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Dreamstation not getting to max pressure.
#21
RE: Dreamstation not getting to max pressure.
I'm not knowledgeable about pressures and such. But I'll comment on the DreamStation vs ResMed experience.

DreamStation is my primary machine - it's what my first DME "gave" me. ResMed is the machine I paid for out of pocket to use when I travel, because it is a smaller footprint on the nightstand and it has a great travel case.

Originally, I slept *much better* with my DreamStation. With my ResMed, all of my apnea symptoms came back. I found that - for me personally - I sleep more soundly with the less aggressive algorithm of the DreamStation.

I resolved that issue by switching my ResMed to the "soft response" setting. Yay!

So... I have no idea if this is something you're dealing with... but I thought it's worth mentioning. Maybe try the soft setting, and see if you sleep better.

Also, I totally agree with you about the feeling of pressure. With my ResMed, the same pressure feels stronger. I've been told that's not possible because a a pressure of xyz is a pressure of xyz, and they're calibrated to deliver the pressure of xyz. BUT I personally do feel a stronger pressure from my ResMed.
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#22
RE: Dreamstation not getting to max pressure.
I've been trying different settings for the past week and think I've hit on something. The past 2 days are the best I've felt in a long time.  I've been able to go cycling 10 miles each day and not be wiped out. I taped my mouth last night which seems to have helped too.  My oxygen levels are a lot better too. But I'm having a lot more RERA.
Tonight I'm going to try the same settings with the new Resmed machine.


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#23
RE: Dreamstation not getting to max pressure.
Let's see how this works when you start using the ResMed machine. It'd be nice to see fewer RERAs and hypopneas, but the two brands of machine have such different algorithms that we probably need to be ready to do some fine-tuning once you make the switch.

I'm glad your leaks are getting under control -- that's real progress. And most of all, I'm glad you're feeling better.
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#24
RE: Dreamstation not getting to max pressure.
Wrote a lengthy reply, changed pages to see what the heck could be responsible for the 30L/min leaks... and there goes my reply. Here's take 2.

First, checking in with mouth tape being a godsend for mouth-breathers. I found even then I was occasionally waking up with air entering my mouth and blowing up my cheeks - solved by wrapping a chinstrap around my mouth and back of my neck. Before that, I used an ace bandage (elastic bandage) wrapped around my mouth in the same way. Hope to find an easier solution for the mouth breathing without an FFM in the future. 

Now, fellas, unless I am reading this wrong the leaks are nowhere near managed with a median leak rate of 33L/min! At that high a leak, if you are sleeping on your back, Vegas, then my only conclusion is that the P10 is incorrectly fitted. If you have the straps very tight, I would loosen them - I have found that looser may be better with pillows as the pressure helps to keep a seal. Otherwise, check if you're rolling onto your side or stomach and breaking that seal. If it's not obvious what the issue is, then I'm at a loss, because 33L/min all night is pretty far out as far as leaks go. Maybe your mouth tape is becoming dislodged? I've certainly experienced that. Myself, I use 3M MicroPore tape and have found that to be the most secure of them all on my mouth, and bearable to remove in the morning.

Vegas, it's awesome to feel the difference of improved therapy - but I'm going to say right away that you're going to feel a hell of a lot better than that once you manage those RERAs which still leave much to be desired. The only reasonable way forward is to first manage those leaks and then figure out what remains on your (PAP) plate. It doesn't make much sense to change anything before those leaks are managed.
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#25
RE: Dreamstation not getting to max pressure.
To prevent losses of posts, get the Textarea Cache app. I use it in Firefox.

Vegas, the leak rate is not a problem and pineh probably is not aware that Philips machines record total leaks rather than just excess leak. As far as therapy goes, your RERA, flow limitation and hypopnea could all be better treated with bilevel therapy, or even the Resmed Airsense 10 Autoset using EPR (exhale pressure relief).
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#26
RE: Dreamstation not getting to max pressure.
Woops. Sleeprider, are total leaks the total airflow going out of the mask? ~30L/min seems to be what the manual says for my nasal pillows.

In that case, big woops. Those are very pretty leak rate graphs Smile My apologies for the confusion, Vegas.
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#27
RE: Dreamstation not getting to max pressure.
Thanks for the replies. I'm using 3M micropore tape. I've only used it for 4 nights and am tolerating it well. I'm not a mouth breather but I do have more air leaking from my mouth with the higher pressure. I was thinking of getting a chin strap.
One big issue I've developed over the past year is an itch around my nose with any mask- I have 6. It's a stinging itch that wakes me up and when I scratch it, it breaks the seal of the pillow and I get a blast in the face that wakes me up. I've tried benadryl and cortisone creams with no luck. The P10 mask has the least contact with my skin.
I had EPR off but I'll try it on tonight.
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#28
RE: Dreamstation not getting to max pressure.
You don't have EPR. Philips machines use Aflex or Cflex which does reduce pressure for expiration but in a different way and not as long as Resmed's EPR. It is strictly a comfort feature, and if you use it, I suggest experimenting with settings at 1 or 2 (avoid 3) to find the best comfort.

Pineh, not to worry. Different machines often have different features and displays. The Philips have 2-leak lines, the top one is total and the bottom one is the estimated excess leak. Resmed only reports excess leak, and a leak rate above 25 would be a large leak.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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