Who has a 420E auto for rent

th · Post by th » Fri Aug 19, 2005 1:52 pm

My wife uses a RemStar auto W CFlex. She is not responding as I would like for her to. She is not doing bad but I am thinking she might do better with a 420E. After reading all the posts from WillSucceed on this machine he has me convinced this might be what she needs. Does anyone know where I can rent one for a month? If it works better for her then I would buy it...............WillSucceed has done so well on his posts he might even convinced me to give up my RemStar auto W CFlex ....never
th

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Guest · Post by **Guest** » Fri Aug 19, 2005 2:04 pm

th, can you tell from the data why it isn't working well for her?

WillSucceed, oh oh!! Sounds like a bit of cognitive dissonance may have crept in to some of your posts!

neversleeps · Post by **neversleeps** » Fri Aug 19, 2005 2:06 pm

'Guested' once again!

th · Post by th » Fri Aug 19, 2005 2:17 pm

Her AHI runs from 2 to 6 on the avg of 4. I know a lot of people would be happy with those numbers but she and I feel like it could be better. Most of the night it sits on pressure of 6 or 7 and does not move to her titration pressure of 9. To be honest she needs straight CPAP pressure of 9. When she is on Straight 9 her numbers are always 1 or less. She does not and WILL NOT use CPAP 9 and told me she would give up if she had to do it....what can I say if mama is not happy and sleeping then no one is happy or sleeping in our house
th

neversleeps · Post by **neversleeps** » Fri Aug 19, 2005 2:47 pm

th wrote: To be honest she needs straight CPAP pressure of 9. When she is on Straight 9 her numbers are always 1 or less. She does not and WILL NOT use CPAP 9 and told me she would give up if she had to do it....

Wow! So really, the treatment (albeit in straight CPAP-mode) is working great for her!

Your wife is comfortable at 6 or 7, but uncomfortable at 9, correct? Is it primarily upon exhalation where she has difficulty? Is she using it with C-Flex on? Have you experimented with setting it at all three different levels of exhalation relief? Have you tried experimenting with C-Flex off? Have you experimented with a long ramp time so she is used to it by the time it hits 9?

I am guessing you've tried straight CPAP at 6 for a week, straight CPAP at 7 for a week, straight CPAP at 8 for a week, etc., and have determined her optimum treatment with the least resultant apnea events occurs at straight CPAP at 9.

IMHO, the machine isn't the issue. I think it is unlikely she could obtain a better AHI than 1 or less with a different machine. Some people find straight CPAP results in better treatment than APAP. It appears this is the case with your wife and I don't know how switching to a different APAP machine could change that.

rested gal?

WillSucceed??

derek???

chrisp · Post by **chrisp** » Fri Aug 19, 2005 3:04 pm

Have you adjusted the range from what its at to maybe 6-9 . What you really have is a short between the headsets . I have the same with my wife. LOL

:twis ted:

ozij · Post by **ozij** » Fri Aug 19, 2005 3:06 pm

I agree with neversleeps - it doesnt seem like a machine problem.

She does not and WILL NOT use CPAP 9

Why? Did you try building up gradually to that pressure so that it doesn't overwhelm her?

O.

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neversleeps · Post by **neversleeps** » Fri Aug 19, 2005 3:07 pm

chrisp wrote:...What you really have is a short between the headsets... LOL :twis ted:

ba dum bum.

WillSucceed · Post by **WillSucceed** » Fri Aug 19, 2005 3:28 pm

IMHO, the machine isn't the issue. I think it is unlikely she could obtain a better AHI than 1 or less with a different machine. Some people find straight CPAP results in better treatment than APAP. It appears this is the case with your wife and I don't know how switching to a different APAP machine could change that

I don't agree with this statement. The auto machine will deliver the pressure that it thinks is best for your wife based on it's proprietary algorithm. If her AHI is not where you think it should be BUT, she is feeling rested, energetic, good memory, blah, blah, blah... then I would not worry about it. If, however, her AHI is not where you want it to be AND she feels crappy, then the machine is not doing it's job well enough for her.

I'm assuming that you have the range opened up a bit, so that it is 3-4 points above and below her titrated pressure of 9, yes? I'm also assuming that she is getting good mask fit, with no big leaks from the mask, hose or humidifier, yes? If so, and she is not feeling good, then the algorithm in the RemStar is likely not right for her. This does not mean that I am bashing RemStar, I'm just saying that it does not seem to be suiting your wife.

I REALLY wanted to buy a RemStar auto as I already owned a RemStar Plus with a heated humidifier and had big confidence in RemStar -I still do have confidence in Respironics machines. However, I found that the RemStar auto, fully separate from my problems with C-FLEX, was just not aggressive enough to treat my OSA. I did not get a low enough AHI from it and I felt crappy during the day. Both ResMed Spirit and PB 420E seemed to give me better treatment.

So, back to my comment about not agreeing with Neversleeps post... if you have eliminated all of the associated possibilities (leaking mask, leaking hose, leaking humidifier, defective machine, etc.,) then, in my non-expert opinion, the algorithm in the machine is simply not a best fit for your wife.

I would definetly try a different manufacturers machine and have her try it using the same mask as she used with the RemStar.

WillSucceed · Post by **WillSucceed** » Fri Aug 19, 2005 3:30 pm

WillSucceed, oh oh!! Sounds like a bit of cognitive dissonance may have crept in to some of your posts!

Entirely possible, but I sure hope not. I'm hopeful that my posts are balanced and that I point out the good features of all the machines.

However, entirely possible that I am guilty as charged!

WillSucceed · Post by **WillSucceed** » Fri Aug 19, 2005 3:34 pm

To be honest she needs straight CPAP pressure of 9. When she is on Straight 9 her numbers are always 1 or less. She does not and WILL NOT use CPAP 9 and told me she would give up if she had to do it

You know, if you want to split hairs, you can set her auto to CPAP and adjust the pressure to 8.1, then 8.2, then 8.3... you get the picture. Now that I have said this, I have to confess that I don't have the RemStar Auto anymore but I do still have my RemStar Plus with C-FLEX (by the way, anyone want to buy a RemStar Plus with C-FLEX with VERY low mileage???) and the RemStar Plus can be set for a pressure that is something.something

You might be able to talk her into a pressure that is less than 9, but more than 8 in the hopes of getting her up to 9.

neversleeps · Post by **neversleeps** » Fri Aug 19, 2005 3:41 pm

No, WillSucceed, I was kidding! (Plus, I just love the terminology: cognitive dissonance.) I think perhaps because you're so keenly aware of the possibility, your posts are very purposefully unbiased.

Carry on!!!!!!

WillSucceed · Post by **WillSucceed** » Fri Aug 19, 2005 3:43 pm

Apparently I've fallen down and can't stop typing... Here I go again...

I think it is unlikely she could obtain a better AHI than 1

When I first started using autoPAP I was pretty annoyed at the folks on this forum who had achieved a low AHI. This was when I was using the RemStar auto. My AHI was around 7 or more per hour. While this was a significant improvement over the 39 per hour that I had in the sleep study, I was still miffed.

When I tried the Spirit and 420E, they both gave me an AHI of less than 5 and now that I am settled into life with my 420E, my AHI is consistently less than 1 per hour over the course of every 8 hour night. I do still have some days that I yawn some, but the daytime naps are a thing of the past and I am no longer convinced that I have a dementia or Alzheimers going at the ripe old age of 48. I'm not joking about this --my memory was so bad that I would get into the car and actually have to pull over as I could not remember how to get to places that I have been driving to for years.

So, if you think your AHI is not where you want it to be, have eliminated other factors like leak, try out different machines and see if you can get better treatment. It worked for me.

I'll stop ranting now... (hangs head in shame)

th · Post by th » Sat Aug 20, 2005 7:29 am

I have tried all ranges of pressures. What is strange is I can put the auto in 8 or 8 to 12 and I get the same AHI numbers. If I go to 9 then it will be 1 or less. I am not saying the RemStar sits at 6 or 7(when I set it 6 to 12) all night but I am saying this happens a whole lot. I have seen it respond like it should. The pressure will start at 6 and work perfectly through all the ranges and she will be corrected at 9. Again, she does not and will not use 9 and does not want to try. After reading posts (and I have read a lot ) from WillSucceed I want to try how she does with the 420E. Later on this weekend I will go over 3 months of data on the remstar and see if I might be missing something
thanks
th

I wanted to add here leak avg is around the mid 20's and she does not feel as good as she would like to with a AHI from 2 to 6
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th · Post by th » Sat Aug 20, 2005 12:24 pm

I just went through 2 months + of downloads. 80% of the time when the auto was set from a range of 5 or 6 or 7 it showed very little movement either stayed at that pressure or went over 1 or 2. It never reached her titration of 9. Even set at straight 8 or 8 to what ever made no difference on her AHI. 7 days on 9 she had 1 or less. Her leaks avg around the mid 20's I saw 6 or 7 days leaks that were as low as 18. I just do not think she is responding to the RemStar in APAP mode. That is why I want to try the 420E after reading post from willsucceed. I wish I could get my wife to do with a pressure of 9 but she will not. I have turn CFlex off makes no difference.