How to get to the Clinician Menu:
01) Set Dial Knob to Setup.
02) Press Dial Knob and Ramp at the same time and hold until machine beeps (6 or 7 seconds).
03) Set Dial Knob to Setup again and press it again.
04) Dial down the parameter list.
.....At each point you should see the corresponding value highlighted.
.....It might be useful to write down each parameter and its value for reference.
05) Dial to Back or Exit and press Dial knob.
06) Dial to Therapy
You should be good to go.
Sometimes the DME locks the Clinician's menu so you can't get to it and change anything. It doesn't happen very often but sometimes. If that's the case, then the previous instruction won't work. Not to despair, there is a way around this problem.
01) Unplug your machine and wait for a minute or two ( longer is not necessary )
02) Remove the SD card from your machine and put it aside.
03) Plug In your machine and wait until it finishes the start-up sequence.
04) Now do the steps above to look at the settings.
05) When you are done, Dial back to Back or Exit and press the Dial knob once.
06) Dial back to Therapy.
07) Replace the SD card.
You're done.
Note that if the DME has locked the Clinician's menu and you changed things, the system will restore the DME settings and override any changes you made. This happens because the prescription settings are recorded on the SD card. When the CPAP reads the card after it is placed back in the slot, if the prescription settings are on the card, they will be used to over ride anything you set while in the Clinician's menu.
If you want to change the settings permanently, it is important that you try to consult with your doctor to make sure you are on the same page about your therapy. The relationship between you and your doctor should be a partnership.
That said, even if the DME has entered the settings on the card, you can still make changes.
01) First load any of your data into your copy of the appropriate software (Encore or SleepyHead). That keeps your data safe.
02) Remove the SD card and put it in your computer and look at the files in the P-Series folder. If you see a file of type .000, this is the prescription data for machine settings. Deleting this file will remove the lock on the settings and allow you to make your own settings. It may have a name like USE.000 or REUSE.000 but the file extension will be .000. If you are using a Respironics mask and humidifier, there will be files that record this as well. They have extensions of .002 and .003. It is likely that it is safe to ignore these files.
03) Put the SD back into your CPAP machine.
04) Follow the procedure above for looking at the Clinician's menu and make the changes you and your doctor have decided will improve your therapy.
Is your machine data capable?
If your System One machine has a model number on the bottom that is higher than 400, your machine is data capable and you can use Encore or SleepyHead to get reports. If it is a 200 series, it isn't and you can't get anything but hours of use.
Here is the current list for System One devices:
Respironics System One System Names
250 or 260 - REMStar Plus C-flex - only hours of use data
450 or 460 - REMStar Pro C-flex+ - full data
550 or 560 - REMStar Auto A-flex - full data
560 or 660 - REMStar Pro BiFlex - full data
750 or 760 - REMStar Auto BiPap - full data
950 or 960 - REMStar AutoSV Advanced - full data
106142. - REMStar BiPap S/T C - full data, wave data ?
106048. - REMStar BiPap AVAPS C - full data, wave data ?
See Philips Comparison Guide
Care of the Humidifier tank.
If you use the humidifier, the best water to use is distilled water. This leaves no residue in the tank and nothing for the little nasties to eat and grow with. In the store, you will see all sorts of bottled water to choose from. Don't make the error of assuming that if it says Purified that it is distilled. It's not. Purified water may be good to drink but it still has minerals, etc. in it that make it taste good but not for your humidifier tank. Over time it will deposit mineral salts in your tank that will need to be cleaned out and removed.
The least expensive source of distilled water (if you don't distill your own) is in gallon containers at the grocery store. But gallon jugs are a pain to handle especially if you have arthritic hands or other medical problems. So, I use smaller containers. In particular, there is a bottled water called AquaPod that comes in a cute bottle and happens to have exactly the same volume as the Respironics humidifier tank. I drink the AquaPod water and save the container for my humidifier. Once a week or so, I fill my collection of AquaPod bottles with distilled water by resting the gallon jug on the edge of the sink and pouring the water into the smaller container. Most of the weight is supported by the sink and not so much with my hands.
Daily, I dump out the humidifier and refill it with from one of the AquaPods - it fills it exactly.
If you choose to not go the distilled water route, then tap water can be used safely.
It is best to boil the tap water for a few minutes, let it return to room temperature, and then use it to fill your humidifier tank. This process kills the remaining bacteria that are in tap water (yes there are some but they are normally harmless). Those are the source of that pink slime that sometimes collects in the tank. Boiling also gets rid of any volatile gases like Chlorine that is added to the water supply to keep it safe. Dump out the water each morning, rinse your tank thoroughly with hot water (faucet hot not boiling) and then let the tank dry for a few hours before refilling. It's a good idea to adopt the habit of filling your tank as part of your going to bed ritual so that the water doesn't sit in the machine all day.
If you are using tap water or bottled water (not distilled) then you will need to clean the tank periodically to keep the mineral deposits under control. Harsh chemical are a NO-NO. Only use white vinegar and dilute it about 1-1 with water. Rinse the tank with hot tap water and follow with a vinegar soak and rinse. 10 minutes soaking should do but times will vary depending on the amount of deposits that have collected. After the soak, another rinse in hot water is needed to get rid of the vinegar smell. Keep rinsing and emptying until all the smell is gone.
If there is a pink slime in the tank, then this is a result of bacterial growth and vinegar may not be able to get rid of it. Use some coarse salt to form a slurry in the tank and with a brush or toothbrush, scrub the inside of the tank with the salt slurry. This should break down the slime and get rid of most of it. Follow up with the vinegar treatment and your tank should look clean and sparkling.
Let the tank dry before refilling it in the evening.
Getting your reports.
To get reports about your own therapy, you will need some software to read the data that is recorded on the SD card in your machine. There are two choices for the Philips-Respironics machines, the Encore series and Sleepyhead. The format of the reporting for these are different and which you choose will be a personal preference choice.
If you choose the Encore software, then please note that it will only download the daily Wave data if you download every day. If you don't care about getting this part of the report, then this is not an issue.
if you choose SleepyHead, the Wave data is all loaded even it you don't download every day.
If you have a Windows computer you can choose either of these programs.
If you have a Mac, then the choice is only SleepyHead unless you are adept at installing and running one of the windows simulators.
Encore Feature
A feature or peculiarity of the Encore programs is the reporting of breaths per minute and of tidal volume. If you have only one session per day (turned the machine on at night and off in the morning), these number seem to be rounded off. the breaths per minute number is rounded to whole numbers while the tidal volume is rounded to the nearest 10 mL value. If, on the other hand, when you go to bed in the evening, you wait for a minute or so after the machine turns on and then manually turn it off, wait a few seconds, and then turn it on again, the numbers are reported to the nearest 1/10th.
Keeping Wave Data in Encore Pro if you can't download every day
If you can't download to Encore each day, normally Encore will skip all but the last day's wave data. However there is a work around that will keep all the data. Get and format extra SD cards and label them 1, 2, 3, etc. then each day in the morning, remove the current SD card and note the date for that card. Put in the next card. Do that for all the days for which you won't be able to download.
When you can download again, change the computer clock to the date for the first card and download the data.
Now change the computer date to the next card (in date order) and repeat the process.
You'll get all the wave data saved into Encore.
Be very careful to load the cards in date sequence. If you get them out of order, Encore won't load earlier days after a later day.
I travel with 10 SD cards so I can cover trips that long.
A side Note on the WaveForm Report from Encore
I've often wondered in the waveform report which direction is inhale and which is exhale.
Here is a clip that illustrates this.
This shows taking the mask off before turning the machine off. so, the +LPM is inhale data and the -LPM is the exhale data. Notice that the graph clips as the flow rate exceeds 60 LPM and then comes back as the blower is turned off until flow stops. Also included is a clip from SleepyHead showing the same interval. SleepyHead shows the entire pressure range rather than the clipped range that Encore shows. Another reason to load your data into both programs.