Index score

My apnea index score averages 8.5 and sometimes as high as 10.
This is from the screen on my Remstar Auto M series with AFlex machine set at 6.5 from my Dr. I only was able to get the machine because I had excessive hypoapneas during REM sleep. I can't get an answer from my sleep study Dr and the DME says they needed more data two months ago...I've been on this since Sept. Any ideas?

Nanetteneedssleep wrote:My apnea index score averages 8.5 and sometimes as high as 10.
This is from the screen on my Remstar Auto M series with AFlex machine set at 6.5 from my Dr. I only was able to get the machine because I had excessive hypoapneas during REM sleep. I can't get an answer from my sleep study Dr and the DME says they needed more data two months ago...I've been on this since Sept. Any ideas?

Yeah. Your machine may be set with the wrong pressure.......you may need more.

Have you gotten into the setup screens to see what all the settings are? It may be a good idea if you did.
I'll list the directions and you can go into it and see what they are. I'd suggest you write everything down without changing anything yet. If you'd like to bring them back here, we may have some suggestions.

Is the machine being rented to you or "what"?

Apparently you have had some part of your sleep study, but it's not clear what part. Why won't your Dr. communicate with you?


Den


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Hold down the <- -> buttons while plugging in the little power cord in the back, wait for 2 beeps release buttons. Then press the + key to enter setup mode, use the <- -> buttons to move to the next field, use the -/+ keys to decrease/increase values, when set press the On/Off button to exit Setup.

Therapy Mode = CPAP/AUTO (If Auto is selected, there will be A-Flex or C-Flex options)

CPAP Pressure = NN (only appears in CPAP mode).

AutoMax = 20 cm (default)

AutoMin = 4.0cm (default)

C-Flex Setting = Off, 1, 2 or 3

Ramp Time = (0:05 to 0:45)

Ramp Start Pressure = 4.0cm (can be from 4cm to AutoMin pressure).

Mask Alert = On/Off (beeps on large leak, mask removal).

Auto Off = Off (turns off machine on large leak/mask removal) Suggest leaving it "Off"

Split Night Time = Off (options are Off, 120, 180, 240) Should be "Off"

Show AHI/Leak = On (enables logging to display) Suggest leaving it "On"

Patient Reminder = Off (days to remind you that you get a new mask w/Insurance).

returns to Therapy Mode

Pressing On/Off exits Setup



==========Resetting LCD Display Data====================

To reset LCD Therapy data (does NOT erase any data from SmartCard):

1. Hold down the (<-) (->) buttons while plugging in the power on the back,wait for 2 beeps or 5 seconds, release buttons.
2. Press the (->) key and navigate to Therapy screen.
3. Press and HOLD down the (-) minus key for 5 seconds and/or until therapy data is reset to Zero.
4. Press the (->) key to scroll back to main menu, press (+) key to enter Setup or
On/Off button to exit.


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By the way, what mask are you using? Any leakage problems?


Den

Thank you for your informative replay. Following your directions I was able to get only part of what you mentioned. The machine is rented according to my records from Blue Shield. The mask is Respironics Comfort Fusion. Readout shows Cflex setting is 1, ramp start pressure is 4.0cmH2O, mask alert off, cutoff is off. I haven't been able to use it since Wed cause I have the flu with a bad cough. Sure miss it.
System leak 7 day average is 31.9, 30 day 29.8 and apnea-hypoapneas 7.8 and thirty days 8.7. I do have the study results. I have a heated humidifier set at two. In spite of wrapping the hose with flannel I do get some rain.
Summary of sleep study was REM AHI was 30.6, AHI 6.3 . Oxygen desaturation 86% Diagnosis mild REM related obstructive sleep apnea. I think that is why I had a hard time getting the machine but I do think it helps. Just seems like it might help more. I have to get a new sleep Dr Jan 1st as the HMO won't cover the one I have after that. Sure have felt a lack of involvement from the Dr and DME. Not to mention when a piece broke off the face mask I got a bunch of attitude although they did replace it "this one time"!

Your leaks are not unacceptable, but it really seems to me like your pressure could be higher - 6.5 is about as low as it gets and I imagine you might even be straining to get air half the time. A lot of MD's prescribe a low setting initially, but a lot ofus end up raising it over time. BTW, Respironics masks do break a lot!

Nanetteneedssleep wrote:Thank you for your informative replay. Following your directions I was able to get only part of what you mentioned. The machine is rented according to my records from Blue Shield. The mask is Respironics Comfort Fusion. Readout shows Cflex setting is 1, ramp start pressure is 4.0cmH2O, mask alert off, cutoff is off. I haven't been able to use it since Wed cause I have the flu with a bad cough. Sure miss it.
System leak 7 day average is 31.9, 30 day 29.8 and apnea-hypoapneas 7.8 and thirty days 8.7. I do have the study results. I have a heated humidifier set at two. In spite of wrapping the hose with flannel I do get some rain.
Summary of sleep study was REM AHI was 30.6, AHI 6.3 . Oxygen desaturation 86% Diagnosis mild REM related obstructive sleep apnea. I think that is why I had a hard time getting the machine but I do think it helps. Just seems like it might help more. I have to get a new sleep Dr Jan 1st as the HMO won't cover the one I have after that. Sure have felt a lack of involvement from the Dr and DME. Not to mention when a piece broke off the face mask I got a bunch of attitude although they did replace it "this one time"!

The apparent fact that you can't see some of the settings is a little confusing. Please re-check what is on the top of your machine (model designation) to be sure you have an "Auto".

Near the bottom of the page in this link, there are several M Series clinician's manuals that can be downloaded.

http://www.apneaboard.com/CPAP%20Adjustment.htm

Please download whichever manual applies to the model you have and look at the setup diagrams.

Also, please list EVERY option and setting you see as you go through the configuration screens. (and post them here)

With regard to your humidity setting.....
Keep in mind that too much humidity can have the effect of closing off your nasal passages and possibly a lower setting or turning it off (but still leave water in the humidifier tank) to facilitate better breathing. Also, try nasal cleansing/rinses if you haven't done so already.

PS. I can relate to the cough. I had that about two weeks into my therapy and had to go off therapy for about 10 nights until it subsided and I could keep my mask on......it was a rough time to go through.


Den

I just wanted to add that thanks to the information and support here that I found that my Dr had left the practice and that's why they weren't calling me back! I now have a new Dr who changed my prescription to a higher pressure 20! over the night's progression and also turned on the apap function (thank God!) and now my apnea index is under 5 events each night! I'm very grateful for the people on this forum! Thank you Den!