New to APAP

I have been going through the diagnostic part of apnea for a while now, went through the sleep study(didn't sleep well in the lab) and was prescribed an auto cpap for 6 weeks, at which time I would bring in the card,have it read,and then be issued a cpap machine.

I got home and went to a few sites including this one to recheck prices on the machines and to look over what was available. Then I called around to find out what the local suppliers were charging for them. The place at the hospital quoted me about 2800 dollars for the rental of the auto and the purchase of the cpap (Remstar plus). Another place quoted 2,000 and a third was at 1900. I then called Blue Cross and my insurance agent and with alot of pressure, they agreed to allow me to purchase the auto cpap online from here and they would reimburse me. The doctor was still not happy with it because he said i would not be able to give him the downloads like the supply places would.

So Saturday I finally got my Remstar Autocflex with humidifirer and a comfortcurve mask. I fell asleep pretty quickly and it was comfortable but after 5 hrs the pressure increased enough that it was blowing so hard the mask would not stay sealed. Of course it was too dark to see what the setting went to so I tried the next night to adjust the lower up from 4 to 6 and the upper down from 20 to 16. The same thing happened that night. Other than that I really like both the machine and the mask. Tonight I think I will try dropping the high limit to 13 and see what happens.

That brings me to the software. Would it be a worthwhile investment to buy the software for the machine? and if I do,how easy is it to take the information from the software and prepare it in a form that can be delivered to and read by the doctor? I have noticed that alot of people are using it to self diagnose, and if I start changing settings, does it make it easier or harder for the doctor to do their evaluation as compared to leaving it set at 4 and 20?

I am pretty disappointed at the fact that I bought a respironics apap and mask that are compatible and designed for each other and the machine is still not automatically adjusting. I even shut it off last night and turned it back on and it still was blowing too hard to make a good seal.Any ideas?

PS, This is a great site and it has already helped educate me and make better decisions with the therapy than the Docs have given me, so I am ahead of the curve already.

Denny

The software is well worth purchasing.

There are some things you need to know.

Certain types of patients apparently do experience runaway pressures like you're getting. Different patients do well on different auto machines. However...

You can set your AUTO to CPAP mode, or limit the range it will go to. If I were you, I'd start tweaking the settings. Try setting the upper bound lower and lower and see what it gets you. Unfortunately, in order to know what it gets you, you'll really need the software or someone who has it.

By the way, the doctor is full of crap, unless he doesn't even have a copy of the Encore software there, and was expecting your DME to read the card and send him the results.

But yeah, I'd buy the software and card reader and take a look at what's going on. If you're having runaways, play with the upper bound pressure until you find your AHI (hourly Apnea/Hypopnea Index) rising above 5 or so, then bump it back up one and leave it there... That way even if you get runaway pressure, it'll probably be about the pressure at which the doctor would have set your CPAP machine anyway.

Then just keep monitoring every so often to see how you're doing. If your AHI starts to rise, play with the pressures again.

Just my two cents. I'm not a doctor, and am barely successful with my own Remstar Auto.

Liam, who's been away for a bit.

Thanks for the info. I probably will buy the software seeing how the health care system around here is so congested I can probably learn how to self diagnose myself better with the software and forums like this than I ever will through any appointments with the doc.

BTW

After reading about the comfortcurve leaky elbows, I put mine on for a while tonight and mine leak too. If anyone is passing on the info to Respironics, feel free to add my name and experience if it helps. I think I will see if some petrogel will seal them up.

Hi Denny,

I agree with Liam that having software is the best way to see what's going on in a person's own treatment. If it turns out that you need to use a machine of another brand that uses different software, you can always sell your software and card reader to someone else.

So, it probably would be a good idea for you to get the Encore Pro software and card reader. You sound like you want to take an active role in determining your own treatment. I do admire that!

If your doctor wants printouts later, you should be able to find a DME that you can pay to download your card and print the info out. I think I've even seen some posts on this message board from people who have Encore Pro software and are willing to do that free for others. At any rate, you don't have to buy the expensive software and card reader yourself to get your smart card downloaded and the data printed out - one way or another.

It's kind of a Catch-22. On the one hand, you need the software to really see what your autopap and you are doing together. On the other hand, it's a shame to have to spend the money on expensive software only to find that a particular autopap is not doing the right job for you. Or that autopap in general isn't what you need. In that case, though, you've chosen well in the guessing game, imho, since you have a machine that can be used in any one of four modes when you count the C-Flex feature on or off.

If a person has access to renting machines, that can be a better option sometimes until you know for sure which machine you need. Unfortunately, many DMEs only deal with one brand making a rental try-out of several brands impossible.

A few thoughts about this:

but after 5 hrs the pressure increased enough that it was blowing so hard the mask would not stay sealed.

The pressure increase you experienced might not have been runaway pressure at all. Could be. But it also could very well be that the "blowing so hard" was really necessary. You might actually need a high pressure at times to prevent or deal with events. Of course, if a mask cannot stand up to a needed pressure without leaking, a leak can get so massive that it's just about guaranteed to disturb sleep, in and of itself.

Without software, it would be difficult for you to know if you really were experiencing runaway pressure -- or if that was the pressure actually needed to keep your throat open at that point in time.

I am pretty disappointed at the fact that I bought a respironics apap and mask that are compatible and designed for each other and the machine is still not automatically adjusting. I even shut it off last night and turned it back on and it still was blowing too hard to make a good seal.

I can sure understand your disappointment. Just because a mask and a machine are made by the same manufacturer, it doesn't mean that a mask won't leak. The autopap itself may very well be doing its job of automatically adjusting to deliver the pressures you need. Again, without the software, there's no way to know what's going on.

I use the same Respironics auto you're using, even though not one of the masks I use with it are by Respironics. I'm not saying you need a different mask. Just pointing out that most people don't seem to have to use same brand mask and machine for "compatibility" purposes. Many people mix/match with no problem.

When you turned the machine off and back on, if you're absolutely sure it started right out blowing at a higher pressure than the lowest pressure you have it set at, then it could be a malfunctioning machine.

However, if your impression of "blowing too hard to make a good seal" was actually the machine itself starting out again at the lowest pressure, but the mask not sealing, that could be a problem with the fit of the mask itself. Sometimes if a mask has gotten moist or slippery from natural skin oils later in the night, it's not going to seal as well as when you start out.

So many factors can come into play. Software would definitely let you zero in on a few of them. I think you have the right idea.

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My disclaimer: I'm not a doctor, nor have I ever worked in the health care field. Those are just my personal opinions. A mask or machine one person loves/hates could be wonderful/awful for others. Finding suitable equipment can be an expensive trial and error experience.

Denny wrote:.....I even shut it off last night and turned it back on and it still was blowing too hard to make a good seal. Any ideas?...

First of all, the best way to reset your pressure in the night, when it gets too high to take, is to push the "ramp" button. If you read your manual that came with the machine, you'll discover they designed this feature in to deal with exactly the problem you're having.

Next you need to play with your mask to adjust it so it doesn't leak. It could be possible that the shape of your face makes it difficult for your mask type to seal. Unfortunately finding just the right mask seems to be an expensive trial and error process. By reading all the mask reviews and analysis among the posters here you might be able to determine a few that might work best for you. Also it can take several nights of playing with and adjusting your mask to get it set just right. You'll notice everyone has similar problems and people get quite creative in the fixes they find.


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Would it be a worthwhile investment to buy the software for the machine?

I find the software to be good, but it's value decreases over time.

I used it often in the beginning to see what was going on and to tweak my therapy.

Now, I take a look only once and a while.

But that's just me....