How to change the Expiratory Pressure Relief setting on a Phillips Dream Station.

[R Dillinger]

Hello all,

Just got my first CPAP machine.  Phillips DreamStation.  Tried it last night and did not get to sleep all night.  So much for sleep apnea.  Ha!  
I guess I will have to get used to it.  My biggest problem was on exhaling.  I got too much resistance upon exhaling which irritated me all night.  I am on level 5 for pressure.  

How can I lower the Expiratory Pressure Relief setting on a Phillips Dream Station?   I hope it is easy to do.  I think things will go much better if I did not spend a lot of energy exhaling into a large counter air pressure.  

Can I do this myself or should I call the sleep doctor and tell him about it.  Any advice would be appreciated.  Are there any youtube videos or written instructions to change this setting?  

Thanks,

[OpalRose]

Hi R Dillinger,
You can order a Clinicians manual for your machine here:

https://www.apneaboard.com/adjust-cpap-p...tup-manual

In the meantime, yes...you can change the setting or enable it if need be.  
Phillips Respironics uses the term Flex for their Expiatory Relief Pressure.

You can select OFF, C-Flex, or C-Flex+ (if in CPAP or CPAP-Check mode).
You can select OFF, C-Flex, or A-Flex (if in Auto-CPAP or Auto-Trial mode).
   
You can modify the Flex setting (1, 2 or 3) if you enabled Flex.
The setting of “1” provides a small amount of pressure relief, with higher numbers providing additional relief.

In your case, with a pressure of 5, this feature won’t be much of an advantage to you.  The machine can go no lower than 4.
So, it may be beneficial to raise your pressure to 6cm, set Flex to 2. This would be an expiratory pressure relief to aprox. 4cm.
Or, try a setting of 7cm, Flex set to 2, which would drop expiratory pressure to approx. 5cm.  

In order to get used to the feel of pressure, try using your machine while reading or watching TV.  
You will soon get used to the feel of pressure if your mind is on something else.

[Sleeprider]

I agree with Opalrose. A higher CPAP pressure would have more possibility of providing lower exhale pressure than the pressure of 4 that you are set at. It seems very unusual for anyone to be prescribed such a low fixed pressure, and makes me wonder if you problem is really obstructive apnea. It might be interesting to see the test results.

[R Dillinger]

Hi OpalRose

My machine is set to go from 4 to 7 over time I believe.  I finally found the FLEX setting and set it at three.  I got 4 hours of sleep from the machine last night which is better than no sleep I got last night.  

Yesterday I got another nose cuff which worked well for me.  However; my mouth opened several times since I am wearing a nose only mask.  I assume this happens when my machine gets to the 7 level of pressure.  I called my clinician and he said to give it a few more weeks.  If I keep opening my mouth, I will need a chin strap or full face mask which I do not want.  

Where can I buy a chin strap now if I wanted it?  

Thanks for the URL on the manual.  That will help.  

    


R Dillinger

---

Thanks Sleeprider, 

I think my doctor has it adjusted starting at 4 and goes to 7 over 40 minutes.  I believe at the higher pressures, my mouth starts to open and it wakes me up.  




R Dillinger

[Sleeprider]

I don't think a Flex setting of 3 works well for most users, and can destabilize the airway leading to more events. I would back that off to 1 or 2. This does not work like Resmed EPR. If you machine is set to move from 4 to 7 cm pressure, that sounds like ramp. I recommend you try using the machine with ramp off and see if the pressure is a problem or not for starting out. Using your (low) therapy pressure right from the start can help you with leaks, and a pressure of 4 is just too low for most of us to feel comfortable. Do you sense not getting enough air when you first start your night?

[R Dillinger]

Hi Sleeprider

Thank you for the tips.  I will try and experiment with them.  I'll back off the FLEX and try with the ramp off.

Thanks again.       

R Dillinger

[Hydrangea]

For me, the low pressure of 4 would cause me to mouth breath with a nasal mask. Such a low pressure would make me (even subconsciously) feel air-starved.

I felt that way with a min/fixed pressure of 5. My sleep "doctor" refused to change it, since it "effectively" treated my apnea. (So I made the changes myself.)

[R Dillinger]

Thanks Hydrangea. I appreciate your input.

[Hydrangea]

Thanks Hydrangea.  I appreciate your input.

No problem!