[Pressure] Optimizing Dreamstation, Autoset for Her after Post 50

[JenniferJuniper]

Just checking in with an update. I've been a couple weeks at the new setting and things are going really well. AHI has been low and pretty consistent. Numbers are better when I use the Large nasal pillow as opposed to the Medium, so I'm sticking with Large. I've been feeling good and haven't needed a nap since I adjusted the minimum pressure! Here are last night's numbers. 

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[Sleeprider]

I do think you have dialed in a very effective and comfortable pressure range. Congratulations on the very good results and better sleep.

[JenniferJuniper]

Hi everybody. I thought I'd post an update to see if you have any comments. I still don't totally understand what I'm looking at on OSCAR. I know my AHI is looking good now, but I do wonder why it fluctuates (sometimes it's over one and sometimes under). 

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[Sleeprider]

At 9.5 to 15 and Flex at 3, your AHI is good, but you are left with a lot of flow limitation and snoring which shows continuing airway resistance or obstruction. I'd like to see you take pressure to 10.0 and reduce Flex to 2. You can turn off the VS2 events at the bottom of the charts, as we are only concerned with VS, which is what changes pressure for now. Your median pressure is 11.5 and 95% pressure is about 12.0, so I would not be surprised if we end up close to that as a minimum pressure.

With this much flow limitation, the Resmed exhale pressure relief which acts like bilevel pressure support would be more helpful, but since there is not much we can do about that, keep it in mind for the next machine. If you zoom in on the respiratory flow rate to where you see the individual waves, I suspect they will have a lot of flat or downward sloping peaks that reflect flow limitation from upper airway resistance. While pressure can help to open the airway, it is pressure support (the difference between inhale and exhale pressure) that actually relieves the airway resistance by assisting with some of the inspiratory effort.

[OpalRose]

The pressure fluctuations are being driven by Flow Limitations and snores, which can be cleared up by raising the minimum pressure slowly.

You can move your minimum pressure up by .5cm at a time, and see if that helps with the pressure swings. Otherwise, your numbers look good.

What Flex setting are you using? A Flex setting of 2 often works better than 3.

[JenniferJuniper]

Thanks, guys. I set minimum to 10 and Flex to 2. I'll keep you posted.

[JenniferJuniper]

Here is the data from last night with the new settings. 

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[JenniferJuniper]

Woo boy! OK, I had a REMstar Pro System One C-Flex Plus machine up until October of 2018. At that time I had moved to a new state and got a new doctor who did another sleep study. They ended up giving me the Dreamstation. I just pulled out the REMstar and thought, "Hmm, I'll put the card in OSCAR and see what my data looked like with the old fixed-pressure machine..." I'm pretty shocked. On many days like this back in 2018, my AHI is 0. I am usually over 1 now on the Dreamstation. What does it all mean? What does the data show?
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[Canuck 2]

Well you have it dialed in perfect today(Success) I would leave  your settings alone for a while. Anything below 1 on the AHI is excellent IMO.

[staceyburke]

I also had an older cpap that did better than my dreamstation Bipap.  It was not terrible but I never got it down to what I had on the cpap.  After 5 years on it (doing - worse each year) I came to this site and asked for help.  They did help me and the numbers went down but still not doing well.  I was in the mid 20s in total events each night.  Sleeprider and Fred both said I would do better on a ResMed, so I bought it my self without insurance.  and my numbers have been 3 events or less ever since.  There are a lot of people the dreamstation just does not work as well as the ResMed..