Need Help Changing Altitude Setting - REMStar Auto M Series

[yamar2001]

A Flex is the machine.

Hey Everyone...I just moved to Denver and I've currently been struggling with my machine. I've gone from a 7 day average of 3.3 apneas per hour, to close to 7 apneas per her hour in just two weeks. The number seems to be going up daily. I believe this is because of the high attitude. Can anyone post the directions to alert the machine that I'm now a mile up in elevation? I did a google search and could find directions from the C Flex, but not A Flex. A woman over at the sleep Dr that I will be seeing (a full month from now) told me she's nearly positive my machine automatically adjusts, but if past history is any indication of the future, all these Dr's and Respiratory Therapist look at with apnea patients is compliance rate, nothing else - how long you kept on the mask is all they care about...very odd. She could be right, and if she is I probably has a bigger problem on my hands but I just find it hard to believe that this number would continue to get worse on a daily basis, starting right when I arrived in Denver. Thanks!

[builta]

Hi,

I think that if you look at the specs for your unit you may notice that it has "automatic" altitude pressure correction. If it does, you cannot manually set it. Do you have a humidifier? Have you "tweeked" the humidity setting? When I travel, I find that I had to change the humidity setting on the M-series.

Cheers

[chunkyfrog]

You may also be exposed to new allergens, and your passages are reacting. could try an allergy med or a neti pot.

[builta]

You may also be exposed to new allergens, and your passages are reacting. could try an allergy med or a neti pot.

Hi,

Great thought!

Speaking of that, Are you using the white filter?

Cheers

[Wulfman...]

A Flex is the machine.

Hey Everyone...I just moved to Denver and I've currently been struggling with my machine. I've gone from a 7 day average of 3.3 apneas per hour, to close to 7 apneas per her hour in just two weeks. The number seems to be going up daily. I believe this is because of the high attitude. Can anyone post the directions to alert the machine that I'm now a mile up in elevation? I did a google search and could find directions from the C Flex, but not A Flex. A woman over at the sleep Dr that I will be seeing (a full month from now) told me she's nearly positive my machine automatically adjusts, but if past history is any indication of the future, all these Dr's and Respiratory Therapist look at with apnea patients is compliance rate, nothing else - how long you kept on the mask is all they care about...very odd. She could be right, and if she is I probably has a bigger problem on my hands but I just find it hard to believe that this number would continue to get worse on a daily basis, starting right when I arrived in Denver. Thanks!

No. Respironics (or Philips/Respironics) is the machine manufacturer. A-Flex is a "feature" on the machine......which apparently is an APAP/Auto. Please take the time to learn what you have for equipment and fill out your forum profile.

If your machine IS the Auto, it DOES have an automatic altitude adjustment.

The problem may be in your overall pressure settings. WHAT ARE THEY? If the pressure setting is wide open (4 - 20 cm.) you will have very poor therapy.

Where did you move FROM?
If it was from a much lower altitude, you went to an altitude with a thinner oxygen content. You will be sleeping much deeper until you acclimate yourself to it. If your machine's pressure is set too low in the first place or your minimum pressure is set too low, you're going to be seeing those higher AHI numbers until you increase your pressure settings.


Den

[yamar2001]

Moved from California, at sea level.

As for what type of machine I have... it says REMStar M Series AFlex.... I see nothing else. Sorry if I'm being a pain. When I press Flex it gives me the option of C-Flex 1, 2, or 3.

I believe my low pressure starts at a five, and I was told by the Dr my pressure doesn't go nearly as high as most other apnea patients, but I don't have the exact numbers with me. My Dr in California was so incredibly bad at her job. I asked her for months and months and months if I could set a feature to tell me if I took the mask off in the middle of the night. No she kept telling me. After reading through a super long user manual, I found there' a very simple alarm you can set to wake you up if you do take the mask of... simply put, she did absolutely nothing for me but throw pills at me and tell me that my "compliance seemed okay" that and took thousands of dollars.

I'm off to urgent care so I can get someone to take a look at this machine. Nobody will even talk to me until I get a script from a Dr even though I've been a patient for over three years.

I have noticed the machine is a bit more "wheazy" at night... perhaps it needs to be calibrated or whatever. I'll keep you guys posted, thanks for the help....

[builta]

Hi,

You are not being a pain. Everyone needs help and CPAP support is a great thing. RestedGal and Wulfman helped me a lot! Sometimes wolves are know to bite a little! Just the way it is.

Your machine automatically adjust for altitude. Wulfman and correct (he pretty good) that you should look at your starting pressure. Do you have software so you can see how your therapy pressure and apneas correlate? Pushing up your starting pressure a cm or two may help.

The more information about your therapy that you can include and post the better and quicker the responses are. Update your profile with your machine a, mask and settings. It will help.

Cheers

[Wulfman]

Moved from California, at sea level.

As for what type of machine I have... it says REMStar M Series AFlex.... I see nothing else. Sorry if I'm being a pain. When I press Flex it gives me the option of C-Flex 1, 2, or 3.

I believe my low pressure starts at a five, and I was told by the Dr my pressure doesn't go nearly as high as most other apnea patients, but I don't have the exact numbers with me. My Dr in California was so incredibly bad at her job. I asked her for months and months and months if I could set a feature to tell me if I took the mask off in the middle of the night. No she kept telling me. After reading through a super long user manual, I found there' a very simple alarm you can set to wake you up if you do take the mask of... simply put, she did absolutely nothing for me but throw pills at me and tell me that my "compliance seemed okay" that and took thousands of dollars.

I'm off to urgent care so I can get someone to take a look at this machine. Nobody will even talk to me until I get a script from a Dr even though I've been a patient for over three years.

I have noticed the machine is a bit more "wheazy" at night... perhaps it needs to be calibrated or whatever. I'll keep you guys posted, thanks for the help....

Here's a link to some of the PR machines:

https://www.cpap.com/cpap-machines/phil ... #/1:1::::0:

Here's the one with A-Flex:

https://www.cpap.com/cpap-machine/remst ... -flex.html

I'm listing the instructions to get into the M Series Auto below.

You might want to go through the menu and write down EXACTLY what the settings are in your machine.


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.


.

[Guest]

Thanks for the help guys.

Got a respitory therapist to call me from a local place. We went through my settings...it appears the machine should automatically adjust.

My starting pressure is a 6.0 and I have it on CPAP, the RT told it will stay on 6 all night regardless of if I'm having an episode. He said AUTO will make it so that it pushes more air if I need it. I asked if I should do that and he said he can't comment until he talks with my old Dr. Hopefully tomorrow.

In any case, I think I'll try AUTO tonight. It can't get much worse than it is. Maybe the settings got bumped around in the move somehow? Dunno? In any case, hopefully I'll get this situated soon. I'll update my profile later after work.

[archangle]

Be sure that your machine is set to do Auto CPAP (APAP). This will adjust the pressure up if you aren't getting enough pressure. Even though your machine is capable of APAP, it can be set to do only CPAP.

If it is set to auto CPAP, it may be set to too low of a minimum pressure. 5 is pretty low, but it's OK for some people. Lots of people assume that because it's "auto," you can set the pressure low and let the machine adjust upwards. The problem is that the machine starts on low pressure and doesn't adjust upwards until after you have some incidents. You get the right pressure before the night is out, but you'll have some problems till it bumps up to the max. When you wake up, especially in the middle of the night, check the pressure reading on the machine.

By the way, it's not necessarily wrong to use CPAP only, as long as the pressure is right. Your machine should have a smart card in it. Be sure to bring that or the whole machine to your doctor's appointment.

You can adjust the machine yourself. There is a risk that you can set it wrong and hurt yourself. There is also a risk that your doctor and/or DME will set your machine wrong. You can buy the software and a card reader on cpap.com that will allow you to read your card and look at your own treatment results, but it's not necessarily easy to interpret.

What, if anything, does your machine report for 90% pressure? Press -> when the machine is off to scroll through the readings.

[archangle]

Thanks for the help guys.

Got a respitory therapist to call me from a local place. We went through my settings...it appears the machine should automatically adjust.

My starting pressure is a 6.0 and I have it on CPAP, the RT told it will stay on 6 all night regardless of if I'm having an episode. He said AUTO will make it so that it pushes more air if I need it. I asked if I should do that and he said he can't comment until he talks with my old Dr. Hopefully tomorrow.

In any case, I think I'll try AUTO tonight. It can't get much worse than it is. Maybe the settings got bumped around in the move somehow? Dunno? In any case, hopefully I'll get this situated soon. I'll update my profile later after work.

Well, you posted while I was typing my previous response.

Be sure to NOT set the machine to "Auto off = on." This is confusing, there are two "AUTOs."

Auto CPAP is automatic pressure adjustment. (Therapy mode "Auto" is what it says on the menu.)
Auto Off is "turn the machine off automatically if you take the mask off." This is dangerous because if you get a big leak in the mask, it may shut the machine off.

Be sure that "AUTO OFF" feature is "OFF."

Confusing enough for you?

[yamar2001]

Be sure that your machine is set to do Auto CPAP (APAP). This will adjust the pressure up if you aren't getting enough pressure. Even though your machine is capable of APAP, it can be set to do only CPAP.

If it is set to auto CPAP, it may be set to too low of a minimum pressure. 5 is pretty low, but it's OK for some people. Lots of people assume that because it's "auto," you can set the pressure low and let the machine adjust upwards. The problem is that the machine starts on low pressure and doesn't adjust upwards until after you have some incidents. You get the right pressure before the night is out, but you'll have some problems till it bumps up to the max. When you wake up, especially in the middle of the night, check the pressure reading on the machine.

By the way, it's not necessarily wrong to use CPAP only, as long as the pressure is right. Your machine should have a smart card in it. Be sure to bring that or the whole machine to your doctor's appointment.

You can adjust the machine yourself. There is a risk that you can set it wrong and hurt yourself. There is also a risk that your doctor and/or DME will set your machine wrong. You can buy the software and a card reader on cpap.com that will allow you to read your card and look at your own treatment results, but it's not necessarily easy to interpret.

What, if anything, does your machine report for 90% pressure? Press -> when the machine is off to scroll through the readings.

Thanks for your reply. I turned it onto auto...it was on CPAP only. I also turned the min pressure to 5.5 and the max is set for 20.0 This should help a bit tonight until I can see a respiratory therapist. Given how I just changed altitudes and the machine is weazing a bit... I figure I'm better off with the auto at this point, and set the minimum higher. Come to think of it I'll bump it to six just in case.

I don't usually see a pressure reading when I wake up... but then again I haven't flipped the panel open so tonight I'll give it a look. I have a smart card and I have the software to read it, I just have to find it... we just unpacked and I've never needed it in the past. I suppose all this could be figured out on my own, but may as well take advantage if the respitory therapist can help me out tomorrow. Also would like to have them take a look to see if the pressure readings are acurate.

my 90% that you asked about read 0.00

I have a comfort option of C Flex or A Flex...which do you guys use? I don't really know the difference.

[archangle]

I don't usually see a pressure reading when I wake up... but then again I haven't flipped the panel open so tonight I'll give it a look. I have a smart card and I have the software to read it, I just have to find it... we just unpacked and I've never needed it in the past. I suppose all this could be figured out on my own, but may as well take advantage if the respitory therapist can help me out tomorrow. Also would like to have them take a look to see if the pressure readings are acurate.

my 90% that you asked about read 0.00

0.00? My gawd man, you're breathing vacuum!!!

It may not record this info if the smart card isn't in the machine. I suggest people always put the card in even if they're not going to use the software because you or your doctor might want to read the data later. It can give you a lot of info even many months later. Plus it does keep some data you can see on the machine itself. You can get a new card for $10 or so online, I think.

In order to see your pressure reading on the display, you have to look before you turn the machine off. Peek at it a few times after you put on the mask and start the machine, then whenever you wake up before you turn the machine off or remove your mask.

[yamar2001]

Bummer... woke up feeling more refreshed today than yesterday, but 7 day AHI continues to go up daily. It was 6.5 yesterday, 7.3 upon waking up today... I am getting more and more apneas per hour every night it seems.

I'm finding myself breathing through my mouth a little more than normal, but jeez...I can't for the life of me figure out why my 7 day average would go from 3.2 (good, and had it there for well over a year) to 7.3 in less than two weeks - really hopeful that something is wrong with the machine otherwise I've taken a serious step back.

As for my 90% pressure .... it now reads a 7.0 average

When I woke this morning my pressure was at 7.5

Ugh, really REALLY hope something is wrong with the machine, otherwise moving to Denver, for whatever reason has made me take a SERIOUS step back with the apnea...and I really just got it under control about a year and a half ago

[Hawthorne]

You need to leave those settings for a few nights for everything to adjust. You said you were feeling more refreshed this morning -good sign. See if things improve, as far as your data is concerned with no more changes for a few days.

A minimum of 6 cm seems to be a good start, with a 90% of 7 cm but you may want to raise that minimum to 6.5 in a couple of days and maybe to 7 cm or even more after another few days. Small increases every few days will give time for adjustment to show in the data and won't put your pressure too high. Leave the maximum where it is for now.