M Series Auto Runaway pressure help

Den,

I did not get Encore Pro running on Vista. I have version 1.6i and have not been successful with Vista. I Do have Encore pro running on a machine running XP.

In my reports, I do see that the pressure goes up and flatlines at whatever I have the max set to. It is not showing any large leaks indicating mouth breating or any other leak problem. It is reporting a reasonable leakage for my masks and no large leak rate events. It is showing what I think are fairly high snore numbers at the time it starts to increase pressure (though I do not have the chart in from of me at the moment).

I think I do see what IS happening - but not why it is happening.

Thanks

It sounds like everyone is saying that my machine is working fine. I currently have it set to 6 - 8.5. I go to sleep and wake up after about 90 minutes at 8.5. I need to gut it out and just try to go back to sleep at that pressure and see in the morning if it ever comes down. I have not been able to go back to sleep at 8.5, but I will try it and see what happens.

My sleep study said that my AHI went up at 9 and beyond. My Encore data says the same. And yet, it keeps going up. If my apnea gets worse at higher pressures, it seems that a pressure cascade is inevitable. That is why I wondered if I have some special condition - does everyone get worse beyond a certain pressure?

Most of us have a Sweet Spot, where the AHI is the lowest. If you go past the Spot, AHI goes up OA's a little, H's worse. Mine is anything over 15.5 cm, on CPAP, everyone is different. Jim

Thanks Bob.

Well, at least you've got a computer that you can see your results.
If the number of events are increasing beyond the pressure of 9, then that would somewhat indicate that you may be prone to having Central Apneas. If you have a copy of your sleep study (titration portion), it should mention it in there.
IF.....in your Encore Pro reports, you're having events at pressures at the lower end of your 6 - 9 pressure settings, you might try bumping up the lower end of that range, too......7 or 8 or even try a straight pressure of 9 at some point.
Pressure changes CAN be sleep disturbing for some.....they are for me. (this is another reason to keep a narrow range on pressures)

Den

I used my new remstar for two days and it was fine. Last night I had the same problem, waking up with it running full pressure and not adusting downward after breathing normal for a few minutes. My pressure is set at 6-18. They are sending a tech over tomorrow. Will report back what happens.

msphone wrote:I used my new remstar for two days and it was fine. Last night I had the same problem, waking up with it running full pressure and not adusting downward after breathing normal for a few minutes. My pressure is set at 6-18. They are sending a tech over tomorrow. Will report back what happens.

It's probably working just fine.......there are reasons for why they do what they do.
Go to page 1 of this thread and read Snoredog's post.

Den

BlueHairBob wrote: It sounds like everyone is saying that my machine is working fine. I currently have it set to 6 - 8.5. I go to sleep and wake up after about 90 minutes at 8.5. I need to gut it out and just try to go back to sleep at that pressure and see in the morning if it ever comes down. I have not been able to go back to sleep at 8.5, but I will try it and see what happens.

My sleep study said that my AHI went up at 9 and beyond. My Encore data says the same. And yet, it keeps going up. If my apnea gets worse at higher pressures, it seems that a pressure cascade is inevitable. That is why I wondered if I have some special condition - does everyone get worse beyond a certain pressure?

Why did you lower the pressure on the Auto:Max to 8.5cm? Your PSG said 6cm to 9cm. If the pressure at 8.5cm is not high enough to splint an obstructive apnea it will wake you up especially during REM.

Woke you up after 90 minutes? Our sleep cycles last about 90 minutes ending in REM. REM is where you are more likely to have an obstructive apnea than non-REM.

I would put your Auto:Max back to 9cm as suggested above then learn how to use your machine Auto:Ramp feature.

Next time it wakes you up during the night or for that matter anytime pressure is a problem, simply reach over and hit the Ramp button on top and it will immediately drop the pressure back down to 6cm where you can fall back asleep.

It can take the machine from 12 to 30 minutes to drop back down. You need to learn why it is waking you up after 90 minutes. As mentioned we have a sleep cycle about every 90 minutes, so you may have 3-5 of those per night. If you wake 3-5 times per night like that you are going to be tired during the day even if your AHI=0 and you think you slept 6hrs. In reality you have only slept for 90 minutes.

Two immediate/obvious causes why you may be waking during REM:

1. Your pressure in REM is not high enough to splint any obstructive apnea seen (you lowered pressure from PSG suggested 9 to 8.5) OR

2. You may be having a Central apnea and that is waking you. While the risk is lower at 8.5cm pressure on having a CA, it is possible to have one at 8cm. The easiest way to rule that out is simply looking at your diagnostic PSG to see if you are at risk of having them. Even in the absence of that data you can determine if it is the cause with EncorePro.

Again, if you think you slept for 6 or 7 hours but you are waking up every 90 minutes then you are going to be tired during the day as you didn't actually get 6 or 7 hours of sleep, you had periods of 90 minute naps.

Posting one of your Daily EncorePro pages would help. If you have CutePDF writer setup as a printer, just pull up one of your existing reports and print that page to PDF, then post it like a picture.

I suspect you are having a series of runs about every 90 minutes with double and triple Hypopnea events. IF you have a copy of your titration study table where it shows 5cm to 20cm and the events seen to the right that would be helpful.

It doesn't matter what type the event might be, what matters is you stop them from happening so you can sleep throughout the night uninterrupted, until you are able to do that, you can be assured you will be tired during the day.

Hey Snoredog

Snoredog wrote:It can take the machine from 12 to 30 minutes to drop back down.

How do you know all of this stuff? I'm amazed at the information you post. I'm not questioning your knowledge at all. I'm just wondering how you've learned so much about the workings of the different machines. Is it from using the machines or do you have inside knowledge somehow?

Snoredog wrote:I suspect you are having a series of runs about every 90 minutes with double and triple Hypopnea events.

What are double and trible hypopnea events? Is that where you have 2 or 3 hypopneas very close together?

I set the max at 8.5 because the sleep study said that my AHI went up at 9.

BlueHairBob wrote:I set the max at 8.5 because the sleep study said that my AHI went up at 9.

But, does it "in reality"?
Now that you've got that thing reigned in from the 4 - 20 setting, I would experiment with easing it (upper pressure) up above 9 (like to 10) for a few nights and see what happens. If your Encore Pro reports show you're having events at the lower part of your pressure range.....move it up a bit, too.

Den