Newbie - intro and question about Dreamstation C-Check Mode

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linuxman
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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by linuxman » Wed Jan 11, 2017 9:13 am

Ok, now we're getting some action.

Last night I set it up for Auto mode, 7-20. Much better AHI overall. If I remove the OA cluster there after midnight where the auto was ramping up the pressure, AHI would be in the 3.5 range. It looks like 14-16 is required to really keep me opened up consistently, although there were hour+ long periods where 8-9 was enough. I presume that's due to position or deepness of sleep. Outside of the one cluster near midnight OA's were pretty isolated. Interesting stuff. Leaks weren't too bad, although there were a few short lived blowouts that I quickly got under control. I'm getting some fairly constant little leaks into my eyes at high pressures that are mildly annoying. They come and go with movement. I move a lot. Just for grins I've got a Mirage Quatro coming today to see how I like that style of mask. I think I could certainly live with the View, though.

All in all, a significant improvement. I welcome any recommendations on where to go from here. I may try setting the base at around 8 or 9, since that was the minimum that really helped. I'll see how that does, then consider a higher constant pressure (or just base) if I still get any big OA clusters.

I did notice that it's showing EPAP a couple of cm lower than the pressure. That means I've got some exhalation relief turned on, right? If it is, it seems good where it is. I don't feel any exhalation distress at the higher pressures.

Oh, and one other thing - I ran out of humidifier water at some point, and mouth/throat was bone dry in the morning. So, I'm going to have to work a solution for that at these higher pressures. I'll try bumping down the humidity to see if I can get by at a lower setting and stretch it out through the whole night. Sans that, I guess I'll have to look at some sort of external humidifier with a larger tank (or maybe rig up something to augment the internal one - I'm pretty crafty).


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OkyDoky
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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by OkyDoky » Wed Jan 11, 2017 2:13 pm

linuxman wrote:Ok, now we're getting some action.

Last night I set it up for Auto mode, 7-20. Much better AHI overall. If I remove the OA cluster there after midnight where the auto was ramping up the pressure, AHI would be in the 3.5 range. It looks like 14-16 is required to really keep me opened up consistently, although there were hour+ long periods where 8-9 was enough. I presume that's due to position or deepness of sleep. Outside of the one cluster near midnight OA's were pretty isolated. Interesting stuff.
Yes it does look better. That first OA cluster is because the minimum pressure is to low and the machine doesn't have time to respond to prevent it. For tonight I would put the Mininum pressure at 9 cm. It is the minimum pressure that is most important in controlling the apnea. You are correct in why the pressure differences. It's usually due to back sleeping or REM. Did the changes in pressure wake you up? Some people like a straight pressure for that reason but others like the APAP mode because why have a high pressure all the time if you only need it part of the night.
linuxman wrote: Leaks weren't too bad, although there were a few short lived blowouts that I quickly got under control. I'm getting some fairly constant little leaks into my eyes at high pressures that are mildly annoying. They come and go with movement. I move a lot. Just for grins I've got a Mirage Quatro coming today to see how I like that style of mask. I think I could certainly live with the View, though.
Your leaks aren't bad at all. When you get settled on a mask, you might try out a PadaCheek liner. That might help the little eye leaks.
linuxman wrote:I did notice that it's showing EPAP a couple of cm lower than the pressure. That means I've got some exhalation relief turned on, right? If it is, it seems good where it is. I don't feel any exhalation distress at the higher pressures.
Yes. In your machine it is called FLEX and the setting ranges from 1 to 3.
linuxman wrote:Oh, and one other thing - I ran out of humidifier water at some point, and mouth/throat was bone dry in the morning. So, I'm going to have to work a solution for that at these higher pressures. I'll try bumping down the humidity to see if I can get by at a lower setting and stretch it out through the whole night. Sans that, I guess I'll have to look at some sort of external humidifier with a larger tank (or maybe rig up something to augment the internal one - I'm pretty crafty).
Try different settings first but with winter time heating sometimes getting enough water can be difficult. You could add a room humidifier or since you are crafty, forum member JDS74 has a thread where they added a second humidifier to their CPAP. viewtopic.php?f=1&t=106644&p=1014214&hi ... l#p1014023
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linuxman
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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by linuxman » Wed Jan 11, 2017 2:50 pm

OkyDoky wrote: Yes it does look better. That first OA cluster is because the minimum pressure is to low and the machine doesn't have time to respond to prevent it. For tonight I would put the Mininum pressure at 9 cm. It is the minimum pressure that is most important in controlling the apnea. You are correct in why the pressure differences. It's usually due to back sleeping or REM. Did the changes in pressure wake you up? Some people like a straight pressure for that reason but others like the APAP mode because why have a high pressure all the time if you only need it part of the night.
Good deal. I'll bump the minimum up and see if I can get the initial OA's under control faster. I don't remember any waking due to pressure. A few little wakeups here and there, but actually much less than normal. I got some really good sleep last night.
OkyDoky wrote: Your leaks aren't bad at all. When you get settled on a mask, you might try out a PadaCheek liner. That might help the little eye leaks.
Thanks for the tip..will do.
OkyDoky wrote: Yes. In your machine it is called FLEX and the setting ranges from 1 to 3.
Ah ok... I did see that, but didn't know what it was. I think it's good for now, but I might experiment.
OkyDoky wrote: Try different settings first but with winter time heating sometimes getting enough water can be difficult. You could add a room humidifier or since you are crafty, forum member JDS74 has a thread where they added a second humidifier to their CPAP. viewtopic.php?f=1&t=106644&p=1014214&hi ... l#p1014023
Thanks. I had just run across that thread, and I will look at either just using that external humidifier by itself or in conjunction with the internal one. I don't think I need a *lot* more water, but maybe 25% more or so would do me. It's really dry in the house now - RH is probably in the 20%-25% range. Just par for the course in the winter here.

Thanks again to everyone for all the tips. I'm well on my way.

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linuxman
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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by linuxman » Thu Jan 12, 2017 1:19 pm

Better still. I shouldn't be changing variables, but couldn't resist trying out the Mirage Quattro FFM I ordered. I really like the way it feels...quite a bit better than the Amara View. I did have a big 5 minute long leak around 12:30 that I don't remember, and some moderate leaking for a good while after that. It was the first time with this mask, so I just need to dial in the fit. BTW, I did adjust the leak rate calculation curve in preferences (linear, not really a curve) to match the Quattro. It seems to respond pretty well with the 9cm lower limit. I could probably do 10cm though and feel comfortable. I might experiment with that and well as just a constant pressure. All in all though, a good night's sleep. I am seeing some differences during the day. I was never really tired prior, but I now feel very energized and sort of hyper-awake. Of course this means that my perception of normal had been changed over time. I welcome this new normal .

On humidification I bumped it down to 3 last night and had a little tiny bit of water left. I was a little dry in the morning, but not bad. I could probably live it as is. I'll try 2 tonight just to see if I can stretch out the water a bit more.

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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by grayghost4 » Thu Jan 12, 2017 3:24 pm

I can't imagine that there is a FF mask better than the Amara View .
Looks like you are getting close with the tharapy ... Member one night is not a trend ... a week is better to see a trend . It is normal to have good and bad nights.
If you're not part of the solution you're just scumming up the bottom of the beaker!

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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by linuxman » Thu Jan 12, 2017 5:21 pm

grayghost4 wrote:I can't imagine that there is a FF mask better than the Amara View .
Looks like you are getting close with the tharapy ... Member one night is not a trend ... a week is better to see a trend . It is normal to have good and bad nights.
Roger that. Probably best to just leave things alone for now and get more days in. I'll do that.

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LSAT
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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by LSAT » Thu Jan 12, 2017 5:43 pm

OkyDoky wrote:If your DME and doctor are not involved, I would switch to Auto mode Minimum 8cm (since 6 is doing very little). The Minimum will probably need to be increased after monitoring data but this is a starting point. Put you Maximum at 20cm so we can see where and how much your machine increases pressure. Your CA's are insignificant but your OA's and H's need to be controlled and I think we can help you get your pressure dialed in.
I agree 100%

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linuxman
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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by linuxman » Fri Jan 13, 2017 8:28 am

LSAT wrote:
OkyDoky wrote:If your DME and doctor are not involved, I would switch to Auto mode Minimum 8cm (since 6 is doing very little). The Minimum will probably need to be increased after monitoring data but this is a starting point. Put you Maximum at 20cm so we can see where and how much your machine increases pressure. Your CA's are insignificant but your OA's and H's need to be controlled and I think we can help you get your pressure dialed in.
I agree 100%
Yep, actually the prior night was at 9cm min, and I did 10cm min last night.

Data for last night was a bit weird - spent a lot of time up at 20cm. AHI was up a bit at 6.04. I was a little flemy in my throat last night (fairly common for me), so it could have just been that or the fact that I appear to have spent a good chunk of the night on my back (based on the few times I woke up). It's funny..I really like sleeping on my back, but I've just really not been able to for a long time. It feels great to actually be able to sleep in a different position other than side. The prob is, I use a pretty stiff pillow as I mostly side sleep. If I'm going to spend much time on my back, I'm going to need to switch to something softer to keep my head from tilting forward. The forward head tilting really closes down my throat. I clearly got away with it without too much trouble, but I suspect I'll be at higher pressures doing so.

I noticed that for one period where I was at 20cm my flow rate (both inhale and exhale) was quite diminished from the average. This was between 1-2am. I'm usually at around 25L/min, but for that period I was at around 15L/min. Would depth of sleep do that?

Leaks got out of control at times at the higher pressures, but a bit better overall. I'm not really noticing much leaking when I wake, but maybe it's just small leaks all around the mask. I'll keep tweaking the mask fit to see what I can do about that, and maybe look into some of those mask liners. I still like the Mirage Quattro way better than the View in terms of comfort. On leaking in general..is it possible to get to zero leaks all night, or is that an unreasonable expectation when you're at pretty high pressures?

Anyway, as grayghost4 said, a day does not a trend make, so we'll see how things go from here. No changes for tonight.

Thanks again everyone for all the feedback.

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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by LSAT » Fri Jan 13, 2017 8:39 am

Based on this one nights data, you may have to consider switching to a bipap machine. Your pressures are pretty high and hitting the maximum for that machine.

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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by linuxman » Fri Jan 13, 2017 8:51 am

LSAT wrote:Based on this one nights data, you may have to consider switching to a bipap machine. Your pressures are pretty high and hitting the maximum for that machine.
Ah ok... so are the Bi-pap machines just capable of higher pressures? I'm actually renting this machine at the moment (it's the way my insurance works). Honestly it makes no difference to me to just buy one outright though, because the cost of the cpap and supplies will never be higher than my deductible, so I pay it all anyway.

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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by Guest » Fri Jan 13, 2017 9:14 am

linuxman wrote:so are the Bi-pap machines just capable of higher pressures?
NO, the big thing for me was being able to reduce the exhale pressure (EP) it made using the machine like it was no longer there. So there is a separate Inhale (IP) and Exhale pressure.

You can often pick up a good deal on Craigslist (Health & Beauty) but you have to know the different cpap makes and model and their features or you can get ripped off there too. You can learn the diff right here in this forum while you search. Also to learn the prices compare to cpap dot com.

mangos21
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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by mangos21 » Fri Jan 13, 2017 9:17 am

so DreamStation is compatible with sleepy head now? nice!

linuxman
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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by linuxman » Fri Jan 13, 2017 10:14 am

mangos21 wrote:so DreamStation is compatible with sleepy head now? nice!
Yep. Some of the docs haven't actually been updated to reflect this, but somehow I determined that it was working. Either someone just told me, or I looked at the source code and saw the support added.

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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by linuxman » Fri Jan 13, 2017 10:16 am

Guest wrote:
linuxman wrote:so are the Bi-pap machines just capable of higher pressures?
NO, the big thing for me was being able to reduce the exhale pressure (EP) it made using the machine like it was no longer there. So there is a separate Inhale (IP) and Exhale pressure.

You can often pick up a good deal on Craigslist (Health & Beauty) but you have to know the different cpap makes and model and their features or you can get ripped off there too. You can learn the diff right here in this forum while you search. Also to learn the prices compare to cpap dot com.
Cool, I'll look into those. For now I need some more run time to see the longer term trend, but I'll keep this in mind. It felt pretty good last night, but indeed exhalation was a bit more difficult.

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Re: Newbie - intro and question about Dreamstation C-Check Mode

Post by linuxman » Sun Jan 15, 2017 9:07 am

I've switched to a constant pressure. Last night, 16cm (which is what my longer term 90% point has been while on auto), with C-flex turned on (1). It felt great, but still struggling with some moderate to heavy leaking at times. The leaking is consistently starting a couple of hours after I lay down, so presumably is just position dependent. I generally flop all night long between left and right side sleeping. On the rare times I did wake up I usually had a little bit of leaking around the sides of my mask due to pillow pushing on the mask - nothing major then, but clearly some more significant leaking going on at times. i'm not sure that's really making any difference in the therapy, though. i've been settling into 5-6 AHI with or without leaks.

OA's are not too bad and pretty scattered, but wouldn't mind some improvement. I may bump up to 17 tonight to see if I get any downward response, or if leaks just get worse. I'm also going to experiment with some home made mask liners. Any reason to try with C-Flex turned off? I experimented with it off yesterday while playing with mask fit, and I'm not sure I really need C-flex. At least at 16cm I didn't feel undue exhalation restriction. Of course that might be different while I'm trying to sleep .

[url=ttp://i.imgur.com/U1JVhgz]Image[/url]

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