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mawaw1992
+0 points
·
9 months
ago
Original Poster
I have a Resmed Aircurve 10 VAuto that I had to send into a service center to be repaired so now I have to use my Dreamstation 2 that Respironics sent me to replace my Dreamstation 1 that was recalled. My AHI with the Resmed was averaging 1.07 but now with the DS 2 it averaging close to 6.0. I understand my Resmed is a Bipap machine and the DS 2 is an Auto Cpap. My settings on the Resmed is Min. EPAP 11.00, Max EPAP 15.00 and PS is 2.0. I was wondering where I need to set the DS 2 to be close to those settings?
BiPaps use a bit different terminology than an APAP. EPAP is an exhale pressure and pressure support is the amount that inhale or IPAP is higher than exhale. With an APAP you set the IPAP and then Flex determines how much the exhale is reduced. So you may want to try the DreamSation set at 13 and 17 cm with Flex at 2 cm.
If your pressure support was only set at 2 cm, and your IPAP pressures are less than 20 cm, then a standard APAP should be able to do just as well as a BiPAP. The main differences between a BiPAP and an APAP is that the BiPAP can go higher than 3 cm for pressure support (EPR or FLEX), and they can go up to 25 cm of IPAP pressure.
This said a DreamStation will be a bit different than a ResMed. If you download OSCAR, to view your readings on the SD card you will be able to see what the DreamStation is doing during the night.
mawaw1992
+0 points
·
9 months
ago
Original Poster
I tried the settings you suggested which brought my AHI down to 3.97. But it shows I had 10 central apneas, 10 obstructive apneas and 11 hypopnea's last night. Seems like someone had told me once before you normally increase pressure to reduce obstructive apneas and decrease pressure to reduce central apneas. I don't know about the hypopneas. I don't know which way to go with these numbers. Waiting on my resmed to return is going to seem like an eternity.
You would be best to look at your detailed data with OSCAR. The rules of thumb you mention are generally right. I have found to avoid central apnea events I keep the pressure as low as possible without seeing a sharp increase in obstructive events. I get both but my central events are still two thirds of the total. I have switched to fixed CPAP pressure at 11 cm after experimenting with different pressures. I have also found that increasing my EPR on a ResMed has reduced my hypopnea events significantly. I used to average over 2 for AHI but now average less than 1.
mawaw1992
+0 points
·
9 months
ago
Original Poster
I appreciate your help with this problem I am having. Do you think I should try switching the machine to CPAP with the one pressure setting as you did and see if that works? When I was first diagnosed, the doctor wrote the script for CPAP at 12 cm. Over the years I decided I wanted to try APAP thinking having the machine adjust the pressure itself would be better. So I got my doctor to write a new script for an APAP machine. So I purchased a (Respironics Dreamstation 1) APAP machine. I struggled to get my AHI down below 5. And then there was the recall on the Dreamstation. So after getting some advice from a sleep tech I decided to try Bipap that they thought might help me. Got my doctor to write me a new script for a Bipap machine and that is when I purchased the Resmed Aircurve 10 VAuto. It made all the difference in the world but now it is in the shop. But I noticed you said you switched back to CPAP and that worked better for you. So on the Dreamstation 2, to switch from APAP to CPAP, would I just set the minimum and maximum pressure at the same amount and would it still be using Flex at that point and if it does, where would it need to be set at?
My thoughts would be to try to get the DreamStation working better in APAP mode first to figure out what pressures may be best to try in fixed pressure CPAP mode. I am more familiar with the ResMed than the DreamStation but with the ResMed you just set the mode to CPAP and then it operates with a fixed pressure. But yes setting the machine in APAP mode would just mean setting the min and max pressures the same or very close. I would try 3 cm with Flex first and see how that works. But, at the end of the day it is hard to predict what works, and it is really a trial and error thing. But, I would only change one thing at a time and it takes probably a minimum of a week to see what the outcome is. That is why I went down the road of narrowing down the pressure in APAP mode first and then going to fixed CPAP. OSCAR is extremely helpful in determining how things are working.
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