Veteran User with first auto machine

I've been cpaping since 1997 --- 100% compliance. Decided to invest in my own sleep therapy and buy my first auto unit. Bought the Icon Auto Cpap from cpap.com --- they had my Rx [10] and insurance wouldn't buy a replacement for my Respironics CFlex System One which still works fine. Go figure. I unpack the machine and follow the directions. First attempt to use, I go rampless and nothing happens --- pressure is barely above a whisper. Second attempt, I engage the ramp. Starts at 4 and increases until I fall asleep. I am awakened in an hour with the machine maxed out at 15 then goes to 19.5 which is intolerable. What gives ? I thought these machines were supposed to adjust to your needs from 4 to 20. Does this machine need to be programmed around my Rx of 10 ? If it was, why wasn't it set by the factory or Cpap.com ? Do they ship these machines with no settings and say "Youre on your own ?" I'm back on my old Brick until I can make an appointment with a respiratory therapist. Any help or info would be appreciated.

You're mixing apples and oranges. There are (assuming you have an auto vs plain Cpap) two prescribed settings, e.g. for this note 8 and 14, determined by your inlab (assumed) titration of your ideal pressure need of about 10, so 8 is programmed to recognize the 10 setting just above it (it's customary to set the low pressure just below the ideal #), and 14 is put in because when titrated you almost never, if ever, needed a pressure above e.g. 12, tho' you could in fact set it higher than 14 or even leave it open to 20 (default high for standard c- or apaps, the low default being 4). And, when you go to bed at night, you put on the mask, machine's already been set to 8 and 14, and you go to sleep, hopefully registering 90-95% of any apneas at or below 14, and most likely few if any below 8 (something you would confirm the next a.m. using Sleepyhead software).

The Ramp, however, is strictly a convenience/comfort feature... you set it to e.g. 10 mins and it would auto turn off when the machine reaches the therapy setting of 8... the point being that you would otherwise have trouble breathing with the immediate blast of air set at 8, so need a slow run-in to it, starting at 4 (default low won't start lower) and going up to 8 within 10 mins. You won't be fully 'treated' during that ramp up time, but you also won't have a hard time 'just' starting straight out masking up at 8. That being said, unless you have quite a high (prescribed) setting (e.g. >15, etc) you can choose to just not bother ramping at all, because after the first blast of air (at eight) you adjust quickly and are in therapeutic mode right away. Most of us stop using the ramp feature in the first week of beginning Cpap... but others feel the need, so set the time and level to suit them... but understand that those settings have no bearing on your prescribed ones that go on overnight (8 and 14) to treat potential apneas. Those settings just break you in a bit to the air blast of 8 (in this whole example) and are not treatment as such.

However... if your DME or doctor did not (and it happens all the time!) set things up for 'prescribed' setting numbers and just put in the defaults of 4 and 20, ramp or no ramp (not relevant here), then you need to use software (Sleepyhead, free to download from the forum) to find out what settings are best for you, and we can help you do that if you'd like.

Did you get a copy of the clinical manual with your machine?
If not, you can request it here.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

Did you check to see if the machine had been set to your original RX of 10 in cpap mode? That's what it would have normally been set at if cpap.com set the machine because it would have used the pressure setting on the RX.
Since your original RX called for 10 cm pressure apap mode would have been left alone and would come with the default settings of 4 min and 20 max. Cpap.com won't/can't presume to set any settings "around your RX of 10" in apap mode. They can only go by what is on the RX. At most it should have been set to 10 cm in cpap mode otherwise they are shipped at the factory default settings.

There is no reason that you can't figure out how to use your machine by reading the manual. It's fairly simple but if there is something in the manual that you don't understand if you come here and ask for clarification then someone could probably explain it further.

For most CPAP users, you would need to set the auto CPAP at 8 minimum and perhaps 14 maximum, bracketing your CPAP prescription. Don't use ramp. Not too many of us could succeed with only the auto function and settings of 4-20.

Thanks for all the info. I would be happy to set the 8-14 range myself but I have looked without success for a way to do this on the Icon Auto -- can you tell me where to find a resource in this regard ? I keep getting info for the fixed pressure model. No big crises since my old machine is fine. Just looking fo an upgrade in treatment. Will be calling my provider for an appointment to get it straightened out. I'd love to get it done on my own if possible. Looking for a " recipe " to set the range for this machine. Thanks again for all who have replied,

You need a machine with a range of pressures, an autopap, vs plain Cpap, and even though some people prefer Cpap, having the auto to be able to titrate pressures and see (using software) what happens overnight is much better - Apaps can be used in Cpap mode (single pressure), but Cpaps don't do auto. Take a look at the newer machines on Cpap.com - the 'autosets', with reviews, explanations, etc. etc. Your machine is apparently old and ? bought overseas and there isn't a lot of info now available for it, though I imagine someone else here will be able to help.

And remember the 8 and 14 were just examples... you may need very diff. numbers.

I'm glad I saw this thread. I ordered a ResMed Airsense 10 Autoset machine on Friday from CPAP.com. I ordered the APAP rather than the CPAP In order to have the most flexibility in my treatment and after getting an excellent response from Pugsy when I asked why someone with an order for a CPAP might obtain an APAP instead. My script calls for a pressure of 12 cm so I assumed CPAP.com would put the machine in CPAP mode and a pressure of 12. The representative who took my order stated that they couldn't use my prescription on that machine and so it would come with a pressure range of 4 - 20. As I await delivery of my machine tomorrow, I've been contemplating the 4-20 range. It seems to me that on 4, I would feel as though no air would be flowing and I would be really surprised if I needed 20. I appreciate the guidance provided here. I will probably go with 10-14 or maybe 8-14 and see what happens. I have never used the ramp feature as it seems that whatever pressure it starts at seems smothering.

Night Ranger wrote:Thanks for all the info. I would be happy to set the 8-14 range myself but I have looked without success for a way to do this on the Icon Auto -- can you tell me where to find a resource in this regard ? I keep getting info for the fixed pressure model. No big crises since my old machine is fine. Just looking fo an upgrade in treatment. Will be calling my provider for an appointment to get it straightened out. I'd love to get it done on my own if possible. Looking for a " recipe " to set the range for this machine. Thanks again for all who have replied,

Like Pugsy said:
You can request a copy of the clinical manual:
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

Also search utube, maybe your model is included:

Fisher and Paykel Icon Auto Change Pressure - Video Results

How to change the pressure on F&P ICON PLUS
0:45
How to change the pressure on F&P ICON PLUS
youtube.com
F&P ICON Novo CPAP - changing pressure and temperature
2:17
F&P ICON Novo CPAP - changing pressure and temperature
youtube.com
Fisher Paykel CPAP ICON - How is the Ramp feature ...
1:29
Fisher Paykel CPAP ICON - How is the Ramp feature ...
youtube.com
How to change Fisher & Paykel Icon Auto or Premo CPAP ...
0:51
How to change Fisher & Paykel Icon Auto or Premo CPAP ...
youtube.com

More Fisher and Paykel Icon Auto Change Pressure videos

That link won't connect for me. I have already been to all those videos and none of them show info on the auto version. I'll just wait to see the R.T.

Night Ranger wrote:That link won't connect for me. I have already been to all those videos and none of them show info on the auto version. I'll just wait to see the R.T.

Quote from Pugsy's Apnea Board link:

SECTION ONE:

Clinician Setup Menu Instructions for Common CPAP Machines:

Fisher & Paykel ICON Auto, Premo & Novo: Start from the 12 o'clock position of the Home Screen. Press and hold the button in the middle of the SmartDial, and use your other hand to turn the SmartDial in a clockwise direction until you return to the 12 o'clock postion. Do not release the Smart Dial button while turning. Turn the SmartDial back (counter clockwise) one position while still holding down the button and the settings in the Clinician Menu will appear. You can now release the SmartDial button. NOTE: The Clinician Menu will default back to the Patient Menu after 30 seconds, or if the unit is turned off at the power supply. You can manually exit the Clinician Menu by repeating the instructions to enter the menu.

Also looks like the info on the Premo and Novo apply to the auto.

This link is working. http://www.apneaboard.com/adjust-cpap-p ... tup-manual
To order your clinical manuel by email you have to scroll down to the last section and follow their instructions.

I copied the instructions from the link in case you still have problems but I see SB already did also so I deleted.

The instructions won't get you into a place where you can work with the pressure. There is no clinial manual for the Icon. The best I can hope for is that the machine actually can be programmed to a narrower range than 420. Des anyone know for sure that this can be done ?

These are all listed I would think one was yours. You have to go to the bottom of section THREE. Then follow the instructions for email.

Fisher & Paykel SleepStyle 200 Auto (should cover all 200 series Auto machines, including the HC254)
Fisher & Paykel ICON Auto (silver/grey in color)
Fisher & Paykel ICON Premo (silver/grey in color)
Fisher & Paykel ICON Novo (silver/grey in color)
Fisher & Paykel ICON+ Auto (brown in color)
Fisher & Paykel ICON+ Premo (brown in color)
Fisher & Paykel ICON+ Novo (brown in color)

Night Ranger wrote:The instructions won't get you into a place where you can work with the pressure. There is no clinial manual for the Icon. The best I can hope for is that the machine actually can be programmed to a narrower range than 420. Des anyone know for sure that this can be done ?

yes, they do, the instructions on how to get into the clinical (setup) menu are quite clearly written in the link that okydoky provided, as well as how to request a clinical manual for your machine by mail.

look again, or give up... it's up to you.

I got to the spot -- thanks to all. Having the manual emailed so I'll be interested what tricks they used to keep users out of the clinition instructions.