Having doubts...

6 is a very low pressure.... if you continue on APAP, I'd suggest you try a range of 6-10 to start with and see how that goes for a week. Without software you aren't going to 'see' the results, but you'll be able to ascertain if you feel better than you do now. 6-20 is just too wide open and needs to be tightened up. Getting into clinician's mode to adjust the pressures is simple to do, and someone with your machine can tell you how.

Well, I'm headed home soon so I will check on that info requested when I get there. That is if I don't get distracted by the Gatorade Duels sitting on my DVR

Emilia wrote:6 is a very low pressure.... if you continue on APAP, I'd suggest you try a range of 6-10 to start with and see how that goes for a week. Without software you aren't going to 'see' the results, but you'll be able to ascertain if you feel better than you do now. 6-20 is just too wide open and needs to be tightened up. Getting into clinician's mode to adjust the pressures is simple to do, and someone with your machine can tell you how.

I do know how to get into the clinic mode, that's how I found the settings. I just didn't want to change them without know more info.

Ok, I looked but it simply doesn't give me that info. I have compliance info and settings and that is it. I requested the clinic manual from that website and just got it so let me do some reading and see if I can't find something.

Look in the settings to see if there is a choice to show or turn on patient data and stuff like that. I forget the exact wording.

It may just need a setting change to show data. Confirm exactly which machine you have. I thought all the APAPs, even the old ones showed more than compliance but I could certainly be wrong.

Doesn't look like it.

I have the following

Normal Mode:
Hrs: 464
Turned On:
CFLEX: 3
cm H2O: 6.0

Therapy Mode
NIGHTS >4 HRS: 49
AFLE (A-Flex)
CFLEX: 3
MIN: 6.0 cm H20
MAX: 20.0 cm H20
RAMP: 0:00
ALERT: 1
LED: 1

When first entering into Therapy Mode it flashes 2.6 for a short period. No idea what that is, maybe firmware version or something.

Wait till Wulfman gets here. He knows your type of machine inside and out. He should be able to provide detailed instructions on how to get deeper into the setup settings if the machine has any.

First I want to commend you for the extra effort you have taken to undergo treatment in spite of no insurance and the problems you've run into. Just a few tidbits of input...

Hopefully you have a copy of your sleep report including some of the details of the titration. Do check and see if the 45 minute period with no apneas included time in REM while supine. While it's not an absolute, that scenario is the worst case scenario for some. If your 45 minutes was, for instance, while on your side in Stages 1&2 of sleep, the prescribed pressure might not be based on complete information. When that was the case in a couple of my studies, the doctor noted the study was "technically suboptimal." If you do have an auto titrating machine and set it for a range of pressure, you will be able to see if it stays around 6 or not.

It is not likely you will be able to directly link every symptom you have to your sleep apnea - you could have more than one thing going on, but if you can address even some of them with therapeutic treatment of your OSA, that's a good start. When I hear of mysterious pain, I always want to ask what your sleep studies said about limb movements, and if you move around a lot in your sleep. Some have limb movements while they sleep that they aren't even aware of but may cause unexplained pain when awake. That may not be your issue, happened to be mine.

Best wishes on the mask issues.

No, I didn't get a report like that. I think I maybe can... this hospital and it's affiliated clinics has a paperless system so the only thing I walk out the door with is a list my prescriptions and receipts. They do have an online medical record system but I haven't registered and I had to send a request for a record number which I now believe they are sending by snail mail. So much for paperless.

Just wanted to pause a moment and say Thank you guys. I've felt like crap all day but just talking about it throughout the day has made me start feeling better. I'm still tired but at least the nausea (and anxiety) has faded .

There is also the fact that it may take up to a month for your brain to trust the machine and allow you to sleep deeply according to my sleep doctor. Then it will take time for stable O2 levels to help rebuild your internal damage - that could take months.

Alshain wrote:No, I didn't get a report like that. I think I maybe can... this hospital and it's affiliated clinics has a paperless system so the only thing I walk out the door with is a list my prescriptions and receipts. They do have an online medical record system but I haven't registered and I had to send a request for a record number which I now believe they are sending by snail mail. So much for paperless.

I know we've thrown a lot at you but just wanted to mention that by law you are entitled to a copy of your sleep study(at least 5-8pages)and your cpap RX. These are part of your personal medical records. Once you have them many more questions can be answered. I'm glad you're feeling a little better and that you found this forum.

Without the software on that machine you won't get any patient data.

alshain - I read your comments about various health issues. Your comment about "twitching eye lids" really caught my attention - I have the same thing. I have some information that may or may not be of interest to you. It's off-topic in terms of xpap issues, I'll not get your thread off-topic by adding other information here. PM me if you'd like me to send info on what I have learned. This is not anything weird, I'm not trolling nor marketing anything - just want to give you some help. Sounds like you are going through some rough times and there are many pieces to this puzzle.

cflame1 wrote:Without the software on that machine you won't get any patient data.

cflame1 is right.

The pre-M series Respironics machines can not show any therapy data in the machine window. You'd have to have Encore Pro or Encore Viewer (either one works and gives the same data) to see therapy details from the Respironics REMstar Auto with C-Flex, which is the machine you have, Alshain.

The operating mode "AFLEX" means the machine is in autotitrating mode with C-Flex turned on.

Kathy brings up a very good point about the sleep study titration:

kteague wrote:Do check and see if the 45 minute period with no apneas included time in REM while supine. While it's not an absolute, that scenario is the worst case scenario for some. If your 45 minutes was, for instance, while on your side in Stages 1&2 of sleep, the prescribed pressure might not be based on complete information.

Emilia wrote:6 is a very low pressure.... if you continue on APAP, I'd suggest you try a range of 6-10 to start with and see how that goes for a week. Without software you aren't going to 'see' the results, but you'll be able to ascertain if you feel better than you do now. 6-20 is just too wide open and needs to be tightened up.

Using 6 - 10 for awhile would not be a bad idea.

When talking about a pressure range being "too wide" and the best way to "tighten up the range" in autopap treatment in general however, I have a different opinion. When therapy doesn't seem to be going well -- either subjectively or by seeing a high AHI via software data, I think it's usually the minimum pressure that needs to be raised, while the maximum pressure can remain set high. That would especially be the case if, as Kathy suggested, the titration in the sleep lab did not have a chance to see what pressure worked effectively during REM.

My thoughts about "tightening up the range" in an autopap that has been set for a rather low minimum pressure and a max pressure of 20:
October 2008 Turning off Aflex and Cflex (topic started by DoriC)
viewtopic.php?p=307265#p307265

Also:
Results: 1st night with Auto A-Flex (topic started by TSSleepy)
Two nights graphs posted using pressure range 4 - 20 and 10 - 20
viewtopic.php?p=348963#p348963

November 2008 Just got an APAP (topic started by turbosnore)
viewtopic.php?p=319619#p319619

September 2008 New Guy - Need Help w/Settings (topic started by alanhj13)
viewtopic.php?p=294319#p294319

Wulfman, DreamStalker, and ozij explain why autopaps make changes slowly.
December 2008 Why adjust APAP. Isn't it auto? (topic started by oxygenium65)
viewtopic.php?p=323218#p323218

Something else you might consider, Alshain, is to use your autopap in "CFLE" mode (CPAP with C-Flex turned on.) Set for one straight pressure, like 7 for a week, 8 for a week, and 9 or 10 for a week. Without software, and using a machine that doesn't provide efficacy data in the machine's window, you'd have to just go by how you feel. That might not tell you anything (nor would changing the range in auto mode) if other health problems are what's really responsible for continuing to not feel better. But trying some straight CPAP pressures might make a difference -- especially if there was no REM during your sleep lab titration at the prescribed pressure of 6. Some people sleep better at a fixed pressure than with autotitrating pressures.

Alshain wrote:a Quattro mask... which I hate btw, but I'm still wearing it.

A comfortable mask is the #1 key, imho, to being able to actually sleep well while doing CPAP therapy. It might be worth trying some other FF masks or a hybrid type of FF mask to see if there's another that suits you better. Easier said than done, of course, as a mask quest can be expensive if you have to buy out of pocket. The older ResMed Ultra Mirage FF mask suited me a lot better than the ResMed Quattro does, for example.