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New machine, better results?
#1
New machine, better results?
   

I am trialing a new machine, the Respironics DreamStation, switching from BiPAP to CPAP.

Early indications are pf better results, although not yet "cured". 

The leaks that I constantly battled at sky-high pressures with the System One BiPAP are certainly way better.

My sleep nurse is talking about raising pressure by 2cm once I have used it consistently for a bit longer.

Any thoughts as to the data?
Respironics Dreamstation Auto CPAP ay 8 cm. fixed pressure.

Resmed AirFit F230 mask. 
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#2
RE: New machine, better results?
Hi Chalkie,

Do you have your sleep study? Can you post it. Do you remember what your titration recommended.

Cannot see if results are better with only new results, it would be good to see the old bi-level data. Also make the new OSCAR data smaller so more info can be seen.

The second half of the graph can you expand the view to about 3 min total.

Yes I have a few questions.

If your previous bi-level were 12-18 why go to 8-20. If you had a flat pressure line I may understand 12 was to much pressure. If you had discomfort I would not understand the switch.
1. Why did you switch to a CPAP machine a Bilevel machine. may deal better with some issues.
2. Why did you have a bi-level the first place?

With pressures over 15 on CPAP, during titration, usually a patient is described a bi-level.

If your info on the side, which I copied below, is correct I would put the minimum back to 12. Which with xflex on is giving a minimum of 10 cm pressure. (usually pressure is increased 1cm at a time. Yours was decreased from 12 (old machine) to 8 (new machine).

------

Machine: Philips Respironics BiPAP ST C SeriINTL 30es
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage FX
Humidifier: Respironics System One
CPAP Pressure: 12-18
CPAP Software: OSCAR

Other
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#3
RE: New machine, better results?
It appears you've posted a chart from last April. It'd be helpful if you'd post a chart for a recent night with the new machine and settings you're trialing.
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#4
RE: New machine, better results?
(11-05-2022, 12:47 PM)Dormeo Wrote: It appears you've posted a chart from last April.  It'd be helpful if you'd post a chart for a recent night with the new machine and settings you're trialing.

It's definitely 4 Nov.

I suspect this is due to mid-Atlamtic mistranslation as 4/11 here means 4 November Smile
Respironics Dreamstation Auto CPAP ay 8 cm. fixed pressure.

Resmed AirFit F230 mask. 
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#5
RE: New machine, better results?
Chalkie, you're right! My mistake.

KeepSmiling has asked some good questions. And I agree with her that you'd benefit from a higher minimum, given the number of OAs and Hs you're having.

Just to underline one question: why move from a bilevel machine to one that lacks those capacities? You can simulate ordinary PAP treatment on the bilevel machine but still have a wider range of options available to you if you need them.

Some of your OAs seem to be a bit clustered, and you may be tucking your chin down to your chest for part of the night. Take a look here to get some ideas about using a cervical collar:

http://www.apneaboard.com/wiki/index.php...cal_Collar
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#6
RE: New machine, better results?
Hi Kerp Smiling

And thanks for your reply.

I don't have a copy of my sleep study, unfortunately.

I have another day's results and am posting it here:

   

Also a BiPAP chart for comparison

   

The reason for the switch is apparently an NHS blanket decision. Standard practice is to start people at 8 cm regardless of previous pressures. I know, seems strange but this was the clinician's decision. She wants to raise pressure but says she wants more data first.

I have never been titrated, to the best of my knowledge. 

I had a Bi-Level machine to treat complex apnea. On the limited evidence so far it appears this machine is doing a better job of controlling centrals.

My data on the side is actually out of date. My pressure was 12-22 on BiPAP and I now use a Resmed full face mask. Am updating sig.

Not sure how to expand the data to 3 min total...


Attached Files Thumbnail(s)
   
Respironics Dreamstation Auto CPAP ay 8 cm. fixed pressure.

Resmed AirFit F230 mask. 
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#7
RE: New machine, better results?
I doubt pressure goes down.

The Oct 23 looks a mess with no breathing detected breaking up the sections. My worry is that you may not have enough pressure in the auto to treat hypopneas.

Why do you say this machine is better.

Do you want to adjust the pressures?

With a full face mask I would not go lower then about 7 cm EPAP.
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#8
RE: New machine, better results?
Forgot to include, to get the 3 min data, put the curser over the flow rate or any other graph and right click.

For events, you can click on events, then on the arrow to open the events. If you click on the event that eill open it as well. Change view size to the minutes you want.
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#9
RE: New machine, better results?
(11-07-2022, 10:58 PM)KeepSmiling Wrote: Forgot to include, to get the 3 min data, put the curser over the flow rate or any other graph and right click.

For events, you can click on events, then on the arrow to open the events.  If you click on the event that eill open it as well.   Change view size to the minutes you want.

OK, thankyou. It is producing a lower AHI so far (last night 5.XX)  and with much lower leaks. 

The pressure is defo going to be raised soon.
Respironics Dreamstation Auto CPAP ay 8 cm. fixed pressure.

Resmed AirFit F230 mask. 
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#10
RE: New machine, better results?
Can you show us a chart for last night?  The last one you posted from 10/31 shows mostly positional apnea. Unless you can get that under control, there's not much good a pressure increase is going to do.
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com

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