Puritan Bennett machines and software

[tillymarigold]

FLs are series of shallow breaths. A certain number of breaths below a certain percentage of airflow. I don't have the manual handy, but it gives the exact numbers in there. What's "good" depends on how you feel. I have UARS and I try to keep my AHI *plus* FL index below 5, but whatever works for you is good.

There should be a graph or table on the front of the manual to your mask that shows what the exhalation leak rate should be at any given pressure. That rate is probably in liters per minute, so you'll have to multiply the number Silverlining gives you by 60 (liters per second times 60 seconds per minutes) to get the actual leak rate. If that number is less than what your mask's leak rate should be, you're in good shape.

That is, suppose that your mask at your pressure should have a leak rate of 28 lpm. Your leak rate (reported by SL) is between 12-24 lpm (.2×60 = 12, .4×60 = 24) so if the mask's exhalation leak rate is 28, you're doing well. On the other hand, if your mask's exhalation leak rate should only be 20 lpm, then sometimes your leak rate is too high.

[scottbla]

FLs are series of shallow breaths. A certain number of breaths below a certain percentage of airflow. I don't have the manual handy, but it gives the exact numbers in there. What's "good" depends on how you feel.

Well...I've been having problems (over the past few years, in hindsight) with various daytime symptoms (concentration/memory probs, tired, headaches, etc), and I just recently got a machine that records data, so I'm trying to figure out what the data means . I'll take another look through the manuals I've got.

That is, suppose that your mask at your pressure should have a leak rate of 28 lpm. Your leak rate (reported by SL) is between 12-24 lpm (.2×60 = 12, .4×60 = 24) so if the mask's exhalation leak rate is 28, you're doing well...

Ahh...I had a feeling...according to this page (linked to from one of these forum pages), my mask should be in the 24-28 range (depending on pressure), so it sounds like that's good (as I was guessing from the way things feel while using it).

http://www.internetage.com/cpapinfo/leak-rates-1.html

Thanx!

[rested gal]

"leaks" is generally in the 0.2 to 0.4 "l/s" range...I don't know what that could be measuring or if that range is good. I've currently got a Twilight NP mask and it fits the best of any mask I've ever had.

Leaks that low are very, very good with the PB machine.

Good mask you've got, too. My favorite.

P.S. It's officially called the "Headrest" again now. A mask of many names -- Aura/Headrest/Twilight NP/back to Headrest. A good one by any name.

[tangents]

My leak rate with the PB420E and TwilightNP/Aura/Headrest is also very low - about .35 liters/second, or 21 liters/minute.

I bought the 420E in May 2007, for several reasons:
1. In reading many, many posts here, I found lots complaints about the Respironics and Resmed lines with their machines and software, but not one complaint against the PB420E.
2. Respironics and Resmed stopped selling their software, but PB did not.
3. PB is smaller and less expensive

I love my PB420E. It's very easy to load the software, and to download your data as often as you want. It records the last 96 hours on the machine, so as long as you download it to your computer every 11-12 days, you won't lose any information. Discount stores sell very long telephone extension cords that allow you to leave your PB420E right where it is and still connect to your computer.

My pressure is 10cm, so I don't need exhalation relief. That being said, I'm surprised that more folks don't jump on the PB band wagon.

My 2 cents for Scottbla is that you wants to get your Normal Cycle States higher. While your AHI is low, it seems to me that you might get a more restful night if your lower pressure was higher than it is, assuming you're running in APAP mode. Look at your "Pressure" screen, it will tell you your 90% pressure setting. Sometimes if you have your lower pressure much below that 90% setting, you will still have problems, even if they are not recorded as apneas or hypopneas. Just my opinion, I'm just a hosehead, not a doctor of any kind. Feel free to PM me if you want to discuss the PB data screens.

Thanks for the thread,
Cathy

[scottbla]

I bought the 420E in May 2007, for several reasons:...

Me too - the software seems to be readily available, but the other reason is that I wanted something to travel and/or go camping with. From what I read, the PB420x draws less current than a lot of others, so it should last longer on battery power. And it's pretty small, so more easily toteable in carry-on luggage.

My 2 cents for Scottbla is that you wants to get your Normal Cycle States higher. While your AHI is low, it seems to me that you might get a more restful night if your lower pressure was higher than it is, assuming you're running in APAP mode. Look at your "Pressure" screen, it will tell you your 90% pressure setting.

Still want to find out what "Normal Cycle States" means

Yeah...the graphs are bumping up against the top end of my APAP range, so I bumped the range up a little last night (but that's not good data due to upset stomach ). In my last sleep study, the apnea counts looked great at pressures around 11-13, so I had CPAP at 12 or 13. When I got the new machine and wanted to play with APAP, I set it to a range of 10-14 and it reports 90% at 14 but the graph just bumps up against 14 a few times during the night now (since getting the Headrest mask). So, last night I moved the range to 10.5-14.5. I figure I'll run with that for a few nights, then adjust some more.

I'll have to look at the software to see if it has a way to limit its stats to a specific date range (i.e. to get averages/etc since the last mask or pressure change). And look at the docs to see if it explains the terms more (which I doubt because it's aimed at medical pros who should already know?).

Thanx!

[ozij]

I'll have to look at the software to see if it has a way to limit its stats to a specific date range (i.e. to get averages/etc since the last mask or pressure change). And look at the docs to see if it explains the terms more (which I doubt because it's aimed at medical pros who should already know?).

Nothing simpler than limiting the range.

On the first, synthesisi screen:

Click on a day that ineterests you - let say the first day of the range. Then Shift + click on the last day of that range - and there you have, with data calculated automatically on the right side of the screen.

When you have many session recorded - use the color bars above the frames to bring up the latest sessions.

Should you want to view all the results for a setting:
Click on the red pencil - and you open window that lets you select which of the settings you want calculated.

That same red pencil will let you select specific sessions on the details screen. When you click it, you get choice of: 96 hours, according to settting, or according to sessions.

You can click on the nightly pressure the same way.
O.

[scottbla]

Nothing simpler than limiting the range...

I knew I'd seen some of that in there when I was clicking on all the things I could think of - thanx for all those details!

[ozij]

Have fun!
And you can export and impot to Excel too...
O.

[Snoredog]

When I was getting my autopap, I had the choice narrowed down to a Puritan-Bennett 420E and a Remstar Classic auto with cflex. I liked the features of both machines. At the time I bought, both had software for the patient with the company's blessing.

I ruled out ResMed because I didn't like their software policy. I thought that if they didn't care enough about my health to make it easy to buy their software, I'd just pass on them.

It was a close, difficult choice. I loved the idea of PB as a travel machine. The software of the PB machine gave superior data (more indepth information). I liked the idea of the machine not needing a card and card reader. It was also more "battery ready." There were no software glitches.

The Remstar Classic Auto, the one I chose, had a couple of advantages. First, it had CFlex, which I didn't understand, but some people seemed to like. The classic Remstar (as opposed to the M series) was sturdy and had a good humidifier.

CFlex was the deciding factor for me. However, as it turns out, CFlex doesn't work well for me at all. For me it causes MORE aerophagia. I have a relatively low pressure setting at 8.5, so I don't really need it to help with breathing against a high pressure.

So, today, if I was choosing, there would be no doubt in my mind that the PB would be the machine of choice for me. Since I don't like CFlex, and the PB machine's software yields more sophisticated data. No card to forget to put back into the machine. Better travel machine, more battery adaptable, and I also like the company better, since they are more patient-friendly.

You rarely hear about the people who don't need or even dislike CFlex or EPR. I suspect that there are many of them out there. If a person is at a low pressure, they rarely would need cflex. Feel free to correct me if I'm wrong on this, members.

The MSeries is not as good a travel machine because of the ungainly power block. I own an M-series but only because I got a very good deal on a practically new one. Plus I got my original machine and software before the ban. So, I'd already invested in the software.

In choosing a backup machine to go with the PB, I'd buy a classic Remstar, lightly used if possible. This would be at a very reasonable cost. It would not matter if this machine was a Plus and didn't have a humidifier, it would be mainly for backup, not data. I'd get an HP 150 humidifier which is superior to any of the attached humidifier and use it with both the PB and Remstar at home. I'd only use the built in PB humidifier for travel.

I haven't seen any discussion of this machine for quite some time. For those who are considering a machine and want data capability, this might be an option. Particularly at the lower pressures or if you know you don't like or need pressure relief.

Call me old-fashioned, but I appreciate a company that does right by me.

I agree with what you said, the 420e is a great little machine. I have the integrated PB humidifier for mine and actually like it, it reminds me of the convience offered by the old classic.

Where I like I don't need the heat from the humidifier, during the winter I use a heated hose, this time of the year I use any humidifier in passover mode only.

As for reports, I think the Siliverlining is the best out there, it is easy to obtain the data from the machine, simple to generate reports. I use a USB-to-RS232 adapter on my Vaio laptop and it works great, never could get EncorePro to work on that computer.

If there is anything missing on the 420e it is exhale relief like CFlex or Aflex, but since those are patented features you won't see them coming down the pipe soon.

I think the 420e is the most flexible auto on the market, it has a lot of good features, it even has auto-Ramp, ramp that works in Auto mode, always has had that feature. This is my 3rd 420, 2nd 420e, I bought one of the very first ones out when they were first introduced. The Silverlining software I had wasn't even made for the 420e, it was for the 418P, I had to hack it to get it to work.

I don't think you can group or put Cflex and EPR in the same class, they are clearly different, one so different it holds the patent on the technology.

If you take a popularity poll you'll find CFlex far superior to EPR. Those equipped with CFlex on their machines are more likely to be using it as opposed to not. Not the finding when you poll those about EPR, most report they are not using it in that mode and are using it in the autoset mode. Since it doesn't work in that mode, not many complaints. Oh there were complaints from those that did use it in that mode. For those that did use it, EPR was disabled during SDB events, it is part of the algorithm, to disable that feature. So it doesn't work in auto mode, it doesn't work when you are having apnea events, it might as well be disabled. If you are using a vantage in the autoset mode it will be disabled.

I also have aerophagia, I'd like to use my 420e more, it is a great little machine and it treats me great, only problem is if I use it for more than a week my aerophagia comes back with a vengeance.

I have a totally different outcome than you and others with aerophagia & Cflex. I've tested that several times, I found if I dropped Cflex settings from the normal setting used of #2 to #1, my aerophagia would gradually creep back.

Aerophagia has always been one of the reasons I use my machine with the lowest Minimum pressure setting I can, previously it was 6.5 cm. However with AFlex I've found I can increase that minimum to 8.5cm without having the aerophagia returning (so far anyway).

I use Aflex on #2, I've tried the other settings, no change in aerophagia but I didn't use it long enough at those other settings to really compare.

While the old Classic was a good ole machine, I think the new AFlex does a much better job with therapy, it is certainly a whole lot more comfortable breathing against it, it is a dream to use compared to Cflex.

I can't even measure the noise level on my AFlex, my dB meter stops measuring anything lower than 50dB. Noise level is a non-issue on the Aflex in my opinion, Cflex version yes, Aflex version no. I've also owned more than a half dozen Classic machines, some quiet some not so quiet, but none of them quieter than this AFlex only noise from it is the air flowing back and forth through the hose and there is nothing I can do about that. If you already have a HC150, you've already eliminated the worst part about the M series. I've traveled with all the machines including the M series and Classic, the 420e is best for travel but the brick power supply is not much of a problem either or at least I haven't had any problems with it. When I stay at my daughter's condo, she has a hide-a-bed, I put my machine on the floor under the coffee table, having the ability to remove the tank easily to refill it actually works pretty good, if the tank wasn't 2-piece and subject to leaks it would be fine. It is that 2-piece M series tank that is its downfall. I could have saved a lot of money over the years buying a HC150 instead of those integrated humidifiers.

Some people ask why I go through so many machines, I've purchased new machines just to get the next firmware level of software in the past on the Classic. I owned 3 or 4 before ever getting one equipped with CFlex, the models before that didn't come equipped with Cflex.

But I can tell the difference in machine response from one firmware level to another. Sure I lose money with every machine I've bought, but I don't look at it that way, I always sell them and recoup some of those costs. People that buy them are the ones with the savings. I look it at it as spending a couple hundred to try something new. So a new machine usually only costs me $200-$300 once I sell my old machine, how much I get depends on who I am selling it to.