Pressure Increases w/o Events

[Steptoe]

I use a DreamStation 2 with APAP pressures at 9.5 min., 11.0 max., with A-Flex at 1.

I have recently noticed numerous pressure increases that do not appear to be in response to or have any relation to apnea, hypopnea, or other events. This often occurs at the beginning of the night before I fall asleep, but it also occurs while I am sleeping at various times throughout the night. I have attached OSCAR screenshots that illustrate this issue. It was my understanding that APAP pressure increases only happen in response to events and do not occur in advance to prevent events.

Any ideas as to why this is happening or if it is something I should be concerned about.

[Tec5]

Unfortunately your Oscar charts did not get attached. will you please try again.
I have no experience with Dreamstation 2; however Dreamstation 1 seems to increase the pressure in response to a flow limitation (in absence of any other "event").

See the attachment.

This may apply in your particular case.

Dreamstation 1 Response to FL.jpg (26.31 KiB) Viewed 765 times

[rick blaine]

Hi Steptoe,

I can't speak for the Dreamstation 2, but the algorithms of earlier PR machines – such as my 961 – are such that, even when 'nothing is going on', every so often the machine ups the pressure by 1.5 cm – just to see if that makes any difference. And if it doesn't, the algorithms bring the pressure down again, by 1.5 cm.

If it is that, then it's nothing to be concerned about.

[SJ-Paddler]

Up front I know nothing about PR machines.

That said the RedMed Airsense manual says it adjust pressure by looking at "Flow Limit, Snore, and Apena Events".

Did you see any Flow Limit increases or Snore increases when the pressure went up?

[Rubicon]

Page 19-20:

https://www.philips.com/c-dam/b2c/ko_KR ... -guide.pdf

[dataq1]

Saw your Oscar in the other forum - no need to attach here unless you want the narrative to be complete here.

The clinical manual for your machine does indicate that Respironics algorithm does indeed change pressure to "PROACTIVELY" challenge the airway,
From the photo below, it appears that these challenges are issued to see if the morphology (shape of the breathing curve) can be improved, or conversely a decrease in pressure is warranted.

Dreamstation 1 Proactive search for best flow morphology.jpg (59.37 KiB) Viewed 748 times

[Pugsy]

pressure probes.PNG (14.67 KiB) Viewed 746 times

Above taken from your posted images over on Jason's forum. If anyone wants to see what he posted..it's here.
http://freecpapadvice.com/forum/viewtop ... =10&t=6915

Are you talking about these little increases that appear in a saw tooth pattern on parts of the night??
If so, those are normal pressure probes that Respironics auto adjusting machines will do.

Nothing to worry about.
Something that Respironics has done for years and years. See below for a more info.
viewtopic/t80875/Respironics-APAP-press ... se-up.html

[palerider]

Saw your Oscar in the other forum - no need to attach here unless you want the narrative to be complete here.

The clinical manual for your machine does indicate that Respironics algorithm does indeed change pressure to "PROACTIVELY" challenge the airway,

Way to repost something that's already been posted.

also, you're in error, the clinical manual for the OPs machine *does not* have that in it.

[dataq1]

Way to repost something that's already been posted.

I just don't understand the animus <sigh>

The graphic that I posted at 11:08 am had NOT been posted in this thread as far as I am aware, so I don't understand what you are talking about regarding "reposting".

Frankly I thought that the graphic (from a Resmed clinicians book) was a rather complete and nicely illustrated explanation for the pressure
" blips" that the original poster was asking about, and that Pugsey referred to 3 minutes after my post as being a technique that Resmed has used for years.

Moreover, it seems to clearly illustrate that the Resmed algorithm does in fact increase pressure (albeit short ~ 2 minute "probes") in advance of an event.

[Steptoe]

dataq1

I certainly appreciate the responses I received from you and Pugsy regarding my question. Was confused by the blips on my DS2 OSCAR reports and you resolved my confusion with these detailed answers. I am sorry you had to endure unwarranted abuse from this palerider character. I found palerider’s post outrageous and obnoxious.

Steptoe

[Pugsy]

I do believe that the discussion here was about Respironics and not ResMed.
Did you have ResMed on your mind?
I wasn't talking about ResMed at all. Thought I was pretty clear about Respironics pressure probes.

BTW when I started composing my post above you hadn't posted yours yet but it took me a while to get it all done and by then you had posted. I never saw what you posted until way later because I didn't bother to look.

Way to repost something that's already been posted.

I just don't understand the animus <sigh>

The graphic that I posted at 11:08 am had NOT been posted in this thread as far as I am aware, so I don't understand what you are talking about regarding "reposting".

Frankly I thought that the graphic (from a Resmed clinicians book) was a rather complete and nicely illustrated explanation for the pressure
" blips" that the original poster was asking about, and that Pugsey referred to 3 minutes after my post as being a technique that Resmed has used for years.

Moreover, it seems to clearly illustrate that the Resmed algorithm does in fact increase pressure (albeit short ~ 2 minute "probes") in advance of an event.

[palerider]

Way to repost something that's already been posted.

I just don't understand the animus <sigh>

The graphic that I posted at 11:08 am had NOT been posted in this thread as far as I am aware, so I don't understand what you are talking about regarding "reposting".

Because you posted a graphic that you got from a post Rubicon had made in the same thread. ergo, a repost.

Frankly I thought that the graphic (from a Resmed clinicians book) was a rather complete and nicely illustrated explanation for the pressure
" blips" that the original poster was asking about, and that Pugsey referred to 3 minutes after my post as being a technique that Resmed has used for years.

Moreover, it seems to clearly illustrate that the Resmed algorithm does in fact increase pressure (albeit short ~ 2 minute "probes") in advance of an event.

Resmed does not do pressure probes.

Please just stop posting, it makes more work for people that have to correct your noise.

[dataq1]

Resmed does not do pressure probes.

Yes, of course, Respironics uses these P-optimal searches (aka probes) while Resmed does not. mea cupla

[dataq1]

I do believe that the discussion here was about Respironics and not ResMed.
Did you have ResMed on your mind?
I wasn't talking about ResMed at all. Thought I was pretty clear about Respironics pressure probes.

BTW when I started composing my post above you hadn't posted yours yet but it took me a while to get it all done and by then you had posted. I never saw what you posted until way later because I didn't bother to look.

Yeah, I had Resmed on my mind, so my mistake!

Regarding composing my reply with the graphic that apparently ____ is upset about, I also fell into the same time warp, in that I had not yet seen Rubicon's link.
Stuff happens.... (and will happen again - we are all just human)