APAP and High Pressure

howellpr · Post by **howellpr** » Wed Feb 22, 2006 12:50 pm

I have been using Remstar APAP w/ cflex for 4 nights. The last two nights I have awoke to the machine blowing at a very high pressure (Encore Pro says 16 cm) and cannot get the pressure to subside without using ramp feature or turning machine off. Anyone have similar experience or suggestions. Could it be a problem with the machine? Any replies appreciated.

DRG · Post by **DRG** » Wed Feb 22, 2006 12:58 pm

Sounds normal to me. Have you already had a titration study? If so, what are your prescribed pressures. If not, the APAP is probably set for a min of 4 and a max of 20.

DRG

NightHawkeye · Post by **NightHawkeye** » Wed Feb 22, 2006 1:56 pm

howellpr wrote:Anyone have similar experience or suggestions.

Yep. Happened to me with the BiPAP Auto when I first started xPAP. The darned thing would build up pressure and stay at max pressure, even if I was awake and breathing "normally". I attributed it to the machine sensing nasal congestion and then just running away trying to resolve that problem. I started nightly sinus irrigations and stayed with fixed pressure for a while, but more recently I converted to using the Remstar Auto and haven't had the problem.

Any chance you've had a lot of congestion?

Regards,
Bill

howellpr · Post by **howellpr** » Wed Feb 22, 2006 2:54 pm

Nighthawk - thanks for the reply. No congestion this week. Is the oddest thing. The thing blows so hard it wakes me up.

hecate · Post by **hecate** » Wed Feb 22, 2006 2:56 pm

How does one do a "sinus irrigation"? When I try to irrigate with saline spray all that happens is water shoots back out everywhere and I'm sure nothing is getting cleaned.

Thanks
Liz

NightHawkeye · Post by **NightHawkeye** » Wed Feb 22, 2006 3:50 pm

hecate wrote:How does one do a "sinus irrigation"? When I try to irrigate with saline spray all that happens is water shoots back out everywhere and I'm sure nothing is getting cleaned.

That's funny, Liz. .
I'm sorry. I know you didn't mean it to be. I use the Grossan Irrigator or Irrigation machine or somesuch. It costs about $100, but you can accomplish the same thing with a Grossan attachment to a WaterPik for about $20 plus the cost of the WaterPik. A search in Google should turn up places to buy it.

My kids think it's hilarious. It takes a little getting used to. I've never had the problem of my sinuses being totally clogged yet but have had one nostril clogged enough that the water sprayed back out though (just like you talked about).

Regards,
Bill

Guest · Post by **Guest** » Wed Feb 22, 2006 4:02 pm

Found the machine here:
http://www.allergybuyersclubshopping.co ... gator.html

One thing it doesn't state is does it run on batteries on electricity.

It does seem like since i've been diagnosed with sleep apnea i've been sticking a lot of money up my nose.

hecate · Post by **hecate** » Wed Feb 22, 2006 4:38 pm

The guest thingy was me.

I do wish we could set permanant cookies.

Liz

Guest · Post by **Guest** » Wed Feb 22, 2006 5:41 pm

howellpr wrote:I have been using Remstar APAP w/ cflex for 4 nights. The last two nights I have awoke to the machine blowing at a very high pressure (Encore Pro says 16 cm) and cannot get the pressure to subside without using ramp feature or turning machine off. Anyone have similar experience or suggestions. Could it be a problem with the machine? Any replies appreciated.

What is your titrated pressure? What pressure range is your machine set to? It comes preset from the factory at the wide open range of 4cms-20cms. It's pretty common for people to do better when that pressure range is narrowed to somewhere around their titrated pressure. Occasionally a user will encounter a situation where the pressure runs up and stays up. It isn't a problem with the machine, but rather the machine's effort to deal with your particular breathing patterns based on the Respironic's algorithms. If you put a cap on the high end of the range that's 3-4cms over titrated it usually solves the problem. What does the software indicate for your AHI at each pressure level? Does it drop at 16cms or does it increase?

NightHawkeye · Post by **NightHawkeye** » Wed Feb 22, 2006 7:12 pm

hecate wrote:One thing it doesn't state is does it run on batteries on electricity.

AC only, no batteries. I'm assuming you're talking about the whole machine. If you're talking about the WaterPik attachment, then it requires electrical no power.

hecate wrote:It does seem like since i've been diagnosed with sleep apnea i've been sticking a lot of money up my nose.

I know the feeling. Hope it works out for you, Liz.

Regards,
Bill

Snoredog · Post by **Snoredog** » Wed Feb 22, 2006 7:29 pm

you Remstar machine is NOT programmed in the autopap or AFLE mode. High pressure like yours is where you want the benefit of an autopap.

RG knows that machine real good, but you can reprogram it yourself very easily (do the power cord plug-in holding down the 2 User buttons sequence to access the setup mode and set the following parameters). Ramp up/down button changes values, right/left User buttons advance to next field.

1. Set the mode to AFLE (autopap w/cflex).
2. Set your low ramp pressure to at least 6cm, if you can tolerate 8cm or 10cm the better it will be for you.
3. Set your high ramp pressure to what was found on your last titration +2 (if that was 16cm, then set this to 18cm).
4. Set any timer value found (i.e. 00:00) to 00:00, it MUST be at zero for autopap mode to work. If it currently says 30:00 then it is in the cpap mode for a 30-min Ramp, not for autopap mode.
5. Set any Cflex setting for breathing comfort, I suggest starting at 2 (options are Off, 1, 2 or 3).
6. If using any FF mask set Patient alert to 1 (or On, 0=Off).
7. Set if you want the buttons/LCD to light up (1=On, 0=Off).
8. To exit Setup, press the On/Off key.

With these settings you'll start out with 6cm pressure and go up to 18cm if needed with a cflex setting of 2. It will still record the same as before. To exit the Setup mode, press the On/Off button. As you become used to cpap you should increase that bottom pressure from 6cm to like 10cm leaving you with a range of 10cm to 18cm. 10cm with a cflex of 2 is pretty easy to breathe against.

Goofproof · Post by **Goofproof** » Wed Feb 22, 2006 7:37 pm

hecate wrote:The guest thingy was me.

I do wish we could set permanant cookies.

Liz

Window Washer Pro will allow that but it won't stop the problem.

howellpr · Post by **howellpr** » Wed Feb 22, 2006 9:06 pm

Anonymous wrote:
howellpr wrote:I have been using Remstar APAP w/ cflex for 4 nights. The last two nights I have awoke to the machine blowing at a very high pressure (Encore Pro says 16 cm) and cannot get the pressure to subside without using ramp feature or turning machine off. Anyone have similar experience or suggestions. Could it be a problem with the machine? Any replies appreciated.
What is your titrated pressure? What pressure range is your machine set to? It comes preset from the factory at the wide open range of 4cms-20cms. It's pretty common for people to do better when that pressure range is narrowed to somewhere around their titrated pressure. Occasionally a user will encounter a situation where the pressure runs up and stays up. It isn't a problem with the machine, but rather the machine's effort to deal with your particular breathing patterns based on the Respironic's algorithms. If you put a cap on the high end of the range that's 3-4cms over titrated it usually solves the problem. What does the software indicate for your AHI at each pressure level? Does it drop at 16cms or does it increase?

dangst · Post by **dangst** » Thu Feb 23, 2006 2:19 am

Sounds like a smilar problem to what I have been having with runaway pressures on 420e (search for earlier posts). There was some good discussion at the time.

howellpr · Post by **howellpr** » Thu Feb 23, 2006 9:59 am

I changed from the comfort curve nasal interface to an Activa mask that I have and NO PROBLEM last night. May simply be that the Comfort Curve is not going to work for me. Thanks to all that posted.

Phil

APAP and High Pressure

APAP and High Pressure

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Re: APAP and High Pressure

Re: APAP and High Pressure

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