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[Equipment] Initial settings for new DreamStation, CPAP newbie
#1
Initial settings for new DreamStation, CPAP newbie
I've been reading so much on here, and grateful for the advice.  Mailman just delivered a (pre-loved) DreamStation Auto with humidifier and heated hose and hoping you friendly folks can help with my setup.

I was not just tired all the time but falling asleep on my feet frequently. Waking up with headaches and stiff neck, frequent headaches in the afternoon. Rarely sleeping more than 5 hours a night, usually with a break in the middle.  Going to bed at 9pm as I can't stay awake, waking up at 2am and staying awake until 7am when I have to get ready for work...then immediately wanting to go back to sleep again!

I had a home sleep study two weeks ago, with moderate OSA (AHI 21) and O2-sats of 82%.  Clinic put me on a ResMed AirMini with P10 and I got on OK with it while waiting for insurance to deny any help,  and while I purchased a machine from a reputable secondhand CPAP dealer online.  I initially wanted the ResMed A10 but tried it and the DreamStation in the clinic and preferred the DreamStation.  So yeah, now I am doing this on my own without the clinic.

With the AirMini, I managed over six hours of sleep the first few nights and while I didn't have any epiphany of joyous energy, I did find myself not falling asleep in meetings at work, and no headache in the mornings. Then I got Bronchitis Sad
I think the machine actually helped me breathe easier at night, but the last week or so I've been quite groggy from feeling ill, and the coughing has made for a lot of disturbed sleep.

I upped the pressure on the AirMini, settling on 6.45 cm/H2O starting pressure as anything less felt like air starvation. No ramp, EPR of 1.  The "therapy statistics" in the mobile app have my pressure hovering around 9.5-14 cm/H2O. Not sure if that is a Max or 90% figure.  
 I didn't use the HumidX discs (didn't want to pay) and I have a room humidifier.  It's crazy hot here in Hong Kong and I like to sleep in a cold room with A/C on full blast so I used the humidifier even before CPAP.

I've set my pressure at 6.5cm-20cm/H2O on the DreamStation.  Figured I would start with the heated tube and humidifier on the lowest setting, Flex of 2 (seems a little harder to breath out on this machine).  Any tips, hints or advice?  Should I up the starting pressure?

OK this turned in to an essay.  I'm actually quite excited to go to bed tonight!
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#2
RE: Initial settings for new DreamStation, CPAP newbie
It sounds like your minimum pressure should be 9.5cm. But can't be sure without seeing a chart. If you could post a sleepyhead chart here it would help everyone see what's going on. The links below will help you set up your chart and post it.
[url=https:// To download ----> CLICK HERE ./]Download SleepyHead[/url]
Organize your Sleepyhead Charts
Posting Charts
Beginner's Guide to SleepyHead
Mask Primer
5
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#3
RE: Initial settings for new DreamStation, CPAP newbie
Since you like a cold room, you may need a higher tube temperature to prevent condensation. It will not actually heat the air, but will maintain moisture provided in the humidifier section from condensing. As Walla Walla said, we can't tell much without a chart. Once we see the range of pressures and relationship of any AHI events then we should have some ideas for you. Best of luck with your new auto CPAP.
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#4
RE: Initial settings for new DreamStation, CPAP newbie
So I had my first night...the longest I have slept in living memory! I love this machine!  The mask is so comfortable and quiet.

I'm not sure why the report is divided in to two sessions at 1am...my readout on the actual machine says the session was only 5h17m.
Sleepyhead report attached, hoping for some help to get my AHI down.  I really appreciate your help guys, thanks Smile


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#5
RE: Initial settings for new DreamStation, CPAP newbie
Zoom on the first PB and a flatline in breathing at 23:46:28   Dont-know


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#6
RE: Initial settings for new DreamStation, CPAP newbie
Looks great. I think your minimum pressure of 6.5 is a bit low, especially considering the Flex is dropping exhale pressure to 4.5. I think a minimum pressure of 8.0 is going to be where you end up, but it can't hurt to gradually increase pressure by 0.5 or 1.0 cm increments. Your current AHI of nearly 5 will stabilize at higher minimum pressure and it's worth noting your respiratory statistics are excellent in terms of tidal volume, rate, insp time and exp time. Your closeup shows some flow limitation ahead of what is flagged as periodic breathing, but this is of no medical concern and will also go away as you get more comfortable with the therapy. I really don't see any problems here that a higher minimum pressure won't resolve.
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#7
RE: Initial settings for new DreamStation, CPAP newbie
Thanks for much for the advice.  I am truly grateful.

I managed another seven hours of sleep last night, that is amazing right there.  AHI down to 1.17.

However, last night my snoring seemed to increase, and the charts show that sometimes pressure is increased briefly when I snore, other times not so much.
The DreamWear Gel Pillows seem very comfy but much easier to dislodge when I sleep on my side than the P10, maybe I am sleeping on my back more. I dunno.  I'm also still congested and coughing a little from Bronchitis a couple of weeks ago.

Just so grateful to finally get some proper sleep.  like


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#8
RE: Initial settings for new DreamStation, CPAP newbie
This therapy is about not only your AHI, but your comfort and sleep integrity. If you are comfortable with current pressure, there is nothing wrong with trying a minimum pressure of 9.0. Ultimately you choose what works best and is most restful. You seem to be getting very close.
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#9
RE: Initial settings for new DreamStation, CPAP newbie
You could also try 9.5cm for the minimum pressure. By the way you can turn off VS2 if you want. It's not really trustworthy for recording snores. Also unlike VS, VS2 doesn't affect the pressure.
[url=https:// To download ----> CLICK HERE ./]Download SleepyHead[/url]
Organize your Sleepyhead Charts
Posting Charts
Beginner's Guide to SleepyHead
Mask Primer
5
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#10
RE: Initial settings for new DreamStation, CPAP newbie
What a difference!  I just managed my first night <1 AHI, with only 0.3 reported.  Amazing  Grin   Starting rate now at 9.5cm/H2O.

If I went to bed earlier I probably could have slept for something approaching 8 hours.  But here's the funning thing...I wasn't tired.  Huhsign 

Although I felt drowsy during a mid-morning presentation, after that my energy levels seemed to climb throughout the afternoon.  Whereas usually I am dying to go home for a nap around 3pm, yesterday I just powered on through without feeling like I needed to sleep.  That feeling lasted well in to the evening.  It was so weird because I felt too listless to sit and watch TV (i.e. fall asleep on the couch). 

 I even contemplated going out for dinner, which is something I haven't done on a school night in five years!  Hopefully soon I will be in a position to actually make plans after work.

There was one period in my data around 1.30am that is much less flow rate and seemingly more regular than the rest of the night.  Overview and close-up attached if anyone has comments on that.

Thanks again for all your valuable help.


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