Need some help with hypopneas and remstar auto

[finnuser]

Hi All,

A new user here. I've had my Philips Rem Star Auto CPAP with me for a week, it is configured for APAP (4-20cmH2O). I've been using sleepyhead to analyze my sleep and the needed pressures, and I've already increased the 4cmH2O minimum to 6.0. The problem is that I keep getting mostly hypopneas during the night, and the machine seems either not to respond to them or to react too slowly and I keep ending up having some 25-30 minutes of hypopnaeic events.

For example, my nap today:
https://drive.google.com/file/d/0B_PDCe ... sp=sharing

and the night before:
https://drive.google.com/file/d/0B_PDCe ... sp=sharing

Am I just getting used to this treatment, or what is going on? The first few nights about a week ago were fine with AHI of 3 to 5, now I am getting these higher numbers and am feeling a bit more tired. I also keep thinking I'm just being too eager to fiddle with the settings and being too enthusiastic to lower my AHI even in this situation when my body just needs to adjust

I was a bit disappointed - to be honest - with the hospital when I found out they only give out these Respironics devices, I was hoping for a ResMed..


edit: need to train on my image attaching skills..

[Pugsy]

Try increasing your minimum pressure from 6 to 7cm and see what happens to those hyponeas...might need a little more than 7cm but see what a 1 cm increase does.

You likely would have had to do this with a Resmed machine too. While it might respond a little faster I don't think it would be enough of a response time difference for it to really matter all that much.

[OkyDoky]

Welcome Finnuser,
You sound like you have done your homework and have a good start. I think with the changes Pugsy is talking about you will find better results.
The machine you have picked is an older model. Take the water out and turn the blower over and look for the Ref#. If it says 560 that is the 60 series which is the latest auto, you have to scroll down a little farther to the choices that have 60 series in them. While there if you would chose text instead of icon it makes it easier for all to see the model without clicking on the icon.

[Pugsy]

Actually according to SleepyHead the machine choice seems to be correct. Usually when the 60 series machines are used we will see it mentioned in the detailed tab right below the AHI big number in Orange.
If the model is 550 then the equipment menu choice is correct.

Hint for people seeing the icony instead of text and wondering which model...you don't have to click on the icon link to see which machine is chosen...just hover your mouse cursor over the image and look to the very lowest left corner of your screen and the model name should show up.
Not a lot of work but a little bit of work and I also prefer text over icony but if people want to use icons...it's not a huge deal to just use the little cursor trick. Main drawback is the size of the letters...and my need to use glasses to read it.

[palerider]

edit: need to train on my image attaching skills..

and data arranging, start here.

https://sleep.tnet.com/resources/sleepyhead/shorganize
then
https://sleep.tnet.com/resources/sleepy ... screenshot
and then to post them:
https://sleep.tnet.com/reference/tips/imgur

[finnuser]

It says Ref 561, so I guess it is series 60. Changed it. I will add my pressure slowly in the coming nights and see what happens. With regards doing the homework, this site has been a tremendous help in getting used to the settings and terms. I'm also however a RN (Critical care) and a paramedic, so the human respiratory physiology and anatomy is quite familiar to me but still this "disease" got me by surprise... well, live and learn!

Thank you guys and gals for a great site, great discussions and for the great team spirit you have going on here

[OkyDoky]

Thanks, Pugsy. I see the difference on Sleepyhead for the 60 series on my reports. But from the reported Ref# I guess Sleepyhead isn't always correct. I just questioned it since it was a newly recieved unit. But recieving a 550 wouldn't be unheard of.

[Pugsy]

But from the reported Ref# I guess Sleepyhead isn't always correct. I just questioned it since it was a newly recieved unit. But recieving a 550 wouldn't be unheard of.

I thought that at least that part of SleepyHead was corrected but I guess not.
And yes, getting a 550 wouldn't be unheard of...often sitting on the DME shelf for a long time or private purchase or family gift or even a used unit from a DME and sold as "new".
You were correct to question it though...I missed it because I wasn't looking for it until you mentioned it.

[palerider]

But from the reported Ref# I guess Sleepyhead isn't always correct. I just questioned it since it was a newly recieved unit. But recieving a 550 wouldn't be unheard of.

I thought that at least that part of SleepyHead was corrected but I guess not.

I'm guessing it's because it's a 561, not a 560, and SH isn't matching it.... I'll send Mark a note to add to the pile for when he starts programming again.