Is my new machine damaged?

[PEF]

Thanks for the info, Julie - I just got the spelling wrong.

[PEF]

I wanted to pick up this thread because I have done about 3 weeks' worth of experimentation just to see if I was going to be able to use the PR Dreamstation and if I could succeed in lowering my AHI. I have kept notes each night and I have my Sleepyhead reports. There has been a change since my last post. My nasal congestion is gone. It disappeared suddenly within one or 2 days (around September 21st), when I STOPPED USING THE HUMIDIFER. There could have been other things helping to cause my nasal congestion, like some allergies, but my nose has been much clearer since I no longer use humidification. What is interesting is that, when I had the congestion, the Resmed reports never changed and when I got rid of the congestion, the reports still did not change. In other words, the congestion had no effect on my AHI when using the Resmed. On the other hand, when I no longer had congestion, my AHI did drop a little, about 1 to 2 points, on the Dreamstation consistently. My takeway (and correct me if I am wrong) is that, all else being equal, the Dreamstation had a lot more trouble doing it's job with the congestion that the Resmed did.

After writing the last post, I used the Resmed (my pressures on that machine are set to min. of 5 and max. of 7) up until 9/22 just to get well rested and feeling good. The last night I used the Resmed, my AHI was under 1 and I slept great. Ready to struggle with the Dreamstation.

When I first changed to the Dreamstation, on the 24th of September, my AHI was running in the 6 to 7 range pretty constantly, having improved a little because of having no nasal congestion and not using the humidifer. The breakdown of events is pretty much the same as always, about 50 to 65% hypoapneas, CA's very tiny, OA's very low and most of the rest being about even FL's and RERA's. My objective was to get it down by using more pressure. This really worked:

On Dreamstation:

9/24 to 9/25 - min 5 max 7 AHI in 6 to 7 range
9/26 to 9/27 - min 5.5 max 7 AHI in 6 range
9/28 to 9/29 - min 6 max 7 no improvement
9/30 to 10/5 - min 6.5 max 7.5 AHI in 4 to 5 range
10/6 to 10/8 - min 6.5 max 8 AHI in 3 to 4 range
last night 10/9 min 7.5 max 8.5 AHI 2.99 (lowest ever on Dreamstation)

So I think it is pretty obvious that on the Dreamstation, the more I raise the pressure, the lower my AHI goes.

I would really liked to have continued with this interesting experiment and make the Dreamstation a success with more (a lot more) pressure. However, I have felt like crap since I switched to using the Dreamstation on 9/24. I feel more and more like I did when I was not using CPAP at all. My morning headaches have come back, which the Resmed got rid of totally. I also feel tired all day. I have really had it with this machine. In addition to that, this machine makes a lot more noise than the Resmed and I have a lot more trouble falling asleep with it. With the higher pressure I have to use on the Dreamstation, I have more issues with leaks and air in my stomach. Also, the automatic on/off, a feature I depend on, does not work well. I really have come to hate this machine. Today, I gave up because I feel so awful and will be using my Resmed tonight.

I will not use the Dreamstation again. It will not do for either a backup or travel machine because I would rather sleep without a machine than use the it. I will probably sell it a some point, so I can buy another Resmed.

[JimW159]

your min and max pressures are both too low, see how the resmed is up close to the top fairly often and the respironics is just pegged out flat at the top a lot of the night?
raise pressure, lower events.

As palerider stated, just because the pressure is set to a specific limit, doesn't mean it WILL run at that pressure. It only means it CAN if needed. My impression of the 5-7 range was that it seemed very tight; much of the time your pressure trace was flat across the top, implying that it would have gone up if allowed. When your titration was done did they really narrow the range so tightly? Keep in mind, the whole purpose of having automatic pressure ranging is that it allows the machine to adjust itself according to your needs - if you need it, it's available.

[Uncle_Bob]

This is really strange. I have used my new Dreamstation now for 3 nights. (I guess I should point out that, for the last 6 weeks or so, I have had increasingly bad nasal congestion that does not respond to anything. Usually worse at night than during the day. I have not had this problem for about 2 years). I am also not using the humidifier on the Dreamstation because it is so humid here. My sinuses seem to better with less humidity. I am also using a nasal mask most of the time, so far all my efforts to fall asleep and stay asleep with my Amara View FFM have failed. I know I need to get more used to it.

Anyway, the Sleepyhead data is totally different on the 2 different machines. My Resmed almost always reported AHI less than 1. By contrast, the Dreamstation is reporting AHI between 5 and 8. One night, I saw some periodic breathing. I will wait a little while to post contrast data, just in case I had a few unusual nights.

Does anyone know why the data can vary so much from machine to machine?

I also have to say that although the Resmed reported good data, I never felt the reality of that. The Dreamstation seems to be reporting the way I actually feel - not all that good.

In my experience different algorithms (manufacturers) = different data.

[PEF]

Thanks for responding, Jim. It was on palerider's advice that I started raising pressure to try to lower my AHI on the Dreamstation.

Here is how I ended up with the range of 5 to 7 initially on the Resmed.

I did not have a sleep study or a titration done at all. Part of the reason for this was because none of my doctors (both here in Panama and the US) thought I had sleep apnea. I thought I probably had UARS and possibly mild OSA. I think I have it and they do too, now that I have been helped so much by CPAP therapy. My husband is amazed by it and he is a retired doctor. However I do still have serious insomnia issues which cause me problems. For example, I was constantly running to doctors for chronic morning headaches and LPR (similar to GERD). The cpap therapy cured both those problems (at least the Resmed machine did).

When I first got the Resmed machine, I just ran it with pressure 4 to 20 because I did not know any better. That just did not work because I kept waking up all night and would finally just take the mask off and go to sleep. Then I joined the forum because I did not want to give it up. After reading some things about pressures, I decided to just set the pressure really low to try to get used to sleeping with it. So I set it to 4 to 10. I had the same problem, so I lowered the max pressure to where I could actually get to sleep and stay asleep with it. That ended up being 6. So I ran 4 to 6 for a long time, My AHI was always very low. Since then, I have tried to raise the pressure a little at a time and I got up to 5 to 7, but any higher than that on the max and I began to have problems again.

I was successful getting up to max of 8 on the Dreamstation this time without a lot of problems, but did have serious issues when I went to 8.5. But I did tighten up the min pressure to 7.5. and maybe I should not have done that. Tonight I will lower the min to 5 and let the max run to 8. Pugsy suggested I use a little more max pressure and I did on the Dreamstation. I let it go to 8.5. It did lower my AHI a lot - to 2.99, BUT I actually felt much worse, woke up with a headache and really painful stomach.

Right now, I have to go back to the Resmed to feel better. I have had headaches almost every day since switching to the Dreamstation, as well as being very tired. I am getting very crabby.

I guess the reason I run it so tight is 1. I need min pressure set to at least 5 otherwise i feel starved for air. 2. I have not been able to run pressure higher than 8 on the max because I get too many wake-ups. I don't know if this is because the CHANGE bothers me or the higher pressure bothers me. All I know is that I wake up.

Uncle_Bob - you are right. I have found out the hard way.

[sgcpapuser]

There was an instance where I flung my cpap machine off the table onto the floor one night. It was a loud thud, but on visual inspection nothing seems broken. In fact there wun any signs of cosmetic damages.

[D.H.]

If it seems to work properly, it's probably not damaged. Since it's a Dream Station, you can check the stats.

[klv329]

When I damaged my respironics 550 auto the DME said it was showing a code that meant don't put pressure on the top or something like that. The knob was bent.

The ahi on it was always higher than on a good machine and I felt like crud cakes. I spent way to much time trying to make it work with different pressures, sleeping positions, etc...

It's good that you moved on to what works quickly and had a backup available. Those backup machines are so important for cpappers.

[PEF]

yes, I suppose it is possible that the machine was damaged in some subtle way. The AHI is higher than on my Resmed. I need to use much higher pressures to get the same results as I do on my Resmed. I just would never know without having another machine to try. However, it seems to work fine.

Well, I will be looking for a good price on a Airsense 10 Auto or even perhaps try a Resmed Adapt.

[JD007]

Hi PEF
I am a newbie here and read with interest your posts. I can't comment if your machine is damaged. However, I did find a setting on my trial DreamStation Auto where you can do a 'self-test' of the machine.

I have been trialing the DreamStation Auto and now the AirSense 10 Auto
My Sleep Study recorded an AHI of 40

On the DS:
Weeks 1 and 2 AHI: 5 to 13 (bad fitting mask, I think)
Weeks 3 to 5: AHI: 2.5 to 4 (Nuance Pro mask)
On the AirSense 10
Week 1: AHI 0.00 to 0.99 (Nuance Pro mask)

Both machines the pressure was set 4 to 15 The Humidifier is turned on and down low. Using between 6 and 8 hours a night.
Using the DreamStation I seemed to be always waking up during the night.
Todate, I have found the AirSense 10 more comfortable to use with less wake-ups. It seems to have a gentler pumping of air sensation.
It also does not have a 'spotlight' for a screen!

However, I am confused at the difference in the AHI readings between the two brands.
As I do not fully understand all the other machine readings, I am not able to comment.

Over the coming weeks, I am wanting to purchase a sleep machine and want to make the correct decision. In Australia the price of the machines and masks are 'outrageous'.
A person at the Sleep Clinic, did comment that these two machines are exactly the same and they will do exactly the same thing. So far, for me, the 'evidence' suggests not.

I would be interested to know how you are going, and also if other persons have received different AHI readings when using different brand machines on same/similar settings.

Cheers JD

[palerider]

However, I am confused at the difference in the AHI readings between the two brands.
As I do not fully understand all the other machine readings, I am not able to comment.

for many people, the differences in how the machines behave doesn't make much difference, and they can be well served by either brand.

some people do much better with one brand or the other, you and PEF seem to be two of those people.

[D.H.]

Thanks "palerider," for suggesting that the two halves be separated during transport. I am planning a trip overseas and now know to do that.

[JD007]

Hi palerider
Thanks for that.

The AirSense 10, is more comfortable for me. Once I have my mask set up, I barely know the AirSense is on.

So in achieving better results with the AirSense 10, it looks like it will be the machine to purchase.

Cheers
JD