Switched from Dream Station CPAP to APAP

mulewhipper · Post by **mulewhipper** » Fri May 10, 2019 2:36 pm

I have been using a Dream Station for over 5 years, with great results mostly. It was starting to get some wear and tear on it so I upgraded to the Dream Station Auto machine.

It came to me preset with settings of my older device.
The Auto High was set to 20 and the Auto low was set to 4.

A little history:
I have been using CPAP for the last 15 years and I have always had a higher pressure setting of 15-18. I have been able to move it down if needed.

My question is, if the lowest pressure setting is set to 4 and the highest is at 20, how come every time I check while using the device, it's only at the lowest setting.
I cannot function at such a low setting. I tried to fall asleep hoping that the device would detect i needed more pressure, but whenever i checked, the pressure was still only at 4.

I had to change the Auto low pressure to 15 to get any sleep the last two nights.

Thanks for any input regarding this.

Ron

palerider · Post by **palerider** » Fri May 10, 2019 3:11 pm

mulewhipper wrote: ↑
Fri May 10, 2019 2:36 pm
I have been using a Dream Station for over 5 years, with great results mostly. It was starting to get some wear and tear on it so I upgraded to the Dream Station Auto machine.

It came to me preset with settings of my older device.
The Auto High was set to 20 and the Auto low was set to 4.

If you had a CPAP before, then the apap is *not* set to your previous settings.

Go into the settings and put the min pressure up to what you used, or maybe a cm less.

Janknitz · Post by **Janknitz** » Fri May 10, 2019 3:14 pm

It takes some time for the auto settings to get on top of your apnea. It does not adjust quickly. By the time you reach REM sleep, the machine might very well get to a high pressure, but it won't get there quickly.

It may also be that if you are awake enough to check the pressure, you aren't needing the higher pressure yet. Have you looked at your charts to see whats happening at those lower pressures? Have you tried a night or two on those settings to see where your average pressure is?

You can certainly adjust the pressure to your favored settings. But it might be interesting to look at the data from a night or two at the wide open settings to see if you truly do need that high of a pressure all night. This is how a home titration is done.

Goofproof · Post by **Goofproof** » Fri May 10, 2019 3:28 pm

4 to 20, what people that don't care if you get treatment set it at "Failure Mode"! Do as Pale rider says, also your treatment won't work unless you are asleep, your breathing changes when your sleep the machine counts on that. Jim

mulewhipper · Post by **mulewhipper** » Fri May 10, 2019 3:57 pm

Janknitz: I haven't checked with the DreamMapper app yet, i will connect to Blue Tooth tonight and see what i can find out.
I have tried it for a couple nights already...basically getting halfway through the night before having to manually adjust to a higher autolow.

Palerider: I have adjusted the min settings to what i need. Just thinking that really isn't taking advantage of what the Dream Station Auto should be doing.

I guess the best thing to do is take a few days (over the weekend) and struggle with a min of 8 and high of 20 and then read my charts.

palerider · Post by **palerider** » Fri May 10, 2019 4:18 pm

mulewhipper wrote: ↑
Fri May 10, 2019 3:57 pm

Palerider: I have adjusted the min settings to what i need. Just thinking that really isn't taking advantage of what the Dream Station Auto should be doing.

I guess the best thing to do is take a few days (over the weekend) and struggle with a min of 8 and high of 20 and then read my charts.

The DS auto is slow to respond. You *have* to get the min pressure up to what you need for most of the night, or you will have bad sleep.

I disagree about using it with a low min "just to see", a better plan is to start with pressures you're used to, and then nudge the min pressure down over time, till you start having more events, then nudge it back up to where you were sleeping well.

mulewhipper · Post by **mulewhipper** » Fri May 10, 2019 4:24 pm

palerider wrote: ↑
Fri May 10, 2019 4:18 pm

mulewhipper wrote: ↑
Fri May 10, 2019 3:57 pm

Palerider: I have adjusted the min settings to what i need. Just thinking that really isn't taking advantage of what the Dream Station Auto should be doing.

I guess the best thing to do is take a few days (over the weekend) and struggle with a min of 8 and high of 20 and then read my charts.
The DS auto is slow to respond. You *have* to get the min pressure up to what you need for most of the night, or you will have bad sleep.

I disagree about using it with a low min "just to see", a better plan is to start with pressures you're used to, and then nudge the min pressure down over time, till you start having more events, then nudge it back up to where you were sleeping well.

Thanks for the prompt response...i will proceed with your advice.

mulewhipper · Post by **mulewhipper** » Fri May 10, 2019 4:32 pm

I just read the Sticky for Newbies...I will install Sleepy Head and read the notes before posting further.

mulewhipper · Post by **mulewhipper** » Mon May 13, 2019 9:43 am

OK...lets see if I have done this right or not.

I have attached results from last nights sleep...

Pugsy · Post by **Pugsy** » Mon May 13, 2019 9:51 am

Please review this thread.
viewtopic/t158560/How-to-post-images-for-review.html
You have included so many graphs that they all have to be so tiny that they can't really be evaluated well.
For the Respironics reports...the graphs on the right side...these are all you need to show

Events
Flow rate
Pressure
Leak

omit the others and make these 4 graphs larger please.
If someone wants any additional graphs...they will ask.

mulewhipper · Post by **mulewhipper** » Mon May 13, 2019 10:01 am

Better??

Pugsy · Post by **Pugsy** » Mon May 13, 2019 10:42 am

Much better, thank you.

I see at least 3 breaks in therapy where you turned the machine off and on. Were there more??? Any idea why?
So how did you sleep overall last night and how do you feel today?

mulewhipper · Post by **mulewhipper** » Mon May 13, 2019 11:18 am

Pugsy wrote: ↑
Mon May 13, 2019 10:42 am
Much better, thank you.

I see at least 3 breaks in therapy where you turned the machine off and on. Were there more??? Any idea why?
So how did you sleep overall last night and how do you feel today?

I typically wake up a couple times during the night for...(age related)bathroom visits

I also woke up at my usual alarm time of 5:00 and turn off the machine...but decided to skip the gym and went back to sleep.
Something else different, is that I have this new device set to Auto on/Auto off. So when i get up to use the restroom, it will shutoff before i return to bed.

Also my last CPAP the humidifier would run out during the evening and i would have to refill, so their maybe some trained behavior behind that.

I feel good today and I feel like I got a restful nights sleep.
I usually wear my fitbit and get a good idea of how much REM vs Deep/Light sleep I get, but last night it was charging, so i didn't wear it.

Pugsy · Post by **Pugsy** » Mon May 13, 2019 11:59 am

Gotcha.
Leave these settings alone for about a week and lets see if a trend is developing or this was a one off fluke night.
Give yourself a bit of time for the body to adjust. There is no urgent need to change anything at this time.
Not that you have much room to change anything anyway.

There is some minor leak happening at times but it only barely reaches large leak territory briefly a couple of times and if leaks aren't waking you up...don't worry about them. The minor leaks are withing the machine's ability to compensate for them.

Your statistic for "time over red line" is incorrect. SleepyHead is basing the statistic on a ResMed leak number which doesn't work for your machine.
Go into Preferences/CPAP tab and either turn off that statistic or adjust the red line number...at your pressures with your mask...and looking at when you actually hit large leak territory...probably should change it from 24 to around 75 or 80 L/min.
Respironics doesn't have a fixed red line for large leak territory...instead it varies with the mask and the pressure.
My advice is just turn it off and use the events graph for large leak watching...see that LL at the top of the Events graph?? That's large leak and the machine will flag large leak there if it thinks you reach large leak territory.
Your actual time in large leak very very minimal and obviously related to what was most likely your taking the mask off to get up to go to the bathroom and letting the machine run until it turns off via the auto off feature. It takes at least 60 seconds before it turns off and that's 60 seconds of large leak when you aren't attached.

All in all a good report especially since you aren't report new annoying issues. I see no reason to change anything at this time and if it was my report I would just give my body some time to adjust to this new way of doing things.

Switched from Dream Station CPAP to APAP

Switched from Dream Station CPAP to APAP

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