I use a Remstar Auto with CFLEX for about a year and the rep told me to leave the machine set at 5 the lowest and 20 the highest. He said that the machine would adjust itself. I'm wondering is that is correct.
Also, do you guys have your machines on a surge protector? Any recommendations? We have alot of lightening in Florida.
More ??? about titration on Auto with Cflex
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A GOOD surge protector (not just an outlet strip) and/or a UPS (Uninteruptable Power Supply) is highly recommended.
All things being equal (which they're NOT with this treatment) the machine will adjust.....but usually not in time.
If your bottom pressure is 5 and it takes a pressure of 10 or 12 or 15 to keep your airway open, it can't respond that quickly.....so the events are going to occur until the pressure reaches that level. Then, at some point, it drops back down.....maybe to the lowest pressure and you start all over again. The events it can't stop are still depriving your system of oxygen and you still feel like CRAP (and it's still damaging your body).
In MY opinion, an "Auto" (APAP) should be used to find the optimum single pressure OR to find the best (narrow) range of pressures that give you the best therapy......not left wide open and thinking it's going to stop all of the events. It WON'T!
Best wishes,
Den
All things being equal (which they're NOT with this treatment) the machine will adjust.....but usually not in time.
If your bottom pressure is 5 and it takes a pressure of 10 or 12 or 15 to keep your airway open, it can't respond that quickly.....so the events are going to occur until the pressure reaches that level. Then, at some point, it drops back down.....maybe to the lowest pressure and you start all over again. The events it can't stop are still depriving your system of oxygen and you still feel like CRAP (and it's still damaging your body).
In MY opinion, an "Auto" (APAP) should be used to find the optimum single pressure OR to find the best (narrow) range of pressures that give you the best therapy......not left wide open and thinking it's going to stop all of the events. It WON'T!
Best wishes,
Den
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
It is okay to trial those settings for a night or two but it can be dangerous if you had any CA or MA events show up on your diagnostic PSG.
The problem encountered is the machine can misread an obstructive event for a central one. Should that happen (and it does) the machine will increase pressure which only makes the CA condition worse. Another problem is if you snore, the snores can cause the machine to increase pressure to treat the snore and in doing so it can trigger the CA events.
Fortunetly you have a Remstar Auto, it has a better response limiter built-in so when it sees a triple event it will limit any response, even it messes up at times but still better than most.
When a RT leaves your machine set to that range for long term, it tells me they have absolutely no idea what they are doing when it comes to setting up a autopap machine.
Suggestion:
1. Find your 90% pressure, if it is a classic Remstar watch the LCD display for the pressure shown immediately when you wake up or if you wake during the night, check the delivery pressure. This can tell you what your pressure is even without the software (while the software is the best).
2. Once you know your pressure, adjust the Max. pressure downward closer to the 90% pressure.
3. You have been on cpap therapy for a while now, how is the 5cm pressure? I would starve at that setting, if you can tolerate it, I would bump the Min. pressure to at least 6.0cm.
4. If you have the monitoring software, if your Max. pressure is flat-lining and AHI starts to climb then you can increase the ceiling and allow the machine to treat those events.
As little as .5cm or (half a cm) pressure on me can trigger a series of CA events for me. I snore (hence name) which also drives up the pressure, so I have to limit mine to 9cm. Flat-lining is pretty normal for me.
If you have a problem where the machine is misreading you, it can sometimes show up as a "moving" 90% pressure where it varies by 2-3cm on a nightly basis or if you increase the Max. it always seems to find it. If your 90% pressure is rock solid night after night you have nothing to worry about.
The problem encountered is the machine can misread an obstructive event for a central one. Should that happen (and it does) the machine will increase pressure which only makes the CA condition worse. Another problem is if you snore, the snores can cause the machine to increase pressure to treat the snore and in doing so it can trigger the CA events.
Fortunetly you have a Remstar Auto, it has a better response limiter built-in so when it sees a triple event it will limit any response, even it messes up at times but still better than most.
When a RT leaves your machine set to that range for long term, it tells me they have absolutely no idea what they are doing when it comes to setting up a autopap machine.
Suggestion:
1. Find your 90% pressure, if it is a classic Remstar watch the LCD display for the pressure shown immediately when you wake up or if you wake during the night, check the delivery pressure. This can tell you what your pressure is even without the software (while the software is the best).
2. Once you know your pressure, adjust the Max. pressure downward closer to the 90% pressure.
3. You have been on cpap therapy for a while now, how is the 5cm pressure? I would starve at that setting, if you can tolerate it, I would bump the Min. pressure to at least 6.0cm.
4. If you have the monitoring software, if your Max. pressure is flat-lining and AHI starts to climb then you can increase the ceiling and allow the machine to treat those events.
As little as .5cm or (half a cm) pressure on me can trigger a series of CA events for me. I snore (hence name) which also drives up the pressure, so I have to limit mine to 9cm. Flat-lining is pretty normal for me.
If you have a problem where the machine is misreading you, it can sometimes show up as a "moving" 90% pressure where it varies by 2-3cm on a nightly basis or if you increase the Max. it always seems to find it. If your 90% pressure is rock solid night after night you have nothing to worry about.
Well that explains alot of my feeling like Crap
That was an excellent explanation. I'm not sure what an APAP machine is though. I guess for now I should just narrow the range until I get the Encore Pro software up and running.
I got your steps on installing the software and card reader. There were 72 steps. That seems like alot and a bit overwhelming for an already sleep deprived person. Cognitively impaired you know.
What kind of range spread is typical. Is it several points say from 9-13 or is it closer say within a half a point say 8.5-9?
Thx Victoria
I got your steps on installing the software and card reader. There were 72 steps. That seems like alot and a bit overwhelming for an already sleep deprived person. Cognitively impaired you know.
What kind of range spread is typical. Is it several points say from 9-13 or is it closer say within a half a point say 8.5-9?
Thx Victoria
Re: Well that explains alot of my feeling like Crap
Yes, The install could be made easier, infact it could be made almost automatic. But, it hasn't been, but it is doable and well worth doing. I know my best treatment pressure on CPAP is 15.5 Cm, any higher and I form Centrals, so I limit the top to 15 cm and I set the low to 11 cm. That gives me the treatment I need and a lower pressure ost of the time.vdol52 wrote: There were 72 steps. That seems like alot and a bit overwhelming for an already sleep deprived person. Cognitively impaired you know.
What kind of range spread is typical. Is it several points say from 9-13 or is it closer say within a half a point say 8.5-9?
Thx Victoria
My AHI for Feb 07, was 0.68, not too bad, considerating congestion problems. Jim
Use data to optimize your xPAP treatment!
"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire
"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire
Victoria,That was an excellent explanation. I'm not sure what an APAP machine is though. I guess for now I should just narrow the range until I get the Encore Pro software up and running. .
An APAP is what you have. It is an Auto-Adjusting (or Auto-Titrating) CPAP machine. The terminology takes a bit of getting used to. I learned a lot about this with responses to my prior post "Gadget Junkie needs recommendations."
viewtopic.php?t=17650&highlight=gadget
Greg
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