Regarding settings on a replacement bipap??

[RosieB08]

Hello everyone,
I've been treated for moderate obstructive sleep apnea since January, 2010 and have been using a bipap since the beginning. I started using the AirCurve 10 VAuto BiLevel Machine with HumidAir Heated Humidifier back in July of 2015. This past weekend my machine died on me and after jumping through hoops all week, taking machine in to be looked at, contacting insurance (100 times), trying to sleep without a machine for 6 days, and finally paying full purchase price, (because insurance only replaces machine every 5 years), I got a new machine...exactly the same as I had. 

I purchased the machine online from a site that I have purchased supplies from before and they had my prescription on file. They stated when I ordered the machine that my settings would be put in prior to shipment. The only thing is that the settings are not the same as in my old machine that was set by my local provider. I received the clinical manual by email, but I'm not sure what settings should be changed. The recommendation from my last sleep study states "Recent testing in this facility demonstrated moderate obstructive sleep apnea with significant desaturations." and under "Recommendations the report has "BIFLEX (level III) at a pressure setting of 12/8." The prescription that my Family Physician gave the online provider states "BIPAP - PRESSURE 5/20."

How do I check to make sure I am using the correct settings? What's the difference between the 5/20 my family doctor has on prescription and the 12/8 from the sleep study doctor?
Any help would be greatly appreciated. My last study puts me at overall hyponea index of 28.4 per hour and I want to make sure I am getting the right treatment for this.

I've attached pics of the settings that are on the new machine.


[url=//imgur.com/a/rOMgy1h][/url]

[SarcasticDave94]

Hi RosieB08,

Welcome to the Apnea Board.

The 5/20 is nearly full open for your machine. Some doctors do that to get you to self titrate by way of viewing your results upon use then adjusting more specific settings later. The sleep study data is probably closer to what you need but I cannot be certain as I didn’t see your original settings.

Let some more knowledgeable members chime in on a starting point. We’ll be able to help better assist after you get Oscar report tool and post results.

[RosieB08]

Hi RosieB08,

Welcome to the Apnea Board.

The 5/20 is nearly full open for your machine. Some doctors do that to get you to self titrate by way of viewing your results upon use then adjusting more specific settings later. The sleep study data is probably closer to what you need but I cannot be certain as I didn’t see your original settings.

Let some more knowledgeable members chime in on a starting point. We’ll be able to help better assist after you get Oscar report tool and post results.

Thanks for the reply, Dave. My family doctor will not be viewing my results, this doctor took over for my regular family physician when he retired so he didn't even see me for this condition. I just called the office and asked for a prescription and was assuming he would read the sleep study and/or go by the setting that my original doctor gave. The settings on this new machine are nothing like the old one and I feel this is going to be a problem for me.

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Hi RosieB08,

Welcome to the Apnea Board.

The 5/20 is nearly full open for your machine. Some doctors do that to get you to self titrate by way of viewing your results upon use then adjusting more specific settings later. The sleep study data is probably closer to what you need but I cannot be certain as I didn’t see your original settings.

Let some more knowledgeable members chime in on a starting point. We’ll be able to help better assist after you get Oscar report tool and post results.

Thanks for the reply, Dave. My family doctor will not be viewing my results, this doctor took over for my regular family physician when he retired so he didn't even see me for this condition. I just called the office and asked for a prescription and was assuming he would read the sleep study and/or go by the setting that my original doctor gave. The settings on this new machine are nothing like the old one and I feel this is going to be a problem for me. 

Also I will not be installing Oscar as this is also my business computer as I work from home and the company I work for does not allow any software installed that is not approved by them first. The only thing I can use is MyAir on my iPhone.

[Dormeo]

Could you ask a friend if you could temporarily put the software on their machine and use it to upload charts to the forum? I suspect it’ll be hard for the experts to advise you without a chart or two.

[SarcasticDave94]

OK got it on the doc situation. Gurus on settings can help here. Post data when you're able.

[Gideon]

One minor change, set essentials to plus, the difference is more info.

Please try to find a computer that you can use for OSCAR. It is important to see data to provide you with good info.

As a minimum, we would need to know what the breakdown of your AHI is, OA, CA, H, FL, and RERAs

5/20 is intended to be an initial VAUTO mode setting with the default PS of 4, the 12/8 are intended to be in Mode S (manual) 8 EPAP and 12 IPAP which is PS 4.

I suspect that neither is optimized for you.

[RosieB08]

One minor change, set essentials to plus, the difference is more info.

Please try to find a computer that you can use for OSCAR.  It is important to see data to provide you with good info.

As a minimum, we would need to know what the breakdown of your AHI is, OA, CA, H, FL, and RERAs

5/20 is intended to be an initial VAUTO mode setting with the default PS of 4,  the 12/8 are intended to be in Mode S (manual) 8 EPAP and 12 IPAP which is PS 4.

I suspect that neither is optimized for you.

Thanks! So I used OSCAR but I'm not sure what data to put on the forums, I have 3 different session information, one for 2h 16m, one for 1h 45m, and one for 2h 27m. I'm assuming that is the times I slept between getting up and going to the bathroom, (can't be helped due to medical). I have clicked all three sessions for last night and attached a screenshot. Thanks for your help!

[Dormeo]

I’m glad you found a computer to use. Yes, the sessions are between the times the machine if off, and you’re right to turn them all on. Could you check whether you have CAs turned on in the lower left? And could you put the flow limitation chart in place of the mask pressure chart?

[RosieB08]

I’m glad you found a computer to use. Yes, the sessions are between the times the machine if off, and you’re right to turn them all on. Could you check whether you have CAs turned on in the lower left?  And could you put the flow limitation chart in place of the mask pressure chart?

Oh boy! Lol can you tell me how to do that or give me a link as to how I can do these things? Thanks!

Edit:
I see how to drag and drop the flow limitation chart but do not see the CA's in lower left.

[SarcasticDave94]

I’m glad you found a computer to use. Yes, the sessions are between the times the machine if off, and you’re right to turn them all on. Could you check whether you have CAs turned on in the lower left?  And could you put the flow limitation chart in place of the mask pressure chart?

Oh boy! Lol can you tell me how to do that or give me a link as to how I can do these things? Thanks!

Edit:
I see how to drag and drop the flow limitation chart but do not see the CA's in lower left.

Look at bonjours post above. At the bottom is a blue link to Organize Charts. That's a good place to start. Mine has a similar one but (at the time of this post) points to sleepyhead the last generation report tool. I'll update mine to point to OSCAR.

Edit: my OSCAR link is there now