[CPAP] REMstar Auto A-Flex, Auto-CPAP or Auto-Trial?

[Beauchard]

The context. I live in the Netherlands, a different insurance system. CPAP and treatment is part of medical insurance, but it is made as cheap as possible. I have no sleep doctor that I can phone, just a hospital lung specialist that I see every few years. He knows little about machines and masks.
The machines are supplied by a health supplier whose representatives are not employed for their intelligence. So you have to be self-sufficient.
I have always used the same APAP for many years. The only real way to get a newer machine was to change to a different medical insurance company.
I changed my medical insurance and received the Respironics Remstar A-flex system one with the auto-trial and CPAP-check modes. I received the machine in the post. It was set to auto-CPAP.
After some time I started having problems. Leaks, waking up after a couple of hours and general problems. It seemed to be a pressure problem.
So I entered the setup and switched to the auto-trial mode. After a month this went into the CPAP-check mode that registers 10cm.
My questions: Am I now in an APAP mode? If not, should I switch back to auto-CPAP?

[OpalRose]

The auto trial is exactly what it says. It's a trial. I believe it would be similar to auto titration in a sleep lab.
It automatically put you back to straight CPAP mode at whatever pressure it thought to be effective, which was 10. You are still in CPAP mode. There is nothing wrong with staying on a straight pressure
if you are sure it is handling your apneas. But you can't know that unless you use software to track it.

What pressure range did you use prior to getting this new machine? If I had to base a pressure range based on the straight pressure of 10, then I would set it at 8 minimum and 13 max, then watch your numbers for a couple weeks. Do you know your AHI numbers?

The best thing you can do for yourself is to download the Sleepyhead software to track your numbers. At the top of this page, there also is a link to request the clinical manual for your machine.

[trish6hundred]

Hi Beauchard,
WELCOME! to the forum.!
Hang in there for more responses to your post and much success to you as you continue your CPAP therapy.

[Beauchard]

Thanks for the reply.
The machine registers my AHI. It is between 1.8 and 2.8 with the straight pressure of 10. Is it necessary to use an APAP mode when the AHI is this low?
I am having a problem with a dry cough that wakes me up. May have something to do with the humidifier or I may just have a cough.
I do not know the earlier range. I do know that I was gasping for breath in the beginning and would sometimes wake up with the feeling that a hurricane was blowing through my nose.
If APAP is necessary then the 8 min and 13 max does seem reasonable based on 10 straight pressure.

[OpalRose]

Thanks for the reply.
The machine registers my AHI. It is between 1.8 and 2.8 with the straight pressure of 10. Is it necessary to use an APAP mode when the AHI is this low?
I am having a problem with a dry cough that wakes me up. May have something to do with the humidifier or I may just have a cough.
I do not know the earlier range. I do know that I was gasping for breath in the beginning and would sometimes wake up with the feeling that a hurricane was blowing through my nose.
If APAP is necessary then the 8 min and 13 max does seem reasonable based on 10 straight pressure.

It's hard to say if you would do better on AUTO. If you feel the straight pressure of 10 is hard, then switch to AUTO CPAP for a couple weeks and see how you feel.

You can also set the EPR or AFLEX ( depending on your machine) to give a pressure relief when exhaling. You can set it to 1,2 or 3. I would try 2. This gives a reduction in pressure of 2. So when you exhale, the pressure would drop to 8, then go back to 10 on inhale. It is a comfort feature.

If your mouth is dry, be sure you are using the humidifier.

Request the clinical manual for your machine (top of page) and download the SleepyHead software. This will give you a much better idea as to how you are doing.

[Beauchard]

Thanks, I am now on auto 8 to 13 and my AHI is quite low. 90% pressure is between 10 and 11. I prefer the auto.
I have an appointment with an ENT over 3 weeks to have a look at my other problems

[OpalRose]

Sounds like you have a handle on it.
You should Download the Sleepyhead software, then if you have any issues, you can look at the charts to see what is happening.
Good luck.