How can I change the pressure on my Remstar CPAP?

littlebaddow wrote:

ozij wrote:
What in the world is a "sleep surgeon"?

O.

A fish

No, silly. Here's asleep surgeon:

My sleep doctor did on the first one and prescribed a pressure (apparently without objective evidence) for me that was almost twice what I needed.
Would twice the NEEDED pressure have been dangerous for me? (cause me "serious harm"?)

Wow. That really stinks. Over time, yes that could cause you serious harm. When the pressure is that much above therapeutic levels, you actually can cause central apnea to appear in a patient who otherwise only had obstructive apnea. So you would be back in the same place you were before really because you aren't at the therapeutic level for you. It would be like forcing so much air in that it actually causes you to stop breathing.... Hence the central apnea. If the pressure is too low, then you aren't getting rid of the apnea and hypopnea and still may feel tired etc. during the day, as well as continue to desat during the nite.

Why would any sleep doctor in their right mind prescribe CPAP or APAP for treating central apneas?

Over time, straight CPAP can correct central apnea. Bi-level with a back-up rate is really not that effective for centrals. You can eliminate some of the centrals with Bi-level, but I have seen way too many people come into the lab with central apnea and still have a horrible night on Bi-level. They continued to desat and stop breathing, even with a rate.... Yucky stuff. There is a doctor who spoke at our hospital... Can't remember his name but I know my boss would... who gave specific evidence for why straight CPAP is better for central apnea. At the time, it made absolutely perfect sense to me.
One of my patients has central apnea and has been using straight CPAP for 2 years now. He had already done a sleep study a year before I did his PSG and he ended up on bi-level and hated it. Stopped using it altogether. Then, after the PSG with straight CPAP, and after about a month of treatment, his blood pressure improved by 20 points. For him straight CPAP has been very effective.

Colrdgrn wrote:Bi-level with a back-up rate is really not that effective for centrals.

What is a bi-level with timed backup for?

Colrdgrn wrote:I was browsing this post and am concerned. Basically, I am going to answer this from the perspective of a registered sleep tech

Codrdgrm, you echo a familiar theme. Do you just HAPPEN to have an Electrical and Computer Engineer Degree? Just curious. You sound like the type .

colrdgrn wrote:Changing your pressure without OBJECTIVE evidence for the change is dangerous...

If you actually believe what you are trying to make us believe, you have actually just made the case for owning an APAP. .

Colrdgrn wrote:My sleep doctor did on the first one and prescribed a pressure (apparently without objective evidence) for me that was almost twice what I needed.
Would twice the NEEDED pressure have been dangerous for me? (cause me "serious harm"?)

Wow. That really stinks. Over time, yes that could cause you serious harm. When the pressure is that much above therapeutic levels, you actually can cause central apnea to appear in a patient who otherwise only had obstructive apnea. So you would be back in the same place you were before really because you aren't at the therapeutic level for you. It would be like forcing so much air in that it actually causes you to stop breathing.... Hence the central apnea. If the pressure is too low, then you aren't getting rid of the apnea and hypopnea and still may feel tired etc. during the day, as well as continue to desat during the nite.

Why would any sleep doctor in their right mind prescribe CPAP or APAP for treating central apneas?

Over time, straight CPAP can correct central apnea. Bi-level with a back-up rate is really not that effective for centrals. You can eliminate some of the centrals with Bi-level, but I have seen way too many people come into the lab with central apnea and still have a horrible night on Bi-level. They continued to desat and stop breathing, even with a rate.... Yucky stuff. There is a doctor who spoke at our hospital... Can't remember his name but I know my boss would... who gave specific evidence for why straight CPAP is better for central apnea. At the time, it made absolutely perfect sense to me.
One of my patients has central apnea and has been using straight CPAP for 2 years now. He had already done a sleep study a year before I did his PSG and he ended up on bi-level and hated it. Stopped using it altogether. Then, after the PSG with straight CPAP, and after about a month of treatment, his blood pressure improved by 20 points. For him straight CPAP has been very effective.

Colrdgrn,

Thank you for responding.

Best wishes,

Den

Wulfman wrote:Colrdgrn,

Thank you for responding.

Best wishes,

Den

Den, you are a true gentleman. I marvel at your restraint.

Anonymous wrote:

Wulfman wrote:Colrdgrn,

Thank you for responding.

Best wishes,

Den

Den, you are a true gentleman. I marvel at your restraint.

Thanks! However, my restraint was REALLY tested with my sleep doc!!!

Take care,

Den

Thanks for the instructions. I use a Remstar Auto with heated humidifier. My Dr. originally prescribed a minimum setting of 5 and a maximum of 15. Based on some of the comments I have seen on this site I got curious so double checked my settings and they were set at a min. of 4 and a max of 20. My diagnosis was moderate OSA. I changed the settings this morning to what my Dr. said it should be, as I have noticed that there have been times where I woke up feeling like I was going to explode, and maybe this explains why. My equipment:
1, Remstar Auto.
2. Heated humidifier. I currently have it set on 4, as I had it lower and found that I wound up with a very dry mouth - I live in a dry climate.
3. Fisher & Paykel flex fit 431 full face mask. I changed to this one a couple of weeks ago and find it much more comfortable. Had to change because the resmed full face mask I had been using is no longer available.

I have been using my APAP for about 2 1/2 years - Can't say I like using it but like the results.

I have recently changed suppliers of my equipment - I received good service from my local DME but their central billing office was horrible. I have good insurance, but it was just too much of a hassled dealing with their billing office to get the billing correct. They were also very expensive - A six foot hose through them, for example was $40, but I can get it online for $10. They wanted $400 for the Flex Fit 431 and I got it on line, including headgear, for $130.

wow, 400 for the flexifit? dang and i thought a dme was trying to rip me off by trying sell it to me for 250, lol. but i had already got one new online for 114 dollars shipped.

If you know what your pressure is and buy a secondhand machine, you need to set it to your pressure. I just bought one secondhand that's set to 7 lbs, my script is for 15.
[quote="colrdgrn"]Colrdgrn,

Please register and join the "hose head club". Hang around and do LOTS of reading. I'm sure it will further your education. We have a pretty savvy and diverse group here.

Best wishes,

Den

Wow,
Ouch..... I never implicated that your group isn't smart etc. - and I know that changing the pressure on your CPAP is for the most part easy... But I still have the same opinion that patients should not be deciding pressure themselves because the simple fact is - you don't really know what you are doing in your sleep. The woman in the post wants to decrease her pressure. She was wearing a full face, which suggests to me she is an oral breather. Now she is going to a nose clip. Probably not a good idea if she is a mouth breather because her nose is going to get even more stopped up with all of the pressure being directed into her nose. Then she says she needs a decrease in pressure. Maybe, but even if she decreases to a "comfortable" pressure - it may not be completely therapeutic. I am all about researching apnea and CPAP - and I think it is great that you have continued with CPAP therapy. Much better than those I see who come to the lab with horrible apnea, swear they don't have it, don't give CPAP a chance, and then leave untreated.
But - I still don't think patients should be deciding their own pressure - based on what they think/feel their pressure should be. I am not really in agreement with the APAP systems either because from what I have experienced with patients, APAP doesn't seem to be effective in treating central apnea. Probably more effective for obstructive apnea....I have read many research articles about apnea and I attend the Sleep conferences... But I also have experience with patients and CPAP. Changing your pressure without OBJECTIVE evidence for the change is dangerous - you could do serious harm to yourself. That's my point.

[quote="oldgearhead"]Why not pay $6.00 (on Ebay) and buy the DME manual..

I have a Remstar Plus model number 1005960. I have had it for around 5 years I think. I have had a awful time over these years adjusting to even wearing it at night but have recently started forcing myself. I have been diagnosed with moderate sleep apnea. I am finding that the pressure needs to be adjusted higher as I am snoring and my breathing is stopping with the mask on per my spouse. I have no idea what my prescription was..can I just up the pressure a little ??? If so....do I follow the instructions that I have found on this board? I am afraid I am going to mess the settings up as I dont know what the original pressure was and have no clue what I am doing here. Please can somebody help me change the pressure as I really would like to sleep. Thanks in advance so much.

Lisa M wrote:I have a Remstar Plus model number 1005960. I have had it for around 5 years I think. I have had a awful time over these years adjusting to even wearing it at night but have recently started forcing myself. I have been diagnosed with moderate sleep apnea. I am finding that the pressure needs to be adjusted higher as I am snoring and my breathing is stopping with the mask on per my spouse. I have no idea what my prescription was..can I just up the pressure a little ??? If so....do I follow the instructions that I have found on this board? I am afraid I am going to mess the settings up as I dont know what the original pressure was and have no clue what I am doing here. Please can somebody help me change the pressure as I really would like to sleep. Thanks in advance so much.

If you have already found the instructions, then when you go through the menu options, write down what they are (ALL of them) before changing anything. If you have further questions, please feel free to ask.
Does that machine have C-Flex? Some of the Plus models had it and some didn't. If your machine has 5 buttons on the top, it probably has C-Flex. If it only has 3 buttons it does not.
Do you have your original prescription? (either the original or a copy of it) If you don't, can you get it from your doctor or from the place where you got your equipment (DME)?

Glad to hear you're giving this therapy another try.
What mask (specific make/model) are you using? If you're using a nasal mask, you may be leaking air out your mouth while you're sleeping.


Den