REMstar Auto - CPAP mode on - still getting pressure pulses

[Pugsy]

Okay, got some PR S1 Pro wave form reports. I have 4 samples, there were 6 pages total. It does seem to score the pressure pulse points BUT they also seem to coincide with events for the most part because as you can see there are long times when there are none.
I would think that the Auto machine in straight cpap mode would do the same but one would need to look at all the waveform reports to see frequency or pattern.

First one timed 11:30ish, there aren't any for a long time and this is typical of this persons report. Nothing goes on for an hour or 2 then all hell breaks loose.

[Wrathwielder]

Okay, got some PR S1 Pro wave form reports. I have 4 samples, there were 6 pages total. It does seem to score the pressure pulse points BUT they also seem to coincide with events for the most part because as you can see there are long times when there are none.

Thanks SO much! You're right about the graph being uneventful and them BAM! Guess that is probably REM sleep - mine tends to do that a little bit too

I was hoping we wouldn't see the red blocks on her Pro model, but it looks like if I switched out the Auto I'd have the same pulse issues

I used the REMstar Auto again last night and I had a TERRIBLE time falling asleep. Just as I'd drift off I must have had a central apnea (as is common for me) and instead of it just being taken care of on its own, the machine sent a pulse and it not only wakes me up, but I get a short burst of anxiety and my heart starts racing...this happened over and over for about 20 min. until I was able to drift off.

Very frustrating to say the least. I've finally found a machine I LOVE that is quiet and small and now I don't think I'll be able to use it because of a little setting in the firmware...

Too bad we don't have any firmware hackers out there that could tweak the pulses off...

I've decided to drag my old S7 back out for now so I can get some good sleep until I decide if there's a machine out there that I haven't tried yet

Thanks again for all your help! I really appreciate it!

-Greg

[Pugsy]

Thanks SO much! You're right about the graph being uneventful and them BAM! Guess that is probably REM sleep - mine tends to do that a little bit too

Yes, probably in REM and probably for sure she has rolled over onto her back. She is much, much worse in the supine position and only moderately worse in REM. It's a battle to keep her on her side. Hard to do when we have aches and pains and simply need to move around a bit.

Sorry I couldn't bring you better news. Since the pressure pulses don't occur without events (at least very often) if your events are well controlled the pressure pulses should at least be minimal in CPAP mode completely. Have you compared a full night in cpap mode with your software to see if this seems to be the case with you in your waveform data?

Almost all the new machines have some sort of variable pressure to make things more comfortable or use something to determine events type. With your sensitivity to the slightest change it makes it harder to decide which might be best. Even the new ResMed machines use the FOT thingy.

Since I can sleep through APAP going up to gale force winds obviously I never notice the pressure pulses at all.

Have you ever tried the Respironics M series?

[Wrathwielder]

Have you ever tried the Respironics M series?

Is there an 'M' series Auto that doesn't do ANYTHING but blow in CPAP mode?

Do they still make new M's or was it replaced by the S1?

Thanks!

-Greg

[Pugsy]

Is there an 'M' series Auto that doesn't do ANYTHING but blow in CPAP mode?

Do they still make new M's or was it replaced by the S1?

They do not make the M series machine now but they are readily available still and some very inexpensive. Yes, PR S1 machines replaced it.
It uses the Infineer DT 3500 Smart card reader for transfer to software. It will work with the newer EncorePro and Viewer versions. I have used it till I got this PR S1 APAP about a month ago.

I do not know if it will have pressure pulses. I do have M Series APAP but I am not a good judge of what it does since I can sleep through the changes. The software doesn't score pressure pulses so the machine doesn't gather that particular data but it doesn't mean it doesn't use the pressure pulse points as sensors.

We would need to look deeper in how M series machines gather their data to see if it would work for you.

[Janknitz]

if your events are well controlled the pressure pulses should at least be minimal in CPAP mode completely.

I think that the OP is having centrals in transitional sleep--right as he's falling alseep, and that triggers the pressure pulses, waking him up. I've seen a few other people complain about this too (wasn't that one of Avi's issues?). They have a really hard time ever getting to sleep because every time they are on the brink of sleep, the pressure pulse wakes them up.

Seems to me that people who have complained bitterly of the pressure pulses on the PR S1's didn't find it to be a problem on the S9's. Even though both the ResMeds and PR's must do this, it apparently doesn't feel the same with a ResMed, so it might be worth trying out a ResMed S9 to see if you have the same problem or not--if you have access to one for a trial period.

[Pugsy]

I think that the OP is having centrals in transitional sleep--right as he's falling alseep, and that triggers the pressure pulses, waking him up. I've seen a few other people complain about this too (wasn't that one of Avi's issues?). They have a really hard time ever getting to sleep because every time they are on the brink of sleep, the pressure pulse wakes them up.

Seems to me that people who have complained bitterly of the pressure pulses on the PR S1's didn't find it to be a problem on the S9's. Even though both the ResMeds and PR's must do this, it apparently doesn't feel the same with a ResMed, so it might be worth trying out a ResMed S9 to see if you have the same problem or not--if you have access to one for a trial period.

I can see where sure is a problem for some people I had thought about ResMed but wondered if OP would be also sensitive to the FOT pulses. If he could try one out that sure would be ideal.

I haven't had time to research my M series machine to see if I can find anything in the literature about how it's sensors work. Since it doesn't score centrals it might not need that particular sensor setting and thus not have the pressure pulses.

[Wrathwielder]

...so it might be worth trying out a ResMed S9 to see if you have the same problem or not--if you have access to one for a trial period.

Unfortunately I've already tried an S9 (see my "LORD HELP ME rant" a few messages up). It was the first new machine I tried since I was currently using a RESMED S7 and wanted to stick with the brand.
Couldn't believe how small and high-tech the thing was! Was all excited until the first night I used it. Every exhale produced a little "chirp" sound.
Before I even had a chance to ask my wife if she heard it she told me she was hearing a strange noise...
I went online and found numerous other posts about people hearing this noise as well. I stuck the S9 in a closet for 3 months and went back to the S7.
I recently dug it back out again and checked online hoping for a new resolution in the months that had transpired, but no go...just more posts about the same thing.
I compiled a cut-and-paste list of at least 25 different posts from people describing the problem so I could have some ammo when I went to Resmed.

After talking to my DME, he checked with Resmed and they said they were unaware of this issue...no surprise there.

I returned the S9 before I ever had a chance to use it long enough to experience any other issues, like pulses or what-not.

I got a F&P Icon next - LOVED it, but it "whistled" noticeably on every exhale...tried another one, same issue so they are made that way.

In both of these cases, the noise was only noticeable after going above 11 or so cm - below that it was not NEARLY as noticeable...I run at 14

I guess maybe the majority of people use lower settings than I do so this isn't a big enough deal for these companies to look into.

The REMstar auto is very quiet - it doesn't have a problem being quiet at higher settings...but I just can't fall asleep with it.

Oh well! I will see if anyone else can verify whether or not the 'M' series does anything fancy with the pressure while in straight CPAP mode and go from there...

Thanks again to everyone for the help!

-Greg

[rested gal]

Personally, I would not get an "M" series machine by Respironics. I have a couple of them and do not like them nearly as well as the ResMed S8 (S8, not S9) machines. Just my personal preference... because, the ResMed S8 is quieter than either of the two M series machines I've used. And I like being able to check last night's AHI/Leak in the window on the ResMed machine. With the Respironics machines, there are weekly/monthly averages shown...not any "just last night" data to see. I'm not one bit interested in seeing weekly/monthly averages. The ResMed machine shows those, too, but I don't bother to look at them. I want to see only what happened "last night" -- one night at a time.

Neither the Respironics "M" series machines, nor the ResMed S8 machines use any pressure pulses.

The Respironics M series REMstar Auto with A-Flex can be used in Auto mode or CPAP mode.

The ResMed S8 Autoset with EPR can be used in Auto mode or CPAP mode.

Either of those machines would be quieter and smaller than your current S7, and they'd deliver therapy without sending out pressure pulses in either operating mode.

If you wanted to go straight CPAP machine, without any autotitrating capability at all, then one of these two are what you'd want:

Respironics M series REMstar Pro with C-Flex

or

ResMed S8 Elite with EPR.