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The Plus machines don't give any useful data.

Julie wrote: ↑

Mon Apr 15, 2019 4:40 pm

The Plus machines don't give any useful data.

I think that the only thing they record is hours of use... for compliance purposes.

They're basically only good for a hose dryer.

kbh209 wrote: ↑

Mon Apr 15, 2019 1:31 pm

My friend just dropped off a Phillips Respironics REMstar Plus CPAP machine. How do I get into Physicians Mode? Also does the machine have an auto ramp mode?

Photos are top and bottom of the machine to help determine the make and model, sorry I couldn't get the images to show up on the forum

https://photos.app.goo.gl/rZ1gPYTzWiNgJtVp8
https://photos.app.goo.gl/j1gZm4uY6w8Cpzxv8


I need to set the machine to a 9 for the max pressure and if there's an auto ramp, the low end of the pressure needs to be set to 4

Google the machine with clinical menu

@Katestyles, I ended up at SleepApnea dot com and found out how to get into those settings. The only thing I wasn't sure of was the setting called C-Flex, since my Resmed Airsense 10 didn't have that...it seems to be a REMStar only feature.
@Palerider, I don't use SleepyHead or any software to look up details on my sleep, I just needed a CPAP machine so I can get proper sleep so I'm not sluggish during the day.

Your machine calls it EPR (Exhale pressure relief) if in fact that model has it.

Julie wrote: ↑

Mon Apr 15, 2019 8:17 pm

Your machine calls it EPR (Exhale pressure relief) if in fact that model has it.

interesting, then I'll wait until next week for the technician to set the Respironics in my machine since I honestly don't understand the C-Flex feature. I want to make sure everything is set to how I need it. I know I got the Auto Ramp set correctly to start at 4, and the ramp time being 45 minutes, and the therapy pressure set to 9.

CFlex is the exhale relief feature and the most you can get is a 2 cm drop with the max setting of 3.
It doesn't work like EPR works on the ResMed machines. Instead the actual amount of reduction during exhale is based on how forcefully you breathe.

My suggestion...play with the settings and simply choose a setting that feels comfortable for you. It's not a critical issue to have it be exactly like EPR on a ResMed machine.

You should know that 4 is the machine's default low setting and 99% of us can't inhale at that min... not therapeutic, so most raise it to at least 6 or 7. And a ramp time of 45 mins is pointless as well at such low numbers because for the 45 mins while it's 'ramping up' all the way to 4 (or 6 or even 9) you're not being fully treated. Such a time would maybe be appropriate for someone whose min. setting was much higher, and who had determined that the initial spurt of air when masking up was so strong as not to be tolerated, but that would not apply to you... most of us haven't used the ramp feature since the week (or so) we got our machines and most just let the machine start out at its prescribed min. setting (e.g. 6, 7 etc) and go off to sleep.

interesting that the maximum RAMP time for the machine is basically pointless. *snorts* Does the ResMed Airsense 10 have a higher RAMP time?
My original physician at Adventist Health Lodi Memorial is who went over my sleep results with me and decided based off of the results and the way my nose and passage ways were affected by my chromosome abnormality, to go with the level four start up pressure. I guess tonight I could try level 5 and tomorrow level 6 to see where it gets uncomfortable.

Don't confuse min. prescribed setting (4 in your case) with ramp settings of time, etc.

Sometimes all a person needs is 4 cm to hold the airway open and prevent the airway from collapsing.
Sometimes people are quite comfortable with 4 cm...most people do prefer a little more air moving but not everyone needs more air moving to be comfortable.
I personally don't care for it myself and I learned a long time ago it didn't do a great job holding my airway open but that's just me and what I need. You might be entirely different from me so I am not going to tell you to change something if you and your doctor are happy with it and there's no apparent need to change it. Just because I (or most other people) don't like it doesn't mean you wouldn't/shouldn't like it.

There is zero need to push the ramp button though if your pressure setting is 4 cm....there's no where for the ramp to go to...the lowest the machine will go is 4 cm with or without ramp being used.

to clarify the machine starts up at 4 cm and then ramps up to 9 cm. Sorry if I had confused anybody

kbh209 wrote: ↑

Wed Apr 17, 2019 9:38 am

to clarify the machine starts up at 4 cm and then ramps up to 9 cm. Sorry if I had confused anybody

Ahhh...now that sounds much more logical and common.
Just so you understand though...if you need 9 cm to hold the airway open and you fall asleep before the end of the ramp time there is the potential for you to have airway collapses happen while asleep and during the whatever remaining ramp time you have to meet.
For this reason we always suggest that people try to limit the ramp time to approx time needed to fall asleep if they need or want to use the ramp feature. Some people won't need it. Some people will need it and that's fine as long as they understand what can happen during ramp should they fall asleep and they are still at sub optimal pressures.

Some of the newer machines have a smart ramp feature which will suspend ramp should it sense your breathing looks like you are asleep...but the 250 model you have doesn't have that feature.

yeah and the ramp is only 45 minutes long, it takes me I think 1.5 hours to 2 hours to get to sleep.

Ever since the spare ResMed stopped working, now that it's been a few weeks of no therapy, it literally feels like I'm starting over again, training myself to keep the mask on for as long as possible. I'm not sure if I need to adjust the C flex but may need to, because the night of 04/17/19, it felt like my lungs were full of unnecessary air, when the machine reached 9cm. . .or I simply need to exhale better. It is frustrating that this isn't a simple transition so I can get a good night's sleep, that's for sure.

If you can't fall asleep before the end of ramp time and want more ramp time....just reach over and push the ramp button again.
Obviously the real fix is to make it so you don't take so long to fall asleep and I know that is easier said than done.

Play with CFlex and just pick a setting that is the most comfortable for you if you can. It's not going to be the same as EPR but it's all you have to work with for exhale relief on a Resprionics model machine like you have.
It is different though and the body sometimes takes its own sweet time when adjusting to "different".