Optistart PR 560

I wonder about the function of PR optistart. If you set the pressure at 8, for example, will optistart adjust the pressure both up AND down then after 30 hours? How much can optistart adjust the pressure every night? And is there any limit to how many cm as the pressure can be changed?

Bump

I saw in another thread that you are also getting the 560...I was wondering why you were asking these questions.
I will send you a private message in a few minutes with a link to the provider manual so you can see if the manual addresses your questions.
I don't know if how the Optistart actually works is explained well in that manual or not.
Personally, it's just so easy to have it set to auto mode and come up with your own range of pressures that I don't see the value in the Optistart feature unless the pressure changes are a disturbing factor to your sleep.

I cant find info in the manual. But I suspect that cpap-check mode means that the machine is in cpap mode. But there is a mode called auto-trial as well, I wonder if it sets the minimum pressure after 30 days in apap mode?
I wonder because I have a discussion with a sleep technician in a sleep forum here at home in Sweden. I'm not sure he knows what he's talking about.

My understanding is that auto trial is for 30 days and then it sets the machine to straight cpap pressure.
auto trial is just that...a trial of auto mode and then reverts to cpap mode.
It isn't going to try different minimum pressures and pick the best one...you would still have to set the minimum pressure to be used in auto trial mode.
It isn't nearly as "automatic" as people might think.

You might as well be using full time auto mode with a good minimum pressure to start with unless the changing pressures during the night in auto mode are a disturbing factor to sleep. Even then I would still keep it in auto mode but only give it a tiny range because in cpap mode you lose Flow limitation reporting since it is only available in auto mode. Flow limitations are one of the things the machine will try to prevent by increasing the pressure. Since in cpap mode the machine can't change the pressure the machine simply doesn't bother to flag FLs...a potential pressure needs factor gets ignored.

It starts to clear, Auto-trial enters cpap-check mode after 30 days and uses 90% pressure as a cpap pressure. Then every 30 hours after that adjusts the pressure by 1 cm each time, up to 3 cm up and down.
So probably makes sleep clinic in Auto-trial on 4-20 and you get to have it as the first 30 days.
But then I wonder, is this feature only on cpap machines?
As PR 460?
Is it because they dont wont to print the recipe for apap?

Hi Lazer1234,

I don't use a 560, but I will share what I know from using a 460 in Auto-Trial and CPAP-Check modes. Oh, I see you replied to Pugsy, but perhaps what I write will still be helpful?

The time frame for the Auto-Trial is a maximum of 30 days on my machine (then it is used up), so those of us with 460 machines don't want to set for 30 days all at once. The minimum is three days. When set in Auto-Trial a Min and Max pressure are put in by the Doctor (or in my case, by me with consultation with my Doctor), and the number of days are chosen. We know that some of our nights of sleep are great, and others can be unusually bad AHI, so that is why the machine needs at least three nights to make a guess for a minimum pressure. In the case of model 460, that is a pressure which corresponds to the pressure that worked 90% of the time (for example, the machine was at or below 10 cm during 90% of the time total of those nights of Auto-Trial). Then my machine switches into straight CPAP in CPAP-Check mode at that 90% pressure which was determined during Auto-Trial. Every thirty hours of sleep the machine checks to see how that pressure was doing, and can either keep the pressure the same or switch 1cm (up or down) to a new CPAP pressure (for example 10cm for the first few nights, but then after 30 hours of sleep it might realize a lower pressure could work and go down to 9cm). I find the machine trends toward lower pressures, which might be good for comfort, but perhaps not all-perfect AHI or RDI (but still well treated).

I thought I'd seen a brochure someplace or a titration guide using this feature, but I can't find it. I'm guessing the Auto-Trial mode is slightly different for the 560 when used for Opti-Start. It isn't about getting a reasonably effective straight CPAP pressure, but about finding a good minimum pressure for the Auto range. Whereas we know some machines were issued to patients set to "open range" Auto (4-20cm) and never checked in the months to follow, the Opti-Start gets an idea of an effective minimum starting pressure during the trial period, and then narrows the range by setting that new minimum (so for example a machine originally at 4-20 might now be 8-20). I don't know if it keeps monitoring the minimum pressure every 30 hours of sleep and continues to assess that minimum on the 560 models.

If your Doctor trusts you to watch and learn, then Opti-Start isn't necessary (as Pugsy said). If you are to be abandoned by your medical team, and if you don't come getting great advice here on CPAP-Talk, then Opti-Start is a safety net, allowing the machine to do the sleuthing.

IMHO this was a great feature added by Philips Respironics. I know folks who were handed a machine and had no real follow up on efficacy. With these features the folks who never get follow up have a machine doing pretty good monitoring and long-term adjustments.

--SleepyCPAP

Thanks SleepyCPAP and Pugsy, it clears.
The 460 is the cpap, auto-trial, cpap-check
The 560 is the cpap, apap, auto-trial, cpap-check + Optistart that adjusts minimum pressure every 30 hours


Next week when I got my 560, they should update to the newest software 3:04