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Franksteele
Unread post  Post subject: Yet another new CPCP user....  |  Posted: Tue Feb 11, 2020 6:56 am

Joined: Sun Feb 09, 2020 4:57 pm
Posts: 2
PAP Mask: Dreamwear Respironics Full Face CPAP Mask
PAP Machine: Philips Respironics Dreamstation Auto CPAP
Humidifier: Dreamstation Humidifier
Pressure Setting: trying to figure this out

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Hi

I’ve tried to read a lot of the posts on this forum before posting this but after a few pages i could not find what im looking for - im sure its all here, posted before so im sorry if you have to keep telling the new ppl where to look!

I just want to say from the start that I’m very new to CPAP & Sleep Apnoea, although I had a sleep study over 10 years ago and was diagnosed with sleep apnea in 2009 with an AHI of 59, I wasn’t able to get used to the CPCP machine, the noise, the mask, pressure so I carried on until now.

Anyway, ive now got to the stage where I can’t function at work properly – falling asleep at my desk - luckily im self employed so I’ve have had to take time off in order to get used to the Philips Respironics Dreamstation Auto CPAP, Dreamstation Humidifier & Dreamwear Respironics Full Face CPAP Mask in order to get back to a normal life.

- Note, Due to a broken nose, I can’t breathe through my nose at all so am a 100% mouth breather.

I'm in the UK (London) and just find the information given to me with the machine very limiting from the specialists ive seen – no humidifier until I asked and then was told to keep trying for another week, not heated tube & no follow-up support number in order to help make changes to the machine. I was told to look at youtube for further information. I’m not saying there’s anything wrong with youtube if you know what you’re looking for but when I decided to go to a private clinic after all the issues I had before in 2009 with the NHS (National Health Service) and spent some of my savings , I had a sleep study and I was given my sleep study report and a quick tour of the Philips Dreamstation & mask with the standard settings and off I went thinking this wont take long at all otherwise the consultants would have told me a lot more information (wouldn’t they??). I’ve since had to purchase the humidifier and heated hose and literally trial and error – a lot or tries & errors and that’s why I’m here asking for your help as I think using OSCAR and the Dreamstation propoerly is the way forward for me - not just try these settings as ive said before.

So, the issues I have with the Dreamstation are;

1. After the initial ramp time (which I’ve changed) I keep waking up as if the machine is chocking me – literally trying to force feed me to much air. - ive since changed the machine to CPAP (from Auto) and reduced the ramp to slowly build up increasing daily by 1 or is it 1cmH20 wih humidifier etc so im currently up to 9cmH20 with an AHI of 2.32 and sleeping for about 2 hrs - see below but i know this is just the tip of the iceberg
2. I’m a heavy mouth breather to so I sound like Darth Vader wearing the mask – I don’t see any cure for this apart from wearing some earphones with light music on when trying to sleep
3. After downloading the Dream station Manual I’ve still not no idea what changes I should make in order to use the CPCP machine correctly. I watched loads of videos and tried to use OSCAR and import the data from the Dreamstation which i think i now understand some of the readings but not enough to make changes the the CPAP machine correctly.

As ive said above, due to the amount of pressure from the tube being supplied I found that if I changed the therapy setting to CPAP- it was on Auto (i think) and suffocating & changing the cmH20 to 8 (now 9) I’m now able to breath while using the machine not chock and think I might have had some sleep – I don’t even know if this is the best or correct setting?

I can’t get the humidification to work well, its on A / Auto & humidifier 5 but I’m getting a very dry mouth still and tube temp 1 which I will put up tonight as I woke with a very cold chest.

I’ve tried most of the settings but without really knowing what is the best way forward im really just guessing.

My sleep study report 3 weeks ago was 5 hrs 34 mins of sleep time;

Total Events REM NREM All Night
pRDI 353 NA NA 74.9
pAHI 353 NA NA 74.9
ODI 319 NA NA 67.7

I can scan and email the complete sleep study report and the last few weeks OSCAR readings from the SD card too if needed - as I was not even told about Hypopnoea, obstructive or any other readings found in the application so don’t know how to go forward and resolve these issues.

Also, are there any videos or web links etc on reading the OSCAR stats and understanding what actually happening and what I need to do or change in order to control the sleep apnea and get some sleep that would also be a great help.

One last question – as I’m still new to the Dreamstation (3 weeks odd) is it worth me continuing with the Philips Dreamstation Auto CPAP as I’ve read a lot people on the forum saying that the ResMed AirCurve 10 ASV is better or gets better results, easier and quicker.

Sorry for all the mixed questions - ive been updating this email for the past few days and should have posted it sooner.

I look forward to your replies and help

Frank.


Attachments:
File comment: Initial Sleep Study results
FS Sleep Study Report.pdf [1.66 MiB]
Downloaded 4 times
File comment: OSCAR Readings
FS Oscar - 11.02.2020.png
FS Oscar - 11.02.2020.png [ 238.02 KiB | Viewed 123 times ]
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Pugsy
Unread post  Post subject: Re: Yet another new CPCP user....  |  Posted: Tue Feb 11, 2020 8:58 am
User avatar

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1545
PAP Mask: Bleep/DreamPort nasal mask
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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The dry mouth comes from mouth breathing and sometimes even at maximum humidity delivery the humidifier can't rehydrate the oral/mouth mucosa well enough. It was never really designed to hydrate the mouth...it was designed to hydrate the nasal cavity which is much smaller.

So you can try using more humidity if you can go higher than 5 setting ...don't know if it will.

Otherwise most people just add some sort of oral hydrating product to their bedtime routine.

I am not sure what your final question was about pressure settings.
The one screen shot shows barely 2 hours of use.
Why are you not using it more?
What were the settings you were using when in auto mode that you had a problem with?


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Franksteele
Unread post  Post subject: Re: Yet another new CPCP user....  |  Posted: Tue Feb 11, 2020 9:49 am

Joined: Sun Feb 09, 2020 4:57 pm
Posts: 2
PAP Mask: Dreamwear Respironics Full Face CPAP Mask
PAP Machine: Philips Respironics Dreamstation Auto CPAP
Humidifier: Dreamstation Humidifier
Pressure Setting: trying to figure this out

Offline
hi
thanks for the reply.

i will try to increase the humidifier again tonight

up until a few days ago i didnt have the heated tube so after 1/2 or so id wake up each night with a really bad cold chest and couldnt go back on the Dreamstation. This happened repeatedly until i received the heated tube and now im finding my sleep on teh CPAP machine getting longer and longer. i never slept more than 10 - 15 minutes before without waking up 8 times + per night so getting to 2 hrs is great for me. i will try now to get back to sleep after waking now i know it is 2 hrs of sleep - but how long was i in a deep sleep - how can i tell?


also - anything else i should change on the CPAP machine??

Many thanks!!!

Frank.


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Pugsy
Unread post  Post subject: Re: Yet another new CPCP user....  |  Posted: Tue Feb 11, 2020 10:25 am
User avatar

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1545
PAP Mask: Bleep/DreamPort nasal mask
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

Offline
Unfortunately these machines don't record any sleep data at all.
Heck, they can't even tell if we are asleep or not.
Without any sleep data we can't really determine what stage of sleep we are in. We can sometimes spot REM stage sleep if our OSA is worse in REM and we need more pressure and we see pressure increases but not everyone will see that happen so it really isn't a good guideline. Too many "maybes".

Actually what I would like to see you change is very minor in terms of settings.
In CPAP mode the Flow Limitation flagging is turned off...so the lack of any FLs being flagged doesn't mean much. FLs are important because they can be the early warning signals that the airway is trying to collapse.

I would suggest going back to auto mode so the FL flagging is at least turned on. You can set the minimum to equal maximum in auto mode and the machine will function like it would in cpap mode except you get the FL flagging turned on.

It's really hard to offer much more than that at this stage with such small sleep sessions to go on and I would suspect that at least part of what we see flagged are more related to being awake and not real asleep flagging happening.
Watch the videos here....while it is mainly talking about central apneas we can have false positive flagging in any event category.
My AHI routinely is between 1 and 3...and 80% of it is always arousal/awake related flags. More pressure isn't the fix for awake flagged stuff. The fix for awake flagged stuff is to fix whatever problem is causing the awakening in the first place.

I would also suggest a modest apap range just to see what the machine is wanting to do.
Like minimum of 9 and maybe max of 12...very tight range. Let's see if the machine even wants to go much higher or not.

BUT.....right now your primary goal is to get more sleep.
Without sleep none of this stuff matters much....so you do what you have to do to get the sleep first.
Then we have something better to evaluate and then see if we need to tweak anything.

Gotta get the sleep first if we expect to evaluate it.


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