New user on Auto CPAP with C flex (M series)

[DublinBoyo]

Hi, I recently purchased CPAP machine from cpap.com and started using it. I used it for two nights and found the following data from its dashboard LCD display.

90% Pressure
7 days average: 4.0 cm H2O
30 days average: 4.0 cm H2O

System Leak
7 days average 14.5 L/min
30 days average 14.5 L/min

Sessions > 4
7 days average 0
30 days average 0

Therapy Usage
7 days average 0 Hrs/night
30 days average 0 Hrs/night

Summary data
Therapy Hours 0.2
Blower Hours 14.0
Total Session 0

Questions I have are:
1. Why is the pressure always remaining 4.0 I thought concept of Auto was to adjust it automatically? I checked at various times of the night and it always remained at 4
2. Is there a leak? I set up the mask alert on so shouldn't it alert me when the mask has leaks? I kept the machine running without putting the mask on (so the leakage should be found by machine sensor) and kept so for more than a minute and no alert came out.
3. Do I need to hold down <- and -> buttons every time I switch it on? I only did it as per manual for the first use afterwards I only switched it on normally by using the power up button.
4. From above data do you think I am not using it normally? I also keep distilled water up to the mark in humidifier tank as asked in manual and set it to 2 or 3.
5. Can I use deionised water instead of distilled? In Ireland distilled water is very hard to get by in superstores.

I contacted cpap.com but they didn't read my email in full they thought I was asking them to translate the above data. All I want to know is if or not I am using it right?

Thanks for reading this far, any pointer will be gratefully received.

[Hawthorne]

I think maybe your machine is set in cpap mode, since the M Series Auto cpap with C-Flex also works in straight cpap mode. You need to set it in "auto " mode and set a pressure range for the machine to adjust pressure when needed.

If you orderd it from cpap.com with a prescription for a single pressure, it will be set in cpap mode. You need to get into the "Setup" to change that. If you bought the machine from cpap.com, the 2 page (back and front of card stock paper) Clinician's Setup Guide should be there. That will tell you how to get into the setup mode and set it to auto as well as some other things.

You don't need to hold down the arrow buttons every time you start it (in fact it can be set to "auto on" so that it comes on when you hook up to it with your mask and hose). You can set it to "auto off" as well but I turn my off with the on/off button.

Distilled water is best. I don't know anything about deionized water though. You are doing the right thing with your water level in the humidifier water tank and 2 or 3 is probably a good setting.

Not sure about your mask alert. I don't use it and ahve turned it off because I don't want to be wakened in the night with it.

If you don't have the Clinician's Setup Guide, PM me your email address and I can send it to you as an emai attlachment.

By the way, 4 cm is a very low pressure whether it is a straight cpap pressure or the minimum pressure in an auto range. You may find that you need to raise that. Most people can't get enough air at 4 cm and the CO2 doesn't move out of your mask through the vent very well. You may get headaches or feel like you are struggling for air.

Also, the data on the LCD screen is not that accurate. You may want to consider buying the software and card reader for more accurate and more detailed sleep data.

I hope I have hit most of your questions!

[DublinBoyo]

You most certainly did Hawthorne thanks a bunch!

My prescription said I needed "auto" between 4 and 20 pressure scales and I had a confirmation email from cpap.com that they set it like that. I must get into the setup mode tonight and see if it is indeed set to auto or not. Tonight will be my third night so I am really not that used to it as yet.

Yes I have bought the card reader software and whole lot too. I will perhaps download the data over the weekend. I just need to make sure that when I download the data it doesnt erase it from the card because I need to go to hospital with my sleep data every 3rd month too! That's part of the treatment.

Thanks again, I will let you know how I get on. I do have the user manual.

[Hawthorne]

The data will stay on the card when you download the data onto your computer, unless you erase it with a free utility program that is available so you don't need to worry about that.

The M Series has had a firmware problem with missing the "Detailed Data" page about every 7 sleep sessions. You will get shorter reports when that happens. It rights itself again after a day or two and you get the full report again until the next time it skips. Since you don't want to erase your card because of having to take it in to be read at the hospital, you'll have to miss those couple of days every so often. I have heard of it not happening on some M Series machines and you may have gotten one that doesn't lose that detailed data every 7 sleep sessions.

If there comes time when you don't need to take the card to the hospital anymore, you can ask here about that utility and then you can erase the card every so often and not miss that data. Some people don't bother with the utility. They just miss the days of detailed data and then go on. That's what you'll be doing for now anyway.

A setting of 4 cm to 20 is too wide open. I don't know what your titrated pressure was but with a minimum setting of 4, you may not feel too rested since it could take the machine too long to get to the pressure you need to deal with events and I mentioned the other problems with that low minimum setting when I answered your last post here. To get the most help from your machine, your minimum pressure should be a cm or two below your titrated pressure. That way it gets you there faster with fewer events. The maximum of 20 cm is probably not a problem unless you had central apneas show up in your sleep study. Higher pressure can induce those.

Unfortunately most prescription give an auto setting of 4 cm minimum and 20 cm maximum. Almost everyone has to change that to get better therapy.

I don't know how the hospital will react to you changing your own pressure settings, if that should be a good thing, when you see your data. I guess you'll have to work that out.


I'm glad you have the software. You'll be able to see a lot when you get that up and running!

[roster]

....Yes I have bought the card reader software and whole lot too. I will perhaps download the data over the weekend. ............

Now you are headed toward success.

[Wulfman]

A couple of thoughts.......

You (your data) may have coincidentally been the victim of the infamous M Series taking two nights off. (it records the compliance data but the detailed data is not available) Consequently, there was virtually no meaningful data in the display.

I would suggest that you go through ALL of the options in the machine and write them down and report them back here. It's possible that the "Split Night" may be turned on.......you DON'T WANT it on.

Since you purchased it from CPAP.COM, you should have gotten a card with the machine that included the setup instructions. However, I'll list them here again (along with the reset instructions) for you to write down the options and current settings.

Den



Hold down the <- -> buttons while plugging in the little power cord in the back, wait for 2 beeps release buttons. Then press the + key to enter setup mode, use the <- -> buttons to move to the next field, use the -/+ keys to decrease/increase values, when set press the On/Off button to exit Setup.

Therapy Mode = CPAP/AUTO (If Auto is selected, there will be A-Flex or C-Flex options)
CPAP Pressure = NN (only appears in CPAP mode).
AutoMax = 20 cm (default)
AutoMin = 4.0cm (default)
C-Flex Setting = Off, 1, 2 or 3
Ramp Time = (0:05 to 0:45)
Ramp Start Pressure = 4.0cm (can be from 4cm to AutoMin pressure).
Mask Alert = On/Off (beeps on large leak, mask removal).
Auto Off = Off (turns off machine on large leak/mask removal) Suggest leaving it "Off"
Split Night Time = Off (options are Off, 120, 180, 240) Should be "Off"
Show AHI/Leak = On (enables logging to display) Suggest leaving it "On"
Patient Reminder = Off (days to remind you that you get a new mask w/Insurance).
returns to Therapy Mode
Pressing On/Off exits Setup



==========Resetting LCD Display Data====================

To reset LCD Therapy data (does NOT erase any data from SmartCard):

1. Hold down the (<-) (->) buttons while plugging in the power on the back,
wait for 2 beeps or 5 seconds, release buttons.
2. Press the (->) key and navigate to Therapy screen.
3. Press and HOLD down the (-) minus key for 5 seconds and/or until therapy data is reset to Zero.
4. Press the (->) key to scroll back to main menu, press (+) key to enter Setup or
On/Off button to exit.

[Hawthorne]

Wulfman - I told him about the "missing data" and the fact that the card with the setup instructions should be in with his machine, earlier in the thread. He mentioned that he had that.

Thanks for reinforcing what I already said in this thread.

[Wulfman]

Wulfman - I told him about the "missing data" and the fact that the card with the setup instructions should be in with his machine, earlier in the thread. He mentioned that he had that.

Thanks for reinforcing what I already said in this thread.

Sorry 'bout that. Sometimes I don't take the time to read all the previous posts as fully as I probably should.


Den

[DublinBoyo]

First of all guys - all of you there - thanks a bunch for all the pointers. Much appreciated really.

My (sad) saga continues.

I almost didn't sleep at all in last few nights - just impossible for me to get adjusted to the
- mask
- noise.

When I was suffering from sleep apnea at least I didn't notice much that I wasn't sleeping; now I know I am not. I only hope it gets better with time like rest of you.

However the machine itself is still an issue. I checked a good few times each night and the pressure never changes from 4.0. Even the data on the LCD have this still:

90% Pressure
7 days average: 4.0 cm H2O
30 days average: 4.0 cm H2O

System Leak
7 days average 14.5 L/min
30 days average 14.5 L/min

I went into the setup and therapy mode is indeed set to AUTO (and not CPAP) and min pressure is set to 4 and highest to 20.

I even have auto off set to ON and leak alert set to ON. Leak alert never comes up. I even intentionally kept the machine running for a few minutes without putting the mask on to see if the auto off (set to ON) kicks in and stops the machine. Nope!

Frustrated, I called the CPAP help line. The girl said that if the machine is set to AUTO then there is nothing else she can do and she said it was not possible that the machine could run at 4 pressure all the time. She asked me to send the machine back to them.

I live in Ireland I bought the machine in US while I was touring the country so I simply brought it back with me (used a local US address for CPAP.com to deliver for free). Now if I am to send that back from Ireland at my cost and also pay to CPAP.com for delivering to Ireland I am probably talking about same amount of money as what I spent to just buy the machine!

Any advice guys? I am really very upset now! The whole idea of saving some money (it's more expensive in Ireland however adding the cost of this shipment will probably bring it to same level) in the US just came back like a boomerang!

[Pugsy]

Here's a thought. The minimum pressure is set for 4 cm. While you are awake that is what you are going to see at any time you check it. It will drop to 4 cm minimum while you are awake. If you are indeed not sleeping much then the 4 cm average could be that because you don't have enough time to alter the average... but then again remember it is an average and these can easily be skewed with. These are 7/30 day averages and unless you clear it to zero each night you may not see a big change in an average.

You really need to see the daily detailed graph to see if the pressure ever raises at all. So install the software and look. Then you will know for sure what is going on with the pressure.

Your first post mentioned 4 sessions but only 0.2 hours of therapy. That isn't much therapy hours to create any meaningful data.

Gotta see the detailed report. Use the software, you won't lose anything off the card.

[Hawthorne]

Did you try even a detailed report for 1 night?

You said you had the software and reader so you should get that. maybe you can post Page 4 (Detailed data) on this forum. You need to use a program called "photobucket" and upload a jpeg file to that.

Maybe you could try raising the lower pressure to 6 cm to see if that changes.

[Wulfman]

I was hoping you'd use the format I listed for the instructions and report back on what ALL of your settings are.

I'd turn the Auto-Off to "Off".

If you had a sleep study and were prescribed a CPAP pressure, I'd suggest setting the minimum pressure to THAT pressure.

As previously stated, if you in fact have the software and card reader, you should be able to see what's happening.


Den

[roster]

........
I almost didn't sleep at all in last few nights - just impossible for me to get adjusted to the
.....................
- noise.

............. I checked a good few times each night and the pressure never changes from 4.0. Even the data on the LCD have this still:

90% Pressure
7 days average: 4.0 cm H2O
30 days average: 4.0 cm H2O

System Leak
7 days average 14.5 L/min
30 days average 14.5 L/min

..........

One thing that jumps out is the complaint about the noise. At 4.0 cm pressure and leak of 14.5 lpm there should be only a tiny bit of noise. Please explain the noise you are hearing.

I agree with Den, you should go into the menu and report back here each and every setting.

Let's get these two questions answered first.

I am not ready to declare the machine a lost cause at this point.

[DublinBoyo]

Eureka! It worked.

All of you were right so far. So I am thankful to you all.

I am paying the toll here for taking 3 weeks off to travel in the US .. lol... almost 12 hrs day at work... so could not download the data to PC yet (will most certainly do when I get some time and post here).

It's right that I was seeing 4.0 constant pressure because as one said I was not sleeping at all. It's also right that I suffered the 2 days data loss symptom in the first two nights. So last night I zeroed all data on LCD as was instructed on the forum and went to bed determined that I would sleep no matter what and also used ear plugs.

It worked. Sleep wasn't 100% good but I slept. In the morning I found average pressure for one night showed 5.1 - and finally, it also shows therapy hours: 1 and blower hours: 5.6 and AHI 1.1 (do not know if it's good or bad)...

So overall, I think I just need to keep using it. Thanks all guys.

Regards

[Hawthorne]

Great!

An AHI of 1.1 is excellent!

Keep at it! I takes time to adjust to this! We've all been where you are!