Trialing a Dreamstation (2?) for 4 weeks

[NeedSleepPlease]

I asked my Nurse Practitioner about sleep apnea because I thought I was showing signs (im 300lbs, snore pretty badly, wake up dizzy often and it lasts most of the day, every single day I wake up at 100% fatigue already and it never goes away), she pretty much dismissed it and told me to use an app on my phone to see if i have it but we could do a sleep study in future if needed. I had heard that the waiting list for the hospital sleep study was over 10 months, so I looked for another solution and found Philips Pharmacy Sleep Services, an Australia service thats now operating in New Zealand pharmacies as well (where I live). I explained my symptoms to the pharmacist and asked if I could hire the machine (4 weeks, $250) without having to hire the stick-to-your-forehead device first ($130) and she agreed that my symptoms meant I probably did have sleep apnea, and yes we could skip straight to trialing the machine which is a Dreamstation AUX500T15C (which I think is a Dreamstation 2?).

I started on Feb 1st with the nasal pillow that just has the little slit in it, and found that impossible to breath through because im a side sleeper and it just crumbles when I turn my head sideways. The first week was horrible, headaches, not sleeping more that usual cus I was constantly having to adjust the mask to be able to breath etc. I went back to the pharmacist and we tried on the Dreamwear Gel Pillows, with the two nubby bits that go up your nose. This was much better, but I was still struggling. On Feb 6-9 my apneas went up and up until on the 10th.. I tightened the mask and they dropped way back down again. Having the mask this tight really hurt the insides of my nose though, it was pinching really hard at my septum (the fleshy bit).

Spoke to the pharmacist again and she recommending taking the night off, so I did on Feb 13th. On Feb 14-16th something magically changed and I was able to sleep more easily with my face on a diagonal (my natural position is smooshed into my pillow, which you cant really do), and whilst Feb 14-15th was still pinching my nose, Feb 16th had little to no nose-pinching. Feb 14-16th almost felt like an ok nights sleep, I wasnt fussing with the mask too much, I managed to move my pillow so the top vent stopped blowing against my pillow really loudly and waking me up all the time. I would *almost* go as far as to say last night (Feb 16th) felt.. good.

Im new to all of this, so ive been reading the forums here. I found the OSCAR software (HOW COOL IS THIS!!!) which finally showed me what was actually going on, because the pharmacist just keeps saying "everything looks really good" but I honestly dont think shes had much training in this. I will attach my OSCAR data in case anyone can point out anything thats going on that I need to change or adjust (last nights full charts and then the overview, let me know if theres a more helpful page/chart I should be sharing!).

I was also interested to read about the whole Philips saga and made me think twice about buying one of these machines at the end of the trial as it dosnt seem Philips products are recommended any longer due to all the kerfuffle! If I do buy it through the pharmacy, the machine is $2200NZ and the mask is $320NZ (things are just more expensive over here). Im not sure I want to spend that much money on a machine from a brand with a dodgy past? But then, this is the machine and mask that I will be used to. So, hmm, thoughts?

[Gideon]

Welcome to the forum.

The Summary info says you are doing great but the daily charts says you should feel better with min pressure of 6.

See that triangle between February and 2024? Click that and minimize the calendar then we will see your settings.

[NeedSleepPlease]

Thank you for the welcome!

Like this (see attachment)? We started it at '4' because im Autistic and really hate change and cant deal with things touching me (like air blowing at my face or harnesses on my head lol). But im pretty sure I watched her get into the 'clinician only' settings to change the pressure, perhaps I try tonight at '5' and see if I can handle it?

EDIT: I found my way into the forbidden settings (ha) and changed it to 5, ill see how that feels tonight! Ty for deciphering the chart!

[NeedSleepPlease]

I tried '5' last night and other than it being a bit anxiety-making to start with, seems to have been ok during the night! Ill do 5 again tonight, and then see if I can handle 5.5, and possibly 6. Can someone please tell me how I read the charts to figure out what pressure im needing during the night? The last commenter suggested I should be at '6', but im not sure which bit of the chart shows that?

[Gideon]

It to let your pressure relief function.
Look at your differential pressures at pressures GT 6

[NeedSleepPlease]

Sorry, I didnt understand that at all! Ive read through the 'how to read OSCAR data' wiki and im still really confused. What does the "95%" mean in the charts?

[Crimson Nape]

95% is actually 95-percentile.  This column means that the parameter was at or below this value for 95 percent of the recorded time span.

- Red

[Sleeprider]

The increase in pressure to 5.0 really helped. Your event rate dropped and we can finally see the effect of Flex providing expiratory pressure relief. Snores and RERA are significantly reduced. I know changes make you anxious, but I think a minimum pressure of 6.0 will work even better. this is still a low pressure and you might even want to use it in CPAP mode rather than Auto-CPAP. This would avoid those 1.5 cm pressure changes during the night that the Philips algorithm uses to test a higher pressure.

The Philips Dreamstation is honestly an awful auto CPAP machine that is not only recalled and discontinued in the U.S. but is slow to respond to events to raise pressure. If you eventually are asked to buy a permanent machine please request the Resmed Airsense 10 autoset.

[NeedSleepPlease]

Ohhhhhh, ok, that makes more sense, thank you!

[NeedSleepPlease]

Thank you for your reply! So I tried it on 5 again last night, and other than the mask hurting the hell out of my nose again, the 'feeling' for 5 was ok. Tonight, I will try 5.5 whilst im reading in bed and then see if i can flick it up to 6 for the rest of the night, if not, ill do 5.5 for the night and try again with 6 tomorrow, ive got the machine hired until the 1st, so still about 10 days left to try the settings. Ive attached last nights data, please ignore anything hinky just before I woke up, I think my right nostril got stopped up an hour or two before I woke, as I woke to the mask askew and the machine trying to force a small hurricane up my nose but I was too asleep to reach up and try to adjust the mask!

I did a little research, and theres a NZ company called Edensleep who seem to stock ResMed machines and masks, and also hire them out from $35 a week, so when im finished the Philips trial, I think I will trial a ResMed machine and nose-pillow mask for 2 weeks just to make sure they are going to work for me, and then probably buy that set (im hoping their nose-pillow mask dosnt pinch like the Philips one does). This company sells the "ResMed AirSense 10 AutoSet APAP Machine" for $1970 so not only is it $230 cheaper than the Philips, it seems to be 100x more recommended than the Philips! They also sell the "ResMed AirSense 11 AutoSet" machine for $2199 which I would consider if the consensus here was that it was infinitely better than the AirSense 10, but if not, id prefer to save the $230 and get the AirSense 10!