Sierra

Yes, if you want to take the responsibility for changing pressures it is not that hard. Just press and hold the round set button on the front, and the ramp button on the top at the same time for about 5 seconds. That will put it into the clinical mode. Go to the Therapy section and it will give you the option to set minimum and maximum pressures. Here is a link to a full manual which also explains it.

DreamStation Technical Manual

I find it best to only change one thing at a time, and then give it a few days to determine if you got the improvement you were expecting. The results change from night to night with no changes in the setting, so you can kind of fall into a trap by thinking that all the change for the next day was due to the change. You really need an average of nights from before the change to after the change to see the real impact of it.

Full face masks are often prescribed to those who are identified as mouth breathers. It stops the problem of air leaking out of their mouth during sleep, but it does not stop mouth breathing. I would suspect your mouth is dry due to mouth breathing. Are you using a humidifier? That can help.

The other alternative is to use a nasal pillow mask, and if you open your mouth while sleeping then use mouth taping. It is not for everyone, but I have found it much better than using a full face mask. Here is a thread about the Benefits of Mouth Taping. The combination of mouth taping and a nasal pillow mask essentially forces you to breath through your nose.

I think the nasal mask is the preferred choice if you can make it work. I find if I can get my nose clear at night I am good through the night. If I can't get my nose clear on both sides, I use a generic Otrivin spray in the nostril that is congested. I try to avoid excessive use of the spray as continued use can make the congestion worse. Some report good results with using a corticosteroid nasal spray daily on a preventative basis. I believe it used for congestion due to allergies. However, I tried Nasacort and it did not help me.

The other issue is having no humidifier. A humidifier can help a lot with nasal congestion. Perhaps you should be going back to your clinic and requesting a machine that has a humidifier.

Your results look very good for a first setup with a new machine. I can't quite see your full Leak Rate graph but if the lower of the two green traces stays below 24 L/min then it is good.

If it were my machine I would ask about setting the minimum pressure higher in the 8-9 cm range. That could prevent some of the hypopnea and flow limitations you are seeing. And I would use the Auto Ramp with a start pressure of 7 cm. That should feel more comfortable going to sleep. The 12 cm max looks good. There were a few flow limitations when the pressure is maxed out, but that is not too bad.

The first on line CPAP supply store that we got my wife's machine from 4 years ago or so was willing to look at your machine data if you zip the files and send it to them by e-mail for review. I believe they limit that service to one year. They also told us "off the record" about SleepyHead and suggested we might want to use it. They also showed me how to make changes to the machine using the Clinical Menu.

The place I bought my machine from was more no frills. They made it clear they don't want to review your data, or provide ongoing advice. They did offer to set up the machine based on the sleep study report that was used as a prescription. I told them no, and that I wanted to set the machine up myself, and to just ship it to me the way it comes from the factory.

I also believe some bricks and mortar clinics will do a similar thing and show you how to make adjustments.

The other think to consider is that some, perhaps many, users do not want to take any responsibility for making the adjustments. They want the clinic to do it all. So perhaps there is a place for both types of service. One that provides the full meal deal, and others that want the bare bones...

I believe the 10 ST is just the updated version of the S9 VPAP ST, and should still do up to 25 cm pressure. It just has no auto pressure adjustment function, and the IPAP and EPAP have to be set manually.

See this link:

Swift FX - P10 Hybrid

First the easy answer. While I do not subscribe to it, ResMed offers what they call MyAir service. Each morning the basic summary data is uploaded automatically to the ResMed cloud. If you sign up for the service (no cost) you can access your own personal data which I suspect is tracked to the serial number of the machine. It is very high level stuff that is provided to mainly encourage you to keep using the device. For example you could get a poor AHI score but if you used the machine for 8 hours you would be given a very high overall score. This service is very difficult to turn off, and for some it raises privacy issues. Technically they could track from the cell service where you actually are located.

Next the more complicated. Your provider can access the data too. Whether or not they actually monitor it is something I am suspicious of, but I don't really know. I suspect because they have thousands of clients they really do not monitor results. Is there a flagging system that identifies those with bad AHI? Perhaps, but I doubt it. Second hand information but I do understand the DME system and insurance providers in the US may track compliance and take the machine away if they have paid for it, and you are not using it.

The clinic does not get the detailed data unless you as the patient bring the SD card in to them. They have software similar to SleepyHead which they can display the detailed data. Perhaps someone that is going back to their clinic on a regular basis may bring their card and ask them to look at it. However, the problem is that it takes quite a bit of time to review detailed data. I'm skeptical that it is really done much.

You have to understand there are two basic ways in which people get machines, and it varies from area to area. Some have the DME or insurance provider pay for it in a kind of a full meal deal arrangement. The cost can be in the order of $2400-2800 in addition to the cost of the sleep studies. Other people like myself without insurance can just get a prescription and buy the machine from an on line provider for $800-900. Most of these are quite clear that they provide no monitoring. The full meal deal providers should, and should answer any questions you have. Do they though....

There is lots of information and help on line if the patient wants to make the effort that will assist them in understanding the results. The basics are quite simple. The guidelines are to achieve an AHI of <5. The more difficult stuff comes in when one cannot do that. Then what do you do? And the obvious simple answer is go back to your sleep clinic that did the sleep study.

The popular ResMed and Repironics machines are essentially all supported by SleepyHead. An informed buyer of a CPAP will make sure it is supported before they buy. There is not much hassle to install it, unless you are trying to get by with using a tablet or phone instead of a real computer.

My thoughts are that clinics make money by doing sleep studies, selling the machine, but not much in supporting the user after that. Some would prefer you come back for another sleep study, rather than just look at your data and make a change to the settings. Other clinics are not in that business, and will tell you about using SleepyHead.

My preference is to stay out of it.