Breaking up OA clusters- PR System One Remstar Auto w/ Aflex

[coolbranch]

I noticed lately that machine not increasing pressure fast enough to open airway. The result seen on the graph is OA clustering, occurring close together. I see no unintentional leaks on graph. Is this typical with my machine? Pressure range set 10- 20.

[Terry]

I noticed lately that machine not increasing pressure fast enough to open airway. The result seen on the graph is OA clustering, occurring close together. I see no unintentional leaks on graph. Is this typical with my machine? Pressure range set 10- 20.

Mine did that too. The machine seems to be too conservative when raising pressure, and too aggressive in dropping it back down.

I was much happier after I raised my minimum pressure up to the level that simply prevented the OAs.

[coolbranch]

Thanks Terry. I have lowest pressure at 10 now. After further study, I now see where my last week average pressure was 10.69 and last 30 days was 10.84. I plan to bump to 11 on the low side tonight.

[Terry]

Thanks Terry. I have lowest pressure at 10 now. After further study, I now see where my last week average pressure was 10.69 and last 30 days was 10.84. I plan to bump to 11 on the low side tonight.

It will be interesting to see how that works out.

Terry

[coolbranch]

Last night I was hosed up for 7hrs 44min. Went 7 hrs without an event, then I had 5 OA's in a 4 min period of time. The Remstar Auto bumped pressure up one cm then bumped one more cm 2 min later. No unintentional leaks during the 4 min period. One desat to 89. I would determine bumping the low side pressure to 11 to be somewhat of a successful adjustment. The Remstar rocked on for 7 hrs with it's hunt and peck feature which I like. The machine is what it is when it comes to breaking up clusters. I may have rolled over on my back during that time. I am thinking about doing a video, with timestamp, on myself one night just to see how I sleep.

[coolbranch]

https://dl.dropboxusercontent.com/u/1067...essure.jpg

Since I moved the low side pressure from 10 to 11, the machine has been able to anticipate pressure needs and keep the airway open. AHI has been maintained around 1 or below.

The graph link indicates a pattern for the last couple of weeks.

Thanks Terry. I hope to have found the sweet spot.

[archangle]

The current APAP machines aren't intended to react that quickly to apneas.

You need to set the minimum pressure to be high enough to prevent most of your apneas. Yet another reason to have a fully data capable machine, and to review the results and make adjustments.

The tradeoffs are complex, and I don't think we understand all that goes into it. I believe that some of the modern machines adjust upward based on things like "flow limitations," snoring, and the shape of the airflow waveforms.

You might think the machines should react more quickly, but some people are disturbed by the pressure changes. There's also some concern about the machine "running away" to higher pressure with some people. Some of the side effects like aerophagia are helped by lower pressures.

The A10 AutoSet for Her has a "for her" mode that does a more "gentle" auto algorithm. I think the issue of adjustable auto sensitivity/speed is an interesting idea that should be explored.

[Terry]

https://dl.dropboxusercontent.com/u/1067...essure.jpg

Since I moved the low side pressure from 10 to 11, the machine has been able to anticipate pressure needs and keep the airway open. AHI has been maintained around 1 or below.

The graph link indicates a pattern for the last couple of weeks.

Thanks Terry. I hope to have found the sweet spot.

Congratulations! Try it where it is for a while.

Later, you may find that bumping it up another notch will keep you right around "0".

Terry

[coolbranch]

Roger that... I will.

[Evpraxia]

Thank You, THANK YOU for this thread!

I think this is the answer for my hubby's issues with HIS PR System One, his settings are at 12-18 and he has severe SA; OA and CNS. I will bet you he should be at a higher lower number, like 13 or 14 to 18.

You folks are SO great! Go pat yourselves on the back - each of you deserves it!