Change CPAP Pressure Settings - Adjusting your machine with a Clinician Setup Manual

There is a lot of talk about how it's "illegal" for Sleep Apnea patients to adjust or change their own CPAP machine pressure settings; that only a licensed, certified or qualified technician, physician or clinician can do it.

First of all, I challenge anyone to show me any local, state or federal law that makes adjusting your own legally-obtained CPAP machine a crime, or even threatens punitive action for doing so. Go ahead - I double-dog dare 'ya.

If you can show me such a law, I'll give you a one-year free membership on Apnea Board.

Oh, wait... that's already free. Moving right along...

Yes, you must first have a prescription to obtain a CPAP machine - but after you OWN one, you are within your rights to do whatever you darn well please with it, including using it as a leaf blower, running it over with the family car, or... (oh no!) - changing your own pressure settings.

Below is some excellent info someone emailed to me regarding setting pressures on common CPAP machines.

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Remember the last time you went to the pharmacy to pick up a prescription? You walked up to the counter, handed over the script, waited a few minutes and received a full bottle or package of something - pills, liquids, whatever. "Take the prescribed dose once per day for ten days, with food", the pharmacist said.

Fast forward to right now. You've just bought a CPAP machine - or maybe you've been using a CPAP machine for years - and you've discovered that you don't know how to adjust the pressure setting. The primary function of the CPAP machine is to blow air at a certain pressure, and you don't even know how to change the pressure? That's like not knowing how to change the ringer volume on your cell phone, isn't it? Isn't that a vital function that all CPAP users should be familiar with? To you - and to most other CPAP users - the CPAP machine is a mysterious "black box". Something only someone else knows how to program. You just turn the thing on, put on your CPAP mask and hope your CPAP therapy works as advertised.

So why is it that you don't know how to adjust the pressure setting on your CPAP machine? It's a 30-second procedure that takes only a few pushes of a couple of buttons. The problem is that the manufacturer of your CPAP machine has hidden some controls from you. In fact they've hidden an entire menu of controls found in what is commonly referred to as the "clinician's setup" or "provider setup" mode.

Before I begin spilling the beans about the clinician's setup, consider that trip to the pharmacy one more time. When you think about it, there's an awful lot of trust between you and your doctor, the doctor and the pharmacist, and the pharmacist and you. You've been told what to do, and they're assuming you're going to do it - correctly. You're also assuming your doctor wrote the right prescription and the pharmacist filled it as written.

Taking this trust issue a step further, consider the fact that when you get a prescription filled at the pharmacy, you don't have to go get one pill at a time. You're trusted with the whole bottle of pills and everyone involved is assuming that you're responsible enough not to do anything stupid with those pills.

So given the secret of the clinician's setup mode would you suddenly become irresponsible? Untrustworthy and reckless? Bent on self destruction by way of CPAP machine? It could happen. But I don't think it will.

I firmly believe you are your own best primary care provider - that nobody else is looking out for your health and well being as much as you are. I therefore think you should be trusted with the knowledge of how to adjust the pressure setting on your CPAP machine. Don't get me wrong. I'm not advocating changing the pressure setting on your CPAP machine willy nilly, without regard for your own well being, and I'm certainly not providing you with medical advice (primarily because I don't know you and I'm not a doctor). I think all responsible CPAP users should use common sense when using their CPAP machines, and I think it's a very good idea to talk with your physician or sleep therapist before making any changes to your CPAP therapy. Pressures should be changed slowly, in small increments, over a long period of time. Be sure to note any changes in how you feel.

For a detailed explanation of how to determine the optimum pressure on your CPAP machine, click here. Sleep apnea is a very serious condition, and altering your prescribed therapy settings could reduce the effectiveness of your CPAP therapy.

Whether you have a constant pressure "regular" CPAP machine, an automatic CPAP machine or a bilevel CPAP machine, getting into the clinician's setup mode is fairly simple.

If you're not sure which CPAP model you have, please go to our CPAP Pictures Page to identify your machine.

If you'd like assistance or advice from fellow Sleep Apnea patients, please join the Apnea Board Forum and ask any question you like.

There are three primary sections on this page:

Section One is a list of brief instructions on how to enter the Clinician Setup Menu for common CPAP machines.
Section Two is a list of common CPAP Clinician Setup Manuals available via direct download.
Section Three is a list of CPAP Clinician Setup Manuals available through email only.

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SECTION ONE:
Clinician Setup Menu Instructions for Common CPAP Machines:

Respironics REMstar Auto (older pre-2007 standard unit, not "M" series, not the PR System One): you can enter the setup menu by holding down the Ramp button and both of the right and left arrow buttons under the display window, while plugging in the CPAP. The 3 buttons must be held down until the setup screen starts.

Respironics REMstar M Series (CPAP or BiPAP):   Unplug the power cord from the back of the CPAP machine, then hold down both the left and right arrow keys while simultaneously plugging in the power supply. Once the device beeps twice, release the buttons. After you hear the two beeps, you'll see the word setup in the lower right corner of the LCD screen. When you select setup you'll be in the clinician's mode where you can adjust every feature of the CPAP machine, including the pressure setting.

Philips-Respironics PR System One (REMstar Auto, REMstar DS150, BiPAP ST, BiPAP AVAPS, BiPAP Auto with Bi-Flex, BiPAP Pro with Bi-Flex, REMstar Pro with C-Flex & REMstar Plus): For Setup Instructions with pictures, click here. Supply power to the device: first, plug the socket end of the AC power cord into the power supply. Then plug the pronged end of the AC power cord into an electrical outlet that is not controlled by a wall switch. Finally, plug the power supply cord's connector into the power inlet on the back of the device. Once the device is powered, the home screen appears (it is a large box on the screen with four little boxes you choose from by turning the control wheel). Turn the wheel to toggle between the 4 options and highlight "setup". Once setup is highlighted press and hold both the control wheel and ramp button on the device for at least 5 seconds. You will hear a double beep and the provider mode screen will appear. Also, you should remove the smart card prior to making adjustments, otherwise it will revert to the previous settings. (note: setup manuals for the REMstar Auto, BiPAP Auto & REMstar Pro machines are available by email, below)

Respironics SleepEasy: Plug in the machine while simultaneously pressing the plus and minus buttons on top of the machine. The LCD shows the pressure setting along with an icon of a open padlock. To move between options, press the ramp button. The plus and minus buttons adjust the increments.

Respironics BiPAP Auto SV & BiPAP ST (older gray colored model): Click HERE for instructions on how to enter the Clinician Setup Menu.

Respironics REMstar Lite: plug the cord into the AC outlet and leave the other end unattached to the machine. Then, firmly hold down both the ramp and power button while plugging the cord into the machine at the same time. When you do so, the "unlock" icon appears and the blower starts up. You can then navigate through the menu to change pressures.

Puritan Bennett GoodKnight 420 Series: Make sure the CPAP machine is plugged in, then find the secret button beneath the "Go" in the word GoodKnight which appears just above the LCD screen. Press the secret button and the Information Access button simultaneously for 2 or 3 seconds. The CPAP machine will now be in the provider setup mode. Press the Information Access button to cycle through the list of adjustable settings, and use the arrow buttons to make adjustments.

Invacare Polaris EX (and possibly other Invacare models): While in stand-by press and hold both up and down arrows for about 15 seconds. Press up arrow for setup. Use up and down arrows to adjust each setting. Press the large invacare (enter) button to go to the next setting. If it asks you "compliance yes/no?", select "yes". (complete manual via email is listed below)

Fisher & Paykel HC 234: Enter programming mode by holding down the "Ramp" (top) button and the "Next" (Right arrow/bottom button) for three seconds. When you get into the pressure set mode you will first be able to set adjust altitude, which is indicated by a drawing of a mountain range on your screen. You can change or ignore this setting and then push the "Next" (Right arrow/bottom button) to advance to pressure setting which will be indicated by the characters "cm h20 " on the screen. Use the Up and Down keys to change the pressure setting. Lastly, push the bottom button again to exit programming mode.

Fisher & Paykel HC 220 & 220LE: On the side of the machine where the power switch is, you should be able to see a litt small cut-out shape like a square, or hidden door. Simply push and pull down and it should slide off, under that there is a black dial that you turn up or down to change the pressure. (note: the right dial, not the left). Right in front of the adjuster knob is an LCD window that will give you the current pressure setting.

Fisher & Paykel ICON Auto, Premo & Novo: Move the SmartDial to the user Preferences position (tool wrench icon). Hold down the SmartDial button with your thumb until you hear the 'tick tock' sound. Do NOT release the middle button yet. While holding down the button, use your other hand to rotate the dial 380 degrees clockwise until you are back at the top (12 o'clock position). Rotate the dial one pitch counter-clockwise back to the tool wrench icon, release the middle button and you be in the Clinician Menu with additional options appearing on the left quarter of the screen.

ResMed S8 Compact, S8 Elite, S8 AutoSet Vantage & AutoSet Spirit: Press the right and down arrows simultaneously for about 3 seconds until the word "clinical" appears. Select Menu, then use the left and right arrows to cycle through the settings. Use the up and down arrows to make adjustments.

ResMed S9 Series (S9 AutoSet, S9 Elite, S9 Escape Auto, S9 Escape, S9 VPAP S, S9 VPAP ST, S9 VPAP Auto & S9 VPAP Adapt): For Setup Instructions with pictures, click here. Plug in machine and turn the Push Dial until the device is showing the Home position (Home Icon illuminated). In Home position, press the Push Dial and the Setup Menu buttons down simultaneously for 3 seconds. The clinician menu will appear. Select parameter(s) you wish to modify with the Push Dial (push down to select, turn to modify). When done, select the Home choice again from the displayed menu, push down the Push Dial again and the adjustment is saved. (complete manual available via email, below)

ResMed VPAP II: For Setup Instructions, click here.

For the ResScan data-reporting software, click here

ResMed S7 Lightweight: For Setup Instructions, click here.

ResMed Moritz S & Moritz ST BiPAP: For Setup Instructions, click here.

Weinmann SOMNOsoft+: Press the ramp-button until "Soft" can be seen in the Display. While still pressing the ramp-button press the humidifier button, until the pressure-setting-menu appears.

Weinmann SOMNOcomfort 2: Press the ramp-button until the display is clear (or 'A' is blinking if Automatic Mode is enabled). While still pressing the ramp-button press the humidifier button, until the pressure-setting-menu appears.

Breas PV10 CPAP: For Setup Instructions, click here.

Viasys Orion CPAP: Press both the plus ( + ) button and minus ( - ) button simultaneously to get into the clinician setup menu. First set the ramp pressure values, then the ramp time. After these is the altitude setting (1 - 9 where 1=1,000 feet above sea level); to find your altitude click here.   Next, set the standard pressure in increments of 0.5 cm/H20 of pressure.

Evo RemRest 900 Series: Turn on the machine, then turn off the machine. Immediately after that, simultaneously press both arrow buttons. While holding those 2 buttons down hit the power button to take you to the setup mode.   Scroll through the menu using the arrow buttons until you get to the particular setting you want. To change the pressure use the up and down arrow buttons to change the levels. When done press the mode button to apply settings and then power off machine.

DeVilbiss 9000 series machines: Turn on the machine, then turn off the machine. Immediately after that, simultaneously press the down arrow button and the ramp buttons. While holding those two buttons down hit the power button to enter the setup mode. Scroll through the menu using the select button until you get to IPAP and EPAP settings. Use the up and down arrow buttons to change the levels. When done turn off the machine.

DeVilbiss RPM Bilevel: To unlock the prescription settings, make sure the blower is OFF (OFF should be shown on the display). While pressing the DELAY and DOWN buttons, press the ON/OFF button to start the blower. The prescription settings are now unlocked and can be changed using the UP and DOWN buttons on the keypad. Press the SELECT button to advance to the next setting. The first value displayed on the LCD will be the mode.

SECTION TWO:
CPAP Clinician Setup Manuals Available via Direct Download:

These are Adobe PDF files, you will need the free Adobe Acrobat Reader, available for download HERE
If you're not sure which CPAP model you have, please go to our CPAP Pictures Page to identify your machine.

(right click on the manual name, then select "Save File As...") to save it to your computer:

Respironics REMstar Basic M Series

Respironics REMstar Plus M Series

Respironics REMstar Pro M Series

Respironics REMstar Auto M Series

Respironics REMstar Plus (This older model has 3 buttons on the top, this is not the PR System One, C-Flex nor the M series) - [The 5-button C-flex version available through email below]

Respironics BiPAP Pro (not the PR System One)

Respironics BiPAP Auto M Series

Respironics REMstar Auto M with A-Flex

Respironics REMstar BiPAP Auto SV

Respironics REMstar LX & LX Plus

Fisher & Paykel SleepStyle600 (setup instructions also cover model 604)

ProBasics ZZZ-PAP

DeVilbiss Horizon LT 8000 series (older pre-1999 unit)

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SECTION ONE: Clinician Setup Menu Instructions for Common CPAP Machines:

SECTION TWO:CPAP Clinician Setup Manuals Available via Direct Download:

SECTION THREE: CPAP Clinician Setup Manuals Available via Email:

If you're not sure which CPAP model you have, please go to our CPAP Pictures Page to identify your machine.

SECTION ONE:
Clinician Setup Menu Instructions for Common CPAP Machines:

SECTION TWO:
CPAP Clinician Setup Manuals Available via Direct Download:

SECTION THREE:
CPAP Clinician Setup Manuals Available via Email: