Changed to ResMed Aircurve 10 VAUTO and Dreamwear mask - bit of a rough start

[Sacktime]

Hi all, I am new to the board but an 8 year CPAP user. My CPAP machine was a Resperonics Auto Bi-PAP and Comfort Gel mask. My machine started to fail so I decided to upgrade to a new machine and try a new mask since the Comfort Gel is being discontinued and is no longer on Resperonics site. I talked to my DME and they required a new prescription before I could get a new machine. After getting my new prescription I meet with the DME and found out they were not stocking the new Dreamstation Auto bi-PAP yet, just regular CPAP machines. They did have the ResMed Aircurve 10 VAUTO so I decided to go with that, I also checked out various masks and decided to give the Dreamwear mask a try.

I have now used these for 1 week and after a rocky start I am getting things dialed in. The first two nights were very bad, I had mask leaks and after tightening it up I awoke with a very sore columella area between the nostrils. The pressure felt too high and even filled my ear canals with air. After two bad nights, I read a lot of posts on this forum and got the clinician manual for the ResMed and Sleephead software loaded. What I figured out was the DME set the PS at 7 which is the max number in my prescription. The prescription was 5 EPAP, 14 IPAP (same as my old Resperonics machine) and a max PS of 7. The old Resperonics machine auto adjusted both the EPAP & IPAP as needed, the ResMed uses a PS setting, so after understanding what PS did and looking at my old numbers from Encore I figured out that I needed a PS between 3 and 4.

After setting the PS to 4 everything has gotten much better, I am now able to loosen the mask and still keep a seal and not kill my nose or blow out my ear drums. I still have more tinkering to do with settings, but my AHI is now down to 2 (was between 5-6 with my old CPAP devices).

I am having some issues with the Dreamwear mask straps slipping off the back of my head, but by adjusting where my hose lays (behind my pillow, instead of hanging from my headboard) things have gotten better, but it still happens a couple of times a night. The Dreamwear mask is also causing me to have red areas on my face where the mask frame tubes touch my face. I have added the pads around the tubes, but that doesn’t seem to help much, so I don’t think it is a response to the latex. I do have rosacea so that may be the cause.

I do have some questions:
1. What PS setting are most people using, or is it a personal preference thing.

2. The DME set the Climate control and tube temperature to manual, I have changed them both to auto as that was what was recommended in the clinician manual. What are most people using.

3. What setting should be used on the ResMed machine for the Dreamwear mask (pillow or nasal mask) the DME set it for pillows.

4. Anyone have suggestions on how to minimize the red face areas I am getting from the Dreamwear mask. I have the red marks on both sides of my face all day long. I like the Dreamwear mask otherwise but this may cause me to switch back to a nasal mask.

[OpalRose]

Sacktime, Welcome to Apnea Board!
What size frame are you using with the Dreamwear mask? Possibly try one size larger if it is leaving red marks on your face, or you may have the straps too tight. Try loosening them a bit while you are laying down. As long as you don't get any leaks while adjusting, it should be ok.

As far as settings for the Aircurve, someone with experience with that machine will help.

[notsleep]

answer ? 2 mine is on auto works great for my environment

answer ? 3 nasal is what it should be not pillow

answer ? 4 i do use the pads too maybe wash the whole mask with the soap you have used before on other masks this is a great mask so i hope it works for you ,way to tight if it pulls up on you nose, larger frame size needed

the mask is latex free

[PoolQ]

1. I use 4, Doctor set it and STRONGLY recommended that I not "mess with my pressure" as I tend to mess with everything. Pretty sure there is more than a guess in setting the main 3 numbers.

2. I have humidity off and temp set to 63. This is personal preference, if auto works, fine, if you start feeling congested then play with it.

I don't use that mask, so I have nothing for you there.

(read up on the T1 and T2 settings so you know they are there and what they are for. If you also have COPD these would be therapeutic, otherwise they are comfort settings, I had to increase T1 to be able to breathe)

[trish6hundred]

Hi Sacktime,
WELCOMME! to the forum.!
It’s great to hear that you are getting your new machine adjusted for your needs.
I think the Drreamwear is a nasal mask, so you would need to have your mask setting to nasal.
Hang in there for more suggestions and answers to your questions and much success to you as you continue your CPAP therapy and good luck to you with your new machine.

[Sleeprider]

I do have some questions:
1. What PS setting are most people using, or is it a personal preference thing.

2. The DME set the Climate control and tube temperature to manual, I have changed them both to auto as that was what was recommended in the clinician manual. What are most people using.

3. What setting should be used on the ResMed machine for the Dreamwear mask (pillow or nasal mask) the DME set it for pillows.

4. Anyone have suggestions on how to minimize the red face areas I am getting from the Dreamwear mask. I have the red marks on both sides of my face all day long. I like the Dreamwear mask otherwise but this may cause me to switch back to a nasal mask.

Your PR BiPAP had pressure support (difference between EPAP and IPAP), but it might have been expressed as a range. If it was not set, the default PS MIN was 0.0, and unless you had breathing or flow events, it might not have changed much. Mine is set to a range of 4.0 to 8.0, but rarely exceeds 5.5.

Your EPAP should be set to relieve most OA. You then add PS to reduce snores, Hypopnea and RERA. If you start to see CA, you've gone too far. So, if you want to self titrate on bilevel, just start at 2.0 and go up until you see the ideal reduction of H, RERA and minimum CA, and you've got it.

I use the manual humidity settings. It actually gives more humidity, and it's easy to change on the front dial. The previous System One was the automatic in the 60 series. I found setting humidity to 2 and heated hose to 3 works on my PRS1 machine. YMMV since you're now using Resmed.

As far as skin chafing, I have severe rosacea as well. It's important to keep contact minimal and the straps need to be kept clean and free of any detergent residue. If you see a dermatologist he might have additional suggestions. I did better with my current Airfit P10 head gear than I did with the more substantial headgear of the FX.

How do you like the Resmed so far compared to the PR machine?

[cpdaniel]

I do have some questions:
1. What PS setting are most people using, or is it a personal preference thing.

2. The DME set the Climate control and tube temperature to manual, I have changed them both to auto as that was what was recommended in the clinician manual. What are most people using.

I use the Aircurve 10 VAuto as well with min EPAP 8, max IPAP 20 and PS 4, no ramp. I have the climate control set to full auto (using the heated ClimateLine hose).

3. What setting should be used on the ResMed machine for the Dreamwear mask (pillow or nasal mask) the DME set it for pillows.

4. Anyone have suggestions on how to minimize the red face areas I am getting from the Dreamwear mask. I have the red marks on both sides of my face all day long. I like the Dreamwear mask otherwise but this may cause me to switch back to a nasal mask.

I use a full face mask - can't help you with these.

[Sacktime]

Sacktime, Welcome to Apnea Board!
What size frame are you using with the Dreamwear mask? Possibly try one size larger if it is leaving red marks on your face, or you may have the straps too tight. Try loosening them a bit while you are laying down. As long as you don't get any leaks while adjusting, it should be ok.

As far as settings for the Aircurve, someone with experience with that machine will help.

I have the medium frame and it seems to sit between my eyes and ears properly and it doesn't feel tight. I was able to loosen the straps once I got my pressure settings corrected. I am a side sleeper so I think that is where the pressure against my face is coming from.

[Sacktime]

answer ? 2 mine is on auto works great for my environment

answer ? 3 nasal is what it should be not pillow

answer ? 4 i do use the pads too maybe wash the whole mask with the soap you have used before on other masks this is a great mask so i hope it works for you ,way to tight if it pulls up on you nose, larger frame size needed

the mask is latex free

So far auto seems to work for me, but on my old machine one of the things that broke was the humidifier, so having humidity again since I live in the north is a great improvement.

I know the mask is latex free but I may be sensitive to silicone too, but most likely just any pressure on my skin causes it to turn red.

[OpalRose]

Sacktime, Welcome to Apnea Board!
What size frame are you using with the Dreamwear mask? Possibly try one size larger if it is leaving red marks on your face, or you may have the straps too tight. Try loosening them a bit while you are laying down. As long as you don't get any leaks while adjusting, it should be ok.

As far as settings for the Aircurve, someone with experience with that machine will help.

I have the medium frame and it seems to sit between my eyes and ears properly and it doesn't feel tight. I was able to loosen the straps once I got my pressure settings corrected. I am a side sleeper so I think that is where the pressure against my face is coming from.

Sacktime,
I tried the Dreamwear and like it, except I feel that pressure on the side of my face too. I'm also a side sleeper so I understand what you are saying.

My main mask is the P10 nasal pillow, but there are times when my nostrils get sore, and I have to try something else, like the Dreamwear.

A lot of people seem to like the Dreamwear, but I think there are tradeoffs with all masks. One thing positive with the Dreamwear is the hose being at the top of your head, but I still prefer the P10, it feels as if I don't have a mask on at all.

Good luck in getting it sorted out.