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mayuh
Unread post  Post subject: Two weeks in - too much pressure for new DreamWear Mask  |  Posted: Thu Jul 05, 2018 6:33 am

Joined: Wed Jul 04, 2018 11:05 am
Posts: 5
Location: Graz, Styria, Austria
PAP Mask: DreamWear FF
PAP Machine: DreamStation BiPAP
Humidifier: DreamStation
Pressure Setting: 19 - 24

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Hi there,

first post and yeah, I'm a noob :-) Though I tried to educate myself as quick and profound as possible. I was recently diagnosed with OSA (AHI was around 40) and had my machine fitted on the 19th June. I was sent home with a Dreamstation BiBAP with 19-24 (!) pressure and a ResMed Quattro FFM. I think I generally accept the therapy very well, as I think it will help me a lot.
The first week I had AHIs under 2, sometimes under 1. But I was far away from feeling rested. I felt like run over multiple times to be honest. I learned about sleepyhead and started to analyse things there. What I saw was that in the night they tried to dial me in, their last pressure adjustment was from 16 to 24 -- something I interpret as they were losing their patience and just went up to prevent any further apnoeas...

To cut a long story short: I must have to ability to scratch my nose or I get nuts :-) Also my mouth was very dry... So I got a new mask, the very comfortable new DreamWear FFM.

I had to tighten the new bugger so much, that I woke up with several different aches from the neck, mouth and worst - my septum. Then I checked a few instructional videos from Philips (and also asked my supplier), and came to the conclusion that it should not be fitted so tight, but rather comfortable. Guess what - it leaks like crazy when the pressure goes over 20.

Now, as I already think my pressure is way too high I decided to alter the prescribed pressures. The first night I went (yes, way too much change, but on purpose) to a range of 12-18, totally aware that my AHI will skyrocket, but I wanted to make sure the mask doesn't leak. Also from sleepyhead data I saw that I already sleep rather well at 16-17, when the ramp hit that range. Also when at max pressure of 24 I tend to wake up after 10-40 minutes hitting the ramp button again.

Anyway, I'd like to ask you for advice to achieve my goals of a comfortable mask and low AHIs and a good quality sleep with my equipment. Maybe this is the holy trinity ;-) I guess it's almost as realistic to ask additionally for a house on the beach, a yacht and a lottery win :-) Whatever is easier to achieve :-)

Maybe you can suggest an auto BiPAP setting? I think my gear can do that?

Any advice is appreciated and thanks in advance!
Mario.

---------------------------------

I hope I did the screenshots correctly (I couldn't find the other flow thinggy requested in the dropdown menu)
Dates description:
29th and 30th are with the Quadro FFM
1st of July: with the new DreamWear. Strapped like crazy onto my face.
2nd of July: DreaWear FFM, worn very comfortably. Old pressure of 24 and leaking
3rd of July: lowered max to 18
4th of July: same. but changed to 19 before I fell asleep again after an hour...


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mayuh
Unread post  Post subject: Re: Two weeks in - too much pressure for new DreamWear Mask  |  Posted: Thu Jul 05, 2018 6:33 am

Joined: Wed Jul 04, 2018 11:05 am
Posts: 5
Location: Graz, Styria, Austria
PAP Mask: DreamWear FF
PAP Machine: DreamStation BiPAP
Humidifier: DreamStation
Pressure Setting: 19 - 24

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last screenshot


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diamaunt
Unread post  Post subject: Re: Two weeks in - too much pressure for new DreamWear Mask  |  Posted: Fri Jul 06, 2018 12:00 am
User avatar

Joined: Wed Mar 02, 2016 2:26 am
Posts: 1749
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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mayuh wrote:
Maybe you can suggest an auto BiPAP setting? I think my gear can do that?
.


How 'bout Min EPAP 10, MaxIPAP 25, MinPS 2, MaxPS 5, see what turns up.

It looks like the snores mosly stop around 9 or 10 EPAP.

_________________
https://sleep.tnet.com/resources/sleepyhead
how to post:
https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur


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mayuh
Unread post  Post subject: Re: Two weeks in - too much pressure for new DreamWear Mask  |  Posted: Fri Jul 06, 2018 2:21 am

Joined: Wed Jul 04, 2018 11:05 am
Posts: 5
Location: Graz, Styria, Austria
PAP Mask: DreamWear FF
PAP Machine: DreamStation BiPAP
Humidifier: DreamStation
Pressure Setting: 19 - 24

Offline
Thanks for your suggestion. This night I tried - in lack of better knowledge - Settings of EPAP 8, IPAP 24, PSmin 4, PSmax 8.

I maybe have to mention that we had a major thunderstorm with hail this night and that woke me up several times (at least I think I did) as I sleep directly under a roof area window...

My snoring went up, and your 9-10 EPAP suggestion totally makes sense, when I look at tonight's report:


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mayuh
Unread post  Post subject: Re: Two weeks in - too much pressure for new DreamWear Mask  |  Posted: Fri Jul 06, 2018 2:32 am

Joined: Wed Jul 04, 2018 11:05 am
Posts: 5
Location: Graz, Styria, Austria
PAP Mask: DreamWear FF
PAP Machine: DreamStation BiPAP
Humidifier: DreamStation
Pressure Setting: 19 - 24

Offline
Even after watching tons of vids on Sleepyhead, I still have one more question. Are those Hypopneas real (50%)? Or were they just falsely flagged?

...and thanks for your patience :-)


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diamaunt
Unread post  Post subject: Re: Two weeks in - too much pressure for new DreamWear Mask  |  Posted: Fri Jul 06, 2018 9:05 am
User avatar

Joined: Wed Mar 02, 2016 2:26 am
Posts: 1749
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

Offline
I don't know what a 'false' hypopnea would be, or if one could determine the difference.

_________________
https://sleep.tnet.com/resources/sleepyhead
how to post:
https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur


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mayuh
Unread post  Post subject: Re: Two weeks in - too much pressure for new DreamWear Mask  |  Posted: Tue Jul 10, 2018 7:33 am

Joined: Wed Jul 04, 2018 11:05 am
Posts: 5
Location: Graz, Styria, Austria
PAP Mask: DreamWear FF
PAP Machine: DreamStation BiPAP
Humidifier: DreamStation
Pressure Setting: 19 - 24

Offline
So I tried the new Auto BiPaP settings for the last 5 nights.

I do feel comfortable with them but my AHI is close to 5. I always sleep 4-5 hours before waking up for an hour or so and sleep again in the mornig for another 1-2 hours. I guess that's pretty normal for the first few months that my brain tells me it has had enough sleep. Nevertheless I feel tired throughout the day...

Anyway, the sleepyhead data doesn't make any sense to me at all. I'm pretty sure I don't understand them fully yet.

Like the second round of sleep, where the machine uses low pressures of IPAP 13 and EPAP 10, it looks to me that I sleep very well (zoomed it a bit in the second sunday screenshot) and no snores - while on monday with the higher pressures of 17/13 I have quite a few more apneas, tons of snores and all of a sudden RERAs.

What's going on? Any idea?

Thanks!


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Pugsy
Unread post  Post subject: Re: Two weeks in - too much pressure for new DreamWear Mask  |  Posted: Thu Jul 12, 2018 8:50 pm
User avatar

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 615
PAP Mask: ResMed AirFit P10 or DreamWear Gel nasal pillows
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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When we have nights when there are significant pressure change needs it's usually because of either sleeping position or maybe REM stage sleep.
Maybe you were on your back more when you had the night when the machine wanted to go so much higher than on the other night...or maybe you happened to get more REM sleep or maybe a combination of both caused the increased pressure needs.

It's quite common to have some rather significant pressure needs differences when we are on our backs compared to side sleeping.
Same for REM vs non REM sleep stages.

Mine is REM sleep...my OSA is 5 times worse in REM sleep than in non REM and I have seen pressures increase 6 to 8 cm during the time frame that I would expect to see REM stage sleep.
Yours appears to be happening a lot more than we normally would be having REM (which is usually about 20% of the night and in chunks) so my first suspect for the higher pressure needs would be you were probably on your back more at those times.


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