Remstar settings and CFLEX/AFLEX

[patseguin]

I just got a new Remstar Auto M Series and had my first night on it last night. I left all the settings on defaults and slept fairly well actually. The pressure range in auto mode is 4-12. My sleep study doctor had recommended a setting of 8 on a CPAP. Should I set this machine's minimum pressure to 8 or should I leave it since it should choose the correct pressure for me anyways? Also, the manual mentioned something about a "breathing circuit". I have no idea what that is supposed to be. I have the unit w'humidifier with the hose connected and a Mirage Swift II connected to that. What's this "circuit" they talk about?

Also, i just found out that there's a new model now with AFLEX. How is that different and is it worth sending my unit back for the AFLEX model?

[Guest]

You should keep it at the pressure your doctor prescribed.

[DreamStalker]

Some folks have trouble with low pressure setting of 4 cm but because you are using the Swift interface, you likely did not get that starved feeling for air ... had you been using a nasal mask or full face mask it ay have been different. So if you slept fairly well, on this rare occasion I would agree with bio-major Guest for now.

Try and leave your settings alone for at least a week or two and then use the averaged data to determine which way to make any adjustments if any. Keep an eye on your leak rates because your first step in optimizing your treatment is to make certain leaks are kept in check.

Breathing "circuit" refers to the entire system/setup from flow generator machine, thru humidifier, thru hose, into mask, into your lungs, and back out thru the mask CO2 vent ports.

As for AFLEX vs CFLEX, perhaps someone else can explain the subtleties but at your titrated pressure of 8 and the fact that you said you slept well on your initial use, these features may not be all that significant for you.

Best wishes and Happy PAP'in!

[rested gal]

Hi Pat,

As far as I know, the "breathing circuit" is just the closed loop between you and the machine. In other words, the breathing circuit would be the hose and mask (and humidifier, if a humidifier is being used.) The breathing circuit is everything connecting you to the machine.

There's nothing particularly wrong with using 4 as the minimum pressure in the range on your autopap...IF you are comfortable breathing at 4 cm. Personally, breathing through a mask is easier for me with a minimum pressure no lower than 6. 4 cm feels stifling to me. Just depends on how 4 feels to you. If it doesn't feel stifling and doesn't feel like "work" to breathe air in, then 4 for the minimum suits you ok.

I do think, however, that setting the minimum pressure up fairly close under the recommended pressure that came from a sleep lab titration is a good way to use an autopap, for most people.

If it were me and my prescribed single pressure from a sleep study was 8, I'd set the autopap at 6 or 7 for its minimum pressure setting. I'd set it at anything from 12 on up for the maximum pressure. As long as the machine didn't have to hit the top pressure I had set, it doesn't matter how much more additional ceiling room is set up there since it's not going to be used.

btw, as you know, I'm not a doctor and am not offering medical advice. That's just how I'd set it, if it were me.

I've not used the autopap with A-Flex, but have heard several people who do have one that A-Flex makes breathing extremely comfortable. If you could swap for it, fine. But if it would be a hassle to get the DME to swap machines for you, and if you're comfortable with the C-Flex on your current machine, I wouldn't worry about trying to get A-Flex.

Good luck with your treatment, Pat. You have an excellent machine, imho.

[Wulfman]

I just got a new Remstar Auto M Series and had my first night on it last night. I left all the settings on defaults and slept fairly well actually. The pressure range in auto mode is 4-12. My sleep study doctor had recommended a setting of 8 on a CPAP. Should I set this machine's minimum pressure to 8 or should I leave it since it should choose the correct pressure for me anyways? Also, the manual mentioned something about a "breathing circuit". I have no idea what that is supposed to be. I have the unit w'humidifier with the hose connected and a Mirage Swift II connected to that. What's this "circuit" they talk about?

Also, i just found out that there's a new model now with AFLEX. How is that different and is it worth sending my unit back for the AFLEX model?

For most folks, a bottom pressure of 4 would be suffocating and you would more than likely be having more events at those lower pressures. If your titrated pressure is actually 8, that's where your bottom pressure should be (or darned close to it), in my opinion.
It's your therapy. If you feel comfortable asking the doctor to bump up the bottom pressure.....by all means, ask him/her. If you want to do it yourself, the instructions are available......somewhere....... (and downloadable)

http://www.cpap-supply.com/Articles.asp?ID=130

I can't really address the "A-Flex" situation (from experience). Supposed to be nicer, but at lower pressures (where you're at), I doubt there would be a significant difference. Some folks even turn off the "Flex/EPR" features on their machines......and some machines (like the Puritan Bennett machines) don't even have it.

Den

[patseguin]

Thanks for the input. I might try a minimum setting of 6 or 7 like restedgal said. It should be noted that I bought my equipment from cpap.com. The DME I was dealing with offered little or no support and a bottom of the line unit. I did not feel like I was benefitting from the CPAP machine at 8 and wanted an auto unit. I don't even know how to check leak rates. I looked at the screens a little this morning but it seems all the data is on a 7-day basis so I won't see anything until the 7 day mark. So, after the 7 days, if my 90% pressure setting is 8.7%, for example, should I keep using it on APAP mode or set it at 8.7 in CPAP mode?

[Snoredog]

[quote="patseguin"]Thanks for the input. I might try a minimum setting of 6 or 7 like restedgal said. It should be noted that I bought my equipment from cpap.com. The DME I was dealing with offered little or no support and a bottom of the line unit. I did not feel like I was benefitting from the CPAP machine at 8 and wanted an auto unit. I don't even know how to check leak rates. I looked at the screens a little this morning but it seems all the data is on a 7-day basis so I won't see anything until the 7 day mark. So, after the 7 days, if my 90% pressure setting is 8.7%, for example, should I keep using it on APAP mode or set it at 8.7 in CPAP mode?

[rested gal]

So, after the 7 days, if my 90% pressure setting is 8.7%, for example, should I keep using it on APAP mode or set it at 8.7 in CPAP mode?

That would be your choice. It's always a good experiment, imho, to try a straight pressure to compare how you do using cpap mode vs apap mode. I wouldn't bother with setting a pressure at a decimal point, though. If I were going to set it at 8.7, I'd just go on and set it at 9.

If I were going to use it in autopap mode and I had seen that over a period of a couple of weeks the 90% pressure was 8.7, I'd also try this experiment... I'd set the minimum pressure at 7 or 8, and the maximum pressure at the 12 you have it at (or more, if the machine was hitting that pressure at all) and see how that goes.

As you probably already know, the software would give you much more info to help decide what tweaks you might want to make, than what you get from the weekly/monthly averages in the machine window.

[Wulfman]

Thanks for the input. I might try a minimum setting of 6 or 7 like restedgal said. It should be noted that I bought my equipment from cpap.com. The DME I was dealing with offered little or no support and a bottom of the line unit. I did not feel like I was benefitting from the CPAP machine at 8 and wanted an auto unit. I don't even know how to check leak rates. I looked at the screens a little this morning but it seems all the data is on a 7-day basis so I won't see anything until the 7 day mark. So, after the 7 days, if my 90% pressure setting is 8.7%, for example, should I keep using it on APAP mode or set it at 8.7 in CPAP mode?

I've been under the impression that you CAN see the daily/nightly stats.....but I have no first-hand experience with that machine. Maybe somebody else can tell you. (I'm thinking it needs to be unplugged and re-plugged in or something like that....with reporting parameters turned on in the setup)

Again, it's your therapy.....and whatever it takes to obtain the best therapy should be your goal.

Den

From Snoredog's instructions:

Menu for M Series Auto

1. Hold down the <- -> buttons while plugging in the power on the back, wait for 2 beeps, release buttons.
2. Press the + key. <- -> buttons move to next field, -/+ keys decrement/increment
3. Check the following field(s):

-Therapy Mode =...... (CPAP/Auto)

-Auto:Max =...... (default=20.0cm)

-Auto:Min =...... (default=4.0cm)

-C-Flex Setting = 2 (options are off, 1, 2 or 3)

-AutoRamp Time =...... (options are 05 to 45 min)

-AutoRamp Pressure =...... cm (4cm->AutoMin)

-Mask Alert Feature =...... (On/Off)

-Auto Off Feature =...... (On/off)

-Split Night Time = Off (off, 120, 180, 240)

-Show AHI/Leak Feature = On (On/Off)

Press On/Off button to exit.