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[Pressure] Should I adjust my DreamStation minimum pressure?
#1
Should I adjust my DreamStation minimum pressure?
I am brand new to this message board, so please bear with me. 

I spent several years with "insomnia", where I would fall asleep with no problem, but then wake up at about 3 am and struggle to get back to sleep. Doctors kept telling me it was anxiety. During this time I was also clenching my teeth while I slept, and broke two molars, which had to be replaced with very expensive implants. The oral surgeon suggested I might have sleep apnea, which nobody had ever mentioned to me since I didn't have any of the usual risk factors. I had a sleep study done and was diagnosed with mild apnea. 

I've been on CPAP for about seven years and it's been great for me. I have the DreamStation Auto CPAP with nasal pillows. I find the nasal pillows very comfortable. I recently got the new headgear "arms" and that seems like an upgrade because it keeps the headgear more stable. I have a heated hose and humidifier.

Recently I've been waking myself up with snoring, which is very unusual. My AHI is always low, but I do feel sleepy during the day lately and have been taking naps. I've tried the S, M, and the L nasal pillows, and keep going back to the L, because the smaller sizes seem to not give me quite enough air. But now I'm thinking that has nothing to do with the pillow size and more to do with the pressure setting. I'm curious to know if I should have a higher minimum pressure and, if so, how I reset that. I just downloaded OSCAR, and would love it if you guys could take a look at my info and translate it for me. I'm attaching a couple screenshots--let me know if I didn't post the right stuff. Thanks for any insight you can give me.


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#2
RE: Should I adjust my DreamStation minimum pressure?
With settings of 8.0 to 15.0 your are using the full range of pressure due to the presence of considerable snoring and flow limitation, which are related. In looking through your chart, we can see the frequency of snoring increases significantly when pressure is below 10 cm. I think that instantly tells you where your minimum pressure should be. If you were using a Resmed, we would have access to some limited bilevel pressure functions where we could more effectively attack the flow limitations, RERA and hypopnea, but for starters, I think your sense that minimum pressure needs increased is right on, and based on this chart, it should be at 10 cm.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#3
RE: Should I adjust my DreamStation minimum pressure?
Thank you so much for the info. Can I adjust the minimum pressure myself?
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#4
RE: Should I adjust my DreamStation minimum pressure?
Yes you can. You may want to get the clinical manual in the above CPAP Setup Manual link. Look for your exact model of Respironics. There is an ID sticker on the back. Look for DSX and a number code like DSX500 or similar.

To adjust: You will hold Ramp and the Dial in together for about 5 seconds and you're in the secret setup area. Use the dial to scroll over to the green therapy setting then to whichever setting you're editing, click to adjust via the dial, click to lock it in. After all adjustments there should be a blue patient area. Click and you're back out.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#5
RE: Should I adjust my DreamStation minimum pressure?
Thanks so much. I set the minimum to 9.5 for now. I'll see how it goes tonight and go down to 9 or up to 10, depending on how I feel. I guess I'll look at OSCAR tomorrow too and post results here.
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#6
RE: Should I adjust my DreamStation minimum pressure?
Welcome, it sounds like a good idea to track it via OSCAR. Certainly feel free to post tomorrow and we'll help decipher how it's doing. When you do post on this, add in a critical and reasonably detailed answer to how did you feel. It is the other half of tracking adjustments. Best to your success.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#7
RE: Should I adjust my DreamStation minimum pressure?
Good and bad with first night of higher minimum pressure, probably due to user error. AHI is down even lower, but I had other issues. I realized at some point/s during the night that I should have switched from the large nasal pillows back to the medium or even small (I had only been using the large to try to get more air). I ended up having leaks last night, because I guess the increased pressure was forcing the large pillow out of place occasionally? I don't know, but I woke up several times feeling the headgear slipping, and with a dry throat and headache. Tonight I'll use the medium nasal pillow and see how it goes.


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#8
RE: Should I adjust my DreamStation minimum pressure?
Well, those are outstanding results. You can disregard VS2, so I think you have hit on a setting that works for you.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#9
RE: Should I adjust my DreamStation minimum pressure?
Oh good! I'm going to adjust the mask tonight and switch out the pillow to see if I can be a little more comfortable. You guys have been so much help--thank you!
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#10
RE: Should I adjust my DreamStation minimum pressure?
Congrats on this great chart. Hope your PAP therapy continues to do well.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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