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My Raw (unedited) Notes - Review - Respironics CPAP Machine - DreamStation Auto CPAP.

·      Rigorously researched sleep therapy platform EVER by Respironics.

·      700+ interviews and surveys with patients, providers and clinicians

·      The power of the DreamStation  (This is an over simplification of the power of the DreamStation Auto CPAP.

a)    This machine evolves with us. Sleep apnea can get worse  when you put on a lot  weight (it can get better with weight lose), gets worse when we take a medication that has a muscle relaxing component / side effect to it, drink alcohol, and also as we grow older we tend to loose muscle tone .

 

b)   The machine responds intelligently to your breathing. It uses a 10 second window to see if you stop breathing or if there is an 80% drop in air flow when your breathing using this machine.

c)    This machine will test you. Once it deals with your apnea , it will test you to see perhaps you could handle a slightly weaker pressure setting than it is currently blowing.  Then it will test you to see if you can handle an even weaker setting and still get rid of your apneas. Now if you happen to struggle, it will bounce back up to where it was or it needs to be.

d)   It tells the doctor if you are still snoring. It detects vibratory snore during inhalation. ( By the way, you should not be snoring when you use this or any CPAP).

e)    It shows the doctor if you have Respiratory Effort Related Arousal and Periodic Breathing,  Flow limitations, Non Responsive Apnea/Hypopnea, Obstructed Airway Apnea Index, Central Apnea Index. These are important for the doctor to determine if you are being treated properly and if changes need to be made to the treatment protocol.

f)     Leaks. It informs the doctor how many minutes you are experiencing large cpap leaks, what percentage of the night are you having large leaks and an average Leak score. If these numbers are high, then you are not getting full therapy. Only partial therapy.

g)    You can make the DreamStation Auto CPAP function in Fixes CPAP mode  and CPAP Check Mode .   Now you can also make the DreamStation AutoBiPAP in Fixed CPAP mode, Fixed BIPAP mode and Auto BiPAP mode. This flexibility is fantastic !

h)   Mask Fit – tells you what percentage of time when you were sleeping there was “no leak” but a good seal.

i)     The machine will compensate 2 times the expected leak. But if the leak becomes far to great then it cannot keep up an compensate and then cause a leak.

·       

Appearance

 

·      Apple feel to it.

·      Off white

·      Slim, low-profile design

·       

 

Size

·       Dimensions - Machine Alone: Approx. 7.6 in W x 6.2 in L x 3.3 in H

·       Dimensions - Machine with Optional Heated Humidifier (Excluding Air Outlet Port): Approx. 11.7 in L x 7.6 in W x 3.3 in H

 

Weight

 

·       Weight - Machine Alone: Approx. 1.56 lbs (24.96 oz)

·       Weight - Machine with Optional Heated Humidifier and Power Supply: Approx. 4.37 lbs

·       Dimensions - 80W Power Supply: 5.5 in L x 2.75 in W x 1.5 in H

·       Weight - 80W Power Supply (Without Cord): 1.03 lbs (16.42 oz)

·       Weight - 80W Power Supply (With Cord):1.21 lbs (19.424 oz)

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·       

Sound Level (video done)

·      Very quiet .

·      Seems quieter than the system one cpaps.

·       Noise Level - Machine Alone: 25.8 dBA

·       Noise Level - Machine with Optional Humidifier: 27.9 dBA

·      Noise level on Resmed unit is 26.6 dBA

 

Power Chord

 

·      Long chord – great for hotel rooms.

·      Slightly smaller brick – less weight

·      80W Power Supply

·      It will convert when you travel.

·      Voltage Range is 100 to 240V  AC

·      You can buy DC cables if you are interested.

·      The manufacturer does not recommend you use extension chords with the CPAP.

 

Travel

·      You can separate the  actual machine from the heated humidifier. It definitey makes it smaller.

 

Heated Humidifier

 

Water Capacity - OPTIONAL Humidifier: 325 mL

·       Dishwasher safe. Top rack

·       Use the Heated Tube – if your bedroom temperature in the cooler months is below 70 degrees Fahrenheit.

·       The heated tubing does a good job eliminating condensation and it also allows you to warm the air up if you desire. We have many patient’s who like to sleep in cooler rooms but they would prefer the air hitting their noses just be a little bit warmer.

·       There is 2 modes of humidification

 

a)    Adaptive - The machine has a sensor on the outside that monitors your room humidity/temperature level. It then does its very best to give you the right amount of moisture without  you experiencing condensation (droplets of water in your tubing and mask). 

-       The problem some people experience is …..it does not provide sufficient amount of moisture for them. They feel their nose or mouth very dry.

-       You can raise the temperature of the hot plate and it will give you more humidity. The range is 0 to 5

-         

b)   Fixed -  In this mode the heater works like a pot of water on the stove.  The higher the number, the hotter the temperature of the hot plate and thus you will get more moisture. 

-       You also run the risk of experiencing condensation if your room temperature at night is kept on the cooler side.

 

·      Tube Temperature  -  this is how you control how warm the air feels for to you. You want it warmer, make the tubing temperature number lower. The range is from 0 to 5. Also, if you are experiencing condensation, increase the tubing temperature.

 

·       PreHeat  – This allows you to preheat the water before you use your Respironics Dreamstation cpap. The benefit here is you will get a heck of a lot of moisture the moment you turn the machine on. This is a very valuable feature for cpap users who are feeling very dry to begin with as a side effect from medication, hormonal changes and even certain disorders like Sjogren’s Syndrome.  This CPAP will heat up your distilled water up to 30 minutes before you intend to use your CPAP.

·      Wait 15 minutes before taking the chamber out after using it to let it cool down enough  before cleaning. You don’t want to burn yourself.

·      The manual states do not place the heated humidifier directly on carpet, fabric or other flammable material.

·      Air dry away from direct sunlight.

·        

 

 

 

Automatic Altitude Adjustment

·      Yes. This machine automatically adjust the altitude for you up to 7500 feet. For example, when you are in a higher altitude city, the air is thinner. In order for you to get the same effect from your CPAP pressure at sea level….the machine has to blow at a slightly stronger way at higher altitudes. It does this for you automatically.

Warranty

·      2 years

 

Leak Compensation

·      Yes. If there is a small leak, the machine will blow a little harder to compensate for it.

 

Tubing

 

·      Regular tubing 15mm and 22 mm

·      Heated tubing is only at 15mm

·      When cleaning the heated tubing please do not submerge (drown) the tubing. You don’t want the electrical contact points on the tubing to be wet for long periods. Just run soapy water right through it and rinse the same way. Then quickly towel dry the contact points.

 

Filter

·      Please use the disposable fine filter along with the pollen filter.

·      Negative – since the filters are now hidden in a compartment, people forget to check the filters. Out of sight, out of mind. You can choke the machine this way.

·      Insurance will pay monthly for the disposable filters and once every 6 months for the reusable pollen filter once a month

·      Only wash the reusable filter.

·       Many people want to know if they can use a Bacteria Filter with this CPAP. This is what the manufacturer states… “,If required connect a   Bacteria filter to the device air outlet, and then connect the flexible tubing to the outlet of the Bacteria filter. When using the Bacteria filter, the device performance may be affected.  However  the device will remain functional and deliver therapy.”

·       

Mask fit:

·      This tells you how good of a seal your mask was when you were sleeping with it. The formula here is 100% minus the large leak. Typically the number we are looking must be as close to 100 as possible.

 

Mask fit Check

·      Please ask the medical equipment company to turn this feature on. This feature enables you to test how good you CPAP mask is working.  In fact I would take it one step further, while during the test , lay down and start rolling into all the positions you normally would turn to in your sleep and see how the mask performs. Then try to mask any adjustment on the mask. If your mask fails this test repeatedly, change the cushion, or get a new replacement mask or just try a different type of mask. Actually reach out to your home medical equipment company and ask them to help you solve this problem.

·      This fit check is on a 40 second countdown timer.

 

90% Pressure

a)    Valuable piece of information . It shows you how strong the CPAP was blowing at you 90% of the time while you were asleep. This feature is only available in the Auto CPAP and Auto BiPAP machine.

b)   Quite often, this number changes  when you put on a lot or lose weight, take a medication that has a muscle relaxing component / side effect to it, drink alcohol, as we grow older we tend to loose muscle tone thus this number can change.

 

RAMP. There is 2 types of ramp:

 

·      Ramp#1 – Standard Ramp. You can control ramp starting pressure only. In the system one you could control ramp  pressure and time.

·      Ramp #2 Smart Ramp

·      Recognizes events and increases pressures as needed to provide therapy during ramp time. It works like an auto CPAP the moment you press the ramp button. It stays on the low side but the moment the machine senses you are having trouble breathing it starts to increase the pressure faster to correct the problem. It will not wait to increase the pressure like in the regular ramp mode.

·      The few people I tried it our with liked the standard ramp mode better. It allowed them time to fall into deep sleep faster without being woken up by the increase in CPAP pressure.

·      Knowledge that treatment will be therapeutic if events take place during the ramp time

·       

 

 

 

CPAP Check Mode

·      Checks on user every 30 hours to determine if CPAP pressure is optimal; will adjust to meet changing patient needs. It will increase the strength by 1cmh2O.  The maximum amount it can increase is by 3cmH20.

·      This is truly the most under utilized feature.

·      Designed to reduce trips to patient homes to remove and exchange CPAP after an auto trial period

·       

 

Auto Trial

·      Delivers breath-by-breath auto CPAP therapy for up to 30 days per patient; then transitions to CPAP-Check mode.  You only find this feature in the Auto CPAP model.

·      Designed to reduce trips to patient homes to remove and exchange CPAP after an auto trial period

·       

 

Opti-Start

 

Provides optimal starting pressure that can enhance patient comfort and reduce likelihood of residual events at beginning of therapy . Your starting pressure will be closer to your 90% pressure. Thus this way you are sleeping longer periods of time with no episodes of apnea.

 

 

 

 

CPAP Check

 

Checks on user every 30 hours to determine if CPAP pressure is optimal; If it is not, it will increase the strength by 1cmh2O. The maximum it will increase is only by 3cmh20.

 

 

 

Display

·      Patient-facing color screen with daily feedback.

 

 

EZ-Start

 

·      For example if someone actually needs a CPAP setting of 14cmh2O but there is no way he/she could tolerate it.

·      If the EZ-Start is engaged, it will start at 50% of the prescribed pressure (but the minimum pressure must at least be 5cmH20). In this case it will start at 7cmH20. Now everytime that person can successfully sleep more than 4 hours a night with their CPAP at 7cmH20…the CPAP machine will on the next night start at 8cmH20. It will continue to do so until  the prescription setting is achieved. Previously, doctors would have the medical equipment company increase the pressure by 1cmh20 every week. Now the machine will do it automatically. Fantastic feature.

·      Designed to reduce in trips to patient homes for pressure changes and patient visits to the office for pressure checks

 

 

 

Patient Info

 

 

Dream Mapper App

•       Patients can stay motivated and get the help they need fast.

o   Easy-to-use .

•       Gives patients feedback on their therapy usage, mask fit, and apnea hypopnea index (AHI)

•       Provides helpful videos and guides about System One and Philips masks via web, tablet or smart device

•       Only improvement it needs is – show the leak amount.

        

 

Modem


·      2 types:

a)    Wireless modem – it transmit 1 hour after you hit the off button. It uses cell phone technology. 

b)   Wifi Modem – hourly call.

 

·      Many people feel it is big brother watching. If you feel that way….just take the modem out.

·      With the modem…we can change settings easily via the computer also.

 

 

 

Performance Check

·      Simplifies in-home device evaluation for easy remote troubleshooting

·      Help reduce device troubleshooting over the phone

·      Reduce number of functioning devices returned for service

·      Our research shows 25% of returned devices are found to be operating normally*

  

Oximetry

·      You can connect a certain type pulse oximeter to your CPAP if the doctor wants to know what your Oxygen level is when you are asleep with your CPAP.


Automatic On and Off

Careful about auto off…large leaks and the machine thinks you are done using the machine and then shuts off.

Auto on – very nice feature

 

 

 

 

 

 

 

Comparison Sheet between the different models DreamStation CPAP and BiPAP.