Newbie Needs Help - Dreamstation 1030X

[muziccity]

So I had my first sleep study done in December and it showed 75AHI. I picked up my Dreamstation 1030X a little over a week ago and have been slowly starting to adjust to it. I'm not getting great sleep with it yet, maybe 3 or 4 hours here and there. It tells me my AHI is currently between 20-35. (My AHI appears less in Oscar for whatever reason) 

I was hoping that somebody here would be able to assist in someway. I'm so sick of being tired all freaking day! I tried out another forum but apparently this is an AVAPS machine and there are not a ton of experts on it.  One person commented that they didnt think this was the right machine for me. My sleep study said to titrate to a cpap machine... idk

I cant post images or links yet, so you probably cant help much. I'll add more data when I'm allowed to do so. 

Of course my ultimate goal is to get a good nights sleep and hopefully one day have energy again.  I have been getting worse and worse every month for the past 10 years. Doctors tried everything in the world to fix my lack of energy and related problems but failed. I wish I would've had a sleep study earlier! Hopefully this APNEA is the culprit and this machine will help fix it. I typically sleep 10 hours a night and then 5 hours of naps throughout the day and absolutely cannot function at all. I'm a single dad, I cant live like that!!! This can get my life back, I'm so hopeful. 

Here are the settings for my machine. 

Mode: ST
IPAP: 16
EPAP: 11
BPM: 10
Ti: 1
Ramp Start: 7
Rise: 1
Mask Type: Off

[DeepBreathing]

G'day muziccity. Welcome to Apnea Board.

You can attach images to your posts straight away, but you need to have a few more posts before you can post links.

As always, the best place to start is with the baseline evidence, so please post a copy of your sleep study. We need to see all the charts and tables, not just the written summary (which often leaves out some important details).

Can you also post a daily screen image from OSCAR? The page needs to be formatted as described here. That will show us in some detail exactly what's going on, and how we can help you overcome any problems.

[muziccity]

Thanks for the reply. I'm looking forward to figuring this out! 

The only data I have from my sleep study is my first one which was without me hooked up to a cpap machine. I couldn't sleep very good, so we didnt have enough time to move on to a machine. That was done at a follow up appointment and I never received the results from it. I have attached my first sleep study and a night of recent data from Oscar. The Oscar data didn't have a "snore" section, which I assume is because of my machine. If there's anything else you might need, let me know.

[muziccity]

I just got back the results from my 2nd sleep study that I did in December. Hopefully this will help you determine what I should do. I'm kinda trying to decide if I should use the ST Mode or the CPAP mode. I've really been struggling. I do not feel any better at all. I still require a couple naps each day, I still have no energy. I'm extremely depressed but I'm a single dad with a little girl, I've got to try to get better. I feel like I'm dying. Any help would be appreciated.

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Here's a few more attachments...

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Sorry for all the attachments. This is all.

[DeepBreathing]

G'day muziccity. Thanks for posting these - they give a very complete picture of your situation.

The very first thing that jumped out at me was the technician/doctor's note that the bipap therapy was unable to resolve your central and obstructive apnea. So they've given it a shot, failed and sent you away with a machine they knew wasn't going to work - at least that's how it looks to me.

The 1030 is a BiPAP S/T machine, which is a pretty high-end device but probably not exactly what you need. Although Oscar reports it as a AVAPS machine I don't think that's correct. Oscar inherited from SleepyHead a lot of errors in the way Philips machines are handled. This has been fixed in a new version of Oscar which is currently going through testing prior to public release.

I have to ask - was ASV considered, and if not, why not? It's obvious the bipap isn't working for you, and in your situation I'd push for a trial with the Resmed Aircurve 10 ASV.

[SarcasticDave94]

FWIW I think the current ResMed machines that can do AVAPS are the ST-A, Stellar 100 and 150, and Astral 100 and 150 (called iVAPS in ResMed literature). In the US, the ST-A will script as E4071 like VAuto and ASV. You won't need Stellar or Astral.

[DeepBreathing]

I think the issue here is two-fold:

1. I don't think muziccity's machine is in fact an AVAPS. I think that's an error in Oscar. The 1030 is listed by Philips as a BiPAP S/T. The AVAPS is the 1130.

2. I don't think it's been established that muziccity actually needs an AVAPS type machine. He has severe complex apnea which is normally successfully treated by ASV.

muziccity - could I ask you to check two things for me please?

1. Confirm the model number of your machine - it will be on a label on the back or underneath. Remove the humidifier before turning it over!

2. Check what mode the machine is set in. Looking at your Oscar screenshot above I wouldn't be surprised if the machine's actually in CPAP mode.

[SarcasticDave94]

muziccity,

For clarification, I was not implying you need one of the machines I'd mentioned.

And DeepBreathing is correct. Let us know the model number of your unit. It should start with DSX...

[Sleeprider]

Muziccity, you have complex apnea, and you have failed at the BiPAP S/T. I would really like you to get a Resmed Aircurve 10 ASV rather than the Philips Dreamstation BiPAP SV because it will be much easier to setup and fully treat your central apnea and hypopnea. You need to inform your doctor's office that the ST is not working and "I feel like I'm dying". You feel that way because the central apnea and hypopnea are continuing to cause severe oxygen desaturation. This is an urgent issue, and the backup rate on ST has not worked, and cannot work because the pressure support of 16/11 (PS 5), is not enough to cause a breath when your spontaneous effort is not there.

Right now, you are tired, and it's hard to focus on things, but you must learn about treatment emergent central apnea and complex sleep apnea. You need t know your S/T machine is designed for individuals with COPD or thorasic weakness or obesity related hypoventilation, none of which are your problems. You have complex sleep apnea and the ASV (adaptive servo ventilator), is the perfect machine. It delivers a low exhale pressure that stabilizes your airway and prevents obstructive apnea, then uses pressure support (the difference between inhale and exhale pressure) to deliver a breath when needed, in the volume needed to maintain your respiratory rate and volume. Most people with ASV experience a complete remission of their obstructive and central apnea.

Please call your doctor today, and request "ASV titration" as soon as possible. You would benefit from supplemental oxygen until this test is completed and ASV equipment can be dispensed. Do not let this slide. Your doctor already knows the ST will not work and is waiting for your call.

[SarcasticDave94]

I agree with Sleeprider fully. I have an ASV, and I've experienced being on a very wrong machine. Prep for a bit of a fight, but we'll help you with pointers on how to get a ResMed ASV ASAP.

Do some Q & A with me and others (here on this thread is OK) as needed. One tip now: complain to the doc loud and lots on ST failing you with poor therapy. If needed, write it down; "This is how I felt after x night of sleeping. Here is my complaint, doc."