Newbie issues w Dreamstation Autopap

[esel]

Palerider - those mask liners are definitely something I will check out, thanks.

they were a game changer for me when I was wearing a full face mask. the lady that runs padacheek.com is really nice and cares more about helping people than making a buck.

Here's my latest insight: one thing I couldn't understand is why I DID NOT have this problem with the PR System One. I mean, I didn't like the resistance against my exhale but I could live with it okay and go to sleep. Now I just discovered that tubing size affects the actual pressure coming out at the "patient end" of the tubing, and I am pretty sure that I had the larger size tubing, which according to the PR manual, brings down the actual pressure to 3.6 . So I used to have 3.6 actual pressure vs. 3. 8 for the smaller tubing that I now use with the Dreamstation.

there's a tubing setting. just make sure that it's appropriate for the tubing you're using. the machine adjusts pressure to compensate for the greater resistance in smaller tubing. if you use large tubing but have it set to slim, you'll end up with more pressure.

I bought a used machine, hooked up my hose, and thought it was defective, pressure seemed way too high, until I remembered I was using standard tubing but the default setting on the machine was for slim tubing... after changing that, it felt fine.

For me, as I feel the amount of air rushing out of the tube at 4 cm, I know it is more air than I would normally be inhaling as part of a resting breath....

this is a *common* mistake people make. they take the mask off, and there's all this huge amount of air blowing out of the mask, and they start freaking out. some engage in hyperbole about "gale force winds" "leaf blower" "blow the mask across the room" crap.

the *fact* is, the machine has a pressure sensor right at the outlet, it measures pressure typically in centimeters of water. ie, how much pressure it takes to push down that many centimeters of water. you can feel *exactly* how much pressure that is by sticking a straw in a glass of water, and blowing. four centimeters is slightly over 1/2 inch. so, stick a straw 1.5 inches in a glass of water, and blow.. if you got bubbles to come out, you've just blown harder than 4cm/h2o pressure.

now, as to that rush of air, like I said, the machine is set to create a specific pressure. pressure is the result of resistance to flow. when there's no resistance (or very little) like when your mask is off... the machine creates MORE flow, to try and get pressure. but there's no resistance, so the air just blows out, so the machine tries harder, spinning the fan faster, and faster, till it's at full speed, trying to make some pressure, pushing against nothing.... so you get a huge amount of flow with no pressure. it's like turning on the garden hose and letting all the water run out, it doesn't go very far, big flow, low pressure, but if you put your thumb over the end, the flow goes way down but the pressure goes up, and the water shoots a much longer distance.

as soon as you put your mask on, the machine senses the the increasing pressure, and slows the fan down. (it checks maybe a hundred times a second, maybe more, depending on the model.) it slows the fan down till there's only that very gentle 4cm/h2o of pressure, that you blew bubbles with. and none of it is blowing up your nose... where would it go? if it was actually blowing up your nose, you'd eventually explode! no, the air, and that gentle pressure, is just sitting there, until you do what you normally do, until you inhale, THEN air goes up your nose, into your lungs, giving you the oxygen you need to live. then you exhale and the air comes back out your nose, against that tiny bit of pressure... and flows out the vent holes in the mask.

Wauuuu palerider ... are you OK ?
Never saw such a long reply nice, easy to understand, and no sarcasm

[emmagoldman44]

Just a follow up report, although very few people probably are in my situation of 4 cm being a little too much pressure to go to sleep with....

I did get the larger size, 22 mm, tubing and did notice a subtle difference in pressure. That minor drop in pressure was actually enough to make it into my comfort window and has solved the problem! Yay

I would prefer to have the option of a heated tube for when I am sick and then want maximum humidity in the tube but I guess I will try keeping the tube under the covers with me and a tube cover. I am thinking of repurposing those old socks with a big toe hole

So now, my main remaining issue is that weird burst of pressure that occasionally occurs at the end of inhalations. I am going to try to get my hands on a system one again to make sure that I remember correctly, that I didn't have this problem with that machine. And because that machine is now "obsolete" hopefully I can buy it for less.

[palerider]

So now, my main remaining issue is that weird burst of pressure that occasionally occurs at the end of inhalations. .

turn off flex.

[JimW159]

Hmm, using a larger tube setting is something I should definitely try. I appreciate your points about getting used to the pressure but, remember that I didn't have this problem at this same setting on my PR system one with the larger tube, and also, it has been 4 weeks now on my current machine and it hasn't gotten easier for me in the last few weeks. One factor in my low AHI success at a low pressure is probably that I additionally use a tongue retractor - I forget the brand name but it has the look of a pacifier and helps to keep my tongue out of the back of my throat. By itself however, it was inadequate.

The feeling that one is breathing AGAINST pressure is common at first. In reality, the pressure is increased in response to an increase in resistance in the airway; in short, the machine is breathing WITH you. The "pacifier" may well be an important contributing factor in your experience. The pressure of the xPAP is responsive and, if using auto, variable with need to keep the airway clear. Have you considered forgoing the "pacifier" for few nights to see what happens? I would also suggest installing SleepyHead so you can see what is really going on throughout the night. http://sourceforge.net/projects/SleepyHead Regarding leakage: it is probably the single most common problem alluded to in complaints related to the usefulness of xPAP as a therapy. It is, IMO, the largest single contributor to a user's failure to tolerate the therapy. It is also one of the hardest and most intrusive components of therapy to control. From chinstraps to tape to mouthpieces, virtually everyone here has fought against the bugaboo of excess leakage - there are no universal solutions, only personal ones. Regarding your machine choice: if one were to do a poll of the female users here, I would be surprised if the users of the ResMed AirSense 10 For Her Auto did not give high marks to the ease with which they adapted to it. I, though not female, found recently when I trialed a DreamStation Auto that its relief felt significantly different from the AirSense 10 Auto I currently use. Prior to getting the AirSense 10 Auto, I had been using a System One Auto and found it very different than the DreamStation. Although I can provide no specific numerical differences, others may be able to. The AirSense 10 For Her models were initially touted for having control algorithms that were specifically tailored for breathing patterns of women. Some discount that, but others do not; at the time ResMed published research data supporting the claims. I cannot speak to the validity of the research, only its existence. https://www.ncbi.nlm.nih.gov/pubmed?db= ... d=16173651
Good luck in your search for solutions - an inch gained is a valuable as a mile.

[m13l1n1]

Sometimes this might have something to do with the mask you are using that blocks moving air. See if you have air escaping from mask when exhale or try different size mask might help. There's a machine diagnostic option on DreamStatation that you can use to check if your machine is working properly. I have the machine with flex at 3 and never feel different but I don't use ramp function. Ramp function is only good if you can't go to sleep easily with high pressure. Usually for first time cpap users.

Sent from my SM-N910W8 using Tapatalk

[palerider]

Sometimes this might have something to do with the mask you are using that blocks moving air. See if you have air escaping from mask when exhale or try different size mask might help.

nonsense.

[JimW159]

See if you have air escaping from mask when exhale ...

I concur with palerider: nonsense
If you DON'T have air escaping there is something seriously wrong. Where do you think air exits when you exhale? Your ears, maybe - or is it the purpose of flatulence? Talk about bad breath!