Evaluate me! Also - my provider and his hogwash...

[Ministerman]

Sigh, this is frustrating.  Sleep shouldn't be so stressful!  

Here's my chart from last night - my AHI went up again!  Not "terrible" but still not the right direction.

[ajack]

Have we worked out if you machine is working properly now? It was faulty and I really would like to try another one.

[Ministerman]

I don't know if the machine is faulty.  I mean, it seems to be working - but I don't know.  

Why would you think it is faulty? Is there a reason for concern in the charts?

I'm scared to ask my "provider" because he'll look at the data and see that I've changed the numbers and settings, and then probably say "Well, you messed with it so it's not doing what it's supposed to do."

[ajack]

I know dream stations are slow to respond, but this one just doesn't do much at all. When it was on 5, the max went to 7 and the OA/H were ignored. now it is on 12 and is rising to 14.

Put it back to 5 tonight and see if it climbs back to 14. I have my doubts. Tell them the truth. You've been on several forums trying to get it treating your apnea and trying lots of pressures, to no avail. It would be sensible to try one of their demo ones. I don't know how your insurance works, you may not be able to swap brands.

[Ministerman]

My insurance doesn't cover any of this mess.  I have to do everything out of pocket.

[ajack]

OK, but the machine has to work properly. It is under warranty. I'd go back today or put it back to 5 tonight and see what happens.

The history is
setting 5 max 7
minimum pressure at 7. My 90% pressure was 8
then 10
then 12 to 14

[Ministerman]

I have also ordered a collar to wear -- i'm trying my best to figure all this out.

[Sleeprider]

I don't think I'd set the machine to 5 again. That didn't work. The machine is very slow to respond to obstructive events and it is worth having the supplier check for warranty. So the real question is, who did you buy this from? Did you pay full price? Wish we could have helped before the purchase because we know Supplier #33 is much less expensive than most for new machines.

[Ministerman]

Obviously I responded with the higher minimum pressure.  I agree the higher pressure is better for me.  I am still slightly "foggy" in the morning, and as I'm typing this, I don't feel 100% awake.  I know it takes a while for some to respond to therapy as well.

I paid $575 for my machine, which included the humidifier, tube, case, and then another $90 for my dreamwear mask.

I like the dreamwear mask a lot with the tube on the top of the head.  I wouldn't be able to deal with a tube coming out of my nose.  I do wonder if I would do better with the nasal pillows instead of the nasal mask.

I've sent a note off to my physician asking him what he thinks I should do.  He's a pretty chill guy.  All he did was sign off on the prescription from the sleep study.

[Sleeprider]

As you know, the methodology you are using to adjust pressure is sound and based on accepted protocols. I don't think your doctor will object to the changes you have made so far, and he certainly understands that pressure optimization is a trial and error process whether it is done by the patient or in a lab. I think it is a good idea to keep him in the decision loop and touch base. Where your titration has gone off-track is that your machine is not doing its part. It should be responding to obstruction with higher pressure, and as you have found, your machine apparently requires manually increasing the minimum pressure to get it to respond properly, or as expected. That is why we have speculated there may be a problem with the behavior of your Dreamstation, and have suggested that a Resmed Autoset does a better job of responding ahead of events. We understand things are out of pocket for your, and because of that, you should continue doing what has worked so far; observe results and increase minimum pressure in response to obstructive events.