Trialing a Dreamstation (2?) for 4 weeks

[Sleeprider]

What model mask are you using and what size nasal pillow. Your description of pain sounds like the nasal pillow is too small and it is entering your nose rather than sealing along the outside of the nares.

[NeedSleepPlease]

Ive attached a photo of the headgear and mask, im having trouble finding exactly what this mask is called. The harness is a Medium and the nose-pillow piece is a Small.

I text the pharmacist to say that I tried 5 and it was ok, and that ill be trying 6, at this communities recommendations, she text back "What is their logic on that? Your aponea are within the normal range, you would only increase pressure if your aponea weren't improving at a lower setting. Also your issue is gushing noises and sore nose, which higher pressure will only increase these issues."

To me, this sounds like shes only had the most basic training for providing this programme and you guys know a hell of a lot more. How do I reply to her to let her know why you guys recommended 6? Im still struggling to read the charts. Looking at my last chart, am I correct in my understanding that 95% of the time, I was using between a 5 and a 6.5? Which means that a 5 is on the lower side, and something closer to 6 would be more comfortable? The 5 was easier to breathe with once I got used to it, the 4 was harder to breathe with, I had to take extremely deep breaths the whole time to get enough in.

Also, I fixed the gushing noise from the top vent by punching my upright pillow down in the middle, so the air no longer hits it. Im also interested in that she thinks the higher pressure is causing a sore nose, and not the fact that the mask is literally pinching me. Would you recommend I try a Medium nose-pillow mask if she has one?

[Sleeprider]

This is similar to the Resmed P30i nasal pillows mask but look a lot less comfortable. The big difference is Resmed uses a diffused vent that is very quiet and won't blow on your mate. Also the nasal pillows are much softer and more contoured to rest outside the nostrils. My recommendation is to request the medium nasal pillows cushion to see if that is more comfortable.

Why a pressure of 6.0? Because we are optimizing your pressure to get the best possible results. When you started therapy, your minimum pressure was 4.0, but you had a 1.44 AHI as well as high flow limits, and snores. When you changed your minimum pressure to 5.0, you cut the AHI in half and had even better results for flow limits and snores. You tried a minimum pressure of 5.0 on a second night and confirmed the pressure was better, but there are still residual OA, H and flow limits. With a minimum pressure of 6.0, it is reasonable to expect that these residual events will clear even more and that will lead to better sleep, more comfort and less pressure variation. I would not ask permission from someone trying to control my therapy, and this is how you can do it yourself https://mail.apneaboard.com/dreamstation...structions The problem is that the Philips auto CPAP machines are not proactive in preventing events, and it is necessary to set the minimum pressure to proactively optimize results. That is also the reason you will be asking for a Resmed Autoset when this trial is over. You might want to ask this pharmacist why they are hiring a recalled machine that has potentially carcinogenic polyurethane foam. https://www.apneaboard.com/forums/Thread...-ONE-USERS Furthermore, Philips has entered into a consent decree with the FDA and discontinued U.S. sales of most of its CPAPs BiPAPs, ventilators and test equipment including this machine. https://www.apneaboard.com/forums/Thread...in-the-U-S

[NeedSleepPlease]

Thank you so so so so so much for explaining that! I think I almost understand now! I will pass on what you've said and see how she reacts haha.

I couldnt work out if this trial machine, AUX500T15C, was one of the recalled or not? If so, im pretty angry that its being rented out and that they are trying to sell you one of these machines at the end of the trial. Annoyingly, this seems to be a Philips programme only, so ill have to try the ResMed (at a cost, again), from the previous mentioned local website. Knowing what I know now, im pretty annoyed to have spend $250 trialing a machine that has SUCH a dodgy past from a company who sound like they suck, because I now have to spend more money, to trial a ResMed from someone else.

I will let her know your explanation and ask if she has a Medium nasal-pillow mask to try, and if she does, when I pick it up tomorrow, I will ask why they are hosting a programme for such a dodgy company with a really worrying past in these machines, im actually pretty annoyed and would like my $250 back because theres no way I could buy one of these machines after the trial, but I dont think ill get it back because they obviously dont see an issue with them.

Thank you again so much for sharing your knowledge, I really really appreciate it, this is all pretty overwhelming to start with but you really seem like you know your stuff!!

[Sleeprider]

AUX500T15C is an original Dreamstation 1 marketed for the Australian market. It is recalled and discontinued. Sales of this device are discontinued in the U.S. for safety concerns, but the consent decree does not affect off-shore sales. The recall thread previously posted has a lot of details, but this device was manufactured with a PUR foam in the air-channel that has been shown to break apart causing particles to be injected into user's lungs. There are a number of class action suits for health impacts. All devices like the Dreamstation 1 were recalled over 3-years ago and either remanufactured or replaced with a Dreamstation 2. The Dreamstaiton 2 is now also discontinued in the U.S. over concerns for the safety of the replacement foam, which also went into the remanufactured DS 1 machines. Either way, you should not use that device for long if you have a choice. The fact these devices are discontinued in the U.S. but continue to be sold in Europe and AU is a concern for us on Apnea Board. Something unsuitable for sale here should not be passed off to the rest of the World. I suspect there are big discounts being provided to incentivize liquidating these machines outside the U.S.

Here is the US FDA recall notice for your friend at the pharmacy. https://www.fda.gov/medical-devices/safe...ue#devices If this doesn't get you out of your lease, they have no ethics.

[Sleeprider]

FYI, I checked on what the Australian health services are doing with this. The answer appears to be, not much. https://www.tga.gov.au/safety/product-re...entilators

[NeedSleepPlease]

I text the pharmacist your excellent explanation and she just text back "Excellent. Good to have extra analysis. We can definitely try different sizes, ill let you know what sizes we have when im back at work tomorrow". I think she realised that you know what you're talking about

Oh wow, so this IS the dodgy machine!?? Thats SUPER concerning!! I would like to try a Medium nose-pillow mask for a few days to see if that stops the pinching and then I will (gently) let her know that I am extremely disappointed to have spent $250 trialing a dangerous and recalled machine and I will print off the relevant info from the link you sent and take it with me, requesting perhaps, some or all of my money back, because knowingly renting out a machine that is known to be dangerous is really really really not on. Thats.. dodgy and underhanded and extremely worrying that Philips is still running this Pharmacy Sleep Study programme in AU and NZ.

[Sleeprider]

I think she realised that you know what you're talking about

Well I'd hate to think I've given nearly 30,000 posts of bad fraudulent advise. It is the success of members like you that keeps me coming back. You will have comfortable, effective therapy and probably forget all about Apnea Board, but it's fun to watch the progress.

[NeedSleepPlease]

Well I really appreciate you continuing to come back and give your time and knowledge to newbies like me, its made me feel more empowered about learning the ins and outs of CPAP and how to get it to best work for me as I embark on this journey!

Here are the last two nights at 6, it felt ok during the night, but the first night my right nostril decided to stop itself up again just before I woke up and I ended up getting a face full of hurricane until I realised what was happening and took the mask off haha.

Now that ive upped it to 6, the 95% says 7.5, would that indicate that I could be more comfy at a higher number? Or am I not quite understanding this bit yet?

[NeedSleepPlease]

Now im looking at second-hand ResMed machines, ive asked what their total hours clocked are, am I to understand that most CPAPs do about 15-20k hours? I sleep 12 hours a night, every night, so at 15k hours the machine will only last 3.5-4 years, which is a bit of a worry, as I cant afford $2k for a new machine every 3.5-4 years! If im looking at a second-hand machine, ill need to work out how many hours its got 'left' and if the price reflects that.