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Help Dialing In New CPAP Machine
#1
Help Dialing In New CPAP Machine
Hello - Got myself a Respironics DreamStation Auto to replace my trusty System One Series 60. The Board was very helpful in dialing in my System One and i'm hoping I can get some insight into setting up my DreamStation. 
With my old machine, I was getting an AHI of 1.0 or slightly above. Pressure range was set 8.0-13.0. 
My CPAP tech has suggested a pressure range of 9.0-16.0 for the new machine. I left it at that for the first week and have attached last night's Daily. 
My average AHI for the week was 0.66.
My average 90% pressure for the week was 9.7
My average pressure for the week was 9.1
I'm wondering if I should reduce the minimum pressure setting from 9.0 to 8.0 and reduce the maximum pressure setting from 16.0 to 12.0.
I'd appreciate thoughts from the Board.


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#2
RE: Help Dialing In New CPAP Machine
Welcome to the forum

Your numbers are excellent. The only thing I would change is the Ramp, I would turn it off. Most, not all, of the experienced users here do not use a ramp.
You Max pressure is of no concern at all, you could set it to 20 and not have an issue. You go up to 9 and have probing, exploratory pulses looking to see if your pressure needs to be adjusted, it doesn't.

How do you feel? with these numbers changing settings should be based on how you feel, you do NOT want to chase numbers.

That said I see no problems with trying a lower min pressure say 8, and maybe 7, with you carefully comparing which 'feels' better for you.
Gideon - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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#3
RE: Help Dialing In New CPAP Machine
Thanks. I understand what you're saying. I was considering lowering the max pressure to prevent run-a-way pressure spikes but I don't seem to have any of those anyway... So there doesn't seem to much point in it.
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#4
RE: Help Dialing In New CPAP Machine
The Philips Auto CPAP is very slow or reluctant to increase pressure, and in your case, it only does the occasional "test" increase to a higher pressure, otherwise it is at 9.0 all night. No need to worry about the max pressure. Those 1.5 cm pressure increases are built into the Philips algorithm and have nothing to do with your therapy needs. My own take is a minimum pressure of 9.5 might be better to knock out whatever VS2 might be. Your results are about as good as it gets, and not changing anything, as suggested by Gideon, may be the best approach.
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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#5
RE: Help Dialing In New CPAP Machine
Both replies to my question suggest that I leave the maximum pressure as it is and make subtle changes to the minimum pressure. What I'm going to do is raise the minimum from 9.0 to 9.5 for a couple of nights - maybe a week -  and see what it does to the numbers. Following that, I'll decrease the minimum to 8.5 for a while and see what that does.
Thanks for the encouragement. I thought i was doing well but nice to hear it from the Board.
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#6
RE: Help Dialing In New CPAP Machine
I've been using my new DreamStation for two weeks. After the first week, the forum suggested I play with the minimum pressure setting but leave the maximum pressure alone. I increased the minimum from 9.0 to 9.5. Right off the bat I noticed that average AHI was down but Snoring was up.
I'm wonder which direction I should go next. I've attached representative screenshots for both weeks and the Summary Data.
Thanks for your insights. You've been very helpful in the past.

          
        2/11/21                         2/13/21                       Stats


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#7
RE: Help Dialing In New CPAP Machine
Philips machines register snores as VS or VS2. Only VS is used by the auto algorithm to increase or change pressure. VS2 is not well understood, and we often recommend that users turn that flag off. It can be flagging noises like mask leaks, tube rubbing on a corner and other noises. The fact AHI is reduced is good news, and if your therapy is feeling better with this increase, you can disregard the VS2 events and continue.
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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#8
RE: Help Dialing In New CPAP Machine
Three weeks into my new DreamStation Auto and continuing to tweak my pressure settings. 
Week 1 pressure was as set by my provider: 9.0 - 16.0
Week 2 pressure set: 9.5 - 16.0
Week 3 pressure set: 8.5 - 16.0
Screenshot Daily from weeks 1 & 2 are attached to previous posts.
Week 3 Daily is attached to this post.
As you can see, I tried pressures slightly above and below my provider's setting - just to see how my data would change.
Wondering if any conclusions can be drawn from my "trials". And where, if anywhere, I should go next.
Once again - Thanks for your thoughts.

           2.25.21 Daily                  Stats


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#9
RE: Help Dialing In New CPAP Machine
The difference in results are less than 0.2 AHI, negligible. It's clear you stay near the bottom of your set range and events are very low. Feel free to just turn-off VS2. What feels best? That is what you should use.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
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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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#10
RE: Help Dialing In New CPAP Machine
The issue I have is that I always sleep well and wake up feeling good, no matter what my machine settings are. The only thing I have to go by is the data. 
Knowing that pressure settings are having no effect on my sleep or how I feel in the morning, should my goal be to find the lowest AHI I can? Or is there something else by which I should gauge my therapy?
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