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Dreamstation vs Vauto in a supposed UARS case
#1
Dreamstation vs Vauto in a supposed UARS case
So first i got Dreamstation it fixed my sleep SOMEWHAT.

Still had arousals, wakenings, drops in O2, and bad sleep quality, often woken up shaking from anxiety that held me through the day, entirey day almost. I had/ have tintinus, ortosthatic pressure drop upon standing up, dizziness, small mandible, very large tongue (can touch my nose with my tongue), very slim circumference of my neck, low BMI, skinny guy, chronically tired, drop in concentration almost as if I have ADHD. Further more I recently developed depression, panic attacks and anxiety. 

Doctors prescribed me with 4 different antidepressants and believe it or not even benzos which is horrible in such case. They did PSG without EEG and i was awake for more than half of the night, they gave me AHI of 3 and said I am fine. They did not address RERAs, nor flow limitations, nor EEG nor was AHI correct because they were not even able to tell how much was I awake since they had no EEG. 


I got Dreamstation and to my surprise AHI at pressure of 6 to 7 was 7. When sleeping on my back it went way up to 20! 

I slept on my side and increased pressure but flow limitations persisted and even at pressures as high as 17! IT made me swallow air and hurt but no help.


Sleeprider from here and Bonjour  and SarcasticDave94 suggested I should get Vauto for flowlimitations and use some pressure support.

I did so and from what I can tell subjectively, my sleep is much better and I do not wake up anymore. 

I collected some results and my opinions I think Vauto was really much better than Dreamstation and it cost me just 700 euros more here in Europe. 

If my comments are wrong I urge the gurus on here to explain what we will see in the results I will be posting in case I am wrong. 

All in all I think Resmed Aircurve 10  Vauto is WAAAY better than this Philips Dreamstation.

Here are O2 desaturations.

The one with more desaturations is from dreamstation.
The one without desaturations is from Vauto.

Here are O2 desaturations.
The one with drops is from Dreamstation. 


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#2
RE: Dreamstation vs Vauto in a supposed UARS case
Here are some pictures of flow limitations, very low airflow rate sometimes on inspiration, very messy tidal volume, basically what made my O2 dip, you can see huge gasps for air in tidal volume graph.  Higher AHI, waking up often feeling horrible.  Compare that to tidal volume in Vauto I will post in next reply.

Reply only allows 3 images.


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#3
RE: Dreamstation vs Vauto in a supposed UARS case
Here is an overview of what Resmed Aircurve 10 Vauto did...

Very little hypopneas and obstructives.

Tidal volume looks more clean like a flat horizontal line, often constant at 520 or 530.


For Dreamstation it was often around 400 and often also around 330. That usually happened before gasps and huge inhalations.


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#4
RE: Dreamstation vs Vauto in a supposed UARS case
Now here are some close ups for Dreamstation with flow limitations, low tidal volume and consequent inhalations.

Please note that airflow upon inhalation was sometimes at 8 or even as low as 5! 

Currently with Aircurve 10 Vauto with 4 cm of pressure support it is almost always above 23-25.


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#5
RE: Dreamstation vs Vauto in a supposed UARS case
Dreamstation: Here are some more flow limitations, flattening of the curve upon inhalation, low tidal volume, arousals often following it.


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#6
RE: Dreamstation vs Vauto in a supposed UARS case
Here are close ups for Resmed Aircurve 10 Vauto.

No flattening of inhalation.

Tidal volume high. 

Inhalations often all equal and the same.



I do feel better, dreamstation did help me, but it just wasn't "it". So I kept on digging. 

Please everyone give me your thoughts.

I thank all of you so much and also thank Resmed and good AMERICAN engineering that conqueres ALL diseases lol <3


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#7
RE: Dreamstation vs Vauto in a supposed UARS case
Also, had I listened to the doctors, I would have been now on 4 antidepressants and benzos, that is 5 dangerous psychoactive substances that should be REALLY used as last resort when patient is losing it, has no biological causes and is thinking about killing oneself or attempts to do so.


So yeah I would have been drugged and I would not be able to BREATHE!.

Thank you everyone from this forum! 


I can say I feel like 70% better already. I just could not bear 4 to 5 months for them to give me appointments, do the tests and then in the end to tell me "sorry insurance won't cover UARS treatment". I paied Dreamstation on my own. Since I did not visit a sleep lap, I bought 5 to 6 masks to try them all out which one fits. Once Dreamstation faild I paid for Vauto, all in all it set me back around 5000 Euros. I got the cash ready for AVS before I set up the Vauto, just in case Vauto fails as well. And this sleep last night was worth it... It worth worth of every cent I paid. I am crying literally... Thank you all...

I will still seek for a proper sleep study to finally see if it indeed was UARS or not.
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#8
RE: Dreamstation vs Vauto in a supposed UARS case
You added 100 mL to tidal volume and 1.0 L/min on minute vent and also evened out respiration. Without the flow limits, RERA are unlikely to occur. The elimination of flow limits (flattened inspiration) is going to reduce respiratory effort and make respiration much more even. These are actually pretty impressive results.

In time, you will adapt to the pressure support and the CA events should diminish. The CA events at this level are usually not disruptive to sleep, because they actually arise from over-ventilation, so you take a brief pause. As I said, they normally diminish as you become accustomed to improved ventilation support. You can cap max pressure at 14 if you want. The machine only goes as high as needed, and at this point you don't need a high IPAP range. Give these settings a couple days, and then try trigger sensitivity on very high. I want more than one night on trigger sensitivity high before making the change, so if we see an improvement it is more meaningful. You can then choose what is most comfortable.
Sleeprider
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#9
RE: Dreamstation vs Vauto in a supposed UARS case
(06-24-2020, 12:37 PM)Sleeprider Wrote: You added 100 mL to tidal volume and 1.0 L/min on minute vent and also evened out respiration. Without the flow limits, RERA are unlikely to occur. The elimination of flow limits (flattened inspiration) is going to reduce respiratory effort and make respiration much more even. These are actually pretty impressive results.

In time, you will adapt to the pressure support and the CA events should diminish.  The CA events at this level are usually not disruptive to sleep, because they actually arise from over-ventilation, so you take a brief pause.  As I said, they normally diminish as you become accustomed to improved ventilation support. You can cap max pressure at 14 if you want. The machine only goes as high as needed, and at this point you don't need a high IPAP range.  Give these settings a couple days, and then try trigger sensitivity on very high.  I want more than one night on trigger sensitivity high before making the change, so if we see an improvement it is more meaningful.  You can then choose what is most comfortable.

Thank you so much...

I did not know what I was looking at.

I noticed 100 mL for example but for me it was just a number, I did not know exactly what it meant. Big change or small change or idk...
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#10
RE: Dreamstation vs Vauto in a supposed UARS case
(06-24-2020, 12:25 PM)fejsbukpejdz Wrote: I will still seek for a proper sleep study to finally see if it indeed was UARS or not.

What you show in your data is the classic FL that leads to RERAs that you see in UARS.

If you can get a study in a lab that will look for RERAs, then that can confirm. 

But not all labs really do, I understand (though mine, by chance, did, before I even knew what a RERA or UARS were), and so I wouldn't waste the time and possible expense without first confirming that.
Caveats: I'm just a patient, with no medical training. And my first experience with xPAP was fairly recent. So I'm somewhere along the path of a steep learning curve.
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