M-Series with A-flex help needed

Blackneto · Post by **Blackneto** » Tue Jul 29, 2008 4:49 pm

Hi all, and thanks to the forum providers.
I've had my machine for 4 weeks, with the card set to Auto.
Things have been great, more sleep than ever.
I'm borrowing it from a local supply place and working with a resp tech.
the only time I ever woke up was when the pressure was really high. I checked it each time it woke me up after the resp tech told me to loock. 14, 13, 9 were the most common pressures i woke up feeling like I was choking to death.

Well the doc had me bring my card in a week ago to the medical supply place and gave me another card set to auto until the doc could assign me my "permanent" pressure..

Yesterday I got my "permanent" card which set my pressure to 13.
But i didn't notice it till bed time and the thing came on full blast.
I tried to use it but it was impossible.
worst night of sleep in a month.

I called the supply place this morning and told them the situation, they said there was nothing they could do as my doctor is out of town on vacation. and he has to set it.

i feel like crap and am ready to pack it up and take it all back tomorrow.

I noticed in various sections on this board there's info on how to manually set various machines. I was wondering if there was a the instructions in the faq would work with my machine?
viewtopic/t32637/Remstar-Setup-Instructions.html

I just want to set the pressure to 8 so I can sleep or get it back to auto mode.
anyone have a clue?

thanks.

crossfit · Post by **crossfit** » Tue Jul 29, 2008 5:33 pm

How did your doctor decide on that pressure? Was it based on what your machine data told him? Or did you have a titration sleep study (psg)?

The problem with simply turning down the machine is that the pressure may be set to 13 because that is the amount you need to prevent apneas and hypopneas. It might not be comfortable and you may have to work to find ways to tolerate it but pressures lower than that are really not helpful as they aren't stopping your illness.

Some of the ways people get used to their pressure include using the ramp feature. It will start lower than your set pressure and you can get used to it while it gradually builds up to the higher pressure. With that gradual build up, you might sleep through it when it finally gets to 13. On auto, if you were lower and it had to go to 13, it would be more abrupt, and thus more likely to wake you, than the ramp feature.

Another way people get used to it is to wear the mask with the machine turned on while watching tv or reading before bed.

One thing that also helps me is to try to think of other things than the air blowing in my face. This is taking practice. I am only a week on my machine (same one as you have) and I am just starting to get to be able to focus on other things as I drift to sleep. It is really hard to NOT think of the air. Instead, train yourself to think of something you did during the day or something you want to do the next day. You will find yourself drifting back to thinking about the darn windstorm going up your nose but each time, just gently remind yourself to think of something else.

Snoredog · Post by **Snoredog** » Tue Jul 29, 2008 5:38 pm

that is the bad part about taking your SmartCard in to have the doctor or DME read it, you get hit with unknown.

I would reprogram it with:

Mode=Auto or AFLE
Auto:Min=7.0
Auto:Max=15
Flex=2
Auto:Ramp=6.5
Ramp Timer=30

When you turn it it will go to 7.0, press the Ramp it will drop to 6.5, it is free to move up to 15 cm pressure if needed.

crossfit · Post by **crossfit** » Tue Jul 29, 2008 5:42 pm

You may also want to consider getting a smart card reader and the encoreviewer software to read your own data. It is much easier to figure these things out with that data. Without it, your just guessing and can't know if your really getting good treatment.

Blackneto · Post by **Blackneto** » Tue Jul 29, 2008 5:43 pm

crossfit wrote:How did your doctor decide on that pressure? Was it based on what your machine data told him? Or did you have a titration sleep study (psg)?

thanks for the response.
It was based on what the machine told him according to the tech.
the tech said the data showed I was at 13 most of the time.
the Ramp button worked for a little bit last night but the pressure came on too strong before I went to sleep.

that makes it unusable for me. It's also very frustrating after a month of use with no problems.
I haven't had a talk with him since he's on vacation and the nurse said she can't make any decision.
I monkeyed with it an was able to set it back to auto-mode, I think, but will search for more info tonight and mess with it more in the morning when I get home from work.

thanks for the settings info Snoredog.

GumbyCT · Post by **GumbyCT** » Tue Jul 29, 2008 5:43 pm

If you have the machine you linked to you're all set. If not, which machine do you have?

I think what you are doing is looking to set the ramp pressure to 10 for 20-30 min. until you can get used to 13 correct? You are gonna have to get used to it. I certainly wouldn't drop back down to 8 all night long. It really won't help you.

Write ALL of your settings down 1st

http://www.cpap-supply.com/Articles.asp?ID=130

Good Luck,
GumbyCT

crossfit · Post by **crossfit** » Tue Jul 29, 2008 5:46 pm

You might also want to read the "our collective wisdom" section of these forums - click the yellow lightbulb above the forum. There is some stuff there regarding changing your own settings. Once you decide if that is really what you want to do, do a search on my name. I just asked how to change this stuff a few days ago so you can find that thread and your on your way.

Blackneto · Post by **Blackneto** » Tue Jul 29, 2008 5:52 pm

GumbyCT wrote:
Write ALL of your settings down 1st

oops too late, not that they were worth anything.

but i get what you say about not setting it permanently to 8.

I don't have the machine that i link to but the M-Series with A-flex.

But I was able to get it into therapy mode and look at all the settings.

As i indicated in my original post i just want to get it set to where I can use it till my doctor gets back.

thanks.

Wulfman · Post by **Wulfman** » Tue Jul 29, 2008 5:54 pm

Here's a more complete list of settings for the Auto w/A-Flex

Den

Respironics M Series Auto with C-flex/A-Flex:

1. Hold down the <- -> buttons while plugging in the power on the back, wait 2 beeps, release buttons.
2. Press the + key. <- -> buttons move to next field, -/+ keys decrement/increment
3. Check the following field(s):

-Therapy Mode=XFLEX (CFLEX/AFLEX)

-Auto:Max=NN (default=20.0cm)

-Auto:Min=NN (default=4.0cm)

-CFlex/AFLEX Setting=2 (options are off, 1, 2 or 3)

-AutoRamp Time=NN (options are 05 to 45 min)

-AutoRamp Pressure=NNcm (4cm->AutoMin)

-Mask Alert Feature=ON (On/Off)

-Auto Off Feature=Off (On/off)

-Split Night Time = Off (off, 120, 180, 240)

-Show AHI/Leak Feature=ON (On/Off)

Press On/Off button to exit.

crossfit · Post by **crossfit** » Tue Jul 29, 2008 6:00 pm

If you start out with the settings snoredog gave you, you should be alright. I have mine set similarly. Doc set it from 4-20. It was too much range. I couldn't get enough air. So I start it at 8 now. Last night I lowered the top range to 15 because my >90% average was around 11.2. I don't use the ramp with this particular set up because I like the 8 starting level. Generally, keep your 13 in there somewhere so you have it available if needed. The apap should adjust for it. Adjusting your settings while checking in with the doc when he/she is back should be okay. And I highly recommend getting the software too. It will tell you exactly how many times you had apneas and hypopneas and at what pressure they were corrected. It is much more useful than just the average data we get on the led screen. Stay in touch. I have learned a ton being here and even when I don't have questions, just popping in to read stuff helps me learn more.

Billmanweh · Post by **Billmanweh** » Tue Jul 29, 2008 6:12 pm

I have a couple of questions about this same machine. Is there a maximum setting for the Auto:Min setting? That is, can the lower range only go say high? And can I not use the AFlex with straight CPAP? I found when I went from Auto to CPAP last night AFlex didn't seem to an option.

Hawthorne · Post by **Hawthorne** » Tue Jul 29, 2008 6:31 pm

Billmanweh - not sure about your first question but as far as the A-Flex in cpap mode. No. You can use the C-Flex settings though, in both cpap and auto setting.

crossfit · Post by **crossfit** » Tue Jul 29, 2008 6:31 pm

AFlex is only available in Auto mode.

I can't find anywhere that says if the minimum has an upper limit besides the machines limit of 20. It just says that it's default setting is 4.

crossfit · Post by **crossfit** » Tue Jul 29, 2008 6:35 pm

I just checked on my machine. It seems 14 is the maximum the minimum can be set to.

Blackneto · Post by **Blackneto** » Wed Jul 30, 2008 10:54 am

A little confession maybe in order here.
One of my clients is a Sleep Center.
I've been working for one of the Doctor there for the past 10 years as the IT Administrator for his various practices. But have pretty much avoided any talk about apnea, CPAP and things related. Mostly because my attitude was "I could never sleep with all that 'feces' on my face"

3 months ago they were testing a new device that Embla gave them for doing studies at home and the Director asked me if I would consent to try it out for them, with the warning that they would require a sleep study.
Well things have been getting bad, i've been going on maybe 3 hours of sleep a night for the past year.
Since my HMO is part owner in the sleep center, the director able to cut through a bunch of red tape and get me into the doctor and get the insurance to cover everything. Since my Doctor friend isn't really covered by my insurance without a referral I was assigned the HMO's sleep technician.
My friend off-handedly told me "Yeah, XXXX can handle it since you have a pretty mild case." All my events occur during REM and I never got to deep sleep during the study. I cant remember how many events they said I had and haven't seen my study. (funny thing is that I can log on and look at it any time i want but for professional reasons I haven't)
I personally doubt i've had deep sleep for 6 months prior.

Anyway I got hooked up with my tube and stuff and things couldn't be better.
This morning I mentioned to my Friend what happened with my doctor as to what happened with my card and he laughed. He actually crowed that he had warned my Doctor that he shouldn't be basing pressures on what the apap tells him.
Anyhow without giving me any advice (from a professional standpoint) he told me the next time I see him to try to force him to do the titration at the sleep center (which I would get for free).

anyhow thats my story.
thanks to all that helped with getting my machine back in order.
I got it set up and am ready for bed.

M-Series with A-flex help needed

M-Series with A-flex help needed

M Series with A-Flex