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Respirionics System One Auto Flex Pressure Prpblem ??
#1

A little history

7 years ago I started therapy with a basic Resmed CPAP. It was set at 8. A few years later I tried an auto CPAP as a test for a week. The result was an average of 14. The results ended up on my Internist's desk and I couldn't get him to make a decision so I started setting the pressure. I couldn't handle the pressure od 14 but did work up to 13. In the last year as my old CPAP stared failing I was up to 15.

Now to my current problem. The new Respirionics is an auto CPAP set from 5 to 20. My experience has been that the pressure that I feel coming out of the mask vent is no where like I am use to. Believing that the auto feature was not working and it was just staying at the low setting I changed the setting of the machine so that it was supposed to auto start when I put the mask on but it didn't start.

I took it back to the provider and the technician reset the settings and I tried it in her office and it did start automatically. But as luck would have it, that night it didn't work for me. I checked the settings and they are correct.

I'm thinking I got a bum machine and am wondering if the pressure is ever changing. It is certainly nothing like it use to be, but maybe the past pressure was too high.

Your thoughts would be appreciated. Thanks
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#2
First, some people say pressure when they mean flow.

Your new machine is set to start at a pressure of 5 cm-H2O. In response to it sensing flow limitation, snoring or obstructive apnea, it raises pressure. The set limits permit it to raise a high as 20. So, you will not feel the 13 cm-H2O as in the past -- it will be 5 to start. During sleep it should rise to whatever level it finds "best" for your apnea.

Auto start sometimes doesn't work with a full face mask. There is a flap valve in the mask elbow that prevents asphyxiation in the event the machine quits. Find it, and hold you fingers over as much of it's large vent hole while inhaling. That should make it start.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
Hi gondolabob,
Since you worked up to where you could handle a pressure of 15, what you could try to do is to set your minimum pressure to 12 and your maximum pressure to 17. This will give you a tighter range for your machine to work between.
Hang in there for more suggestions.
trish6hundred
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#4
Have the same machine. Its going to start at the min pressure its set for. It wont raise unless it needs and youll be asleep when it does so you wont notice it unless the pressure wakes you up or you blow a leak. And it could be that its not having to raise the pressure that much to meet your needs.

Your profile says your not running software. To know exactly what is going on you really should download Encorebasic or sleepyhead.

As far a auto start Ive only had one mask on, a nasal where it actually worked without me having to put a hand over the vent and take a sharp breath. Thats not unusual. And it has nothing to do with the auto workings of the machine when your asleep.

I seriously doubt theres anything wrong with the machine but if by some odd chance there is Respironics has a excellent 2 yr warranty and you should be able to get it replaced by the DME easily.

But as I said I highly doubt theres anything wrong with the machine. Its just not venting or pressuring while your awake to notice it.

Personally I would do as trish suggested and up the min pressure to probably 8 as a base to start with. And enable Opti start in the clinical settings. That will let the machine calculate your best starting pressure over a thirty hour of use period. Then reset your min to the machines suggested pressure.
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#5
I was thinking that the auto start with the face mask would tell me whether the AUTO CPAP was working. Since the mask can interfere with that theory I'll play around with the mask tonight and also reset the minimum pressure and see what happens. I don't have a problem with turning the machine on manually but being use to continuous pressure has made me question the new machine. The relief from exhale flow is tremendous by itself.

Also I'll look into downloading software and let you know what happens tonight.

Thanks,
Bob
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#6
you can also just look at your info screen on the machine in the am. It will give you your 90 percent pressure which is the highest pressure the machine ran at OR below 90 percent of the night.

Also you can turn the exhalation relief off, choose Aflex setting of 1 2 or 3 with 3 being the most relief or you can change to Cflex which is a different mode of EPR with a different feel to it. And setting of 1 2 or 3 like Aflex.

There is a demo mode of both flex types and settings so you can try them out in real time while awake to see what you like best or no EPR at all if you dont want it on
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#7
You can also just look at the machine's screen while you're using it. It'll display the current pressure.

The auto-start feature has nothing to do with the pressure level being correct.

As others have pointed out, the machine is set to start at 5. That's pretty low, and that's your problem. Since you're used to a higher pressure set it at something like 10, so your range will be 10-20 instead of 5-20. All of this should have been explained to you by the providers who set and reset your machine. The fact that they didn't is a sign that they are lame. Unfortunately, that's the case with many medical equipment providers. There are some good ones out there, but you have to look to find them.

If we find that, after setting the range to 10-20, you are spending all of your time at a pressure of 10, we can lower the range slowly and allow you time to adjust to the lower pressure.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
If the other tricks don't work, take the mask off, put the end of the hose in your mouth and inhale and exhale a few times to see if the auto start works. That eliminates the mask as a factor in the autostart.

Sometimes you can start the machine despite the full face mask by deliberately inhaling and exhaling deeply or rapidly a few times.

Get the software, but even without the software, the PRS1 machines show the current pressure on the display if you can read the teeny, tiny text on the low contrast LCD display.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#9
More background.

My doubts about the machine were due to the fact that a few years ago I used a RESMED auto CPAP for a week for diagnostic purposes. As tight as I had the full face mask there were times that the air flow just about blew it off, not really but the air escaping the mask was tremendous. The result of this test set my average pressure to be 14. Going back to my old CPAP I had to start at a much lower pressure mainly due to the exhaling flow. I finally got up to the 14.

Consequently, when I first used the Responics System One Auto Flex and there was little flow and never an air leakage problem plus the auto on and off not working I thought I had a defective unit.

My provider, a retail store operated by the local hospital, equipped the Auto CPAP with a Sleepmapper SD card and a blue tooth communication device which communicates back to them. After 30 days they will contact me an I'm supposed to return it. In addition to their monitoring what happens it is also to confirm that I'm using the unit. Medicare and my supplemental insurance is paying the bulk of the cost. In addition I paid a $300 upcharge.

Because of this I have to be careful with the changes I make to the settings. I have raised the minimum pressure from 5 to 8 and feel that I can go up to 9 without upsetting my provider. The small increase to 8 has helped and last night on one of the occasions I got out of bed the unit did restart automatically so the mask must be causing the auto starting problems. But these problems aren't important as long as the machine is properly adjusting the pressure.

For some unknown reason I don't seem to need the flow that the earlier test showed.

The VIC 90 reading this morning was 952.1184.9172.1832. Tomorrow Ill check the machine's screen for readings.

Thanks, everyone for you helpful comments

Bob
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#10
If your on medicare the DME is not allowed to up charge you. You pay 20 percent of what medicare agrees to pay. NOT 20 percent of what the DME charges.

As to your machine, the VIC no tells you nothing. In the screen in the morning turn the knob after you stop therapy to info, press it, in that info screen turn the knob to scroll down until you see 1 day 90 percent pressure. That will be the pressure the machine ran AT or BELOW for 90 percent of the night.

That will tell you the machine is pressuring up during your sleep unless it has no need to raise pressure but at 5 cm im betting it raises at least some.
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