newbie with an old machine?

[ajack]

As has been said, increase your minimum pressure, you could even start at 9 and leave it on auto, this should get your AHI down and it looks like the machine wants to go higher.

[Kohkie]

I have a similar machine the PR System One 550. I also have Medicare and Tricare. You do need to get a sleep study for Medicare and Tricare to pay if your last sleep study was over 10 years ago. I'm getting a new machine with my doctor's recommendation/prescription, without a sleep study but my last one was 5.5 years ago. Neither Medicare or Tricare will pay anything if you get a machine without a doctors recommendation/prescription. Also your doctor has to confirm to Medicare that you are compliant. Meaning that you spent at least 30 days consecutively using the CPAP for at least 4 hours every night. You have 3 months to become compliant. If you do not, Medicare and therefore Tricare will not pay.

I noticed your machine pressure settings Min/Max were 6/20 and your average pressure was 9.9. I have had better luck with bringing in the Min/Max to closer to what my average is. For example my average 90% pressure is 15.4, so I set the machine Min/Max to 14.5/18.5. Generally my average AHI is in the 0.8 range. When I had a wider range, as you do, my AHI was much higher.

Good luck
Tami

[Spearcatcher72]

I set the machine to CPAP with 8.5 and have been there for 4 nights. AHI is averaging 4.24, based on individual nights at 2.86, 5.88, 2.81, and last night 5.49.

I'm only averaging about 6 hours of sleep per night, but I think that's mostly because of my environment. When the sun comes up I usually wake up. I need to go to sleep earlier or figure out how to keep the room dark until I awaken. Part of the problem is my designer wife...she'd kill me if she knew I posted that. Her window treatments do not allow me to keep the room dark. Easy solution is going to bed before midnight. I'll have to work on that.

I've had several AHIs over 5, and none below 2 except for the night spent in the lab for titration when at a constant 4CM yielded 4.6 after an hour and 42 minutes; pressure was then increased to 6CM and it was .2 for the duration of the study, which was 4 hours and 22 minutes. My latest results at 6 CM after 61 days yielded an average AHI of 4.13.

I'm envious of those of you with such low AHI scores, but with all of the variables, including masks and machines, this still feels like throwing darts blindfolded after 6 beers in a crosswind--with rap music blaring in the backround for good measure.

I would like to hear from people who felt moving from an older machine like my 2011 REMstar Pro series 1 to a newer automatic machine that optimized the situation fared. My thinking is that setting a fixed pressure is a good first start to solving sleep APNEA, but using modern technology to adjust to TONIGHT'S sleep issues might be a better solution.

Lastly, my imported results from SleepyHead last night shows the following:


AHIApnea Hypopnea Index 5.49
Philips Respironics System One
RemStar Pro with C-Flex+Model 450P - P042598198685
PAP Mode: CPAP
Fixed 8.5 (cmH2O)
Date Sleep Wake Hours
4/28/2017 01:41:36 07:53:20 06:11:44
Periodic Breathing 0.57%
Large Leak 0.00%
Clear Airway 1.45
Obstructive 0.48
Hypopnea 3.55
RERA 0.00
Flow Limitation 0.00
Vibratory Snore 0.00
Vibratory Snore (VS2) 0.97
Pressure Pulse 6.78
Breathing Not Detected -146.92

Thoughts???

Thank you for your kind input. As the theme song from Monk used to say, "It's a jungle out there..."

[Spearcatcher72]

Ajack and Kohkie, I'm sorry that as a Newbie I didn't realize that there was another page of postings so just found your two posts. I can follow the advice both of you gave me--I'll go back to auto and start at 8.5, increasing the range to say 13. I'll do that tonight.

One thought, however, is that my machine's auto function was really designed for general titration, not for continuous use in auto. It allows an auto mode for 30 days, and I only have about 20 of those left. I believe someone said that limitation can be reset, but I don't know how to do that.

Kohkie, I'm going to make an appt with my Sleep Doc (whom I like by the way, although he doesn't yet know that I've been adjusting my machine myself; however, I don't think he's going to be bothered by that), and get an RX for a new machine. My sleep study was 12/20/2011, and the Titration was on 12/28/2011. With Medicare and Tricare I'm in the same approximate situation as you are. Hopefully I can get a new machine. Of course, which one is the next hurdle, and again I'd love input from anyone who'd like to share with all of us about seeing improvement when going to a newer machine.

Thank you all!!!

[Pugsy]

It allows an auto mode for 30 days, and I only have about 20 of those left. I believe someone said that limitation can be reset, but I don't know how to do that.

It involves going into the clinical menu setup and totally erasing all your therapy data.
I think it is called "reset therapy data" or something similar.
Do it only after all the 30 days of apap mode have been used up and make sure that all your data is in your software.

Flow limitations....being 0.0 when in fixed mode doesn't mean anything because FL flagging is turned off in fixed/cpap mode.
You must be in apap/auto mode for FL flagging to be turned on.
So with the 0.0 when in fixed mode we don't know if nothing happened or the machine simply didn't flag them.

[Soothest Sleep]

I need to go to sleep earlier or figure out how to keep the room dark until I awaken.... window treatments do not allow me to keep the room dark.

I don't see where you mention what CPAP mask you use, so depending on what style you have, this may or may not be useful: Have you tried using a sleep (eye) mask to block light from your eyes?

Jean