Dreamstation AHI # and General Help

First - thanks so much to this forum. I was recently diagnosed with sleep apnea and this forum has answered so many questions and really helped me be at ease with some of the issues I was having.

That being said - its been quite a struggle getting adjusted to CPAP therapy and I am particularly curious about the accuracy of the AHI numbers. I can't say that I have necessarily felt any better and the numbers seem to reflect that (from the original study). I have had and continue to have a myriad of "issues" adjusting to the machine (noise, nose irritation, waking due to pressure release from mouth, grogginess when waking), though, my numbers have improved over time according to the machine. It has only been two weeks and I am trying to brush it off as just adjusting, but it is getting frustrating.

Now to the numbers. With my original sleep study my AHI was documented at 2.5 with an RDI of 9.6 (I had 27.7 events during REM which was the biggest reason for therapy). On the follow up titration study they came to the conclusion that a pressure of 4 cm H2O was best which brought AHI to 0 and RDI to 3.7. The Dreamstation recorded my first 2 nights at an AHI of 10 and 11 which is WAAAY more than what the study documented even without the therapy. Over the past few weeks these numbers have come down, but the lowest recorded was 4.8 which is still almost double the AHI of my original test. I have tried to make any adjustments I can (flex adjustment) but the pressure ramp is locked.

So my questions really are - any advice on some of the issues I am having and does anyone have any thoughts on the very large differences in AHI numbers?

Thanks,

Jon

I registered but as this is my first post, I am not sure the info will come up
Machine: Dreamstation CPAP Machine
Mask: Swift FX Nasal Pillow

griz31 wrote:waking due to pressure release from mouth

Are you doing anything about this? When you lose pressure, you can still have the breathing events that CPAP is trying to prevent. I recommend a DMI Firm Foam Cervical Collar as the first try. It's cheap and easy to wear and aids in prevent jaw drop. http://www.walmart.com/search/?query=dm ... dmi%20firm

griz31 wrote:nose irritation

- Observe how the hose runs from the machine to the mask. Manage your hose in such a way that it does not pull on the mask when you move in the bed. You need some slack in the hose. Check when you bed down that the slack is there.

- Watch the manufacturer's videos on how to adjust the mask headgear. There is a medium range, not too loose and not too tight, that needs to be achieved. https://www.cpap.com/

- Do use a small amount of Lansinoh lanolin on irritated areas.

http://www.target.com/p/lansinoh-hpa-la ... m=lansinoh

-CG

griz31 wrote:grogginess when waking

Your pressure is set at the lowest possible - 4.0. Many cannot tolerate pressures below 6.0 or 7.0. You may not be getting enough air at this low pressure, and that could cause grogginess. Breathing events from mouth leaks could also be causing grogginess.

griz31 wrote:Dreamstation CPAP Machine

If that is your machine, that gave you a straight CPAP "brick". A brick is a machine that does not record the full data needed for proper management of your therapy. A straight CPAP is a machine that will only run at one pressure. An APAP (auto POP) will adjust pressures according to varying needs over the night.

It's a real bummer to get stuck with a brick. Can you possible exchange it for a fully data-capable APAP?

Chicago Granny - Thanks for the information - I will certainly look into those suggestions you mentioned for waking due to pressure and nose irritation. I will also ask the doctor about the pressure setting upon my next follow-up as I can't do anything about it on my own since it is locked. I am assuming that during the titration study they would have checked other pressures though, so I'm not sure what more he can tell me other then lets see if something else works?

The Dreamstation didn't have any information on it to distinguish whether it was Auto CPAP or just CPAP. Upon downloading the sleepyhead software I found that it is in fact a Dreamstation Auto CPAP. I have updated the information below.

On that note - I am seeing the same information in sleepyhead as the dreamMapper app as far as the numbers are concerned. Still wondering about the accuracy and reason for discrepancy.

Thanks,
Jon

griz31 wrote:Chicago Granny - Thanks for the information - I will certainly look into those suggestions you mentioned for waking due to pressure and nose irritation. I will also ask the doctor about the pressure setting upon my next follow-up as I can't do anything about it on my own since it is locked. I am assuming that during the titration study they would have checked other pressures though, so I'm not sure what more he can tell me other then lets see if something else works?

The Dreamstation didn't have any information on it to distinguish whether it was Auto CPAP or just CPAP. Upon downloading the sleepyhead software I found that it is in fact a Dreamstation Auto CPAP. I have updated the information below.

On that note - I am seeing the same information in sleepyhead as the dreamMapper app as far as the numbers are concerned. Still wondering about the accuracy and reason for discrepancy.

Thanks,
Jon

Your machine is not locked...you just don't know how to adjust it

griz31 wrote:Still wondering about the accuracy and reason for discrepancy.

If we could have sleep studies (without CPAP) every night for a month, we would see a wide range of AHI values. We sleep differently every night. Plus, your sleep in the unfamiliar setting of a lab is likely to be very different from sleeping at home in your own bed.

Trust what your machine is telling you.

Someone here should tell you how to get into your machine's clinician's menu so you can see all the data and change pressure if warranted.

You should learn to use SleepyHead software ASAP - https://sleep.tnet.com/resources/sleepyhead

Most of the regulars here manage their own therapy and don't depend on the inefficient and ineffective route of using a doctor to manage it.

LSAT wrote:Your machine is not locked...you just don't know how to adjust it

ChicagoGranny wrote:Someone here should tell you how to get into your machine's clinician's menu so you can see all the data and change pressure if warranted.

Thanks I found this information - pasting it here in case anyone else is interested:

"Once the device is powered, press and hold both the control dial and the Ramp button on the device for at least 5 seconds. You are now in Provider Mode. To adjust a setting, rotate the control dial to your desired menu option, then press the control dial to select that setting. Rotate the control dial to change the setting. Press the control dial again to save the change. Select the "Home" icon to exit Provider Mode and return to Patient Mode"

ChicagoGranny wrote:If we could have sleep studies (without CPAP) every night for a month, we would see a wide range of AHI values. We sleep differently every night. Plus, your sleep in the unfamiliar setting of a lab is likely to be very different from sleeping at home in your own bed.

Trust what your machine is telling you

I do understand that its probably different every night (though I would think it would be better in my own bed), but I wouldn't think numbers from 2.5 to 11. If the machine is truly accurate, than I think this is grounds for discussion with the doctor as to why the numbers are so drastically different.

ChicagoGranny wrote:You should learn to use SleepyHead software ASAP - https://sleep.tnet.com/resources/sleepyhead

I downloaded it and will continue to look into it. Although I have been monitoring on the DreamMapper app daily from my phone.

ChicagoGranny wrote:Most of the regulars here manage their own therapy and don't depend on the inefficient and ineffective route of using a doctor to manage it.

I would be interested to hear what they would do as I dont have near enough experience to mess with pressure settings on my own.

Thanks,

Jon

griz31 wrote:I dont have near enough experience to mess with pressure settings on my own.

Right.

griz31 wrote:I would be interested to hear what they would do

Data is critical. Without data, it's like landing an airplane in the fog without instruments.They would like to see some screenshots of a typical night.

It's also important to understand what other health problems you have, what medications you are taking and anything else you think is important.

Near the bottom of this page, viewtopic.php?f=1&t=110638&st=0&sk=t&sd=a , you can see some screenshots organized in a helpful way.

After you have some well-formatted screenshots of a typical night or two, it would be prudent to discuss them with your doctor.

griz31 wrote:I dont have near enough experience to mess with pressure settings on my own.

You start looking at some of your data and get the forum members to explain things, and you will find it is not so complicated. That is, not so complicated for a typical obstructive apnea case. Your titrated pressure of 4.0 is an indication that your case may not be typical. But, be glad, low pressure needs are much more comfortable than high needs. At least for most people. Personally, I have no problem with my high pressure needs.

ChicagoGranny wrote: Data is critical. Without data, it's like landing an airplane in the fog without instruments.They would like to see some screenshots of a typical night.

It's also important to understand what other health problems you have, what medications you are taking and anything else you think is important.

Near the bottom of this page, viewtopic.php?f=1&t=110638&st=0&sk=t&sd=a , you can see some screenshots organized in a helpful way.

After you have some well-formatted screenshots of a typical night or two, it would be prudent to discuss them with your doctor.

Thanks CG I will work on putting together some more information from Sleepyhead. Appreciate your help!

Chevie wrote:You start looking at some of your data and get the forum members to explain things, and you will find it is not so complicated. That is, not so complicated for a typical obstructive apnea case. Your titrated pressure of 4.0 is an indication that your case may not be typical. But, be glad, low pressure needs are much more comfortable than high needs. At least for most people. Personally, I have no problem with my high pressure needs.

Once I put together some of the data it will be interesting to see how it all fits together (with help from others). Glad even with your higher pressure needs you were able to get it working for you!

-Jon

Here is a screenshot of one of the first nights:


Here is a screenshot of a better night:


Any suggestions?

Are you having any dry mouth?

If those were my charts, I would set the machine to APAP mode with min pressure 4.0 and max pressure 8.0. Let the auto function do some work and see if it can reduce the number of events. The chart should be reviewed after one night with the changes.

ChicagoGranny wrote:

griz31 wrote:Dreamstation CPAP Machine

If that is your machine, that gave you a straight CPAP "brick". A brick is a machine that does not record the full data needed for proper management of your therapy. A straight CPAP is a machine that will only run at one pressure. An APAP (auto POP) will adjust pressures according to varying needs over the night.

It's a real bummer to get stuck with a brick. Can you possible exchange it for a fully data-capable APAP?

Incorrect. That machine is fully data capable, it just lacks the APAP feature. I used one with SleepyHead for a while waiting for my Auto machine to arrive.

chillAtGVC wrote:

ChicagoGranny wrote:

griz31 wrote:Dreamstation CPAP Machine

If that is your machine, that gave you a straight CPAP "brick". A brick is a machine that does not record the full data needed for proper management of your therapy. A straight CPAP is a machine that will only run at one pressure. An APAP (auto POP) will adjust pressures according to varying needs over the night.

It's a real bummer to get stuck with a brick. Can you possible exchange it for a fully data-capable APAP?

Incorrect. That machine is fully data capable, it just lacks the APAP feature. I used one with SleepyHead for a while waiting for my Auto machine to arrive.

look again, ChicagoGranny is 100% correct, the CPAP model is a brick. the PRO model is full data.... however, the OP has neither of those.

ChicagoGranny wrote:Are you having any dry mouth?

If those were my charts, I would set the machine to APAP mode with min pressure 4.0 and max pressure 8.0. Let the auto function do some work and see if it can reduce the number of events. The chart should be reviewed after one night with the changes.

I'd suggest at least 5 for min, 4 is too low, based on the single pressure, maybe even 6-10cm.

chillAtGVC wrote:Incorrect. That machine is fully data capable, it just lacks the APAP feature.

You are wrong in both cases.

1. The OP has an APAP - DreamStation Auto CPAP Machine
If you had read what he wrote, you would have seen he corrected which machine he has,

griz31 wrote: Upon downloading the sleepyhead software I found that it is in fact a Dreamstation Auto CPAP. I have updated the information (in my equipment profile).

after I said,

ChicagoGranny wrote:If that is your machine, that gave you a straight CPAP "brick".

2.

chillAtGVC wrote: I used one with SleepyHead for a while waiting for my Auto machine to arrive.

The DreamStation CPAP is a brick. You might have used the Pro model.