First Night with CPAP.. some questions

[OpalRose]

I'll give you the same advice that Stacy gave.  

What you are feeling is what we call "air starved" due to your pressure set too low.  
Set your minimum pressure at 8cm with EPR at 3.  Leave max at 20cm for now.

EDIT: Missed that you have a DreamStation. Set Flex to 2.

Know that this may still need adjustments.

[Gideon]

Your RDI = 5.55 because your RERA = 4.0
Your flow limits are also high. I know this because RERAs are a series of flow limits ending in arousal. Arousals are bad because they disturb sleep.

Your machine does not have the best tools to treat flow limits, RERAs, and snoring. Thus we need to increase (min) pressure. To try to resolve these issues and allow you to breathe better.
set Min Pressure = 7 ( and that may need to be increased.)

A better solution would be to trade in your machine for a ResMed AutoSet which will treat these much easier.

[Gideon]

Please note that the OP's machine is a DreamStation, it has no EPR

[biorn]

While the Philips offers Flex to ease pressure during exhale, it is a momentary reduction of pressure up to 2-cm and CPAP pressure returns before inhale begins.  The Resmed uses a true bilevel pressure with up to 3-cm difference between inhale and exhale. The increase of pressure for inhale begins when you start to inhale, so the increase of pressure is true "pressure support" just like a BiPAP.

On the dreamstation you have the A-flex with the pressure decrease of 2 and increase 1. (Like the Prisma 20a)

But the prisma have the same setting of the increase before the end of the exhale.

   

It's very very anoying over 6cmH2O.

Edit: yah the graph are inverted between the 2 screens. (sorry)

[biorn]

Please note that the OP's machine is a DreamStation,  it has no EPR

There is the cflex and aflex on it which is more efficiency as the EPR but less confortable.

[SarcasticDave94]

Yes, that would be the best edit, a swap from Respironics to ResMed AutoSet. Short of that, edit Flex and pressures as have been suggested.

[OpalRose]

Please note that the OP's machine is a DreamStation,  it has no EPR

Thanks, I edited my post above.

[tierdal]

How exactly would higher pressure make breathing OUT easier?? It's called air starved when you have trouble pushing your breath out your nose?

I'll try to adjust those settings and I'll definitely trade out for a resmed Monday.

I get the min pressure 4 to 8 but what's the other thing exactly?  Flex?

Why is dreammstation even on the market? You guys make it sound like it's a piece of garbage

---

Your RDI = 5.55 because your RERA = 4.0
Your flow limits are also high. I know this because RERAs are a series of flow limits ending in arousal.  Arousals are bad because they disturb sleep.

Your machine does not have the best tools to treat flow limits, RERAs, and snoring.  Thus we need to increase (min) pressure.  To try to resolve these issues and allow you to breathe better.  
set Min Pressure = 7 ( and that may need to be increased.)

A better solution would be to trade in your machine for a ResMed AutoSet which will treat these much easier.

What is rdi and rera exactly? And what should they be at? And why is this cpap machine not able to deal with them? Why would they sell this garbage? Jesus if I hadn't come here I wouldn't know how bad I had it. This industry is fucked.

[SarcasticDave94]

Not that we weren't honest before, but a few like Respironics better because of the slow response. However, there's a few examples on the wiki that shows what OSCAR would look like comparing Respironics DreamStation to ResMed. There can be quite a drastic night/day difference. And that most times means ResMed treats Apnea better and more comfortable than Respironics.

As for pressure, most adults will need at least a minimum of 6cmH2O to breathe well with mask on. Your Respironics has Flex that supposedly should help do a bit of pressure relief when exhaling. And yes there's going to be a little resistance when exhaling but if measured in PSI, it's very low. 6 cmH2O is 0.0853401 PSI for example.

There's a glass of water and straw exercise that proves how little pressure these PAPs are really giving. I forget exactly how it goes but other members can give you the rest on it.

[Gideon]

It's simple
Take a tall glass of water and a straw
Place the straw to near the bottom of the glass and let your youth loose and pretend you are a kid and blow bubbles.



How did it feel? Any issues? Didn't think so.




What just happened?
You exerted enough force to displace the water and blow bubbles.
This force, assuming 8 inches of water, is equal to the maximum pressure produced by a CPAP, 20 cm of water (cmw). A BiLevel, the next class of device up, it is 10 inches of water or 25 cmw. Most therapy is around 4 inches or 10 cmw.

Many xPAP user complain about the "high" pressures involved. This is just a practical demonstration of the pressures involved in xPAP therapy. It does not mean that you do not have issues related to pressure.

A 'common' complaint is that the 'pressure' is so high that it blows too hard. That is not pressure, that is flow. All xPAP devices attempt to maintain a constant pressure. When a 'leak' occurs, the pressure delivered by the blower in the device attempts to move more air to compensate and maintain pressure.

Try this.
Start your xPAP with your mask off.
Now hold your breath, and close your eyes so the air doesn't blow in them while you
Place your mask on (hand holding is OK). The 'blowing' stops immediately after you put the mask on as the blower speed returns to normal. You ca also do this by using your hand to seal the mask.