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[split] Seek Help with Settings for PR Machine
#1
[split] Seek Help with Settings for PR Machine
I am a new user, 3 weeks into therapy. I had a ResMed Airsense 10 that I was using and my AHI was great, under 2. I watched a review of machines and was convinced that the DreamStation Auto was a better fit for me, so I returned my ResMed and ordered a DreamStation. I had ordered online and the ResMed actually had a 30 day trial and return policy, so no problem at all returning the device. My DreamStation arrived and I immediately set it to similar settings from the ResMed. Night one my AHI pretty much doubled, with my Hypopnea more than doubling, night two everything has tripled. I turned off the Flex function for night 2, now going into night 3 my plan is to crank up my minimum pressure from 6 to 8. I'm stuck with the DS so I need to figure out the proper settings. The ResMed I ran at 6 and never exceeded 10 during an event. With the DS I have not exceeded 10 during an incident, yet I have so many more incidents. I am hopeful that the bump from minimum 6 to 8 will solve the problem, but would appreciate some guidance. I question whether the ResMed algorithm was maybe a better fit for me, or is it that the DreamStation just records differently?  

On a side note, I have tolerated therapy quite well, average 6.5 hours per night, and give all the credit to the DreamWear Nasal cushion mask.  
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#2
RE: airsense10 autoset -dreamstation autocpap
Hello, bigfoot, and welcome!  Could I ask you to start a new thread, with a subject line something like: seek help with settings for PR machine?  Just paste your message here into the new thread.  Otherwise this thread could easily get confusing, with people responding both to you and to the originator of the thread.



Moderator's Note: Based on Dormeo's recommendation above, these posts have been split off into their own thread.
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#3
RE: [split] Seek Help with Settings for PR Machine
Thanks to Crimson Nape for starting this new thread on behalf of bigfoot.

Bigfoot, congrats on starting treatment for your apnea! And it's good to hear you're tolerating the experience pretty well.

I see you're using Oscar -- excellent! -- and I'd appreciate your posting a recent screenshot of your daily page, following the formatting instructions here:

http://www.apneaboard.com/wiki/index.php...ganization
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#4
RE: [split] Seek Help with Settings for PR Machine
bigfoot756,
Welcome to Apnea Board!
If you used a minimum pressure of 6 while on the ResMed, then most definitely would have to use a higher pressure on a DreamStation.  The algorithms are quite different.  I'm not saying the DreamStation isn't a good machine, but it is slow to react to apneas.  

Also, AFlex (Respironics) and EPR (ResMed) don't give the same comfort level either.  

Until you can download a copy of the Daily Page from OSCAR, where we could give more accurate advice, try a minimum setting of 8, max at 12 and as long as you weren't experiencing many clear airway events, set the EPR to 2.
OpalRose
Apnea Board Administrator
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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: [split] Seek Help with Settings for PR Machine
Oh my! You returned the wrong machine. The Resmed is far more responsive and comfortable with its EPR feature which actively treats hypopnea and flow limitation. Your experience having more events and less comfort on the Dreamstation was predictable, and Flex is strictly a comfort feature. You will need to increase the minimum pressure to about your 90% pressure of the Resmed. Had you asked here first, I doubt you would have been mislead by slick advertising or whatever persuaded you the Dreamstation was a better choice.
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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#6
RE: [split] Seek Help with Settings for PR Machine
As per sleeprider, the Dreamstation is not the right choice for someone with mostly hypopneas and flow limits.
Resmed and Dreamstation are as different as a claw hammer and a lump hammer - both hammers but suited to different jobs.
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#7
RE: [split] Seek Help with Settings for PR Machine
(05-20-2020, 12:29 PM)bigfoot756 Wrote:
 I question whether the ResMed algorithm was maybe a better fit for me, or is it that the DreamStation just records differently?  

Everyone here will tell you the ResMed algorithm is better.  I don't know that I agree, as I think it really depends on the person.  I get better & more restorative sleep on my DreamStation than I do on my ResMed.  But when I switched my ResMed to "soft" mode, I finally get restorative sleep.  I do prefer my DS, though.

I very strongly believe the ResMed and DreamStation must record things differently. ResMed gives me a significantly lower AHI (even if it disturbs my sleep a ton and I wake up with all my usual apnea symptoms).  I've learned not to care much about the AHI, once you're fine tuning it, especially when comparing across the 2 brands.
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#8
RE: [split] Seek Help with Settings for PR Machine
(05-21-2020, 08:33 PM)Hydrangea Wrote:
(05-20-2020, 12:29 PM)bigfoot756 Wrote:
 I question whether the ResMed algorithm was maybe a better fit for me, or is it that the DreamStation just records differently?  

Everyone here will tell you the ResMed algorithm is better.  I don't know that I agree, as I think it really depends on the person.  I get better & more restorative sleep on my DreamStation than I do on my ResMed.  But when I switched my ResMed to "soft" mode, I finally get restorative sleep.  I do prefer my DS, though.

I very strongly believe the ResMed and DreamStation must record things differently. ResMed gives me a significantly lower AHI (even if it disturbs my sleep a ton and I wake up with all my usual apnea symptoms).  I've learned not to care much about the AHI, once you're fine tuning it, especially when comparing across the 2 brands.

The Resmed algorhythm responds to flow limits, the Dreamstation doesn't seem to, or at least not as immediately as the Resmed.
It's thought that flow limits are a precursor to apneas, so raising pressure earlier might prevent the apnea.
I've got both machines too, and like you I've got my Resmed set to soft, I find that quick pressure changes help more with apnea scores, but disturbs my sleep.
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#9
RE: [split] Seek Help with Settings for PR Machine
(05-22-2020, 12:17 AM)sleepyp Wrote: I've got both machines too, and like you I've got my Resmed set to soft, I find that quick pressure changes help more with apnea scores, but disturbs my sleep.

That's my conclusion as well.

I suppose some people are less prone to being disturbed by more aggressive algorithms.
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#10
RE: [split] Seek Help with Settings for PR Machine
I'm sorry, new user, therefore not the best at posting.  I have had my DreamStation cranked up to 8 now for a week or so.  It did decrease my hypopneas and AHI a bit, but its still way higher than it was on the ResMed.  Today my new ResMed arrived and I'm looking forward to a better nights sleep tonight.  I'm either going to return the DreamStation or sell it. Is there any market for very gently used DreamStation out there or am I better off trying to return it?  I'm sure the DreamStation works great for some, just not me.  Too bad too, it checked off more boxes for me than the ResMed, yet it just plain didn't perform for me the way I need it to.  

I will try to post some comparison data here in a couple of days.  Previous ResMed compared to DreamStation, and then compared to the new ResMed.
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