Self-diagnosed on Dreamstation with questions

[0xfeedface]

I have DreamStation 500X150, which I upgraded to the latest firmware (1.8) if that is of any relevance.

[ajack]

No it doesn't matter and it's good to have the latest firmware. Philips has had several ways their auto machine determines treatment pressure. I think there was just a mix between the terms Opti-Start and CPAP-check

[0xfeedface]

Again slightly increased min pressure, worse AHI. What is going on? 

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[ajack]

Give it time, increasing slightly 0.5 at a time will get there. It's fine to go at your own pace.

How the dreamstation algorithm works is available. It will tell you what and how many events it needs, before it will raise pressure.

[0xfeedface]

Last night I tried a min pressure of 8 but could bare sleep 4 hours with it and had to make generous use of the ramp button. What an awful night.

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Now I am thinking of getting a refurb'ed AutoSet …

[ajack]

I like the resmed, The 2 in my avatar and another 2. But I wouldn't toss the baby out with the bathwater yet. There is nothing the resmed auto can do that the dreamS can't, as far as treatment outcomes. You raised pressure and it disturbed your sleep, the same will happen with resmed. Back off to 7.5 max 9.5. I pump up to 25-30cm with ivaps, you do get use to it.

I would do a mask fit function that blows high pressure and see if the leak can be resolved

When I first started, I was sleeping in 1.5-2 hour blocks and wake up. 4 hours is a win

[Sleeprider]

We have seen remarkable improvements in some individuals moving from Philips to Resmed. I would not discount the fact the pressure is delivered very differently and with EPR instead of Flex. I think you have given your current machine a pretty good trial and it is yet to deliver what we would consider "efficacy". In theory both are CPAPs and do the same thing. In reality, there can be significant difference in effectiveness.

[0xfeedface]

Ok, two more nights on the DreamStation, both with pressure settings at 6.5/9.5. On 8 May A-Flex was at 3, on 9 May at 2.

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[0xfeedface]

First night on an AutoSet. It effectively prevented almost all of the obstructive apneas and hypopneas (as expected). But suddenly I have lots of centrals.

[attachment=11898]

I will probably raise the min pressure to 6.5 as it was on the DreamStation, so I can get rid of some of the pressure changes. Any idea on the centrals? Might that be a reaction to the more aggressive algorithm? Should I try the "Soft" setting? Why do they seem clustered? Is ResMed's CA detection reliable?

[Gideon]

I think most of the centrals are induced by theEPR of 3.

With EPR =3 you min pressure should of been 7.

Set your min to 6.4 and EPR to 1.