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Quick question from newbie
#1
Hello all! I just started using CPAP with the Phillips Dreamstation and using the new dream pillow nasal mask. Im doing well and tolerating the machine at first but around 3-4 AM (probably well into REM) I start to feel airway closure during the beginning of expiration. Normal? I'm trying to decide if I need to bump up CPAP pressure (started at 6cm/H2O) or use one of the ABC flexes this thing comes with. Still trying to educate myself with those! Anyone ever have same issue and sorry...I guess this isn't a quick question after all! Thanks folks
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#2
Welcome

Which version of the Dreamstation do you have?
DreamStation Auto BiPAP
DreamStation BiPAP Pro
DreamStation Auto CPAP
DreamStation CPAP Pro
DreamStation CPAP

There are two versions that are auto. And, both an auto and fixed BiPAP.

With BiPAP (generically called bilevel) the pressure drops during expiration.
It's not normal for the airway to collapse during expiration.

You might need a little tweak on the machine. But, I am not familiar with the Dreamstation to suggest a tweak.
It's a new machine from Phillips. Although it works very much like the previous generation machines.

Best way to see what's going on is to look at the flow waveform as it switches from IPAP to EPAP during the hours you feel the issue.
Compare the waveform with times when the issue is not present.

There is a rather long thread about the Dreamstation at:
http://www.apneaboard.com/forums/Thread-...on-the-way




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
Get the Clinicians manual for your machine, see link at top of this page....CPAP setup manual.
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#4
I have the Dreamstation Auto CPAP. It says I have an AHI of 7.7 to 8.5 with a 0 amt of "periodic breathing". 0 leaks as well with this dreamwear nasal pillow. Im 3 days in with starting CPAP and not quite sure if AHI of 7.7 is normal or indicative of pressure increase. Regarding my airway on expiration...it just feels like theres resistance and when it happens...Im up and ripping it off. Funny because im sure there was resistance before CPAP, but I just slept through it. I just snored like banshee.
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#5
cardiac thug ~ I like your last sentence......"I just snored like a banshee". That is almost the same description my husband said about me before I started cpap therapy long ago. In fact every now and then he will comment ...."I heard you snoring a few times last night - did you take off your cpap mask?"
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#6
My wife said the same thing last night, but its better than one of us taking a turn on the sofa downstairs due to my snoring. At least shes sleeping now. I just wish I could get a hold of this anatomical obstruction that pops up now and then on expiration. Its probably tongue or uvula.
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#7
cardiacthug,
Update your profile so that folk know that you are using an Auto CPAP.

From your profile, it looks like you are using the machine as a straight CPAP with a pressure of 6.

You should aim for an AHI of <5. You have only been on CPAP for a few days, so you need to give it some time. If your AHI doesn't start to come down, then you may want to change your setting to Auto CPAP with a pressure range.

There should be a Flex setting on your DreamStation. This is a comfort feature that gives you pressure relief when you exhale.

In my post above, I recommended you order the clinicians manual for this machine and it will show you how to make those changes.
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#8
AHI target should be less than 5. Since we now know you have the Auto CPAP, there should be two pressures: Min Pressure which may be you 6; and a max pressure which you'll need to check in the menu. Also, check the mode the machine is in: Auto or CPAP. (Probably Auto.)

When running auto, these machines raise pressure when snore, flow limitation, hypoapnea and obstructive apnea are detected. Then they retreat back to min pressure.

Get the manual and check what mode and pressures are set in the machine. They should match your prescription.
You may need a tweak in either min pressure or max pressure.

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
It sounds to me like your Auto CPAP is set to fixed pressure of 6.0. If it was me, I'd set it to auto CPAP and use a minimum pressure of 6.0 and maximum pressure of 10.0, the see where the average and 90% pressures go. Your AHI is too high for treated apnea, and excessive OA is treated with more pressure. I think your original hunch was correct. Using the auto mode will allow the machine to self-titrate to your needs.

Or, you can go back to the doctor and let them do it.
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#10
Hi cardiacthug,
WELCOME! to the forum.!
Much success to you with your CPAP therapy and getting it fine tuned to your needs.
trish6hundred
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