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Question about: PR-System-One-60-Series-Remstar-Auto-A-Flex
#1
I'm helping a friend who has a brand new PR-System-One-60-Series-REMstar-Auto-A-Flex. Her Doc's prescription is for straight CPAP at 11, so we pretty much have to stay there until her "compliance" thingy is done. I'm a Resmed guy, so this machine is new to me.

But I do think we're going to have to increase her pressure a little bit because 11 isn't quite doing the thing, so "compliance" or not, we'll probably do that.

In reviewing the manual for this thing, I see a feature called "Split Session," or some such thing. What it does is start the night CPAP at a specific pressure, then sometime during the night switch to APAP at a range of pressure.

That sounds intriguingly interesting to me. So my question is: Is anyone using this feature? What do you think about it?

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#2
Nobody seems to use split night much. I think it's mainly intended for some sort of minimal sleep test type of function.

Do you have the provider manual? Split night IS a CPAP then APAP mode.

To insurance, "compliance" usually seems to be 4 hours a night, and they don't care about pressure. The chances of the doctor or DME actually looking at the data enough to notice the change is small, but it is possible. Most of them seem to only bother checking to see if you're getting your 4 hours so they can ring the cash resgister.

You might want to leave it alone in order to give the doctor a chance to do his job right.
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#3
Thanks Archangle. I would prefer to leave the pressure alone, but her ahi for the last 3 nights is averaging about 14. Her doctor doesn't want to see her for 90 days. Right now I'm just waiting to make sure the CA's go away, then I think we'll increase the pressure a little.
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#4
Well since it isn't broke I have a suggestion to break it..... You could use the split session so that she is "in compliance" at the listed pressure for the four hours, and then go to apap at the higher pressure after she has complied, so she can get real results Big Grin
If everyone thinks alike, then someone isn't thinking.
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#5
I just looked at the clinician manual that came with mine. Its the same machine. You could skip auto trial mode and directly enable cpap check mode with the drs preset pressure intact.

In that mode the machine will only increase or decrease the pressure one CmH20 every thirty hours based on events. It will only increase or decrease the pressure a max of 3 CMH20. In her case it would probably up the pressure over 90 hrs to what she needs or a max of 3 CMh20. You could then set the pressure at what the machine chose based on what its recorded and go back to straight cpap mode since you seem stuck to stay in cpap mode for now. If Cflex is turned on during the cpap check itll set pressure using that and carry that setting over if you reset the pressure unless you change it manually.

Otherwise you could enable opti start in auto mode which would calculate the best starting auto pressure every thirty hours until you disabled it.

Just a thought but the first few days I used my machine my AHI was considerably higher then dropped overnight to the .5 to 3 ahi i run now. She may just need a bit of time to get used to the machine. Also it is running cflex? Takes a bit of time to get used to Aflex or Cflex or it did for me at least
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#6
Thanks guys... I'm going to just watch her for a couple more days... Last night her ahi was still high, but virtually all Hypop vs: the CA and OA's she's been experiencing. So I'm going to see if she can't stabilize a little before we do anything. Also I found out she's sleeping mostly, if not always, on her back. So that will need to be changed for now.
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#7
We're here for you if you need more help, of course Smile

Sometimes watching and waiting is very helpful indeed.
If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
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