changes according to its programming. Snoring is an indication of a closing airway, and you will see a gradual increase in pressure when it occurs, and decrease from a higher pressure when it does not. Once you know what your average and 90% pressures are, you may find an additional increase in pressure is both more comfortable and effective. For new users, I generally recommend minimum pressure equal to average nightly pressure, after a week or two of trial at lower pressures.

Your machine has Cflex and Aflex for pressure and inhale/exhale transition comfort. I would give the Aflex a try. There is a trial that lets you go through the different settings to try out different flex intensities. A-Flex of 3.0 results in about a 2.0 cm pressure reduction on exhale, and a longer transition in pressure, so it does not feel as abrupt, however lower Flex settings can help people that need that faster transition from exhale to inhale pressure. So it's personal preference.
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#3
(12-16-2015, 09:39 AM)Hopefullady Wrote: Hi All. With your help and that if this great site, I was able to change the bottom pressure on my DreamStation from 5 to 6.5.

I wanted to do this because I was waking up as soon as I hit deep sleep feeling like I wasn't getting enough air, even while stomach sleeping where I have only mild OSA. Snoring might have caused this. My apnea is moderate-high while back sleeping.

- I tried machine just now at 6.5 while awake and it feels fine for incoming air, but I still feel that breathing out isn't easy. Is that the "trade-off" for having to use CPAP - or should I look into whatever this exhalation relief is I hear about and change those settings too somehow? If so, where are they in the machine? I didn't see them.

- Also, I know in a snorer. How does the machine respond to snoring? Could it be doing something that is making me feel I'm not getting enough air as I described, and if so, will changing my bottom pressure as I just did, actually help?

Thanks

I suspect that with such low therapy pressures, it might just taking some getting used to and maybe more "practice" while awake. However, it's also possible that your overall pressure is too low, or your exhale pressure is too high. While I'm not familiar with the DreamStation specifically, this board provides the clinician's setup instructions here:
http://www.apneaboard.com/dreamstation-c...structions

It looks like you can activate a bi-level setting, meaning you can decrease the pressure for exhale to make it easier to breathe against the pressure.
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#4
One more note on pressure. Your machine allows you to enable OptiStart. This starts the pressure at the 90% pressure of your previous session. Obviously, this will likely be a much higher minimum pressure than you currently have selected, but the 90% pressure is widely considered the optimum "therapeutic pressure".

The new Philips machines have what is called SmarRamp that works with OptiStart to set the starting pressure in Auto mode to the minimum set pressure. So, try Optistart with SmartRamp, and you should get pretty good results. I have an older machine, so can't vouch for this, but it looks pretty good.
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#5
Thanks SleepRider. Regarding your first response:

How can I find out what my "average nightly pressure" is? I think I saw it before. Is that AHI? It was at 8.0

So if I need more exhalation relief and want longer breaths for shallower breathing, I should raise FLEX to 3, right? It's on AFLEx already.

My cheeks were blowing up today while awake with pressure at 6.5 and I was getting gas, so I lowered my pressure to 5.5. Huge difference. It's not much pressure at all. Even 6.0 might be comfortable. I'll try one of those for several nights. Just hope I don't have problems with snoring?
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#6
Thanks Possum,

"it's also possible that your overall pressure is too low, or your exhale pressure is too high."

^^^ This feels like the problem, yes.


"It looks like you can activate a bi-level setting, meaning you can decrease the pressure for exhale to make it easier to breathe against the pressure."

^^^ Is this what bipap is for, generally?

I'm perfectly fine with this thing on my face and like the machine feeling. It's just when I go into deep sleep this "not getting enough air" feeling happens. I'm trying different things.
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#7
(12-16-2015, 10:57 AM)Hopefullady Wrote: Thanks SleepRider. Regarding your first response:

How can I find out what my "average nightly pressure" is? I think I saw it before. Is that AHI? It was at 8.0

So if I need more exhalation relief and want longer breaths for shallower breathing, I should raise FLEX to 3, right? It's on AFLEx already.

My cheeks were blowing up today while awake with pressure at 6.5 and I was getting gas, so I lowered my pressure to 5.5. Huge difference. It's not much pressure at all. Even 6.0 might be comfortable. I'll try one of those for several nights. Just hope I don't have problems with snoring?

The average an 90% pressures should be displayed on the INFO screens. AHI is the Apnea Hypopnea Index, or number of apneas+hypopneas per hour of sleep. Under the INFO screen you are looking at 90% icon to get the 90% pressure. I was incorrect, that your machine displays the average pressure. You would need to get that, and the AHI breakdown from the Encore software until Sleepyhead is updated for the Dreamstation.

Just use Optistart and SmartRamp instead. That will do everything I suggested without you knowing the numbers.
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#8
For some strange reason the 90% pressure is under the “My Provider” tab rather than “My info” tab.
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#9
Thanks both. Things are getting a little clearer Wink
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#10
should I look into whatever this exhalation relief is - YES
Is this what bipap is for, generally? - YES (I love it)
use Optistart and SmartRamp - YES
adjust your numbers if you want to, just make sure you know what you are doing - YES

whatever floats your boat. Use it if it works for you.

Some prefer to just push through discomfort, I do NOT, I use everything that can make me more comfortable using CPAP. I truly do not understand why some chose discomfort.
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