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Switching machines
#1
Switching machines
My husband has been using a RemStar Auto with A-Flex (560P) for quite awhile now, and it decided to die on him. We were able to get our hands on a Remstar Pro C-Flex+ model 460P from a friend for free to use until we can get something better. The only problem is, the doctor who ordered the previous sleep study is no longer around and his current primary care would require a new sleep study and prescription to get a new machine. We don't have time for that right now as he is a truck driver and he has to be able to show 70% compliance over the 90 days before his DOT physical at the end of the year. So, we need to have something right now and can't wait for all the rigamarole to get a new machine.

Anyway, I use Encore Basic software to download the data from his machine. I can print the summary page and all the doctor looks at is the compliance information. I have that capability with the "new" machine also.

On the machine that died, we had his pressure set at 8-15 and the summary shows Auto CPAP Mean Pressure of 8.6, Peak Average Pressure of 12.7, Average Device Pressure <=90% of Time as 9.7. I need to now what pressure to set the "new" machine to start with. I know this is a C-Flex machine so it's a fixed pressure. Should I start at the peak average of 12.7 or the average pressure <=90% of time at 9.7? I know it's going to be trial and error for awhile to get it right for him but it would help to have an idea where to start. Any  help would be appreciated.

(On a side note, my husband did get Covid-19 and spent 2 weeks in the hospital. He came very close to being put on a ventilator but turned the corner just in time. When he came home, he was on oxygen therapy and couldn't use his CPAP. He stopped the oxygen after only a few days even though his O2 stats were still in the low to mid 80's. He went back to using his CPAP and he credits that with getting his O2 levels back to normal. It's been a little over two months since his diagnosis, and he's been back to work for over 4 weeks now. His O2 levels are back in the 95-98 range where they belong!  Smile
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#2
RE: Switching machines
That's such great news that 1) you were able to obtain a machine to use to get him by, 2) he recovered so well, and 3) he's got such a caring spouse.

I'm not the best person to ask about settings. But if I were in your situation, I'd set it to the 90% of the time pressure (9.7). I'm sure others will reply soon with better advice. But while you wait, I think 9.7 is a great pressure to go with for now.
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#3
RE: Switching machines
Thanks Hydrangea. That was what I was thinking also, but I wasn't sure.
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#4
RE: Switching machines
To get  a new machine try Supplier #2 from the supplier list at the top of the site.  They sell new and slightly used machines.  I purchased mine used with 1 months worth of use for less than 1/2 of the price of the discounted new machine.  They are are very good company, many people here have  got their machines there.   They do have a warranty.

You do not need a prescription (at least I did not)
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#5
RE: Switching machines
Jolycu, of course a new sleep study is not needed to obtain a new machine. The diagnosis will not have changed, and an Auto CPAP will provide effective therapy as suggested by how your husband feels after resuming CPAP. My suggestion is to obtain copies of prior tests and prescriptions, and in the meantime appeal to your primary care doctor that a replacement auto CPAP is needed. Another source may be your supplier (DME) that may have the previous prescription records. You should be able to request those records from them, and they will be sufficient to get a replacement machine.

I strongly urge you to consider a Resmed Airsense 10 Autoset (Auto CPAP) which we have observed to provide better, more comfortable therapy than the Philips Auto CPAP. This is due to a much more responsive auto algorithm and the fact its "Exhale Pressure Relief" (EPR) is actually the same as bilevel therapy, with up to 3-cm difference between inhale and exhale pressure. Supplier #2 currently has these machines at a very good price ($539) and they are pretty lenient with prescriptions requirements for users already using CPAP. If you plan to use insurance, your delay in sourcing a machine will be longer due to all the approvals and requirements they impose.
Sleeprider
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#6
RE: Switching machines
I agree you need to look for an updated machine, but in the meantime....

If you were getting good results with the 560, at the 90% reading of 9.7, then set the fixed pressure machine at 10cm. You can adjust up or down in small increments by .5 after seeing results.

Were you using A Flex on the 560? You can try CFlex of 1 or 2 on the 460.

Good luck, but one word of caution, you should change out the filter and hose on this used machine. Also be sure the humidifier chamber is clean.
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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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#7
RE: Switching machines
Thanks everyone. OpalRose: yes, he was using A Flex on the 560. We'll try the 1 or 2 on the C Flex as you suggest. And I have already put new filters and a new hose on the machine and have thoroughly cleaned it.
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#8
RE: Switching machines
Ok, let us know if you have any questions.
OpalRose
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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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