is this remstar auto working properly

seagull · Post by **seagull** » Sat Aug 06, 2005 9:47 pm

howdy---I just slept a couple of hours, and had my apap set at 8.5- 11. The pressure change seems to wake me up. I put mask on while still awake and watching television, and it booted to 9. I tried lifting my mask and letting it leak to see if it would boot up farther--it didn't. But---when I woke up at an 11 pressure, I sat here for about 5 minutes awake to see what it did, and it STAYED at 11. Seems like being an auto, the pressure ought to change quicker than that, and not change when I am awake and reading, etc. That is why I keep setting it back to straight cpap.

Guest · Post by **Guest** » Sat Aug 06, 2005 10:45 pm

Without analyzing the data from the software over a period of at least several days, it is premature to make a judgement about the efficacy of the treatment you are receiving when your machine is in auto mode.

Seems like being an auto, the pressure ought to change quicker than that, and not change when I am awake and reading, etc.

Actually, it is possible that it changed because your soft palette relaxed (were you lying down?) and more pressure was required to keep the airway open...

rested gal · Post by **rested gal** » Sat Aug 06, 2005 11:10 pm

seagull, as I understand it autopaps are not supposed to jump up and down quickly for every change...including the change when you suddenly are awake and sit or lie there breathing normally and are watching the pressure number. They don't know if you are awake or asleep. I think they're designed to work the pressure back down gradually, testing along the way as the pressure moves back down in increments, to be sure the restricted breathing that was just dealt with doesn't start again. Sudden ups and downs in pressure could be disruptive to sleep, so they take it easy going back down.

As for pressure going up soon after you first start the machine and are awake, I think Guest nailed it...your throat or palate was probably beginning to relax and close a bit even though you were awake. Sitting right here, I can deliberately relax my throat and feel it close off completely, not allowing one bit of air through.

john5757 · Post by **john5757** » Sun Aug 07, 2005 5:14 pm

[quote="seagull"]howdy---I just slept a couple of hours, and had my apap set at 8.5- 11. The pressure change seems to wake me up. I put mask on while still awake and watching television, and it booted to 9. I tried lifting my mask and letting it leak to see if it would boot up farther--it didn't. But---when I woke up at an 11 pressure, I sat here for about 5 minutes awake to see what it did, and it STAYED at 11. Seems like being an auto, the pressure ought to change quicker than that, and not change when I am awake and reading, etc. That is why I keep setting it back to straight cpap.

WillSucceed · Post by **WillSucceed** » Sun Aug 07, 2005 7:03 pm

Seagull:
Can you get the software so that you can see what is happening during the night?

seagull · Post by **seagull** » Sun Aug 07, 2005 7:19 pm

No, but I am hoping the rt who came to my house to set up the machine will have a card reader and a laptop with her. I will ask her to bring one. I don't know that anyone will ever read this smart card. I got the auto because they didn't have my pressure prescribed yet (still don't), not because they cared about the card results. I leaning toward the pb 420e with software though. I would like to at least see a 420 before I order one. The sleep tech said I would probably be an 11 or 12, so I guess I shouldn't be shocked to see the pressure at 11. I had the max set to 11. Thanks. I feel like I've talked to VIPs with rested gal and will succeed answering my posts.

neversleeps · Post by **neversleeps** » Sun Aug 07, 2005 10:06 pm

Ok.... here's one:

rested gal · Post by **rested gal** » Mon Aug 08, 2005 1:40 am

ROTFL, neversleeps! Looks like it would take a forklift to carry it. j/k!!

WillSucceed · Post by **WillSucceed** » Mon Aug 08, 2005 7:47 am

Seagull:

I've used the RemStar auto and the PB 420E. If small size is the factor that will sway your decision, the 420E is a hands-down winner. Even with the integrated humidifier, it is small and easy to travel with. Also, it has great features that make it 'tweakable.'

If, however, exhalation relief is essential to you, the RemStar auto (with C-FLEX) is a better choice. C-FLEX does not suit everyone (another one of my usual rants) but for those who like it, they like it alot.

Again, as always, trial all (ResMed, Respironics, Puritan-Bennett) of the auto units if at all possible, before you buy. The different manufacturers use proprietary algorithms in their machines. While all machines are likely to suit almost all users, some machines just don't fit some people.

For example, when I tried the different machines, ResMed Spirit and PB 420E gave me great treatment but, unfortunately, the RemStar auto did not. This does not mean that there is anything wrong with RemStar -my breathing pattern just did not suit it's algorithm. In addition, I hated C-FLEX. I wanted to buy the RemStar as I already owned a RemStar Plus (non-auto machine) and their integrated heated humidifier. I have great confidence in the reliability of Respironics equipment and I could have continued to use the humidifier and saved some money, but, no go.

So, do whatever you can to trial the different machines -rent them for a trial if necessary. If you can't do this, make you decision based on features and your lifestyle (do you travel alot?) and feel confident with your purchase as they are all good machines.

Hope this helps!

snork1 · Post by **snork1** » Mon Aug 08, 2005 9:15 am

Trialing machines sure would be nice. Unfortunately I am sure I am not unique in having a DME that anything besides the ONE machine they happen to offer is a "special order" and you have to buy it to see it.

I am seriously looking into getting a 420E. I might even do it out of pocket.
I have been using a Remstar Auto for almost 2 years and it definitely seems to have issues. Maybe the 420E will at least give me new fresh issues. haha.

The "stuck on high" issue is definitely one that bugs me on my Remstar Auto. I can lay there awake as long as I want and it stays on max. Looking at the reading from the night, this pegged out pressure has no justification. My work around is to hit the ramp button, which resets it to the lowest pressure, even in auto mode. (this is NOT mentioned in the manual).

Of course I also have a major whine coming from my machine. It still puts a random 1999 date on all the data on the smart card, which bugs my doctor more than me. I have attempted to get it fixed under warranty, but I switched DME's since I bought it so the old DME doesn't want to talk to me anymore (we did NOT part on good terms, and they said the whine was normal) and the new DME doesn't want to deal with warranty since I didn't buy it through them, and of course Respironics will ONLY deal with a DME, so I am caught in the middle with a VERY pricey defective machine. You would think for the premium prices on this equipment that they would have at least a warranty as good as my favorite sports store, REI.

And for travel, the Remstar with humidifier and heated hose power supply is a major bulky heavy boat anchor to lug around. I believe the heated hose (when bought with the special option) can now be plugged right into the 420E, which is a major weight saver right there.

fstanmyre · Post by **fstanmyre** » Mon Aug 08, 2005 9:46 am

I've been through the annoying Remstar clock issue which is basically a design fault. The DME can't fix it. Respironics has a special card which factory calibrates the machine and for some strange reason, is the only way to set the clock. I screamed and hollered about my 1998 readouts and eventually got my DME to replace the machine with a properly set clock on the basis that it was defective.

I bought the 420E and I love it. It works great and the SilverLining software actually permits you to set the clock. Only problem is the software is a bit complicated so you want to be a little technically inclined to use it. The biggest plus for the Remstar is the user friendly MyEncore software. I'm hoping Derek's Remstar will break and he'll buy a 420E and come up with a MySilverLining.

Wulfman · Post by **Wulfman** » Mon Aug 08, 2005 11:04 am

Snork1

Have you contacted Respironics about your problem? I BELIEVE that Respironics HAS to deal with you in any "warranty" situations. You said you've been using it for almost two years..... It does have a 2-year warranty and any "defects" should be taken care of by them even if you're not going through a DME supplier. Like Fred, I also have an "issue" with my machine in that it seems to be losing about a minute a month on it's clock. It started off at about 7 minutes slow and is now up to about 10 minutes. I WAS in contact with them by e-mail and informed them of the problem. They sort of "Poo Pooed" me with something like "seven minutes isn't a real big deal" argument. However, I told them that if it continued to lose time, they'd be hearing from me before my 2-year warranty was up. They didn't tell me that I'd have to go through a DME supplier when I told them that I was the owner. It looks like they WILL be hearing from me again sometime in the future. Other than that little "glitch", I really like the machine. It seems to be doing a good job with what it's supposed to do.

Den

WillSucceed · Post by **WillSucceed** » Mon Aug 08, 2005 11:45 am

Only problem is the software is a bit complicated so you want to be a little technically inclined to use it.

I'm as dumb as a stump when it comes to computer stuff and I have been able to figure out Silverlining. I agree that it is a bit confusing and the documentation is not the greatest but, the data that Silverlining provides in the 'synthesis' screen is very clear and understandable. Also, the 'detailed graph' gives a ton of information that really helps the user to understand what has happened through the night.

If you are not satisfied with the way your RemStar auto treats your OSA, you might benefit from trying a machine from a different manufacturer. PB and ResMed are both good choices. The different manufacturers do use different proprietary algorithms in their machines.

I'd be disinclined to let the DME off the hook just because you two parted on less than happy terms. The warrenty is still his problem, whether he likes you or not. Send him a letter, with a copy of your sales receipt, telling him you want service --this paper trail will help you out later when he tries to tell you that you did not ask for service within the warrenty period.
Get the thing fixed under warrenty and then sell it to someone who wants a RemStar Auto at a reduced price.

Ask him/her what they do for the patient while the machine is out being serviced. Hopefully, they will give you a loaner and, if so, you can compare how it treats you relative to the unit being repaired. I'd be inclined to make a pretty big stink about this if I was told that they don't have loaners for patients whose machine is being serviced under warrently.

If you get a loaner, you can compare your machine against the loaner. Maybe your machine is a lemon and RemStar is still good for you OR, maybe the RemStar algorithm is just not right for you and you need a different manufacturer's machine.

fstanmyre · Post by **fstanmyre** » Mon Aug 08, 2005 12:06 pm

Facts are your doctor is using the info from the encore software. This is good. My doctor, since sacked, didn't even know it existed. Your doctor shouldn't have to deal with an improperly set clock. It is a Respironics defect. Threaten the whole useless bunch with BBB and tell the DME if he doesn't get it fixed pronto your doctor will never give them another prescription. In my case, the DME went to Respironics who simply exchanged my old one for a new one with a properly set clock.

snork1 · Post by **snork1** » Mon Aug 08, 2005 12:58 pm

[quote="Wulfman"]Snork1

Have you contacted Respironics about your problem? I BELIEVE that Respironics HAS to deal with you in any "warranty" situations. You said you've been using it for almost two years..... It does have a 2-year warranty and any "defects" should be taken care of by them even if you're not going through a DME supplier. Like Fred, I also have an "issue" with my machine in that it seems to be losing about a minute a month on it's clock. It started off at about 7 minutes slow and is now up to about 10 minutes. I WAS in contact with them by e-mail and informed them of the problem. They sort of "Poo Pooed" me with something like "seven minutes isn't a real big deal" argument. However, I told them that if it continued to lose time, they'd be hearing from me before my 2-year warranty was up. They didn't tell me that I'd have to go through a DME supplier when I told them that I was the owner. It looks like they WILL be hearing from me again sometime in the future. Other than that little "glitch", I really like the machine. It seems to be doing a good job with what it's supposed to do.

Den

is this remstar auto working properly

is this remstar auto working properly

Re: is this remstar auto working properly

Remstar Clock

Machine	Mask