Post Reply 
Therapy numbers, lack of them, weight loss, etc
Author Message
Galactus Offline

Advisory Members

Posts: 1,384
Joined: Jan 2014

Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #51
RE: Therapy numbers, lack of them, weight loss, etc
Hi vsheline,

So you obviously know way more about this than I could get in a few days. And your help as well as others is appreciated immensely. You indicate the 760 is the better choice, that's fine by me. Will I be able to set that unit up or will I need my doctor? Will it require two specific pressures an inhale and exhale and then a setting pressure difference between them or will it do all the setup, calibration, and setting by itself automatically? I was under the impression cpap was set with 1 pressure, and apap set the pressure automatically (maybe I am mistaken). This bipap really has me confused. I don't want to buy it and then be unhappily unable to set it up properly.

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
08-19-2014 05:32 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #52
RE: Therapy numbers, lack of them, weight loss, etc
(08-19-2014 05:32 PM)Galactus Wrote:  Will it require two specific pressures an inhale and exhale and then a setting pressure difference between them or will it do all the setup, calibration, and setting by itself automatically? I was under the impression cpap was set with 1 pressure, and apap set the pressure automatically (maybe I am mistaken). This bipap really has me confused. I don't want to buy it and then be unhappily unable to set it up properly.

Hi Galactus,

You should request the clinician setup manual for the DS760 to see what adjustments there would be. It may seem complicated at first, because in addition to the basic pressure settings which I will discuss below there is also a Rise Time setting for how abrupt or how gradual the transitions will be when changing from EPAP to IPAP, but initially this can be left at the default value (or if you want to adjust, then 0 is fastest and larger is more gradual), so it's really just the pressure settings which you would need to focus on at first.

I was first set up with a ResMed S8 AutoSet five years ago, after using a fixed-pressure machine for a year. The Respiratory Technician left the pressure range at their default values (wide open, 4 as Min and 20 as Max) under the theory that the machine would adjust itself. That was dumb, because I had gotten used to using a CPAP pressure of 13 and couldn't stand such a low minimum pressure. I got him to raise the "Min Pressure" setting to 6 and then 8 and then 9 which finally was not uncomfortable. The "Max Pressure" setting he continued to leave at its default of 20. In retrospect, I think he would have been wiser if he would have initially set my Min Pressure to about 5 less than my previously-titrated pressure of 13, and if he would have set my Max Pressure only zero or 1 or 2 cm H2O higher than my previous fixed CPAP pressure, and then checked the data regularly to see what adjustments would make sense.

You have been using fixed Pressure of 18 but without any efficacy data. So, if I were you, I would initially set the settings the same and would gather some efficacy data with your present settings. After looking at your data for a week or longer you will be ready to start tweaking the settings from there.

If you now like to use the Ramp feature then I would suggest continuing to use Ramp with the same Start Pressure you do now.

If you now like using C-Flex then I would suggest continuing to use the same amount of Flex as you do now, except in BiPAP modes it is called Bi-Flex.

If using a PRS1 BiPAP Auto, the machine has a therapy mode called "CPAP" mode which will work exactly like your present machine except it will be recording data about leaks and about every breath you take, and apneas, hypopneas, etc).

After watching the data for a week or longer in fixed pressure mode, you could switch to AutoB (Auto BiPAP) mode and set the Settings as follows (and watch the data for a week or longer and then decide where to go from there):

Min EPAP: 13 (about 5 less than now)
Max EPAP: 18 (about the same as now)
Min Pressure Support: 1
Max Pressure Support: 4
Max IPAP (or perhaps called Max Pressure): 22 (set to the sum of Max EPAP plus Max Pressure Support, unless you start to experience problems from high pressure.)
Ramp: same as now
Bi-Flex: same as C-Flex now

The above settings would make the EPAP pressure start at 13, so the pressure whenever exhaling would be 13 until the machine automatically raises the EPAP pressure when it senses obstructions or partial obstructions.

The above settings would make the Pressure Support start at 1. The IPAP would start at IPAP = EPAP + PS = 14, so the pressure whenever inhaling would be 14 until the machine automatically raises the EPAP pressure when it senses obstructions. If PS remaines unchanged and EPAP is raised in response to obstructive events, then EPAP and IPAP would be raised and lowered together the same amount.

But also, ocasionally, the machine will do a slow dance to see whether to raise or lower PS, based on how this affects Flow Limitation. In brief, PS is occasionally raised a little (causing IPAP to be raised because IPAP = EPAP + PS) and if this causes Flow Limitation to be reduced then PS will stay at its new higher value for the next several minutes, until the next test to see if PS should be raised or lowered. Also, PS is occasionally lowered a little (causing IPAP to be lowered because IPAP = EPAP + PS) and if this does not cause Flow Limitation to start then PS will stay at its lower value for the next several minutes, until the next test to see if PS should be raised or lowered. But PS will always stay within the limits set by the Min PS and Max PS settings.

In this way the machine will raise the pressure only as much as needed to avoid obstructive events and any signs of Flow Limitation.

After watching the data for a week or longer you would see if there is something you would like to change, and watch the data again for a week or longer before making other changes.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 08-20-2014 11:31 AM by vsheline.)
08-20-2014 01:29 AM
Find all posts by this user Post Reply Quote this message in a reply
Galactus Offline

Advisory Members

Posts: 1,384
Joined: Jan 2014

Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #53
RE: Therapy numbers, lack of them, weight loss, etc
Thanks everyone for all your help and information. After much thought, and all the great advice I am going to look at the 760P. This is your last chance to talk me out of this!

And while you're reading this, I know to ask about the smoking the pets and to turn it on and check it and be sure it works. Are there any other questions I should ask? Is there a way or a need to see how many hours the unit has been used? Anything else that might matter? If there's anything else I need to know tell me now, because I am going with cash in hand prepared to buy so there will not be any turning back.

Just an afterthought you all seem to agree this is a top machine, so I'll just ask one final time if there is any better out there or is this the one for me?

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
09-01-2014 07:41 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #54
RE: Therapy numbers, lack of them, weight loss, etc
(09-01-2014 07:41 PM)Galactus Wrote:  Is there a way or a need to see how many hours the unit has been used?

I think the Clinician setup manual would explain how to check on total hrs used.

It would be bad if water has gotten into the machine and ruined the blower, or if water had been left in the water tank in the machine for months (of non-use) and mold had grown.

So disassemble and inspect carefully, and power up, and check hrs of use (more as a check on truthfulness of seller's claims than anything else), and check that machine runs reasonably quietly (nothing mechanically wrong with the machine). Notice whether the power supply is too small to run a heated hose.

You might want to bring your own humidifier and hose and mask to use when testing the new blower unit and new power supply.

Good hunting.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 09-01-2014 09:11 PM by vsheline.)
09-01-2014 09:09 PM
Find all posts by this user Post Reply Quote this message in a reply
Galactus Offline

Advisory Members

Posts: 1,384
Joined: Jan 2014

Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #55
RE: Therapy numbers, lack of them, weight loss, etc
Just wanted to say thanks for the help. I bought the 760P as you suggested. I set it up last night as a straight CPAP with 18 pressure set. This machine feels completely different than my old machine. The old machine felt as if the mask was under so much pressure it wanted to fly off. This one feels much gentler. Maybe it is my imagination. I have checked and rechecked the settings and it is at 18 and it's working and sounds very much the same, but for some reason it just feels different.

I guess now I have to get the software, figure out how to use it, and learn all the stuff I know nothing about at all. I'm on the road, I think.

Well that's funny I typed this post and never posted it, I must be losing my mind. In any event I got the software, downloaded the software, installed it, uploaded the card, and have the following chart to show for it. Anyone care to tell me what the heck I am looking at? I think I read somewhere if I am under 5 I am doing ok...... not that I have any clue what that means (still reading stuff)

[Image: 126cylk.jpg]

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
09-05-2014 07:21 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #56
RE: Therapy numbers, lack of them, weight loss, etc
3.2 AHI looks good Galactus, especially for your first night on the machine.

See what it does over the course of a few days. Odds are good the AHI will drop a little on its own as you get more comfortable with the machine and it learns a little about your idiosyncrasies.
09-05-2014 07:37 PM
Find all posts by this user Post Reply Quote this message in a reply
Galactus Offline

Advisory Members

Posts: 1,384
Joined: Jan 2014

Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #57
RE: Therapy numbers, lack of them, weight loss, etc
(09-05-2014 07:37 PM)retired_guy Wrote:  3.2 AHI looks good Galactus, especially for your first night on the machine.

See what it does over the course of a few days. Odds are good the AHI will drop a little on its own as you get more comfortable with the machine and it learns a little about your idiosyncrasies.

Thanks R_G

Idio... what's?? Hey hey now no name calling!!

Ok, so those numbers look ok then, good to know. Am I shooting for any specific numbers?

And what does that 3.2 actually mean? I know it is the added sum of the three below, but like is that in minutes, is it events per hour, what is it really?

And periodic breathing, what is that?

The leak rate I think I get, that's when the mask is leaking which it did for the first time ever last night, actually wore me up. And then that percentage is over the total time, so that seems to make sense but the rest I really don't get.

And honestly I swear this unit pumps differently. I mean 18 should be 18 on any unit no? This feels s=gentler than the other unit. There's a lot of stuff here I just don't understand.

And I think the plan I am using now is to run this for 7 days and then somehow switch to BiPap as Vsheline seemed to broadly outline.

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
(This post was last modified: 09-05-2014 08:29 PM by Galactus.)
09-05-2014 08:27 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #58
RE: Therapy numbers, lack of them, weight loss, etc
AHI is the number of events per hour. So, 3.2 events per hour. The gold standard is 5 or less. You will probably get to much less than the 3.2, but 3.2 is ok.

Periodic breathing. You take a breath periodically. It's a good thing. But wait! That's not it!! I believe it is a measure of how much time you actually spend in apnea events. So .2 percent is pretty low. But I don't have that stat on my machine so I'm not sure.

Can't help you with the difference in how the pump seems to do. I can believe they are different, but different can mean many things. So again, the measure is how you do and feel over the course of a few days.
09-05-2014 08:47 PM
Find all posts by this user Post Reply Quote this message in a reply
Galactus Offline

Advisory Members

Posts: 1,384
Joined: Jan 2014

Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: System One Heated Humidifier + Climate Line
CPAP Pressure: E/I 13/20 PS 4/7 BiFlex 3
CPAP Software: SleepyHead EncoreBasic

Other Comments: Sleep can be a good thing.

Sex: Male
Location: USA

Post: #59
RE: Therapy numbers, lack of them, weight loss, etc
Hmmmm I breathe periodically, I guess that sounds ok with me. I might prefer breathing often... but anything is better than nothing at all.

Yah I agree different is a broad spectrum. Guess I shall just wait and see how it goes.

Today looks better than yesterday based on what I have learned so far! Check it out, I feel empowered today, lol.

[Image: 11m9teq.jpg]

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
09-06-2014 11:36 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #60
RE: Therapy numbers, lack of them, weight loss, etc
Yes, that looks good. Keep it up. Nice to see you're still periodically breathing.
09-06-2014 11:45 AM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  Memory Loss Newbee2016 22 656 11-25-2016 02:15 PM
Last Post: kwhenrykerr
  Lack of progress and getting worse. Pudel 7 384 11-07-2016 02:37 PM
Last Post: Sleeprider
  numbers scottb908 2 220 10-30-2016 10:59 PM
Last Post: trish6hundred
  Is there an end to CPAP therapy? SamStamport 10 517 10-29-2016 08:46 AM
Last Post: robysue
  Insomnia getting worse 3 months into therapy baconjurer 3 502 10-05-2016 11:50 PM
Last Post: PoolQ
  Big variations in nightly AHI numbers JaneAM 22 1,069 09-30-2016 06:39 AM
Last Post: OpalRose
  Auto-Trial –delivers CPAP therapy adjusting pressure 30days ICEMAN 8 1,214 09-24-2016 12:34 PM
Last Post: green wings

Forum Jump:

Who's Online (Complete List)