Breath by breath analysis

Regie · Post by **Regie** » Thu Jan 31, 2008 4:27 pm

I have a Respironics Remstar Auto M Series with A-Flex (510M)

I've done some searching but have not yet found an answer to my problem.

From the reading I have done thus far it seems that this machine is supposed to analyze breath by breath the pressure needed. I've tried about 5 different masks and the best I have found thus far for me is the Fisher & Paykel HC432?? but even it leaks when the pressure increases to around 15.

Last night I awakened and the pressure was about 6.1 - I had been sleeping on my right side. I turned onto my back and later found that the pressure had gone up to around 15. With breath by breath reasoning I figured that if I turned back onto my right side that the pressure would adjust again to the lower setting. I waited several minutes and it never did.

Is my thinking all wet or perhaps I have misunderstood something or is there something wrong with my machine or perhaps in the setup for it?

Thanks much,
Regie

jimbassett · Post by **jimbassett** » Thu Jan 31, 2008 5:14 pm

Nothing wrong with your machine. It doesn't respond to "awake" breathing very well. We breathe differently while asleep and that is what the machine will recognize. You evidently had some big leaks for your pressure to rise that high, and yes the machine will keep it that high for awhile trying to maintain your pressure. I don't know about breath by breath sampling and adjusting. I think that is expecting a little much from the equipment. More expensive machines can do this, but we're talking some serious dollars in this case. CHEERS! jim

TossinNTurnin · Post by **TossinNTurnin** » Thu Jan 31, 2008 6:43 pm

jimbassett wrote:Nothing wrong with your machine. It doesn't respond to "awake" breathing very well. We breathe differently while asleep and that is what the machine will recognize. You evidently had some big leaks for your pressure to rise that high, and yes the machine will keep it that high for awhile trying to maintain your pressure. I don't know about breath by breath sampling and adjusting. I think that is expecting a little much from the equipment. More expensive machines can do this, but we're talking some serious dollars in this case. CHEERS! jim

Is it possible it won't adjust down?

Regie · Post by **Regie** » Thu Jan 31, 2008 8:17 pm

TossinNTurnin wrote: Is it possible it won't adjust down?

Tossin,

I can hit the ramp button or turn it off and then back on, but that is the only way I am finding out that will do it.

With the idea that it does not adjust well when I'm awake, I suppose that if I am asleep and the pressure goes up that it can go down if less pressure is needed minutes later. Anyone got any idea if that is right?

Thanks,
Regie

Guest · Post by **Guest** » Thu Jan 31, 2008 8:42 pm

jimbassett wrote: I don't know about breath by breath sampling and adjusting. I think that is expecting a little much from the equipment. More expensive machines can do this, but we're talking some serious dollars in this case. CHEERS! jim

Jim,

I just discovered where I got that "breath by breath" thinking. It is found on the cpap site with these words:

"automatically adjusts on a breath by breath basis to blow the minimum pressure needed to keep your airway open during sleep"

..."during sleep" I suppose is the qualifying words here. What do you think further if anything?

Thanks,
Regie

Goofproof · Post by **Goofproof** » Thu Jan 31, 2008 8:57 pm

I bought mine to sleep with, it works great for that. Jim

I try not to stay awake all night, second guessing the machine.

Regie · Post by **Regie** » Thu Jan 31, 2008 10:12 pm

Goofproof wrote:I bought mine to sleep with, it works great for that. Jim

I try not to stay awake all night, second guessing the machine.

Goofproof,

It takes adjusting for some of us to get used to sleeping with the machine. I've made improvements but I don't have it licked yet. I don't want to try to out-smart the machine but I do want to understand just what the thing is doing and if I am getting the best out of it that I can. That's why tonight I have ordered the software and card reader and plan to get the additional software that a couple board members have produced so I hopefully can understand it better. That way, maybe I can be a little more up-to-date on living through the next surgery coming up on 2/15/08 and maybe learn what some of these abbreviations and stuff means on the report I got from my last sleep lab visit which is too much like Greek.

Just hoping I don't quit breathing again when they pull the respirator. This is serious business to me.

Regie

Goofproof · Post by **Goofproof** » Thu Jan 31, 2008 10:42 pm

Regie wrote:
Goofproof wrote:I bought mine to sleep with, it works great for that. Jim

I try not to stay awake all night, second guessing the machine.
Goofproof,

It takes adjusting for some of us to get used to sleeping with the machine. I've made improvements but I don't have it licked yet. I don't want to try to out-smart the machine but I do want to understand just what the thing is doing and if I am getting the best out of it that I can. That's why tonight I have ordered the software and card reader and plan to get the additional software that a couple board members have produced so I hopefully can understand it better. That way, maybe I can be a little more up-to-date on living through the next surgery coming up on 2/15/08 and maybe learn what some of these abbreviations and stuff means on the report I got from my last sleep lab visit which is too much like Greek.

Just hoping I don't quit breathing again when they pull the respirator. This is serious business to me.

Regie

I know what you mean, it took them 20 minutes to get the vent tube in me, probably delayed their golf game. You need to also fill out your profile so everyone can see what you are using, the text method makes it easier, Icons are nice but close to useless.

Also you will need the master program Encore Pro, the add-in programs feed off it's database. In a while check your P.M.s. Welcome, I didn't mean to sound gruff, but a lot of people loose site of what's important and waste time fooling around. It's important to take this seriously, and spend your time getting treatment to work. Jim

bigk · Post by **bigk** » Thu Jan 31, 2008 10:49 pm

The maching will typicallt take 20 mins or so to reduce I think - it doesn't instantly react - it makes gradual changes.

RosemaryB · Post by **RosemaryB** » Thu Jan 31, 2008 11:27 pm

Welcome!

The others are right when they say that the machine will behave differently when you are awake than when you are asleep. You have done the best thing by ordering the card reader and software. It does give you a graph of the whole night showing what was happening during the span of each hour of the night. As soon as you get some readouts, you can post them here and ask advice about what they mean. Take off any identifying information first.

I wish you the best with your treatment and your upcoming surgery.

ozij · Post by **ozij** » Fri Feb 01, 2008 3:21 am

The machine does a breath by breath analysis, and decides how to respond based on the changes it finds in a series of breaths. It will attempt to raise the pressure immediately when you hava an apnea, but will not drop it the minute the apnea stops - it waits for your breathing to stabilize.

You waking breathing is different from you sleeping breathing - so you will never be able to track the machine without software Waking breathing is rarely (never?) stable in the way sleep breathing is.

All the automantic machine will adjust down, as well as up, as you'll eventually discover when your have software reports of nights you slept through.

Welcome Regie, and good luck.

O.

TossinNTurnin · Post by **TossinNTurnin** » Sat Feb 02, 2008 4:38 pm

ozij wrote: All the automantic machine will adjust down, as well as up, as you'll eventually discover when your have software reports of nights you slept through.

I guess I'm asking that is even if I have an APAP machine... if it's being used as a straight CPAP machine, does the machine compensate for leaks... by not only going UP, but by reducing pressure as well.

Goofproof · Post by **Goofproof** » Sat Feb 02, 2008 8:48 pm

TossinNTurnin wrote:
ozij wrote: All the automantic machine will adjust down, as well as up, as you'll eventually discover when your have software reports of nights you slept through.
I guess I'm asking that is even if I have an APAP machine... if it's being used as a straight CPAP machine, does the machine compensate for leaks... by not only going UP, but by reducing pressure as well.

The pressure should remain the same, as that's what the machine is controlling. The flow into the hose should be the machine rate (CM H2O) plus The vent rate of the mask + external mask leakage. The problem comes from when these exceed the machines output, then it can't do the job. Jim

ozij · Post by **ozij** » Sat Feb 02, 2008 11:52 pm

If you fix the leak, the machine will recognize it no longer needs to blow in more air in order to maintain the fixed pressure.

O.

TossinNTurnin · Post by **TossinNTurnin** » Sun Feb 03, 2008 5:22 pm

Goofproof wrote:
TossinNTurnin wrote:
ozij wrote: All the automantic machine will adjust down, as well as up, as you'll eventually discover when your have software reports of nights you slept through.
I guess I'm asking that is even if I have an APAP machine... if it's being used as a straight CPAP machine, does the machine compensate for leaks... by not only going UP, but by reducing pressure as well.
The pressure should remain the same, as that's what the machine is controlling. The flow into the hose should be the machine rate (CM H2O) plus The vent rate of the mask + external mask leakage. The problem comes from when these exceed the machines output, then it can't do the job. Jim

OK, I think I'm understanding better.

The PRESSURE is maintained, but the flow rate goes up and down as needed. But if the need exceeds the machine's output capability, then you can't get the therapy you need.

Mask	Humidifier

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