Need Help Changing Altitude Setting - REMStar Auto M Series

[Pugsy]

The 7 day average on the LED screen is just that, and average. You aren't going to see a huge change from night to night. Law of numbers.

Yes, the average AHI has doubled which is not good but you won't see it change from 7 last night to 4 tonight. I just can't happen.

I doubt the change is your machine. I would think that due to the altitude your body is simply needing more oxygen till it gets acclimated to the altitude. You report that you think you are mouth breathing more. This in itself can create enough leak so that the therapy is not effective and thus allow more events. So maybe the mouth breathing is your body trying to get more oxygen???? Whatever the reason why, mouth opening is not good.

If you had the detailed reports from each night in question you would have a better idea as to what is really going on.
You need to know if the leaking or mouth breathing is reducing the effectiveness of the therapy. It can and will cause events to sneak past the defenses.

Do you have the software and card reader so you can see the nightly details and not rely on the machine LED 7 day average?

[yamar2001]

Went to the place... they checked my machine...everything is working fine with it. AHI index now 7.8 for last 7 day average. It continues to go up every single day.... I'm being told by the people at the medical supply place to never adjust my pressure on my own because it can worsen my condition.

He told me to see a DME and the DME could tell me if I need to increase the pressure or not. How will he just automatically know that? Doesn't make sense.

I'm confused, frustrated, and deep depression is setting in. Can't sleep for more than 5 hours a night... and don't even know where to turn anymore. Had this thing under control for a year and a half... and I'm right back where I started now. I don't get what happened....

[Pugsy]

He told me to see a DME and the DME could tell me if I need to increase the pressure or not. How will he just automatically know that? Doesn't make sense.

It makes sense if they use the software to review your data to see what is going on...
Not hard to do at all.

That is why I asked you if you had the software yourself????? It is available.

[Pugsy]

I'm being told by the people at the medical supply place to never adjust my pressure on my own because it can worsen my condition.

Geez, you are already using APAP with a range of pressures so the machine changes pressure all the time.
Increasing your minimum from 6 to 7 or 8 is not the type of change that will hurt anything at all because I bet your machine goes there anyway. It actually might help. Sure wouldn't hurt.

[yamar2001]

The script is actually written for CPAP, not APAP. I put it on APAP because I figured if it would alter the pressure while I was sleep... certainly that would be a better option for the next few weeks until I see a Dr and see if my CPAP pressure has to be adjusted...which I believe it does. The RT told me to put it back on CPAP but I really don't see why I should do that - it's not working properly... and APAP will provide me with at least knowing that the machine is going to try a little harder, to give me more pressure when it senses that I'm having an episode.... what do you guys think?

I do have the software...I believe it's Encore 1.8.49 because it's an older MSeries Machine. I'm just trying to figure out where I can get a card reader...so if anyone can help me with that I'd highly appreciate it.

[Pugsy]

'm just trying to figure out where I can get a card reader...so if anyone can help me with that I'd highly appreciate it.

https://www.cpap.com/productpage/Respir ... r-USB.html


You might find it elsewhere on the web. I haven't looked lately.

[yamar2001]

I will order one.

You think auto is better until I get this figured out? I don't think I have much to lose using auto... you?

[Pugsy]

Yes, I think auto is just fine. Unless you are leaking significantly, the machine won't go where it doesn't think it needs to go to deal with the events.

My concern is that your 6 cm minimum pressure is just a little too low and the machine doesn't have time to go from 6 cm to what you need to prevent the events. The response isn't from 0 to 60 in a few seconds. It actually goes up in stages in response to events and when set a bit too low, it simply can't get to the event in time to prevent it and the event has come and gone before the response is full. Takes several minutes to climb just 3 or 4 cm.

I have seen this with my own M Series APAP. At 10 cm minimum I do very well and AHI is quite acceptable but if I drop it to just 9 cm minimum my AHI will double and I see clusters of events that I don't see at 10 cm minimum.

If you increase the minimum to 7 cm then the machine has a running start (so to speak) to get to what it needs to prevent the events from happening.

A one or two centimeter increase in your minimum pressure is really a relatively small increase since you are starting at such a low pressure already. Now if your minimum was 13 or 14 whole different story but it isn't.

2 years ago I started with 8 cm minimum and it just wasn't enough. I changed it to 9 then to 10 and it didn't hurt me, in fact it got my AHI down to 2 most of the time. I did it all on my own. 3 months later fessed up to doctor and was told I did the right thing, just what they would have suggested.

It is possible that with the change in altitude you need a bit more pressure. It is also possible that other factors may be in play. Weight? Or just body changes in general. Changing the pressure ever so little, won't hurt a thing.

[yamar2001]

Yes, I think auto is just fine. Unless you are leaking significantly, the machine won't go where it doesn't think it needs to go to deal with the events.

My concern is that your 6 cm minimum pressure is just a little too low and the machine doesn't have time to go from 6 cm to what you need to prevent the events. The response isn't from 0 to 60 in a few seconds. It actually goes up in stages in response to events and when set a bit too low, it simply can't get to the event in time to prevent it and the event has come and gone before the response is full. Takes several minutes to climb just 3 or 4 cm.

I have seen this with my own M Series APAP. At 10 cm minimum I do very well and AHI is quite acceptable but if I drop it to just 9 cm minimum my AHI will double and I see clusters of events that I don't see at 10 cm minimum.

If you increase the minimum to 7 cm then the machine has a running start (so to speak) to get to what it needs to prevent the events from happening.

A one or two centimeter increase in your minimum pressure is really a relatively small increase since you are starting at such a low pressure already. Now if your minimum was 13 or 14 whole different story but it isn't.

2 years ago I started with 8 cm minimum and it just wasn't enough. I changed it to 9 then to 10 and it didn't hurt me, in fact it got my AHI down to 2 most of the time. I did it all on my own. 3 months later fessed up to doctor and was told I did the right thing, just what they would have suggested.

It is possible that with the change in altitude you need a bit more pressure. It is also possible that other factors may be in play. Weight? Or just body changes in general. Changing the pressure ever so little, won't hurt a thing.

I've received more help on this website that I have from any Doctor, RT, or any other bullshit person I've seen in the last three years (and spent about 3k in the process!) You know what? I'm going to disregard the RT's orders to not touch the pressure. He said he can worsen my condition....but I'll notice my AHI go up if that's the case I would think.

Nothing is different...I weigh less than I have in a long time. I'm a 168 lbs 5 foot 8 - not over weight. I've changed my diet a bit... I've been far more healthy in the last two weeks than the month prior. The air is much dryer here than where I came from, the RT said possibility adding some water to the resivoir (I didn't used to use it...) would help, but it didn't last night. In any case, I think I'm going to put it on auto and have the minimum set for 7.5 - what do I have to lose really?

He said if I adjust it on my own, not only can my condition worsen, I may not even know there's more apneas per hour because they won't register if the apnea is from TOO MUCH pressure. Everyone wants their cash, the DME, the RT, the sleep "specialists" that charged me $200 a visit to pop on the smart card and see how long I wore the mask...and then rush me out the door without saying another word about how to improve my condition.... everyone.

Except you guys... you're doing it because you know how much this sucks and you want to help. I appreciate that. I think I'm going to order the card and just start being my own Dr. - I'm flat broke until I get paid in a week, so I'll have to order the card then.

[Pugsy]

Don't expect to check the machine tomorrow and notice any huge change in the AHI.
Remember it has 6 other nights worth of AHI numbers in that average.
Without software you have to wait till you have used it 7 nights at the new setting to really expect to see much difference. Got to let those other night fade away in the law of numbers.

[yamar2001]

Don't expect to check the machine tomorrow and notice any huge change in the AHI.
Remember it has 6 other nights worth of AHI numbers in that average.
Without software you have to wait till you have used it 7 nights at the new setting to really expect to see much difference. Got to let those other night fade away in the law of numbers.

I totally understand what you mean... it's a seven day average. With that said, that's why I'm even more alerting what's going on. My 7 day average is going up like .5-.8 every single day! I must be having a bunch of episodes in the middle of the night for it to jump that quickly!

We shall see... I will set it to auto with the min being 7.0 (1 point higher than prescribed CPAP pressure) and max of 10. I think this should help a little. Hope so anyhow. And when I get paid I will order one of those cards.

[yamar2001]

"With that said, that's why I'm even more alerting what's going on"

Ugh, I can't even write properly anymore. That's what two weeks of awful awful sleep will do to someone. I'm going to order that card right when I get my check, thanks alot for the link!!!!

[Wulfman...]

In the interim (till you get the card reader, etc.), I would suggest you use the last portion of the instructions I posted to clear out your nightly data AFTER you write them down. Then, the next morning your numbers will only be for the night you just finished.


Den

[Pugsy]

I would suggest you use the last portion of the instructions I posted to clear out your nightly data AFTER you write them down. Then, the next morning your numbers will only be for the night you just finished.

Thanks Den for reminding me that we could do this. It has been so long since I needed to I had forgotten.
M series machines can be reset to zero each night so that the AHI shown is only for the one night. This has to be reset every day to keep numbers individual. Did not lose other data doing it this way.

I just got the PR S1 APAP and it has a feature to reset data but it resets everything to zero, compliance and therapy also. From the way it is worded it seems to be that way. So can't pull that trick on the new machines.

[yamar2001]

been recording the data since I switched over my machine to auto and stepped up the presure

4.12
90 pressure = 12.0
system leak = 30.2
AHI 9.6

4.13
90 pressure 9.0
leak 33.4
AHI 6.1

4.14.
90 pressure 13.0
leak 40.0 (ouch)
AHI 10.2

4.15
90 pressure = 10
leak = 27.9
AHI = 1.9

the 1.9 ahi is better than I've ever had and I didn't do anything differently. How come my numbers are so all over the place with no changes being made? In any case, hopefully my body has now adjusted to the new settings, and I'll be seeing numbers closer to 1.9 than 10.2 from the night prior.

thanks for all your help folks, really do appreciate it.