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[CPAP] Changing Settings - please help
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Terry5135 Offline

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Posts: 3
Joined: Mar 2013

Machine: Remstar Auto, Intl 551P
Mask Type: Full face mask
Mask Make & Model: Comfortfull Premium HGR, intl
Humidifier: Remstar Heated Humid., Intl 1056216
CPAP Pressure: 12 cm
CPAP Software: Not using software

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Sex: Male
Location:

Post: #1
Changing Settings - please help
I'm using a Respironics Remstar Auto, Intl ref 551P, with humidifier. It's being leased on national health for 95 EURO per month, plus whatever the humidifier is costing. For that, I get a service once a year and a new 260 euro mask each year. If I live long enough, I'll be using it for the next 20 years. Great deal for them, waste of money to my mind, but I don't have much leverage. What's always amazing is that the storm the doctors kick up is greater than the storm the profit making company would kick up.

I've been on 12 cm pressure for two years, except for the ramp button. I've never understood why they didn't put it on auto, because that's how they tested me and I did indeed have an incredibly good sleep that one night. I had plenty of other teething problems in the beginning and when I suggested that there was a problem with the pressure, well, the hair on the nurses got messed up all by itself instantly, as if an electric charge went through it, as both of them jumped to their feet and were protesting in unison.

So, I let it go. The main problem is when I have a little difficulty going back to sleep if I get up for a pee. So, when I had an appt the other day, two years since my last, I resolved to bring up the question again. I had not hitherto sought to find my own way around them, like a good product of authoritarian thinking. Bigwink

Oh man, there's no describing the alarm and mass of sophism that can come flying from the mouth of a bureaucratic doctor. So, I'll skip the rest of the story and just say we arrive at a compromise. The idea was that the company would send out their engineer to change me to auto and then a week or two later, would send one out again to change me back. Finally, today, I get a call, he's going to come out and change it, but he doesn't know anything about changing it back.

So, I said no, and did what I should have done a year or more ago - a web search, and voila here I am. I was going along to get along, but enough is enough, it's time for guerilla tactics. Cool

My position was exactly as the one put so well by SuperSleeper, in his introduction to "Go ahead and adjust the pressure on your own CPAP machine" (which seemingly, as a new member, I'm not allowed to link for you). But you know, arguing with doctors is about as useful as arguing with medieval priests.

Their [self-described] "scientist" at the hospital was going to make the change for me, but when she didn't come back for 30 minutes, I checked and she wasn't able to make the change. SuperSleeper showed me in minutes exactly how to do it. Less than minutes, actually. About 30 seconds, except for timidity on my part. Gee, quelle surprise.

I'm going to request the manual, which is either "Respironics PR System One REMstar Plus with C-Flex" or "Respironics REMstar Auto with C-flex" (it's really hard to tell for sure).

Meanwhile, his brief instructions were sufficient for entering the clinician's menu and after that, things are pretty obvious.

BUT

Aside from changing "cpap" to "auto", I'm not sure if I should change anything else (like, say, 'c-flex' to 'a-flex' or even 'none'). The range is set properly for what the hospital wants (4 cm to 20 cm) as well as most everything else.

So my question is two fold:

1) Do I need to change anything else, other than 'cpap' to 'auto'?

and

2) Is there a way to test it on the spot, while monitoring the lcd screen? (Besides going to sleep, of course.)

Any help would be vastly appreciated. Thanks in advance.
03-13-2013 01:56 PM
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vsheline Offline

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Posts: 1,908
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

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Location: California, USA

Post: #2
RE: Changing Settings - please help
(03-13-2013 01:56 PM)Terry5135 Wrote:  I've been on 12 cm pressure for two years

Hi Terry5135, welcome to Apnea Board!

You definitely should not leave the minimum pressure at 4. You would feel like you are working for every breath. I suggest 10 or at least 8.

I think a-flex applies to APAP mode and c-flex applies to CPAP mode, but I'm not very familiar with Philips Respironics machines.

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: 03-13-2013 03:25 PM by vsheline.)
03-13-2013 03:21 PM
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zonk Offline

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Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #3
RE: Changing Settings - please help
(03-13-2013 01:56 PM)Terry5135 Wrote:  2) Is there a way to test it on the spot, while monitoring the lcd screen? (Besides going to sleep, of course.)

Any help would be vastly appreciated. Thanks in advance.

Your machine 551 (US 550) is PRS1 Auto A-Flex is supported by SleepyHead software. the software would shows detailed data graphs so you'll have better idea whats going on especially if set machine on auto
Go to post #1 for SlepyHead direct download: http://www.apneaboard.com/forums/Thread-...e-JediMark

PRS1 setup instructions: http://www.apneaboard.com/pr-system-one-...structions

The manual contain all the information abut the machine, Read the manual and get familiar with the machine features and how to enable AHI, leak, etc. data displayed on the LCD screen because would not show on screen it set on "off"
03-13-2013 04:57 PM
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trish6hundred Offline

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Posts: 6,449
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #4
RE: Changing Settings - please help
Hi Terry5135,
WELCOME! to the forum.!
Hang in there for more responses to your post and don't give up.
There is lots of information on the board and lots of nice people to help.

trish6hundred
03-13-2013 06:59 PM
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Terry5135 Offline

New Members

Posts: 3
Joined: Mar 2013

Machine: Remstar Auto, Intl 551P
Mask Type: Full face mask
Mask Make & Model: Comfortfull Premium HGR, intl
Humidifier: Remstar Heated Humid., Intl 1056216
CPAP Pressure: 12 cm
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #5
RE: Changing Settings - please help
Wow, outstanding, several replies already! Fantastic forum.

(03-13-2013 03:21 PM)vsheline Wrote:  You definitely should not leave the minimum pressure at 4. You would feel like you are working for every breath. I suggest 10 or at least 8.

I think a-flex applies to APAP mode and c-flex applies to CPAP mode, but I'm not very familiar with Philips Respironics machines.

Take care,
--- Vaughn

Thanks Vaughn, I suspect you're right about a-flex and c-flex. I'll check out the manuals linked below and test it.

I'm not worried about the minimum pressure - at present, on cpap, I use the ramp button a lot and I find it quite pleasant to have the pressure so low before I go to sleep. Especially in the mornings, trying to go back to sleep, I may hit it several times - it's just awkward because I have to reach over my shoulder.

When I did my test sleep, I think the range was the same. My average for the night was 11.8 and I slept soundly all the way through, so in retrospect I find it really odd that they put me on cpap. The test sleep was on apap.

Thank you for the reply.

(03-13-2013 04:57 PM)zonk Wrote:  Your machine 551 (US 550) is PRS1 Auto A-Flex is supported by SleepyHead software. the software would shows detailed data graphs so you'll have better idea whats going on especially if set machine on auto
Go to post #1 for SlepyHead direct download: Link to: Thread-How-to-SleepyHead-CPAP-Reporting-Software-JediMark

PRS1 setup instructions: Link to: pr-system-one-philips-respironics-setup-cpap-clinician-menu-instructions

The manual contain all the information abut the machine, Read the manual and get familiar with the machine features and how to enable AHI, leak, etc. data displayed on the LCD screen because would not show on screen it set on "off"

Outstanding lot of information, zonk, I'll check it all out. I'm not so sure what the software can do since I have no method for reading the card, but I'll look into it. I can display results on that tiny screen, maybe that will be enough. I'll definitely look over the setup instructions before I proceed with my intuition and Vaugn's suggestion.

Many thanks for all that.
(03-13-2013 06:59 PM)trish6hundred Wrote:  Hi Terry5135,
WELCOME! to the forum.!
Hang in there for more responses to your post and don't give up.
There is lots of information on the board and lots of nice people to help.

Thank you, Trish, I truly appreciate it. Don't worry, I won't give up.

Thanks
(This post was last modified: 03-13-2013 08:59 PM by Terry5135.)
03-13-2013 08:57 PM
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Sleepster Offline
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Posts: 4,994
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #6
RE: Changing Settings - please help
(03-13-2013 08:57 PM)Terry5135 Wrote:  Thanks Vaughn, I suspect you're right about a-flex and c-flex. I'll check out the manuals linked below and test it.

C-Flex is what they call it when you're in CPAP mode or have a CPAP.
A-Flex is what they call it when you have an APAP, which is what you have. You're very fortunate that they gave you this machine, as it's very nice. One of the best.

All this feature does, basically, is reduce the pressure a bit when you exhale. You can dial it up from 1 to 3 or turn it off altogether.

Quote:The test sleep was on apap.

A sleep study is done with a machine where the technician can vary the pressure manually to try and find out the best pressure for you. They probably figure that the technician can do a better job than your APAP, so that might be why they put the machine in CPAP mode.

Who knows!

Have you ever looked at your data to see the effectiveness of the therapy? Now that you're in APAP mode you're going to want to look at the data and see if the APAP is adjusting the pressure properly for you. Usually they do, but it's common to have to tweak the settings.

This is one reason why some medical practitioners prefer CPAP's to APAP's. They can just set the pressure at whatever the sleep study technician recommended and they're done.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
03-13-2013 09:27 PM
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Terry5135 Offline

New Members

Posts: 3
Joined: Mar 2013

Machine: Remstar Auto, Intl 551P
Mask Type: Full face mask
Mask Make & Model: Comfortfull Premium HGR, intl
Humidifier: Remstar Heated Humid., Intl 1056216
CPAP Pressure: 12 cm
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #7
RE: Changing Settings - please help
(03-13-2013 09:27 PM)Sleepster Wrote:  C-Flex is what they call it when you're in CPAP mode or have a CPAP.
A-Flex is what they call it when you have an APAP, which is what you have. You're very fortunate that they gave you this machine, as it's very nice. One of the best.

All this feature does, basically, is reduce the pressure a bit when you exhale. You can dial it up from 1 to 3 or turn it off altogether.

Ahhh, thanks for that, I've been wondering. I'm familiar with the feature as I can tell when I'm breathing with the mask on. So I gather I should change to A-Flex also when I change to auto.

Quote:A sleep study is done with a machine where the technician can vary the pressure manually to try and find out the best pressure for you. They probably figure that the technician can do a better job than your APAP, so that might be why they put the machine in CPAP mode.

Who knows!

They didn't do that. Their resources are limited, which may well be the reason. I was first given the nasal mask and couldn't sleep, then the full mask and I slept through. I only saw the report on this the other day - it was on auto all night.

Quote:Have you ever looked at your data to see the effectiveness of the therapy? Now that you're in APAP mode you're going to want to look at the data and see if the APAP is adjusting the pressure properly for you. Usually they do, but it's common to have to tweak the settings.

Yes, I've seen the data and the cpap has been very effective. My problem with it is when I'm restless and don't sleep for a while. It's given me a sore throat from time to time from the pressure when I don't need so much.

Quote:This is one reason why some medical practitioners prefer CPAP's to APAP's. They can just set the pressure at whatever the sleep study technician recommended and they're done.

Well, that makes sense, thanks! They don't care much to explain themselves. The operation is quite bureaucratic and I'm not sure all the doctors one might interview really know - but doctors don't like to say that, so they play whack-a-mole with answers until your satisfied. Too-funny But seriously, one explanation they did give me is that some customers awoke from the leap in pressure when their airways closed.

I just wanted to experiment, basically between the two, and this was what caused problems, because they don't want to turn over control to the patient. I understand at least some of this reasoning - someone will do something stupid and maybe even hurt themselves, so all patients have to be approached with lowest common denominator thinking. But there's something else too in all that, which is a lack of trust and maintenance of control. One doctor actually said to me, even though I'd explicitly told her what I wanted to do, that I might get tempted to lower the pressure. As though only a doctor could think that I might increase my apneas without being aware of it.

As I said initially, I agreed 1,000% with the philosophy expressed by SuperSleeper.

Thanks again, especially for the cflex/aflex explanations.
03-13-2013 10:03 PM
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