Help! My settings are all wrong!

[ozij]

AN
Here's what I understand now:

On a two weeks trial titration on a Remstar Auto.

Based on the Remstar's data, the doc figured a set pressure between 10 and 19 might work for you. And you're trying to find what would be best within that range. Unfortunately, you don't have software to let you do that.

That was not clear to me on reading your first letter.

If I had to set find my best pressure under those conditions, here's what I'ld do:

* I'ld start at the lowest pressure the doc thought safe, and I have a number of reasons for that:

1. The 90 or 95 percentile recommended by an Auto only means that you spent 90 (or 95%) of your time at or below that pressure. The fact that every now and then the machine went up to 20 is not that indicative of you pressure need - you might have been on 20 for about 3% of the time. Which means that if (in theory) you had an AHI of 100, not treating those 3% apneas would leave you with an AHI of 3. not bad...

2. You say the doc based his decision on your snore index. The Remstar has been found by many users on this forum to be very "snore sensitive" and to register "snores" when other machines do not. Which means that a titration based on Remstar snore index will end up higher than one based on either a PSG, or another machine. This was also my own experience: after a sleepless PSG I was given a Remstar for a 2 week home trial, the RT figured my set pressure should be 7.5 because of residual snores, and my one night on that pressure was so dreadful that I put a stop to any further therapy till I spoke to a doctor again. I was then given another RT, and another machine - a PB, and the result is no snores, and a pressure range of 5.5 to 7.5. In the year since, 80-90% of my time is spent at 5.5
So, based on my own experience (A case of one, I know, Brent...) and on a year of reading this forum I would say the Remstar's snore index is probably not the right indicator to look at when looking for a set pressure. The way you feel is much more important.

3. Breathing against the pressure is kind of like weight lifting, your muscles have to get used to doing it, and you might find it easier to get used to the pressure gradually.

* I would also resign myself to the fact that finding the right pressure will take a long time, and spend at least a week - if possible two - at each pressure that I check. The reason for that recommendation is that our nights vary, and even the perfectly right pressure may give us a bad night occasionally. It is also my impression that some people need more time than others to get used to different pressures.

Let us know what you decide to do and how you're doing.

Good Luck

O.

P.S. My apologies for not having noticed the message I reacted to was not the beginning of the thread.

[rested gal]

Apneic Nation, since you got good treatment while on autopap and are getting not-so-good treatment on straight cpap, I'd suggest that you:

buy a Remstar Auto with Cflex, heated humidifier

If I were you, I'd watch the eBay and Yahoo auctions for just such a machine. If you see it on eBay, go ahead and get in touch with the seller by email so you'll have a contact in case eBay removes cpap machine listings, as they often do.

With a bit of looking, you should be able to find a Respironics REMstar Auto with C-Flex and heated humidifier for less than $500.

You've already done well on autopap, so there's no absolute reason you'd need software for it unless you wanted to keep tabs on your overnight data yourself.

[Apneic Nation]

I want to thank all of you for the advice and tips! Even you Snoredog! HE-HE~ I will try to work with this Remstar plus for a few weeks and keep an eye out for an apap!