AHI Went Up After Switching to New Machine - Help?

[bythepen]

Hi!

I'm brand new here. I found this board while googling to find an answer to my problem below. I still haven't been able to find a solution, so I'm hoping you might have some ideas.

For almost five years, I used a ResMed Airsense 10 Autoset and had an average AHI of 0.4 and felt fine.

Recently, that machine has started to have some issues and so my doctor agreed to get me a new machine. I wish I had thought of this, but it didn't occur to me that I needed to request the same model that I'd had before - and no one along the way asked, either. So I ended up with a Philips Respironics Dreamstation. As I understand, this is also a good machine, but as soon as I started using it, my AHI shot up to over 2. I still felt fine for the first week or so but now I feel pretty bad, and my AHI is continuing to climb. It's been 3.7 / 3.5 the last two nights.

I loaded all of my data into Oscar. Below are two screenshots - one from about a month ago on my old machine, and one from last night on the new machine.

It looks to me like my pressure is not getting high enough on the dreamstation. I changed the max to 20 last night but the pressure didn't increase. I can see from the summaries that my pressure on my old machine sometimes got as high as 15, but on this new machine my max pressure is closer to 10. I don't know how to get it to go higher.

As I said, I feel *bad.* This can't continue. I am so tempted to go back to my old machine but I need to at least try to get this one to work. I don't know if the medical equipment company will let me return this one, especially since my AHI is still under 5, even if it's gone up 5 to 10 fold. What I'd really like to do is return this and get a new ResMed.

Is it possible this machine is malfunctioning?

Do you have any suggestions? I'm open to trying to tweak settings and try different things.

Thank you!!

[Dog Slobber]

Comparing the pressure graphs and statistics between the ResMed and Respironics it's obvious the ResMed was treating your events with more pressure.

Personally, I would try to return the Respironics for a ResMed. Barring that I would increase the minimum pressure from 5 to 8, and then reevaluate.

[Pugsy]

Different brands....different auto adjusting algorithms.
Nothing wrong with the way the DreamStation is functioning....you just need more minimum (not maximum) pressure.
Each brand goes about doing its job a little differently.
I have used both brands and with the Respironics I need roughly 3 cm more minimum to get the same results that I get with the ResMed.

[bythepen]

Thank you both! I really appreciate your replies.

I just bumped the minimum up to 8.0 and set up the ramp. I didn't use the ramp on my resmed but I know that putting the mask on at 5.0 is comfortable and 6.0 is not comfortable, so I'm assuming 8.0 would also not be comfortable to start out with.

I'll see tomorrow how it went.

Thanks!

[LSAT]

You should really put on your mask at the higher pressure. If you get it adjusted to the low pressure it may leak at the higher pressure. Once you are accustom to your pressures, it will be easy. I put my mask on at 12 without any problem and I generally have Zero leaks.

[bythepen]

I see what you're saying, LSAT. Thanks! I'll work on getting used to starting at the higher pressure.

Last night's experiment definitely improved my AHI, although it's still not down to where I was on my old machine, so I'd like to keep tweaking it. Some questions:

• should I stick with last night's configurations for a few days to see if my body adapts and the AHI goes lower (is that how it works)?

• last night I had dinner at a French restaurant with food that is different from my normal fare. Might that possibly affect my AHI as well (bolstering the idea that I should stay at the same level for a few more days to see how things go with more normal food)?

• would pushing the min pressure to 9.0 be the next thing to try? I have also been futzing with the AFLEX and now have it at 1, but I'm thinking about turning it off entirely. Would that make any difference in the AHI or is it simply a comfort thing?

Thank you!

P.S. I think the reason the graphs have the data all on the right is because I was messing with the machine in the middle of the afternoon and I think I hit the "start" button at least once. I think that's recorded at the far left.

[zonker]

I see what you're saying, LSAT. Thanks! I'll work on getting used to starting at the higher pressure.

Last night's experiment definitely improved my AHI, although it's still not down to where I was on my old machine, so I'd like to keep tweaking it. Some questions:

• should I stick with last night's configurations for a few days to see if my body adapts and the AHI goes lower (is that how it works)?

• last night I had dinner at a French restaurant with food that is different from my normal fare. Might that possibly affect my AHI as well (bolstering the idea that I should stay at the same level for a few more days to see how things go with more normal food)?

• would pushing the min pressure to 9.0 be the next thing to try? I have also been futzing with the AFLEX and now have it at 1, but I'm thinking about turning it off entirely. Would that make any difference in the AHI or is it simply a comfort thing?

Thank you!

P.S. I think the reason the graphs have the data all on the right is because I was messing with the machine in the middle of the afternoon and I think I hit the "start" button at least once. I think that's recorded at the far left.

welcome to the zoo! while i'm no expert, i'd say yes to each of your questions. giving your body time to adjust is always a good thing in my book. others here will say to change things AT ONCE. but if you are a patient person, i feel slow and steady wins the race.

i have found that what i eat does indeed "mess" with my sleep. if you want, google "sleep hygiene" to see some results. for me, it's mexican food that is my downfall. so i try to have that more as a lunch, say, than a big dinner.

you can try a minimum of 9 on the pressure. but i will certainly defer to the experts here on that matter.

so, all in all, i wish you good luck!

[Dog Slobber]

I almost always like to give things a few days. Both to ensure that last night's data wasn't an aberration, and to give us time to adjust.

You're accustomed to CPAP, so adjusting to the higher pressure shouldn't be a problem. Go with what you're comfortable with.

[bythepen]

Thanks to both of you! I'll give it a few days and see how it goes.

This forum is awesome. I searched for quite a while to get these answers before I stumbled on cpaptalk. I'm so glad you're all here and willing to share your knowledge.

Thanks!

[TropicalDiver]

I went through a similar thing about a year ago. The ResMed algorithm just felt more natural to me. DME suggested a Dreamstation to replace my S9. I tried it but talked them into to a ResMed.

So I would try and swap now -- there may be a 30 day window....

[zonker]

Thanks to both of you! I'll give it a few days and see how it goes.

This forum is awesome. I searched for quite a while to get these answers before I stumbled on cpaptalk. I'm so glad you're all here and willing to share your knowledge.

Thanks!

you are most welcome. most of us here have been where you have been. that is, brand new and not knowing enough. but the very nature of your questions shows me that you have a quick grasp of your situation. i think you'll go far.

i would suggest, as you move forward, that you keep your questions to this one thread for a few weeks. it just helps the experts keep up with you and your particulars.

then later, you are certainly welcome to do as you wish. this isn't a hard and fast rule. i just think it's easier for all involved.

[bythepen]

Thanks so much for your kind words, Zonker!

Since my last post, I went a second night at the higher levels but my AHI went up again. So I called the DME and am very happy to say that they agreed to give me a ResMed and to take back the Dreamstation. I'll be making the switch on Friday, but in the meantime I went back to my old machine (which is aging but still functional) and my AHI dropped immediately to 0.2.

I've been happy with my AHI on the ResMed but since this latest episode and finding this forum, I think it would do me some good to stick around and learn a little more so I can hopefully avoid something like this happening again.

[palerider]

Thanks so much for your kind words, Zonker!

Since my last post, I went a second night at the higher levels but my AHI went up again. So I called the DME and am very happy to say that they agreed to give me a ResMed and to take back the Dreamstation. I'll be making the switch on Friday, but in the meantime I went back to my old machine (which is aging but still functional) and my AHI dropped immediately to 0.2.

I've been happy with my AHI on the ResMed but since this latest episode and finding this forum, I think it would do me some good to stick around and learn a little more so I can hopefully avoid something like this happening again.

Capnloki wants to talk to you about how dreamstations are JUST AS GOOD as Resmeds.

[zonker]

Thanks so much for your kind words, Zonker!

Since my last post, I went a second night at the higher levels but my AHI went up again. So I called the DME and am very happy to say that they agreed to give me a ResMed and to take back the Dreamstation. I'll be making the switch on Friday, but in the meantime I went back to my old machine (which is aging but still functional) and my AHI dropped immediately to 0.2.

I've been happy with my AHI on the ResMed but since this latest episode and finding this forum, I think it would do me some good to stick around and learn a little more so I can hopefully avoid something like this happening again.

you are MOST welcome, good sir. (or madam)

i must say right here that i am convinced that switching to resmed was one of the best decisions i've yet made about my therapy. i improved (that is, lowered) my ahi almost at once.

here's hoping you have the same results.

[zonker]

Thanks so much for your kind words, Zonker!

Since my last post, I went a second night at the higher levels but my AHI went up again. So I called the DME and am very happy to say that they agreed to give me a ResMed and to take back the Dreamstation. I'll be making the switch on Friday, but in the meantime I went back to my old machine (which is aging but still functional) and my AHI dropped immediately to 0.2.

I've been happy with my AHI on the ResMed but since this latest episode and finding this forum, I think it would do me some good to stick around and learn a little more so I can hopefully avoid something like this happening again.

Capnloki wants to talk to you about how dreamstations are JUST AS GOOD as Resmeds.

tsk, tsk. not to mention tut, tut.

to each their own, as the saying goes.