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Breaking up OA clusters- PR System One Remstar Auto w/ Aflex
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Terry Offline

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Machine: Philips Respironics RemStar Auto with A-Flex (560P)
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Post: #11
RE: Breaking up OA clusters- PR System One Remstar Auto w/ Aflex
(09-15-2014 07:43 PM)Evpraxia Wrote:  Thank You, THANK YOU for this thread!

I think this is the answer for my hubby's issues with HIS PR System One, his settings are at 12-18 and he has severe SA; OA and CNS. I will bet you he should be at a higher lower number, like 13 or 14 to 18.

You folks are SO great! Go pat yourselves on the back - each of you deserves it!

Glad to help!

You can keep watching the data and see the OAs drop as the pressure goes up.

The "Auto" machines are a little bit of a scam as many docs prescribe them (wide open), since they can't actually respond fast/aggressively enough. However once you get the minimum pressure set to where it should be, they're very helpful and civilized. Even small changes can make a big difference.

I tried dropping my minimum down by 1 last night and my RDI doubled, and today I feel like crap again. Ugh.
(This post was last modified: 09-16-2014 09:35 AM by Terry.)
09-16-2014 09:32 AM
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coolbranch Offline

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Machine: AirSense 10 AutoSet
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Other Comments: SleepyHead v0.9.8-1 (testing) Build Date: Oct 3 2014 17:17:35 Revision: 4595153 (master branch) Gra

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Post: #12
RE: Breaking up OA clusters- PR System One Remstar Auto w/ Aflex
Terry knows how this works. I will agree that experimenting with the low side pressure on AUTO machines is an important key. Once you get that tweaked, the periodic hunt and peck feature on the PR Sys One Remstar attempts to find the delicate balance to maintain an open airway, at least to the best of these machines current ability

However, I will state that each sleep session, day to day, can be different according to daily habits and experiences. I find that stress levels, food choices and time one eats as well as social alcohol consumption on college football game day may vary results.
09-16-2014 05:28 PM
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vsheline Online

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Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
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Location: California, USA

Post: #13
RE: Breaking up OA clusters- PR System One Remstar Auto w/ Aflex
(09-15-2014 07:43 PM)Evpraxia Wrote:  Thank You, THANK YOU for this thread!

I think this is the answer for my hubby's issues with HIS PR System One, his settings are at 12-18 and he has severe SA; OA and CNS. I will bet you he should be at a higher lower number, like 13 or 14 to 18.

Hi Evpraxia,

What is the breakdown of OA (obstructive apneas) versus CA (Central Nervous System Apneas)?

As you probably know, with some patients the higher the pressure is, the higher the number of CA events they will have.

I am not at all saying you shouldn't raise the minimum pressure (keeping the max unchanged), because that might be exactly what he needs.

But, of course, best to be gradual, such as not increasing faster than 1cm H2O per week or two weeks.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 09-16-2014 11:27 PM by vsheline.)
09-16-2014 11:25 PM
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Evpraxia Offline

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Post: #14
RE: Breaking up OA clusters- PR System One Remstar Auto w/ Aflex
(09-16-2014 11:25 PM)vsheline Wrote:  
(09-15-2014 07:43 PM)Evpraxia Wrote:  Thank You, THANK YOU for this thread!

I think this is the answer for my hubby's issues with HIS PR System One, his settings are at 12-18 and he has severe SA; OA and CNS. I will bet you he should be at a higher lower number, like 13 or 14 to 18.

Hi Evpraxia,

What is the breakdown of OA (obstructive apneas) versus CA (Central Nervous System Apneas)?

As you probably know, with some patients the higher the pressure is, the higher the number of CA events they will have.

I am not at all saying you shouldn't raise the minimum pressure (keeping the max unchanged), because that might be exactly what he needs.

But, of course, best to be gradual, such as not increasing faster than 1cm H2O per week or two weeks.

Take care,
--- Vaughn

Greetings Vaughn,

Actually, I did NOT know about the CAs increasing for some folks with higher pressures. Thank you for mentioning this!

I will get the numbers to you tomorrow - I am exhausted today from working an 11 hr day.

Evpraxia in the Pacific Northwest USA
Diagnosed: 44 AHI when supine, O2 down to 82%
Treated since 20 Sept 2014:: 0.7 AHI, Settings 7-15, EPR on Full Time at Level 3
Better living through CPAP/APAP machines!
09-16-2014 11:50 PM
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Ghost1958 Offline

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Machine: PRS1 Series Sixty Auto Aflex
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: PRS1 with Heated Hose
CPAP Pressure: 10.5 min 16 max
CPAP Software: SleepyHead EncoreBasic

Other Comments: Moderate to Severe SA Obstructive. Rapid O2 desat off the machine.

Sex: Male
Location: KY

Post: #15
RE: Breaking up OA clusters- PR System One Remstar Auto w/ Aflex
Enable the Opti start option in the clinical settings. Give the machine 30 hours and it will reset its starting pressure based the pressure it runs at most of the time with no events. Set that as his minimum. If you dont SET it as the min the machine will start at the new pressure but drop back down to the old set min pressure if no events happen in a bit.
09-16-2014 11:57 PM
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Evpraxia Offline

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Machine: ResMed S9 AutoSet
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Mask Make & Model: ResMed Swift LT for Her - Nasal Pillows System
Humidifier: ResMed H5i
CPAP Pressure: 7-17
CPAP Software: ResScan SleepyHead

Other Comments: Cat Staff, bibliophile, love Classical & Byzantine music

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Location: Pacific Northwest USA

Post: #16
RE: Breaking up OA clusters- PR System One Remstar Auto w/ Aflex
(09-16-2014 11:57 PM)Ghost1958 Wrote:  Enable the Opti start option in the clinical settings. Give the machine 30 hours and it will reset its starting pressure based the pressure it runs at most of the time with no events. Set that as his minimum. If you dont SET it as the min the machine will start at the new pressure but drop back down to the old set min pressure if no events happen in a bit.

Thanks for the tip - we will be working with it today.

Evpraxia in the Pacific Northwest USA
Diagnosed: 44 AHI when supine, O2 down to 82%
Treated since 20 Sept 2014:: 0.7 AHI, Settings 7-15, EPR on Full Time at Level 3
Better living through CPAP/APAP machines!
09-17-2014 04:25 PM
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Evpraxia Offline

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Posts: 313
Joined: Aug 2014

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift LT for Her - Nasal Pillows System
Humidifier: ResMed H5i
CPAP Pressure: 7-17
CPAP Software: ResScan SleepyHead

Other Comments: Cat Staff, bibliophile, love Classical & Byzantine music

Sex: Female
Location: Pacific Northwest USA

Post: #17
RE: Breaking up OA clusters- PR System One Remstar Auto w/ Aflex
(09-16-2014 11:50 PM)Evpraxia Wrote:  
(09-16-2014 11:25 PM)vsheline Wrote:  
(09-15-2014 07:43 PM)Evpraxia Wrote:  Thank You, THANK YOU for this thread!

I think this is the answer for my hubby's issues with HIS PR System One, his settings are at 12-18 and he has severe SA; OA and CNS. I will bet you he should be at a higher lower number, like 13 or 14 to 18.

Hi Evpraxia,

What is the breakdown of OA (obstructive apneas) versus CA (Central Nervous System Apneas)?

As you probably know, with some patients the higher the pressure is, the higher the number of CA events they will have.

I am not at all saying you shouldn't raise the minimum pressure (keeping the max unchanged), because that might be exactly what he needs.

But, of course, best to be gradual, such as not increasing faster than 1cm H2O per week or two weeks.

Take care,
--- Vaughn

Greetings Vaughn,

Actually, I did NOT know about the CAs increasing for some folks with higher pressures. Thank you for mentioning this!

I will get the numbers to you tomorrow - I am exhausted today from working an 11 hr day.

Update:

Vaughn, If I understand the question and the Diagnostic Analysis properly, my hubby's numbers for 2 hours sleep time (no REM sleep) are:

Respiratory events CNS OS Mxd
Index (events/hr) 3 1 1
total Count 6 3 2

11 apneas and 58 hypopneas during the diagnostic portion. Directly from the study report: "It is unclear if the patient may have some component of central sleep apnea, either complex sleep apnea or Cheyne-Stokes respirations. Hopefully, this is not the case."

Evpraxia in the Pacific Northwest USA
Diagnosed: 44 AHI when supine, O2 down to 82%
Treated since 20 Sept 2014:: 0.7 AHI, Settings 7-15, EPR on Full Time at Level 3
Better living through CPAP/APAP machines!
09-17-2014 05:54 PM
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Ghost1958 Offline

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Posts: 957
Joined: Aug 2014

Machine: PRS1 Series Sixty Auto Aflex
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: PRS1 with Heated Hose
CPAP Pressure: 10.5 min 16 max
CPAP Software: SleepyHead EncoreBasic

Other Comments: Moderate to Severe SA Obstructive. Rapid O2 desat off the machine.

Sex: Male
Location: KY

Post: #18
RE: Breaking up OA clusters- PR System One Remstar Auto w/ Aflex
EVpraxia. I forgot to mention though you may already have read it by now in the manual. That machine he has will recalculate the starting pressure every 30 hours of use and set a new starting pressure again as long as opti start is enabled.

I just leave mine enabled. It may go down a bit or up a bit. Mine went from min 6, to min 8.5, then to 9 and back to 8.5.

So unless it makes a larger change than that its just set at 8 min and left there. Itll display its starting pressure when you first start therapy each time. If it were to make a huge change and hold that change for a couple of weeks then Id move the min setting but for .5 to 1 cm its not worth the trouble.
09-17-2014 10:36 PM
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Evpraxia Offline

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Posts: 313
Joined: Aug 2014

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift LT for Her - Nasal Pillows System
Humidifier: ResMed H5i
CPAP Pressure: 7-17
CPAP Software: ResScan SleepyHead

Other Comments: Cat Staff, bibliophile, love Classical & Byzantine music

Sex: Female
Location: Pacific Northwest USA

Post: #19
RE: Breaking up OA clusters- PR System One Remstar Auto w/ Aflex
Thanks, Ghost1958,

I think I understand now. I will let my hubby know.

Best regards,

Evpraxia in the Pacific Northwest USA
Diagnosed: 44 AHI when supine, O2 down to 82%
Treated since 20 Sept 2014:: 0.7 AHI, Settings 7-15, EPR on Full Time at Level 3
Better living through CPAP/APAP machines!
09-17-2014 11:39 PM
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vsheline Online

Advisory Members

Posts: 1,909
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #20
RE: Breaking up OA clusters- PR System One Remstar Auto w/ Aflex
(09-17-2014 05:54 PM)Evpraxia Wrote:  
(09-16-2014 11:50 PM)Evpraxia Wrote:  
(09-16-2014 11:25 PM)vsheline Wrote:  Hi Evpraxia,

What is the breakdown of OA (obstructive apneas) versus CA (Central Nervous System Apneas)?

As you probably know, with some patients the higher the pressure is, the higher the number of CA events they will have.

I am not at all saying you shouldn't raise the minimum pressure (keeping the max unchanged), because that might be exactly what he needs.

But, of course, best to be gradual, such as not increasing faster than 1cm H2O per week or two weeks.

Take care,
--- Vaughn

Greetings Vaughn,

Actually, I did NOT know about the CAs increasing for some folks with higher pressures. Thank you for mentioning this!

I will get the numbers to you tomorrow - I am exhausted today from working an 11 hr day.

Update:

Vaughn, If I understand the question and the Diagnostic Analysis properly, my hubby's numbers for 2 hours sleep time (no REM sleep) are:

Respiratory events CNS OS Mxd
Index (events/hr) 3 1 1
total Count 6 3 2

11 apneas and 58 hypopneas during the diagnostic portion. Directly from the study report: "It is unclear if the patient may have some component of central sleep apnea, either complex sleep apnea or Cheyne-Stokes respirations. Hopefully, this is not the case."

Hi Evpraxia,

Does the Clinician setup manual for your machine explain how to get to a Sleep Report screen on your husband's machine, which will show the AHI breakdown between Obstructive Apneas Index, Clear airway Apnea Index, Hypopnea Index, and other statistics?

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 09-18-2014 02:47 AM by vsheline.)
09-18-2014 02:47 AM
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