First night...

[Pugsy]

Were you using the ramp last night?

1) I really thought the Dreamwear with med cushion would be pretty good for me... but the issues I had were:
a) It dug into my nose all night and was painful just above mustache. This woke me up a lot and my nose is sore this morning.

You had it too tight. You might need the large frame....or loosen that back strap a little.

2) The first 30 minutes before I fell asleep were concerning. I felt like I could not get enough air... wanted to breathe through my mouth to catch up... and I was breathing hard... a little light headed. Almost took it off, but decided to stick it out, and that all seemed to go away once I fell asleep.

Because of #2 I was questioning whether I really needed a full face mask.

I can have a better idea how to answer this once you tell me if you used the ramp last night.

My numbers were OK. AHI 5.1 Machine was set to 8-20. 90% pressure came back at 9.3. Should I bump up to 9 min tonight? I think 11 out of my total of 35 events were while I was still awake and struggling with positioning of the new mask... is it possible the Dreamstation false detected because of shifting and adjusting mask and my AHI is really a bit lower?

No, don't go changing things yet. The 90% pressure just means you were at OR BELOW that number for 90% of the night. It is NOT where you spent 90% of the night. The "or below" part of the definition is very important.

And yes, entirely possible that some false positive events got flagged. Our awake breathing is much more irregular than our asleep breathing and these machines don't know if you are asleep or not. They just measure air flow and irregular air flow can cause the machine to flag some events while awake. We call them SWJ or Sleep/Wake/Junk. They don't count since they are awake related flags.

Use the available software to see what that AHI is composed of ...3 event categories make up the AHI and you have to use the software to see the categories.
Did you know about the software? If not...
https://sleep.tnet.com/equipment

[jtech1]

I did not use the ramp. Tried it while awake and it seemed to make the feeling of not getting enough air worse... ramp was set to start at 4 and get to 8 over 30 minutes. So, when I went to bed I did not enable ramp.

I used Sleepyhead to see the details. Clear Airway 12 (most before I fell asleep), Hypopnea 12, Obstructive 12, RERA 1. Leak rate: 0.00, total leaks: 21.97. Pressure went to 10 for about 30 minutes, but spent most of of the night between 8 and 9.

[Pugsy]

Do you have A Flex exhale relief turned on?
If not, try setting it to 2 or 3 and see if that helps with the feeling you aren't getting enough air when you start the machine.
If it's on...try reducing it or turning it off.

When you have time please add your equipment to your profile like I have mine. Makes it easier for us to see at a glance what you are using.

If your nose is clear I doubt that going to a full face mask will help the issues you are experiencing at the beginning of the night.
Increasing the pressure to 9 might...but I would try AFlex changes first.
Since you didn't use the ramp we can't blame it on not enough air moving. .

You might also spend some time with mask and machine on and not be worried about falling asleep so that the brain gets used to the way the air moves.
Like use it while watching TV or reading a book...something that will take your mind off your breathing.

[jtech1]

A-Flex is enabled. I set it to 3 to start the night, but decided to change to 2 before falling asleep since it felt like it was taking too long after exhale to get back up to pressure... so I change to 2 as a first step... tonight was was thinking about changing the other setting I saw (I forget the name) that does the quick back to full or slow back to full after exhale... it is on slow now.

[Pugsy]

Just play with the various Flex options and see which one is the most comfortable for you.

Respironics Flex relief is flow based...meaning the response or reduction is based on how forcefully you breathe.
So just try all available options including off and see if one seems to fit your own breathing pattern the best and seems more natural.
Everybody is different in how they respond and what feels good to them.

[jtech1]

I tried the large cushion just now and it seems better... the mask test on the Dreamstation seems poor... with the large, it is green when inhaling and red when exhaling. Book said green is good red is bad. Makes no sense... how does it detect leaks? Any real way to check for leaks other than feel air (tough to do because of the vents) or run for a night and look at Sleepyhead?

Anyone know if the Dreamstation is supposed to come with the Wifi add on card? The vendor I bought from told me it did before I bought it... then when I called then to let them know it did not have the card, they said it was built in... which I know it is not... also, i bought the heated tube add on... but they left out the regular tube. That should come with the base unit, right?

[Doublev]

I would dial the min back a little. Maybe to 7. See if that helps.

[Soothest Sleep]

Anyone know if the Dreamstation is supposed to come with the Wifi add on card? The vendor I bought from told me it did before I bought it... then when I called then to let them know it did not have the card, they said it was built in... which I know it is not... also, i bought the heated tube add on... but they left out the regular tube. That should come with the base unit, right?

The Dreamstation has a cellular modem to communicate with your DME--look under the door on the left of the machine (when facing the lcd screen)--that's probably what the "built in" referred to. Under the door on the right side, where the filters are, there is also a slot for an SD card--my machine came equipped with the card, but you can use any readily available SD card. The card stores your data which you can then review with the Sleephyhead software, by taking the card from the xpap and inserting it into your computer's card slot; not by using wifi. Remember to put the card back into the Dreamstation before you go back to bed!

I also use the heated tubing, which was my preferred choice when I discussed my needs initially with the resp. tech. I was not given the standard tube in addition to the heated one.

Jean

[DreamStalker]

Good grief! I guess this is why I don’t post or comment much anymore. I said “seems to push a lot of air the first 20 seconds” I wasn’t stating a fact. So you are correcting what I feel?


Sent from my iPhone using Tapatalk

Don't let that old cranky Granny keep ya from posting on the forum .... she's got a lot to deal with living in that dreadful windy and murderous town.

[ChicagoGranny]

The card stores your data which you can then review with the Sleephyhead software, by taking the card from the xpap and inserting it into your computer's card slot; not by using wifi.

You can transfer the data by WiFi if you buy a WiFi card and use this software - viewtopic.php?f=1&t=114929

[jtech1]

No card in the side slot... cellular or wifi. My Dr wants to have the data sent in so they can see it, and the place I bought it told me it came with the card... then after I received the machine and questioned them on it they said it was built in... then they finally said, no it does not come with it, they don't sell it, and I have to get that from your Dr. I am quite sure my Dr will have NO idea what i am talking about. I am just pissed that they told me it came with it in the first place and it did not.

Last night I tried the large cushion and it seemed like I had to make the mask tighter to keep it from leaking... woke up with the same pain in the nose at the same place. I will try the med again tonight and loosen the mask a bit. Other than that it was pretty comfortable. I woke up once and thought the machine has shut off, but it was still working... seems like after I fall asleep and my breathing normalizes, the machine gets more comfortable also.

AHI went up to 7.97 last night. Still debating when I should try to bump to 9 min. I was really expecting to see AHI below 5 pretty quickly.

Can someone tell me what the EPAP line in Sleepyhead indicates? I thought it was exhale pressure, but I have the flex set to 1, and the EPAP line looks to always be closer 2 lower than Pressure line.

Is there any info on here about best sleeping positions, head/neck/chin positions, pillow type, etc. to help minimize AHI events?

[Pugsy]

Can someone tell me what the EPAP line in Sleepyhead indicates? I thought it was exhale pressure, but I have the flex set to 1, and the EPAP line looks to always be closer 2 lower than Pressure line.

It is exhale pressure.
Flex exhale relief isn't a direct cm reduction per setting number like the ResMed exhale relief is.
Instead the amount of reduction is based on flow rate or how forcefully you breathe.

Example....A setting of 8 with Flex of 1....doesn't necessarily mean that upon exhale the pressure will drop to 7.
It might be more than 1 cm or less depending on how forcefully someone breathes.

End result...nothing to worry about.

[ChicagoGranny]

I have to get that from your Dr. I am quite sure my Dr will have NO idea what i am talking about.

He probably won't! Or if he does, he will deny knowing what your are talking about. I'm laughing because the DME told you to get the card from the doc. I've seen many DME lies reported here, but that is a first for that one.

Just buy a basic SD card like this one - https://www.walmart.com/ip/SanDisk-16GB ... d/23350705

Your computer should have a card reader built in.

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Can someone tell me what the EPAP line in Sleepyhead indicates? I thought it was exhale pressure, but I have the flex set to 1, and the EPAP line looks to always be closer 2 lower than Pressure line.

Flex setting of 1 is just the lowest level of exhale relief. The flex settings are an index, not cm relief.

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Still debating when I should try to bump to 9 min.

Look at your pressure line for last night. Is it spending much time at 9? If it is not, and it is spending much of the night at pressures several cm higher, you might get better results with a higher minimum.

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Is there any info on here about best sleeping positions, head/neck/chin positions, pillow type, etc. to help minimize AHI events?

Backsleeping is usually the worse because gravity is directly pulling your tongue and soft palate into the airway. On the sides or stomach, the effect of gravity is less direct. (With the proper machine settings, one can usually achieve a very low AHI while backsleeping. I do.)

Head should be in a normal erect position like it is when you are standing with good posture. The neck should be straight. If the chin droops toward the chest, the airway is restricted. (Some of us wear firm, foam cervical collars to keep the neck in the best position for airway patency and help prevent the jaw from dropping.)

A pillow should be used that helps you conform with proper neck position. Generally, a thin pillow is better.

What is your preferred or habitual sleep position?

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AHI went up to 7.97 last night.

Click on the Events tab in the lower left corner of your SH daily report. Look at the type of events, the length and the time.

[Mark55]

Possibly you might want to try the nasal pillow setup I use below (Brevida). While I am still having many issues trying to adapt to this CPAP life, most have nothing to do with my mask.

It is unbelievably comfortable, and you barely realize you have two little straps around your noggin due to the fact you can leave them so loose. I sleep mostly on my back, and then change to my sides very early AM, but I am not the type of side sleeper that buries their face into the pillow, so ymmv according to the way you sleep. This mask has never made my face, or nose sore in the least.

For information's sake, I am using flat CPAP mode with a constant pressure of 8 cm, and epr on with a 3cm diff.

Good luck!

[jtech1]

I used the Dreamwear med pillow the last two night and it feels more comfortable than the cushion. I get no leaks except for occasionally when I roll over and the side piece pushes the pillow out of place... I guess I have to learn to not roll my head, but pick up and place it down.

I know I am impatient, and should give it time to adjust, but I have not been able to get below AHI of 5. Last night I tried to stay off my back, and I bumped min pressure to 9, and had the worst night of the four I have used it... AHI 9.47. I seem to get clusters of CA and other events around pressure ramp ups. So I am looking for input on two things:

1) Should I try a constant pressure one night for the hell of it?
2) Is it possible that some people just do not get enough pressure or flow via nose? I have always had sinus issues... and am wondering if I should try a full face mask for comparison purposes. If face mask may work at lower pressure for me and be more comfortable?