My Story and Advice Needed

[Pugsy]

Go here and request the provider/clinical manual for your machine if you don't have it. There's some stuff in it that isn't in the user manual.
https://www.apneaboard.com/adjust-cpap- ... tup-manual

I think this one which may be a 50 series and you have a 60 series
Respironics PR System One BiPAP AVAPS
but how to get into the clinical menu setup area is the same so it doesn't matter.

I want you to go in and tell me which mode....and what all the settings are that you see available to you and what they are set at.
I wonder if they are using S mode and no back up rate or S/T mode with a backup rate.
Can't tell unless you go into the setup menu area....
Can't rely on SleepyHead either to report correct settings on this particular model machine....sometimes it is a bit buggy when it comes to settings.

[seeker_here_in]

Well.....I have no idea why they put you on the machine they put you on. From the looks of things a regular cpap/apap/bilevel machine would have worked out fine.

The model machine they gave you (and the S/T mode being used) is usually reserved for people with major central apnea issues because it will force you to breathe if you don't breathe or make an effort to breathe on your own.
Central apneas are when there is no effort to breathe....the airway is open but you don't even try to breathe.
You did have a few centrals during the diagnostic part of the sleep study but no where near an alarming number if you had done the sleep study here in the US. Now in India they might have different criteria for when they want to step in with a machine like yours for people who have a few (or a lot) of centrals and maybe that's why they did what they did.
Some behind the scenes protocols or criteria that they follow which they use to determine which machine to finally use.

Do you know which mode they are using and what the back up rate might be.
The pressures of 12 exhale and 18 inhale...means you have a PS (pressure support) of 6....which if they were really wanting to treat centrals isn't usually enough.

So I am sitting here scratching my head why you have that machine because it's like using the atom bomb to kill a fly when an ordinary fly swatter would accomplish the same goal....unless you have some sort of lung disease not mentioned in the report.

You are using SleepyHead....can you get me a screen shot of a typical night...not the best and not the worst but a typical night that you see most of the time?
Format the graphs per the instructions in this thread. One image will show me all I need to see if you follow the directions.
viewtopic/t158560/How-to-post-images-for-review.html

You can still use this machine and probably we can improve that AHI a little with a minor little setting tweak.
Most likely just 1 or 2 cm more EPAP and no other changes.

No, I don't have lung disease or COPD.

Attaching screenshots of the last two nights

Screen Shot 2019-03-04 at 11.50.45 PM.png (186.67 KiB) Viewed 538 times

Screen Shot 2019-03-04 at 11.51.25 PM.png (189.19 KiB) Viewed 538 times

[seeker_here_in]

Go here and request the provider/clinical manual for your machine if you don't have it. There's some stuff in it that isn't in the user manual.
https://www.apneaboard.com/adjust-cpap- ... tup-manual

I think this one which may be a 50 series and you have a 60 series
Respironics PR System One BiPAP AVAPS
but how to get into the clinical menu setup area is the same so it doesn't matter.

I want you to go in and tell me which mode....and what all the settings are that you see available to you and what they are set at.
I wonder if they are using S mode and no back up rate or S/T mode with a backup rate.
Can't tell unless you go into the setup menu area....
Can't rely on SleepyHead either to report correct settings on this particular model machine....sometimes it is a bit buggy when it comes to settings.

Here are the settings that I checked from the machine -

thumbnail_PicsArt_03-05-12.02.30.jpg (17.74 KiB) Viewed 533 times

[Pugsy]

%^*()_$#$ insert some bad words

I hate these machines when used to treat plain old OSA. Geezzzz.

Go into the clinical setup menu area and tell us which mode....and exactly all the settings you see....do you see anything below Tidal volume????

Hey PR...do you have that manual? I don't I don't think. I will go look.
Think maybe we can just set it up to be a simple fixed bilevel and do a decent enough job?????

[seeker_here_in]

%^*()_$#$ insert some bad words

I hate these machines when used to treat plain old OSA. Geezzzz.

Go into the clinical setup menu area and tell us which mode....and exactly all the settings you see....do you see anything below Tidal volume????

Hey PR...do you have that manual? I don't I don't think. I will go look.
Think maybe we can just set it up to be a simple fixed bilevel and do a decent enough job?????

Found some stuff under Tidal Volume

IPAP Max 25
IPAP Min 18
EPAP 12
BPM 16
Ti 1.2
Rise Time Lock On
Rise Time 3
Ramp Time 30
Ramp Start Pressure 4
Tubing Type Lock On
Tubing Type 22
System One Resistance Lock On
System One Resistance X1
Patient disc. Alarm Off
Apnea Alarm Off
Low Mint Vent Alarm Off
Low Vte Alarm Off

No idea what any of this means!

[palerider]

%^*()_$#$ insert some bad words

I hate these machines when used to treat plain old OSA. Geezzzz.

Go into the clinical setup menu area and tell us which mode....and exactly all the settings you see....do you see anything below Tidal volume????

Hey PR...do you have that manual? I don't I don't think. I will go look.
Think maybe we can just set it up to be a simple fixed bilevel and do a decent enough job?????

According to the quick start guide I have, it can be set to CPAP, S S/T, T and PC modes, with or without AVAPS. (AVAPS not available in S/T mode).

[seeker_here_in]

%^*()_$#$ insert some bad words

I hate these machines when used to treat plain old OSA. Geezzzz.

Go into the clinical setup menu area and tell us which mode....and exactly all the settings you see....do you see anything below Tidal volume????

Hey PR...do you have that manual? I don't I don't think. I will go look.
Think maybe we can just set it up to be a simple fixed bilevel and do a decent enough job?????

According to the quick start guide I have, it can be set to CPAP, S S/T, T and PC modes, with or without AVAPS. (AVAPS not available in S/T mode).

In the picture that I posted above, it seems AVAPS is on in S/T mode

[Pugsy]

Are you comfortable altering the settings on your machine yourself?
Did you purchase this machine from someone in India? Is it yours permanently or a rental of some sort?
Are they watching your results at all?

[seeker_here_in]

Are you comfortable altering the settings on your machine yourself?
Did you purchase this machine from someone in India? Is it yours permanently or a rental of some sort?
Are they watching your results at all?

I am trying altering the setting if you can guide me.
I have bought this machine from Philips India (not a rental)
I monitor my results on SH but my understanding of the results is limited

[palerider]

(AVAPS not available in S/T mode).

In the picture that I posted above, it seems AVAPS is on in S/T mode

Maybe the manual is wrong. Another problem with the avaps is that the don't produce decent data.

[Pugsy]

Maybe the manual is wrong. Another problem with the avaps is that the don't produce decent data.

Could be an old manual or maybe they changed it in the 60 series that goes overseas or something.

When I had the S/T machine I didn't play with it much in S/T mode with the back up rate because I found it too annoying but I got good results in plain old S mode...running it like a fixed bilevel.

I am thinking S mode...EPAP 14 and IPAP 18 and just see what happens.

[palerider]

Sounds like a good start.

[seeker_here_in]

Maybe the manual is wrong. Another problem with the avaps is that the don't produce decent data.

Could be an old manual or maybe they changed it in the 60 series that goes overseas or something.

When I had the S/T machine I didn't play with it much in S/T mode with the back up rate because I found it too annoying but I got good results in plain old S mode...running it like a fixed bilevel.

I am thinking S mode...EPAP 14 and IPAP 18 and just see what happens.

Sure - lets me try these settings and post the results

Just to be clear, S Mode, IPAP 18, EPAP 14, does AVAPs need to be off or on?

[Pugsy]

AVAPS off.
Start with plain and simple and see if it works or not.
Gotta start somewhere and sometimes simple and easy will work out just fine.

[HoseCrusher]

The oximetry data shows desaturations down to 80% but the report gives a 2 second shot down to 75%. In looking at the graph this drop looks isolated. Is it real? or is it an artifact.

The average of 90 - 93 is a little low so this is something that needs to be addressed.