new machine and numbers are nuts!!

[brax44]

I was using respironics remstar pro auto IQ and numbers were great--I always seemed to do better in normal CPAP mode at 12 rather than APAP and pressure never above 12----i was renting that machine---I bought a new machine, same but with the heated tube---now my numbers are all over --the pressure even has me up to 14 still with OA's??? my sleep study indicated I had no episodes at 12----what is going??? I want to throw this machine out the window---is the pressure different on diff machines??? is the setting for this machine higher than the last one????

[greatunclebill]

first of all, you have to tell us the name and model number of your machine.

[brax44]

old machine ---PR REMstar pro c-Flex auto IQ
new machine--PR system one remstar 60 series auto cpap

[Pugsy]

How are the leaks? Unchanged or greater?
These new machines aren't nearly as prone to chase leaks as the older (pre PR S1 machines) were but they can chase leaks if the conditions are right.
Also how much time is spent at the higher pressures? A lot or just an occasional spike? It might be that the pressure needs are greater in a certain sleeping position or REM sleep or combination of both.

Comparing it to a sleep study....we simply don't sleep the same each night. My sleep study said I needed 8 cm but my REM sleep is where I really need the pressure and I only had 6 minutes of REM during my titration study.
Using APAP we determined that 10 minimum was best but I sometimes see 18 cm...pretty much looks just like REM stage sleep time frame. So sleep studies don't always get it perfect.

The new 60 series machines have the new heated hose. Are you comfortable with the current settings? Perhaps restless sleep is creating awake or semi awake events.

What are you using to view your data? Software? or on the LCD screen.
Could you post an image of a typical report from the prior PR S1 machine and and image of the new machine's report? Need the daily detailed report showing the graphs...so we can see leak, pressure and events in detail.

[brax44]

pugsy leaks are the same--pretty low around 30---nothing is different--im using the same mask----just the numbers are much different---is this machine just more sensitive? can the pressure on one machine be less than another??

[Pugsy]

We don't normally see a large pressure needs difference when we are looking at essentially the same machine.
Between different brands..yeah, we could expect to see it because they do things differently.

I don't know if Respironics has changed the algorithm any with the new heated hose stuff. They might have made some minor changes. We don't have many people who have gone from the non heated hose PR S1 to the heated hose PR S1 to actually compare numbers. Maybe they did change things a little. You are using the Auto IQ, is that right?
How much time did you spend in APAP mode on the older machine? Are we comparing apples to apples here?
You know that there are sometimes things that just affect our pressure needs more at some times compared to others.
We just don't sleep the same every night.

Are you spending a lot of time at the higher numbers? Or is it a brief spike? How long have you had the new machine? I assume that the Flex setting is unchanged?

Personally, I would let the machine do its job and not worry about it. If cpap mode suits you better...then use it.
I can tell you that sometimes we do simply have times where more pressure seems to be needed. May not happen on a regular basis but it does seem to happen. I blame it on aliens. Things happen that we can't explain.

Post one of your current reports...lets see what is going on. Do you know how to post images of your reports?

[troubs]

I went from the non heated to the heated hose, but because I have the 60 series I can only use Encore Basic to look at the data right now.

[archangle]

You might experiment with manual CPAP for a while and see if reducing the number of variables helps you figure things out.

Just for the heck of it, turn off the heated hose as an experiment.

How bad is your AHI on a "bad" night?

Also, please fill in your profile with your equipment so it will be in all your posts. Look a the link in my signature line to see how to do this.

[brax44]

my numbers on the old machine (PR Remstar auto cpap with auto IQ)--were great at 12, never went over 12----new machine on auto they go up to 16??? and it shows im having OA at 15 and 16, when I never had any at 12 or above-----it seems this machine either picks up more info or the pressure is less on this machine??

[Todzo]

I was using respironics remstar pro auto IQ and numbers were great--I always seemed to do better in normal CPAP mode at 12 rather than APAP and pressure never above 12----i was renting that machine---I bought a new machine, same but with the heated tube---now my numbers are all over --the pressure even has me up to 14 still with OA's??? my sleep study indicated I had no episodes at 12----what is going??? I want to throw this machine out the window---is the pressure different on diff machines??? is the setting for this machine higher than the last one????

Hi brax44!

Think back. Did the old machine ever "puff" at you like the new one does?

I think that these "clear airway sensing / pacing" pulses - for some if not many - tend to reduce breathing stability.

If we took a CPAP machine and programmed it to simply raise our pressure 2 cm/H2O every five minutes we would for shure have a hypocapnic (heavy breathing induced) central apnea within an hour. The pressure from the CPAP tends us toward breathing more (much easier to inspire and the exiration muscles train with talking so are strong) and so we reach the point where CO2 washes out and breathing gets way out of hand.

While the clear airway sensing pulses are a small change in pressure (a cm/H2O or so) they often tend to hit me when I inspire and my bodies apparent reaction to that is to breath more - usually in terms of breaths per minute since I know another one will hit me if I do not. So I breath more and so tend more toward breathing instability issues.

Currently I work hard to ignore the pulses. In the future I hope to equip a "brick" CPAP with flow sensing at which point I can scrap my system on PAP pulsing monster that it is.

On we go!

Todzo

[archangle]

If we took a CPAP machine and programmed it to simply raise our pressure 2 cm/H2O every five minutes we would for shure have a hypocapnic (heavy breathing induced) central apnea within an hour. The pressure from the CPAP tends us toward breathing more (much easier to inspire and the exiration muscles train with talking so are strong) and so we reach the point where CO2 washes out and breathing gets way out of hand.

Todzo has a lot of strange ideas about apnea that differ from what most of us think.

[robysue]

Hi brax44!

Think back. Did the old machine ever "puff" at you like the new one does?

The OP's OLD machine was a System One Auto IQ. So if there were apneas, the machine most definitely "puffed" at the user.

[robysue]

brax44,

If I understand what you have written correctly, you seem to be saying this:

Old macine was a PR System One Auto IQ, but you were running (mainly) in CPAP mode---if for no other reason than the Auto IQ feature is limited to thirty days. Old setting was 12cm CPAP for most of the time.

New machine is the Series 60 System One AUTO and you are running in AUTO mode??

Seems to me that the first thing to try is simply setting the new machine up in straight CPAP mode at 12cm and use the same flex and humidifier settings as before. Give it a week at this setting to let your mind and body get used to the new heated hose and how it feels. And evaluate the AHI data over the course of that week.

[brax44]

Every setting is the same as the last machine. The only difference is with the new machine I set it to the recommended flex that pr guide says to match w the appropriate mask I have. The old machine did not have this setting so maybe it was different??? It's just bizarre that one machine works so well and this machine feels different and numbers worse at same setting.

[Todzo]

Every setting is the same as the last machine. The only difference is with the new machine I set it to the recommended flex that pr guide says to match w the appropriate mask I have. The old machine did not have this setting so maybe it was different??? It's just bizarre that one machine works so well and this machine feels different and numbers worse at same setting.

Hi again brax44,

I would definately remove the flex (I run without it).

By reducing expritory pressure:

1. It tends to promote the airway tissues being more swollen since pressure is reduced more of the time so the tissues are under less pressure some of the time and so can swell more.

2. It tends to increase air flow since the diaphram and all have to work less hard to move the air during the times the pressure is reduced.

So the tissues tend to be more full of fluid and more likely to collapse and you tend to use more air which tends to irritate the tissues and promote breathing instability as well.

It also might be wise to raise the head of your bed a few inches. For whatever reasons OSA seems to move fluids from out lower body moving toward our nose (they call this "rostral fluid shift"). I think it is likely that gravity might help with this and it also tneds to keep GERD away. For the couple of dollars it takes to purchase a couple of concrete bricks from a building supply store - well - why not?

May you find good sleep soon!

Todzo