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PR Pressure Hunt and Peck
#1
Exclaimation 
I have a PR System One RemStar Auto with A-Flex (560PBT) with APAP (Variable) and Min 7 Max 10 (cmH2O) (Sleepyhead tells me). The Sleep tech (Resmed) was surprised by the pressure profile which shows pressure "hunting and pecking" from my machine - that he is not used to seeing on the resmed machines. Is my pressure profile "normal" for a PR machine? The PR seems to go searching for a higher pressure when there are no events and even the pressure is declining whilst it detects events.


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#2
The Respironics PRS1 Auto is programmed to evaluate pressure increases of 2 cmH2O at regular intervals. If it does not find an improvement, it drops the pressure back to minimum or until it detects flow limitation or snores. Your chart is absolutely typical for that machine, even in CPAP mode. The higher pressure at about 01:45 was due to flow limitations. Overall, it looks like you're dialed in pretty well.
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#3
Good info--my PR560 does the same thing and I did read something about the pulse, but couldn't find it when I had questions. Thanks for the question and the answer!
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#4
Thanks for the info Sleeprider. At least my Sleeptech will sleep well knowing this. As for me ....

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#5
I'm happy my machine is taking care of me! I'm running higher pressures than you are and have never been bothered by the pulses---on bad night sometimes as many as 15 or more.
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#6
SideSleeper, that is how I look at it too. The APAP is doing its job and is constantly searching and ready. I personally don't notice these pressure changes, doesn't seem to wake me up.
If you look at the pressure graph in sleepyhead, it moves up and down 1.5cm.
OpalRose
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#7
Dear OpalRose / Sidesleeper - my Sleeptech thinks that it is the pressure fluctuations that is affecting me - maybe more noticeable at I am at a lower pressure. I will be trying 7 - 7.5 (lo-hi) tonight and see how that goes.

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#8
My PR 560 also does this. I asked about it elsewhere and was told this is normal for the PR machines. Some describe this as the machine poking you with more pressure. Since not all machines work this way, it is interesting to speculate if this poking is better than non-poking. I have seen events in my data where the machine does nothing while at other times it will do one of these pulses where there was no event. Hopefully the folks that designed it know what they are doing but I have not figured out yet what causes the PR 560 to increase pressure "for cause"
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#9
The pressure fluctuations are built into the algorithm for this machine. For most people it is not disruptive. It can improve therapy in people who do not have the usual flow limitations or snores preceding events, as the machine "tests" a higher pressure, then returns if volume improvements are not recorded. Again, the pressure changes occur over several minutes, and are very gradual. It is not a pulse.

Resmed Autoset machines do not exhibit this fluctuation, but change pressures faster.
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