Page 1 of 3

Worst night yet

Posted: Fri Nov 10, 2017 9:40 am
by MoodyMolly
Last night I tried a FFM for the first time, the Simplus, no major leaks, although it still looks high on sleepyhead. My AHI was the worst it's ever been at 16 (worse than my sleep study.) My pressure was at is max of 15cm for 95%, is that because you need more pressure with a FFM over a nasal pillow? I got a bad AHI score the first night of my nasal pillow too, so maybe it's just a first night learning curve? My AHI has only been ok one night out of the seven I've used it, it's mostly jumping from 7 to 10 every other night with the nasal pillow. Still waiting to hear back from my doctor about changing my minimum pressure... Should I switch back to nasal pillows or try again with the FFM tonight to see if it improves once I get more comfortable with it? Ugh, I want to make this work and get some much needed sleep, I just don't know how to troubleshoot my high AHI.

https://imgur.com/a/DTYCh

Re: Worst night yet

Posted: Fri Nov 10, 2017 10:14 am
by Julie
That score meant you were UP to or BELOW 95%, not that you were at 95% the whole time. But it's your min. pressure setting that matters and it's very low - try bumping it to 6 or 7 and see how thngs go. Only ever change one thing at a time so you know what variable/feature is doing (or not doing) the job.

Re: Worst night yet

Posted: Fri Nov 10, 2017 11:06 am
by MoodyMolly
Julie wrote:That score meant you were UP to or BELOW 95%, not that you were at 95% the whole time. But it's your min. pressure setting that matters and it's very low - try bumping it to 6 or 7 and see how thngs go. Only ever change one thing at a time so you know what variable/feature is doing (or not doing) the job.
Makes sense, thank you. It does seem to have been at 15cm longer than the previous nights with a nasal pillow anyway. How should I go about changing my minimum pressure? On a quick note, my machine seems to have adjusted itself to start my pressure at about 6.5 as soon as it turns on.

Re: Worst night yet

Posted: Fri Nov 10, 2017 12:04 pm
by Julie
Oh, well that's good (the machine's adjusting itself... what is your actual max setting? You can leave that at 20 to see how often it goes how high - you don't want to cap it at a low fig. - no reason to.

Re: Worst night yet

Posted: Fri Nov 10, 2017 12:13 pm
by MoodyMolly
Julie wrote:Oh, well that's good (the machine's adjusting itself... what is your actual max setting? You can leave that at 20 to see how often it goes how high - you don't want to cap it at a low fig. - no reason to.
My Max pressure is 15, min is 5. That's what my doctor prescribed and what the DME set it at, I don't know how to change it.

Re: Worst night yet

Posted: Fri Nov 10, 2017 12:18 pm
by MoodyMolly
xxyzx wrote:
MoodyMolly wrote:
Julie wrote:That score meant you were UP to or BELOW 95%, not that you were at 95% the whole time. But it's your min. pressure setting that matters and it's very low - try bumping it to 6 or 7 and see how thngs go. Only ever change one thing at a time so you know what variable/feature is doing (or not doing) the job.
Makes sense, thank you. It does seem to have been at 15cm longer than the previous nights with a nasal pillow anyway. How should I go about changing my minimum pressure? On a quick note, my machine seems to have adjusted itself to start my pressure at about 6.5 as soon as it turns on.
=======

the machine adjusts the pressure
to account for mask size and other leaks

dont change the pressure unless the data says treatment needs it to work better
Yeah, that's what I thought, the FFM felt like I wasnt getting much air pressure at all compared to the nasal pillow. I'm thinking with my AHI numbers being 10+ at least half the time, it feels like the pressure isn't good enough with the range of 5-15... Obviously I'm no expert or doctor, but it has to be something giving me these less than satisfactory AHI numbers. Sub optimal pressure seems most likely.

Re: Worst night yet

Posted: Fri Nov 10, 2017 12:23 pm
by Julie
Can you go to Apneaboard.com and on the left you'll see How to change your pressures... scroll down til you see your machine and follow the instructions to get the Provider mode.

Re: Worst night yet

Posted: Fri Nov 10, 2017 12:23 pm
by Hopeful50
I don't know about Dreamstation, but with the ResMed Airsense 10 Autoset that I use, you need to tell the machine which kind of mask you-re using - FFM, Nasal, or Nasal Pillows. I wonder if that would make a difference for you?

Re: Worst night yet

Posted: Fri Nov 10, 2017 12:52 pm
by Guest
Hopeful50 wrote:I don't know about Dreamstation, but with the ResMed Airsense 10 Autoset that I use, you need to tell the machine which kind of mask you-re using - FFM, Nasal, or Nasal Pillows. I wonder if that would make a difference for you?
Isn't that the resistance for philips?

BTW: the machine does no increase the pressure for FFMs - the pressure would be the same. However as FFMs have bigger intentional leak there is more airflow needed to keep the pressure steady (that is what you see in the leak chart).
To be able to measure exactly the machines need to guess a little bit about the used mask. Some devices you need to help with that (Philips, ResMed) others guess that by themself.

Re: Worst night yet

Posted: Fri Nov 10, 2017 12:54 pm
by MoodyMolly
Julie wrote:Can you go to Apneaboard.com and on the left you'll see How to change your pressures... scroll down til you see your machine and follow the instructions to get the Provider mode.
Thank you! I'll go check it out.

Re: Worst night yet

Posted: Fri Nov 10, 2017 1:00 pm
by MoodyMolly
Hopeful50 wrote:I don't know about Dreamstation, but with the ResMed Airsense 10 Autoset that I use, you need to tell the machine which kind of mask you-re using - FFM, Nasal, or Nasal Pillows. I wonder if that would make a difference for you?
It does have a setting for mask type, but I'm not sure what it means. It has a mask setting of 1-5, the manual says it adjusts the level of air pressure relief based on the specific Philips Respironics mask. The DME just skipped over the mask setting, leaving it turned off. She didn't say anything about it. Maybe it's because I'm not using a Philips mask, and the mask setting is brand specific?

Re: Worst night yet

Posted: Fri Nov 10, 2017 1:26 pm
by Bertha deBlues
MoodyMolly wrote:
Hopeful50 wrote:I don't know about Dreamstation, but with the ResMed Airsense 10 Autoset that I use, you need to tell the machine which kind of mask you-re using - FFM, Nasal, or Nasal Pillows. I wonder if that would make a difference for you?
It does have a setting for mask type, but I'm not sure what it means. It has a mask setting of 1-5, the manual says it adjusts the level of air pressure relief based on the specific Philips Respironics mask. The DME just skipped over the mask setting, leaving it turned off. She didn't say anything about it. Maybe it's because I'm not using a Philips mask, and the mask setting is brand specific?
I also use a P10 nasal pillow with a Dreamstation CPAP. Nasal pillows are X2 resistance (or you can turn it off), which you access from the My Setup menu.

As for changing the pressure: Press the round white button on the front to turn on the display, then press and hold the round white button and the ramp button at the same time until the display changes to the clinician's menu. From there, you can change things like pressure. Turn the round button to select what to change, then press the button, which allows you to make adjustments up or down. Turn the round button to the desired setting, then press the round button to set the change. I hope this helps.

Re: Worst night yet

Posted: Fri Nov 10, 2017 2:25 pm
by Bertha deBlues
xxyzx wrote:
MoodyMolly wrote:
Hopeful50 wrote:I don't know about Dreamstation, but with the ResMed Airsense 10 Autoset that I use, you need to tell the machine which kind of mask you-re using - FFM, Nasal, or Nasal Pillows. I wonder if that would make a difference for you?
It does have a setting for mask type, but I'm not sure what it means. It has a mask setting of 1-5, the manual says it adjusts the level of air pressure relief based on the specific Philips Respironics mask. The DME just skipped over the mask setting, leaving it turned off. She didn't say anything about it. Maybe it's because I'm not using a Philips mask, and the mask setting is brand specific?
=====

then the mask package should have said the number to use
or there should be a table in the user guide
else google for your mask and the setting nr.
P10 nasal pillows are made by Resmed. The Resmed packaging will not tell you which setting to use for a Dreamstation.

The Dreamstation, made by Philips Respironics, will not tell you which setting to use for a Resmed product.

I have used Nuance Pro nasal pillows, made by PR, and they are labeled X2 for use with a Dreamstation, so that's what I use for my Resmed P10 nasal pillows.

Re: Worst night yet

Posted: Fri Nov 10, 2017 4:13 pm
by Pugsy
Mask Resistance setting on a Respironics machine is not the same thing as the mask type selection on the ResMed machine.

For non Respironics masks you can set it to 0 which is off or try to find a Respironics mask with same resistance as the ResMed....and resistance is NOT the same thing as vent rate.

SleepyHead defaults to a ResMed leak threshold number and it doesn't work so great for a Respironics machine. Go to Preferences/CPAP tab and adjust the 24 L/min threshold to something more in line with a Respironics threshold. Maybe around 60 L/min. Respironics never gives us an exact threshold number because the threshold varies with the mask and the pressure but 60 L/min should get you close.
Making this change will correct the statistic likely telling you that you are having a lot of leaks but you really aren't.

And yes, some people who use a full face mask end up needing more pressure to get the job done than they might need with a nasal mask.
Not everyone of course but enough to know it happens fairly often.

Your minimum pressure isn't sufficient to get to where the machine needs to go in a timely manner to better hold the airway open.
Your AHI is likely going to remain high until your pressure settings are more optimally adjusted and it's the minimum pressure that is the most critical pressure setting.

Re: Worst night yet

Posted: Fri Nov 10, 2017 4:44 pm
by Bertha deBlues
xxyzx wrote:
Bertha deBlues wrote:
xxyzx wrote:
MoodyMolly wrote:
Hopeful50 wrote:I don't know about Dreamstation, but with the ResMed Airsense 10 Autoset that I use, you need to tell the machine which kind of mask you-re using - FFM, Nasal, or Nasal Pillows. I wonder if that would make a difference for you?
It does have a setting for mask type, but I'm not sure what it means. It has a mask setting of 1-5, the manual says it adjusts the level of air pressure relief based on the specific Philips Respironics mask. The DME just skipped over the mask setting, leaving it turned off. She didn't say anything about it. Maybe it's because I'm not using a Philips mask, and the mask setting is brand specific?
=====

then the mask package should have said the number to use
or there should be a table in the user guide
else google for your mask and the setting nr.
P10 nasal pillows are made by Resmed. The Resmed packaging will not tell you which setting to use for a Dreamstation.

The Dreamstation, made by Philips Respironics, will not tell you which setting to use for a Resmed product.

I have used Nuance Pro nasal pillows, made by PR, and they are labeled X2 for use with a Dreamstation, so that's what I use for my Resmed P10 nasal pillows.
=======

then pick the closest mask type and use that number
That is exactly what I said. The closest mask type is X2.