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Had a trial, then was given a free machine
#1
Hi Everyone!

I am a 45 yo Male from Vancouver, Canada. I have likely had sleep apnea for years, but it was untreated until recently.

A relative gave me a machine with 40 hours of use on it (for free). It is not set to my needs, so I changed the cmH2O to 6.5. I'm finding I'm not waking up refreshed like I did while on the trial, but I am having troubles figuring out how to get the settings correct for me.

The machine I have is a PR REMstar Pro C-Flex+

Info from my trial:

Avg Usage/Day = 3 hrs (2 babies at home)
Avg CPAP pressure = 5.7
Avg 90% pressure = 6.5
Avg % of night in CHene-Stokes Respiration = .1%
Avg Clear Airway Apnea Index = .6
Avg Obstructed Airway Apnea Index = .5
Avg Hypopnea Index = 2.0
Avg RERA Index = .4
Avg AHI = 3.1
Avg Flow Limitation Index = .2
Avg Vibratory Snore Index = 3.7
Pressure level to maintain airway patency = 6.5cmH20

Device settings:

Min Pressure: 5.5cmH2O
Max Pressure: 7.0cmH2O
A-Flex setting = 2
A-Flex lock = off
Auto Off = on
Auto On = on
View Optional Screens = on
Ramp = on
Ramp Time = 5 min
Ramp Start Pressure = 4cmH2O
Mask Alert = off
Mask Resistance = 4
Mask Resistance Lock = off
Tubing Type = 15
Tubing Type Lock = off
Opti-Start = off
Mask Reminder Period = off
Change Humidifier Settings = yes
Humidification Mode = heated tube
Tube Temperature = 4
Humidity Level = 3
Humidification Mode on Heated Tube Disconnect = System One
Humidifier Setting on Heated Tube Disconnect = 4

I can mimic these settings in the Clinician Setup Menu, however which ones should I be looking to change to maximize the benefits? By how much should I alter the settings while trying to maximize the benefits?

Any help offered is much appreciated.

Thanks so much in advance!

Doug




























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#2
Hi Doug, welcome. First thing: What is your AHI on the machine now? Can you get SleepyHead up and running so we can see what's going on, what your AHI is, and what types of events make up that AHI? Also need to see from your data if leaks are a problem. We can see that in SleepyHead too.

The PR REMstar Pro C-Flex + machine should have the data I'm asking about.

It's not at all unusual that some of the settings (including pressures) may need adjusting once therapy gets underway. That's why it's good to monitor with software in the beginning. You may need a little more pressure but we don't recommend changing anything without knowing more about what's actually going on.

It can take some time to adjust to CPAP and be able to sleep well with it, even when the trial period went well. Maybe your symptoms just mean that you're not adjusted/recovered yet, or maybe your machine needs some adjustments. We'll be able to help you more when we can see your treatment data.
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#3
Hi kaiasgram,

My current AHI is 1.7 over the last week, and 1.6 over 30 days.

The machine doesn't bother me, at least since the second night.

I'll check out SleepyHead and get back to you all!

Thanks,
Doug



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#4
(10-19-2015, 02:42 AM)DougieW Wrote: Hi kaiasgram,

My current AHI is 1.7 over the last week, and 1.6 over 30 days.

The machine doesn't bother me, at least since the second night.

I'll check out SleepyHead and get back to you all!

Thanks,
Doug

Those are good numbers.Smile

SleepyHead may shed some light on other issues like leaks. Also, flow limitations and snores can affect sleep quality and are not reflected in the AHI, but we can look at those in SleepyHead.

The way you're feeling may also be a matter of time and adjusting to CPAP. Keep us posted and let us know if you need help getting SH going.
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#5
You need to look at data - but - comfort can also make a difference. Have you tried changing the A-flex number up or down 1 number. Will not change the pressure needed for the airway opening, but can change the exhale pressure level and your comfort level, and thus sleep refreshment.
As to pressure - without data, hard to say. Might try putting the max level up to 7.5 and see if that makes any difference.
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#6
Hi DougieW,
The one thing I see that you can change now is your mask resistance setting. If you are using a full face mask, the setting should be X1.

Your profile says Remstar Pro...this would be a straight CPAP, not Auto. Double check your machine type. If it is an auto machine, then based on your titrated study, I would set your minimum to start at 7 and max at 10. If you machine is a straight CPAP, and you are not feeling rested at a pressure of 6.5, make small changes and turn it up to 7.

I would also turn the ramp feature off. With your low starting pressure, it won't be of any help.

The Auto On and Off is annoying. Doesn't always work properly, depending on mask. It's a personal preference.

We really don't like to make recommendations without seeing some data, so try to get Sleepyhead up and running and check back with us.

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#7
I have my machine set to 8cm and use ramp, finding it very helpful. Do you think that the ramp is causing a problem? Do you think it could be helping you deal with that first pressure hit when you first turn the system on?

Ramp is more of a personal setting and IMHO has allowed me to tolerate using CPAP.
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#8
Hi DougieW,
WELCOME! to the forum.!
CPAP therapy can take some time to get used to but just stick with it, it does get better over time.
Much success to you with your CPAP therapy and getting it optimized for your needs.
trish6hundred
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#9
Update:

I removed the SD card from my machine, and my Tech Goddess inserted it into her card reader, but the card reader wouldn't read that specific SD card. It would read a different, unrelated card however. I'm kind of stuck here...HELP!

Douggie

PS. How do I check that my machine is actually data capable?



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#10
(10-20-2015, 11:42 PM)DougieW Wrote: Update:

I removed the SD card from my machine, and my Tech Goddess inserted it into her card reader, but the card reader wouldn't read that specific SD card. It would read a different, unrelated card however. I'm kind of stuck here...HELP!

Douggie

PS. How do I check that my machine is actually data capable?

Your machine (the 460) is a data capable machine. If it was not data capable you would not be seeing your AHI. You can double check the number on the side or bottom of your machine to make sure it's the 460 (PR System One REMstar Pro CPAP Machine with C-Flex Plus).

Did your Tech Goddess have SleepyHead installed? You need SH to read the data on the card. What kind of error message did she get when she inserted your card? I'm not a tech goddess but others may have some ideas about what the issue might be.
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