(09-19-2012, 05:57 PM)xeroid966 Wrote: REMstar is a never used but paid for unit originally prescribed to my late mother. The A-Flex drives me insane and actually wakes me up with all the pulses. I set it to CPAP mode as below but it still pulses.
There are three possible causes for the "pulses" you are feeling, and you've already eliminated two of them.
Possible causes of pulsing on a System One Auto PAP:
1) In Auto mode, the PR System One has a "Search" algorithm that tests whether or not the breathing improves with a bit more pressure. As the main part of this algorithm the machine periodically increases the pressure by about 2 cm in a 4 minute span testing to see if there are any improvements in the shape of the wave flow. If no improvements are found, the machine then lowers the pressure back down to its original level in about 2 minutes. I don't think this is what you were feeling when you were running in Auto mode because this increase in pressure does not usually feel like a "pulse." So I don't think this was the culprit when you were using the machine in Auto mode. And you've switched to CPAP mode, so this is definitely NOT what you are continuing to notice.
2) A-Flex or C-Flex. You said that A-Flex was driving you nuts. (The BiPAP version drives me nuts; but hubby likes A-Flex) Flex drops the pressure at the beginning of each inhalation and then it starts to increase the pressure back up in the second half of the exhalation, and finishes raising the pressure all the way back up once the inhalation is detected. Since the pressure is changing with each and every breath (and by a variable amount), this can be perceived as a "pulsating" sensation. But you say you've turned A-Flex off. You also said that you switched to CPAP mode. So it's worth making sure that C-Flex+ is indeed turned off. Still I'm pretty sure you really have turned all forms of Flex off. And if Flex is off, this is not what you are feeling.
3) Pressure Pulses (PP). The central apnea detection algorithm uses short bursts of pressure (i.e. PPs) to test the patency of the upper airway. These are very short lived "bursts" of extra pressure. The machine analyzes what happens to the back pressure and uses that information to decide whether an apnea is an obstructive apnea or a central apnea. The machine also uses PPs to try to figure out whether there's a live human being attached to the other end of the hose when its having a hard time detecting the breathing. This typically happens if the leaks are really high, but it can happen under other circumstances as well. My guess is that you're noticing the PPs. And unfortunately, the PPs can't be turned off---they're a critical part of the efficacy data scoring algorithm.
That said, if the problem is PPs, you shouldn't be feeling them on most breaths. And there is a way to figure out whether it's the PPs that are really causing problems: You could down load SleepyHead and import your data. PPs show up as little green boxes on the wave flow data in SleepyHead. If you see a whole bunch of them, then you have some additional evidence that it's the PPs that might be driving you batty.
Most people who notice the PP when they first start using a PR System One tend to become less sensitive to them with time. So you could try to give yourself a bit more time to adjust to them. Or, of course, you could go back to one of your older, but tried-and-true machines.
