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Factor's Treatment Thread
#21
RE: DreamStation to Airsense 10 autoset
Increased EPR will improve hypopneas, Flow Limits, RERAs, UARS, and unfortunately in the susceptible individuals, increase CA events.
With your numbers, and I know it is hard to not chase numbers, the EPR setting becomes more of what it was intended to be, a comfort setting. for that we rely on the user's subjective opinion.
An eyeball on your flow limit chart tells me that increasing EPR will lower your flow limits. Do you need it? No. But that alone suggests that a trial of a higher EPR is worth it, subject to how the numbers respond and very importantly, which settings "feel" better to you.
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#22
RE: DreamStation to Airsense 10 autoset
Quote:GideonIncreased EPR will improve hypopneas, Flow Limits, RERAs, UARS, and unfortunately in the susceptible individuals, increase CA events.
With your numbers, and I know it is hard to not chase numbers, the EPR setting becomes more of what it was intended to be, a comfort setting.  for that we rely on the user's subjective opinion.
An eyeball on your flow limit chart tells me that increasing EPR will lower your flow limits.  Do you need it?  No.  But that alone suggests that a trial of a higher EPR  is worth it, subject to how the numbers respond and very importantly, which settings "feel" better to you.
When you say comfort you mean how I feel related to the air pressure and the feel of my breathing based on current settings, correct?
if yes it never bothers me.  I was on a static 11 cmh2o for 4 years no ramp no worries no problems.  I told myself to get over it, it must be done.  My mind is commited.

When you say "feel" better.  You mean how I feel all day after therapy? Also do I have any strange symptoms like headache and such? 

I just want to make sure I am following you all.  Its the RN in me..
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

Got OSCAR?
Organize Charts
Optimizing Therapy

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#23
RE: DreamStation to Airsense 10 autoset
To the RN from the EMT. Comfort as in enabling you to continue use with minimum symptoms. Symptoms may need to be chased to improve comfort.

EPR was intended to relieve pressure on exhale for the primary purpose of improving compliance. To the RN, ResMed with its implementation of EPR has effectively achieved, in its CPAP/APAP machines, a low-end BiLevel with the PS settings of 1, 2, or 3. We tend to view these machines more as BiLevels than CPAPs and utilize EPR therapeutically instead of as a comfort feature.
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#24
RE: DreamStation to Airsense 10 autoset
I bought a ResMed 10 AutoSet out of pocket the other day when my DME called and told me about the recall. I paid too much, but got it same day. Now I’m ticked!

I’m ticked they gave me a Dreamstation for my first machine 3 years ago =) I’ve only got 2 nights on the ResMed, but it’s so much quieter that I don’t know it’s running, my AHI is down under 1 where I was 1.5-3 on the DS. I haven’t been woken up at all with moisture in my mask, which was once to twice a night with DS.

At this point I don’t think I’ll buy a Philips machine ever again. I am a little frustrated that paying as much as I did out of pocket the DME didn’t tell me the AirSense 11 was out though. Not sure if they have any or not, but still. I also have a Dreamstation Go, so Im hoping that Philips decides to replace vs repair so I can sell them both and get a Air Mini for travel/backup, except I use a full face mask so would not get any humidification, right? However, the bean counters will probably trump doing what’s better for the patients to get this addressed quickly.

From what little I’ve seen about the DS 2, it looks like it obsoletes the Go, sure looks about the same size as the go in pics just a little taller.
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#25
RE: DreamStation to Airsense 10 autoset
Quote:GideonTo the RN from the EMT.  

Me to I was EMT first then RN.  In Tennessee its not National Registry.  I was an EMT IV = Intermediate in NR.  I was an Emergency Room RN.  So in ABC  A is the first priority..  Which was generally Open or Intubated..   Cool 

All of the Vents and "B" was handled by the RT's.  It been fun to whip out the Manual and start relearning this stuff.  I am an old RN..LOL

Again thanks so much. Coffee
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

Got OSCAR?
Organize Charts
Optimizing Therapy

My Story
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#26
RE: DreamStation to Airsense 10 autoset
(06-24-2021, 04:22 PM)Gideon Wrote: Per your charts, your DS pressure support from flex was .6. Which is a big difference from the pressure support of 3 from ResMed's EPR=3.  That difference can initiate the CO2 flush increase lowering your CO2 levels and causing treatment emergent central Apneas.  EPR=1 was a good move.  EPR is used to treat hypopnoea, flow Limits and such (not OA), something your DS can not do with flex.  If you see an increase in those events you may need to increase EPR.

I have a new S10 (for her) and I'm seeing more flow rate obstructions.  I set it up yesterday and have one night under my belt with the machine.  I was using a DS1 ABIPAP prior to the change, and when looking at the data I had more CAs than with the S10 on EPR3, no ramp min 6.7, max 14.6, and I felt like I needed to sleep for 14 hours when waking up this morning.  

Your suggestions ring true with me and I'll do the same and move down EPR to 1. 

Thank You
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#27
RE: DreamStation to Airsense 10 autoset
Note that not everyone should make the same edits to their settings. The above suggestions are only for the OP.

So we don't hijack this thread, Phaleronic create your own therapy thread and after seeing data members can address your specific Apnea therapy needs.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
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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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#28
RE: DreamStation to Airsense 10 autoset
(07-02-2021, 07:18 PM)SarcasticDave94 Wrote: Note that not everyone should make the same edits to their settings. The above suggestions are only for the OP.

So we don't hijack this thread, Phaleronic create your own therapy thread and after seeing data members can address your specific Apnea therapy needs.

Thank you, I will do that.

Regards

P
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#29
RE: DreamStation to Airsense 10 autoset
Phaleronic,
I would want to see the settings o. Your PR machine. Preferably with OSCAR graphics. On the surface fro that machine reducing EPR to 1 does not make sense. Show us the data in your new thread.
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#30
RE: DreamStation to Airsense 10 autoset
(06-23-2021, 12:27 PM)factor Wrote: I wondered what the Standard and Soft was for.  However It would seem Standard is better in the long run?  Seems like the better at attacking the obstruction is better for OSA in the bigger picture.  OR is the attacking the same but the force of the pressure just less. aka Standard =bam 10 Soft = 8,9,10.

For me personally, the Standard mode causes me micro sleep disturbances, resulting in stellar AHI but horrible EDS.  Soft mode works great for me - less EDS, and my AHI is still great.
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