Dreamstation not getting to max pressure.

[VegasGMC62]

Thanks for the replies. How do I upload the info from Oscar?

[OpalRose]

Use the F12 to take a screenshot of the daily page.  Organize as per instructions in the links in my signature line.  Use the example graphs for guidance.  Then use the attachment feature to post here.

http://www.apneaboard.com/wiki/index.php...ganization

We need to see the entire left sidebar, minus the calendar and pie chart.  Also the following graphs: Event,
Flow Rate, Pressure, Leak rate and snore graph.

[VegasGMC62]

Ok. Here goes. I have info from 2 different machines and they are wildly different. When I called for supplies a few weeks ago they said I qualified for a new machine and gave me a Resmed I've had for a week. Its awful. I feel terrible on the days I use it and wake up every night with my mouth so dry I can't swallow and it has a humidifier. The Dreamstation info looks terrible to me but I actually feel better during the day.

[pineh]

First of all, as someone sleep doctor has been wildly unhelpful - you are not alone. I'm your opposite - I was sent home with a suffocating pressure range of 4-6 with no titration appointment. The pandemic hasn't helped that. I hope it brings some comfort that you are far from alone. 

The data from the dreamstation is unfamiliar and daunting to me, so I will let the experts handle that.
However, congrats on your machine upgrade! I am very happy for you. It's infuriating to let someone suffer when more appropriate equipment sits on a warehouse shelf, and worse yet knowledge remains unused by a doctor. 

I'm new to the forum, but I have been struggling myself for months with non-event related sleep issues. I can chime in a tiny bit about the AirSense 10 data. I hope to not spread misinformation so I'll keep it simple. 

-A pressure of 8 was certainly too low considering the flow limitations you continue to experience. A lack of events is indeed far from the be-all and end-all of good sleep, as others have mentioned in this thread. 
-A pressure of 10 is the lower limit of what the autoset algorithm thinks you should have. As others in this thread have suggested, you may want to increase minimum to at least 9, perhaps 10.
-Your leaks are out of control for significant portions of the night, though they don't seem to produce more events. Do you sleep on your back, stomach, side? I find that with stomach sleeping you need to really optimize your head pillows so that your nasal pillows seal! Most likely, however, is that the pressure fluctuations are causing you to experience mouth leaks which explain the 30L/min leak rates. You may want to try mouth-leak remedies like a cervical collar, mouth tape (with precautions), or a chin-strap. 
-You have considerable flow limitations, which are not, however, causing further pressure increases. The autoset algorithm is capping your pressures below 12 even though the max is at 16. It would be helpful to see a zoomed-in view of your flow rate graphs, I think. 

Though your overall stats seem in-line with a decent sleep, I can easily believe that you feel crappy. That's not a surprise, especially with a new machine and fluctuating pressures. 

As for the dry mouth - your humidity is fairly high at 5 - you may increase the humidity, and the temperature as well to prevent rainout (condensation in your mask) at the higher humidity levels. However, humidity at 5 is usually enough to keep a mouth nice and moist. Again, I suspect significant mouth leaks are causing your dry mouth and not lack of humidity. The remedy is again something akin to a chin strap or mouth tape.

Best of luck. Post up those zoomed-in graphs!

[Sleeprider]

Vegas, let's revise your Resmed Airsense 10 Autoset settings just a little. Minimum pressure 8.0 and turn EPR on full time at 2. This is going to make your therapy a lot more comfortable, reduce flow limitations, and may even reduce the hypopnea a bit.

[VegasGMC62]

Thanks for the reply. Those large leaks are usually me removing the mask to go to the bathroom or breaking the seal because every mask makes me itch around my nose. I watch myself while I sleep-night vision camera, and never see my mouth open.
I sleep on my back and side. The only mask that works good for me is a nasal pillow that comes loose if I sleep on my stomach. I might try the new one that tapes on.
I can't use a heated hose during the summer because it makes me feel like I'm suffocating so I have to keep humidity at 3-4 to mitigate condensation. In 3 years I have never had a dry mouth with the Philips but its bad with the Resmed. It also seems like the Resmed pressure is twice as strong at the same settings. There were times I could feel air blowing out past my lips and if I opened my mouth the air would blast out.  Nothing like the Philips.
Someone suggested I set the Philips to CPAP instead of auto and a constant pressure of 9-10. I'm going to try that tonight.
I have different insurance than when I started CPAP so I'm having my doctor refer me to someone else to start over. It will help now that I have a lot more knowledge.
Here are screen shots of flow chart zoomed in.

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[VegasGMC62]

Do you mean set it for a static pressure of 8? Use a max pressure? Thanks

[jaswilliams]

Sleeprider said set minimum pressure to 8 leave max pressure at 16 turn on EPR and a setting of 2

[Sleeprider]

I did not comment on maximum pressure because you never came anywhere close to 16.0. Since you don't need pressure higher than 11.0, use that as the max, use a minimum of 8.0 and turn on EPR full time at 2. My assertion is that using EPR is going to transform your therapy to a more comfortable mode. Give it a try. Your starting pressure will only be 8.0/6.0 and the maximum will be 11.0/9.0. Not so bad, but probably more effective.

Any sense of high pressure of flow you are perceiving is coming from leaks. For the most part, you do pretty good with controlling leaks, but they are disruptive when they occur.

[Dormeo]

Thanks for the reply. Those large leaks are usually me removing the mask to go to the bathroom or breaking the seal because every mask makes me itch around my nose. I watch myself while I sleep-night vision camera, and never see my mouth open.

Your itchy nose might calm down if you use Lansinoh a couple of times a day.  A little dab'll do ya.  It's made for nursing mothers, so you'll find it in that aisle at your drug store, or you can find it on line.  When you take the mask off, could you turn the machine off first, using the button on top, just to keep the graph clearer?


I sleep on my back and side. The only mask that works good for me is a nasal pillow that comes loose if I sleep on my stomach. I might try the new one that tapes on.

Yes, the Bleep Dreamport might be an option for you.  Some users felt the vent didn't have enough diffusion, but I *think* they've addressed that, though I don't see any information on their website.  You could phone them and ask.

I can't use a heated hose during the summer because it makes me feel like I'm suffocating so I have to keep humidity at 3-4 to mitigate condensation. In 3 years I have never had a dry mouth with the Philips but its bad with the Resmed. It also seems like the Resmed pressure is twice as strong at the same settings. There were times I could feel air blowing out past my lips and if I opened my mouth the air would blast out.  Nothing like the Philips.

As Pineh suggests, the dry mouth is probably from mouth leaks, and taping your lips closed would be one option.  I use Somnifix strips, which hold well but are very gentle on the skin.  You can also start training your tongue to stay in a position that will prevent leaks even if your lips part:

Try putting the tip of your tongue behind your upper front teeth. Then position the main part of your tongue up against your upper palate. Finally, give a little suck or swallow to create a bit of suction. You should now be able to open your mouth while breathing entirely through your nose. Practice this during the day, and see if you can get it grooved in deeply enough to help while you are asleep at night. For some people, this is really all it takes to avoid mouth leaks.


Someone suggested I set the Philips to CPAP instead of auto and a constant pressure of 9-10. I'm going to try that tonight.

Now that you have a new machine (congrats!), do revise your profile when you have a chance.

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