Where are you located? And where did you get the REMstar M-Series machine? Is it used?
The reason I ask is this: The M-Series was discontinued some time around 2009 or 2010. They use a proprietary data card of some type and without the appropriate card reader, it will be impossible for you to get the full data off the machine that you need in order to "self-treat" your OSA with enough confidence that any changes you make to the clinical settings are helping
the situation rather than aggravating
The data card and the card reader needed to get the data off of an M-Series machine is still sold from vendor #1 on the apneaboard vendor list (http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List)
You will need a copy of Encore as well since SleepyHead is not compatible with the M-Series machines. If these seem like rather formidable hoops to jump through to get the data you need to properly self treat your OSA, you may want to see if you can pick up a used PR System One Auto (Series 50 or Series 60) machine or a Resmed S9 AutoSet. These machines all use standard SD cards to record the data and they are all compatible with SleepyHead.
To answer your specific questions:
Quote:I have the REMstar Auto (M series) A-Flex and I just got into the Clinician mode. Is there somewhere where I can find the meaning and purpose to the modes such as:
Ramp Start Pressure
Slit night time
C-flex setting: Off, 1, 2, or 3 sets the level of C-Flex. C-flex is an exhalation pressure relief system. When C-Flex is turned on, the machine slightly reduces the pressure at the beginning of the exhalation and then increases it back up to the therapeutic setting during the middle of the exhalation. The amount of relief varies from breath to breath and is based on how forceful the exhalation actually is. The higher the Flex setting, the more pressure relief is given. In the clinical menue, there are is also a setting called "Patient" that lets the patient control the C-Flex setting without getting into the clinical menu.
Ramp start pressure: If the minimum pressure is set to anything higher than 4cm, then the "ramp" can be turned on inside the Clinical menu. If "ramp" is enabled, the "Ramp start pressure" is the pressure that the machine uses when the Ramp button on the top of the blower unit is pushed. For example. If the minimum pressure in the Auto range is set to 6 cm and the minimum ramp pressure is set to 4cm, every time the Ramp start button is pressed, the machine lowers the pressure to 4 cm and ramps up to 6 cm during the preset ramp time. The ramp time must be set through the clinical menu.
Split night time: This is a little used "feature". In some situations a sleep doctor will want a patient to be on a fixed pressure during the second half of the night (presumably when the patient is fast asleep and least likely to wake up, but also most likely to be in extended REM cycles, which can be associated with more significant OSA in some patients). If a Split night time is enabled and selected, this sets the amount of time the machine runs in Auto mode before the machine switches over to a fixed CPAP mode with a fixed CPAP pressure setting.
Quote:Rather than pay a doctor and sleep study $1500 plus to tell me what I already know, what stops me from researching the heck out of this and letting my REMstar Auto give me what I need. Using the clinician manual to check any other settings I need to tune it in.
Am I missing something too big to ignore by avoiding the sleep study?Dont-know
Would love your insights,
Sleep jones-in & uninsured,
The fact that you're currently uninsured explains a lot about why you're wanting to start down the self-treatment route.
Going back to my first question: Where are you located? If you are in the US, is there any way that you will be able to get insurance coverage through Obamacare? If so, then it's well worth trying to tackle the sleep problems from both ends: Do what you can with the M-series and reading up on your own now, but also work your butt off figuring out how to get health insurance that will cover at least part of your costs
The reason why is this:
While plain old OSA is the most common version of sleep apnea and while most people with plain old OSA do reasonably with with CPAP/APAP, there are other sleep disorders that can "mimic" the symptoms of OSA. And one of those other sleep disorders---central sleep apnea (CSA)
often gets worse
when the patient is put on a plain old CPAP/APAP machine. A person with CSA usually needs a very fancy machine called an ASV machine. (But note, CSA is relatively rare.)
And then there's another potential problem: About 10-15% of OSA patients who start CPAP/APAP therapy develop
a problem with central apneas after
PAP therapy is initiated. If the problem with centrals does not resolve after several weeks or if it gets worse, these folks wind up with a diagnosis of complex sleep apnea (CompSA)
, and in the worst case scenario, a person with CompSA will need to be put on an ASV machine.
Hence it's important to realize that as you start self-treating your OSA, there's a small chance (10-20% overall) that the CPAP/APAP therapy may not be the most appropriate way to treat your sleep apnea problem. And if you're unlucky enough to be in that minority of apnea patients, then you really will need help from a professional sleep doctor and you will (eventually) need a real sleep test. But if you are not in the small minority of patients with CSA to begin with or the small minority of OSA patients who develop CompSA, then your plan to self-treat may very well work out without any significant problems or complications.