Question regarding respironics auto m series??

Where to begin. I am new to Cpap. Tried a traditional CPAP, had troubles, now I have this AutoPap with A-flex. Have tried several mask from a nasal canula with chin-strap, to a triangular shaped full face, now I'm with one that covers my mouth and has nasal canula's for the nose. Now for my trouble. I get a very good seal on the mask and am comfortable when going to sleep. Try the machine out by "holding" breath for a second or two and the machine does like it's supposed to and pushes more air out. As soon as I breathe, the machine drops back to lower pressure. Then somehow in my sleep, the machine starts putting out way to much air. I mean so much that it breaks seal on mask and wakes me up. Once I wake up and realize what's going on, I can re-align mask to where it seals, but machine will not drop back to lower pressure. The only way to get it back to lower pressure is to push the power button and turn machine off then back on. This is extremely frustrating. I only get about 3-4 hours of sleep before this happens. Once this happens and I've been sleeping, I usually get so discouraged from trying to get machine to cooperate, that I just turn it off and task the mask off altogether. My current settings are min 6cm, max 12 cm, a-flex on 3, heated humidifier on 2. This has been occuring for like 2-3 weeks, everynight. I can reset the data and one night I'll get an average of say 8.5cm with 7 "AHI" and then reset, next night average of 8cm and 3 "AHI". I'm at a total loss and am just about ready to throw this thing out window. Any advice on how to fix this will be greatly appreciated. Oh, and "autoramp" feature is turned off.

An AHI of 3 is not all that bad but I can understand the frustration of waking up with leaks. Just remember that waking up with leaks is a whole lot better than waking up with a heart attack or stroke or not waking up at all ... so NOT give up!

The mask is the hardest part of the therapy ... not just finding the right one, but getting it all set up correctly. Everyone's face is different so you just gotta keep trying.

Make sure that your face and the mask seal are clean and oil free. My biggest problem with masks that seal around you nose and/or mouth is that after about 4 hours, I start developing an oil slick on my face and loose the seal. My solution was to learn to use a nasal pillow interface and control my mouth leaks. I have a full face mask for backup in case of sinus congestion ... have not had to use the backup in over 2 and a half years.

Another thing to look out for is to make sure that the lower mask strap does not rest on the back of your neck ... and instead rests on the back of your skull. If it rests on the back of your neck, it will cause variation in the strap tension as your head moves around resulting in leaks.

Keep trying and you will find the right combination to make the treatment work for you ... best wishes!

Get the software and reader, so you can tell what the machine does while you are sleeping. If you are awake, what the machine does means nothing, it can't start doing it's job until you do yours, by going to sleep, it doesn't play games, it just trys to provide the air pressure into your airway, that's needed to kepp the airway open. Jim

Maybe you should try turning you "Ramp" on and set at 6 for about 15 minutes, just might help then instesd of turning the machine off, you could just hit the ramp button to lower the pressure for another 15 minutes until you fall asleep comfortably.

Goodluck!
SleepyNoMore

My suggestion:

1. Move AFLEX from 3 to 2, you can change that without going into setup, just push the Flex button to 2, press On/Off button.
2. Move your Minimum pressure higher to 7.
3. Move your Maximum pressure to 15.

IF you have difficulty falling asleep with Minimum pressure of 7:
4. Set up Ramp Pressure of 6.5 cm for 30 minutes.

When you first try to fall asleep and if pressure seems too high, hit the left Ramp button.
Pressure should drop from 7.0 cm to 6.5 cm for 30 minutes.
IF you wake again during the night, don't turn the machine off, just hit the Ramp button again, pressure will drop to 6.5 and
start the Ramp again. Eventually you will get used to the pressure and not need the Ramp. Even if Ramp is NOT set hitting
the Ramp button will return current pressure back to the Minimum.

Waking up at night: By limiting the Maximum pressure with your current settings, if you are in REM sleep and an apnea appears
the machine may not have the pressure available to dislodge a stuck tongue (if sleeping in supine position). Let your LCD
data run for a few days without erasing, an average is going to be more accurate picture anyway. Keep in mind that AHI displayed include both apnea and hypopnea. Also observe the 90% pressure displayed.

Hi, I'm new at this as well (been on APAP for two months now), and I had a similar problem with waking up in the middle of the night for a few weeks with the machine in "runaway" and having to turn it off to stop it. Talk about being tired! I ended up changing my machine over to CPAP mode and setting it to maximum APAP pressure, then tweaked and fiddled with the mask and headgear adjustments until I could get it to seal reliably at that pressure. Then set it back in APAP mode. Might be worth a try.

Also, I noticed someone mentioned something about having the headgear straps placed correctly. I believe that was the final key to getting my mask to seal at high pressures; mine was pulled down too low in the back.

I don't have a problem falling asleep when first going to bed and pressure at 6cm. I'm always so tired, falling asleep is never a problem. The problem comes from when the machine starts blowing at god only knows what pressure, I'd say somewhere around 12 since it's the max. This probably happens because of a leak in the mask, but even after I reseal/re-seat the mask, and breathe normally, the machine never drops pressure back down to 6cm. I could do the ramp feature, but overall it won't help anything. If I'm waking up 2-3 times a night due to trouble to machine, then it's pretty useless. I need to figure out why machine is not lowering its pressure accordingly. I've had a pretty hard time with mask, but actually like the one I have now. Please help!!

Also, what do the numbers mean for 90% leak? I mean, what range should I be within. If it matters to my therapy, I was told I have Hypopneas, not apneas by the doctor. Thanks again.

The APAP machine I started out on did the same exact thing - I call it "runaway". Situation: You have a few hypopneas or apneas in a row, so the machine upps the pressure to prevent any more. The increased pressure causes your mask to start leaking. The machine mistakes your leaking mask for an apnea that won't stop and rapidly increases the pressure until it hits the max, where it stays. You wake up with the thing blowing like crazy, and even after reseating your mask, it won't quit, because it's trying to "prevent any more apneas like that one (mask leak) you just had".

Reseating the mask each time and waiting for the machine to lower its pressure (which takes way too long) or hitting ramp each time is miserable since it's only a temporary fix and the whole situation is starting over, only to wake you up again in a few hours. The solution is to figure out how to seat your headgear/mask when you go to bed so that it doesn't start leaking when the machine starts upping the pressure in the middle of the night. One (unpleasant) option is to wait for it to go into runaway, spend some time adjusting your headgear until you can tell the mask isn't leaking at all, then wait the 20 or 30 minutes for the machine to eventually drop its pressure back down. When you go back to sleep, if it happens again, then you still don't have a good enough seal with the mask.

Better yet, take some time during the DAY to figure out your seal issue. You could temporarily change the settings on your machine so that it runs only at the max pressure, put your mask on, lie down, and work on figuring out where and why it's leaking at that pressure.

Hang in there!!! You might ask some of the people on this forum who use the same type of mask for their help with sealing issues. It WILL work out eventually!

Jcochran wrote:I don't have a problem falling asleep when first going to bed and pressure at 6cm. I'm always so tired, falling asleep is never a problem. The problem comes from when the machine starts blowing at god only knows what pressure, I'd say somewhere around 12 since it's the max. This probably happens because of a leak in the mask, but even after I reseal/re-seat the mask, and breathe normally, the machine never drops pressure back down to 6cm. I could do the ramp feature, but overall it won't help anything. If I'm waking up 2-3 times a night due to trouble to machine, then it's pretty useless. I need to figure out why machine is not lowering its pressure accordingly. I've had a pretty hard time with mask, but actually like the one I have now. Please help!!

Try using straight-pressure CPAP mode till you get used to this therapy (and especially if you want a good night's sleep)......maybe at a pressure of 9 or 10. Leaks and snores will drive your APAP crazy.....and you, too, in the process.

Den