(11-25-2013, 12:21 PM)spc23 Wrote: sorry I meant pressure is rarely above 11, averaging around 10 with no large leaks indicated. From night to night the AHI varies from 5 up to 15. I do awake with uncomfortable pressue so I ramp it down to get back to sleep. This happens several times in 6 hours. I have been using CPAP for over a year.

Quote:I do not have software and from what I am reading my Philips Respironics Remstar Auto A flex machine does not work well with any free soft ware.

Quote:My DME provider has recently changed due to Medicare coverage and I haven't had good response in contacting them. I don't see the sleep dr. again until June. I understood that the auto setting should increase the pressure as needed but does it also decrease? Not feeling rested, ready to quit!

(11-25-2013, 12:21 PM)spc23 Wrote: sorry I meant pressure is rarely above 11, averaging around 10 with no large leaks indicated. From night to night the AHI varies from 5 up to 15. I do awake with uncomfortable pressue so I ramp it down to get back to sleep. This happens several times in 6 hours. I have been using CPAP for over a year.

(11-25-2013, 12:50 PM)robysue Wrote:

(11-25-2013, 12:21 PM)spc23 Wrote: sorry I meant pressure is rarely above 11, averaging around 10 with no large leaks indicated. From night to night the AHI varies from 5 up to 15. I do awake with uncomfortable pressue so I ramp it down to get back to sleep. This happens several times in 6 hours. I have been using CPAP for over a year.

So you're getting the data off the System One's LCD each morning?

Some questions:

Are you using an APAP range? If so, what's the minimum pressure setting? What's the maximum pressure setting? You'll need to get into the clinical menu to check these settings if you do not know them.

the range is 5-16,

You say you are using the ramp several times a night. That may explain the higher than desired AHI. What is your beginning ramp pressure set to? What is your ramp time set to? You should be able to find the beginning ramp pressure in the patient set up menu, but the ramp time setting will only be visible in the clinical menu.

ramp starts at 4 and it takes 45 min to increase. I assume that is 5 and keeps on going as is needed.

When you wake up "with uncomfortable pressure", what exactly is "uncomfortable" and how does hitting the ramp relieve the discomfort? Is the problem air in your stomach? Is the problem that it is hard to exhale against the pressure? Is the exhaust flow hitting your arms or chest or bouncing off the covers and hitting your eyes?

I just wake up, pressure is higher and I can hear it and the air seems cold now that it is winter. I had the auto humidifier set for 5 but when I check the plate it is cold. I have since taken off the auto mode for humidifier, which senses room temp, etc. Now when I awake, I can feel the humidity so I turn that down too. I use a Remzz liner to help with leaks but I think maybe what I am hearing is small leakage that wakes me up. When I ramp it down, it is quiet again and I can fall back asleep. I don't sense that the exhaust is hitting covers or pillow but that maybe the source of the noise. I am usually on my back as that is when I snore. When I awake, I ramp it down, turn on my side and go back to sleep only to repeat the process later in the night. If the ramp stays at 4-5 for 45 min, that may be why the pressure for 90% of the time is only 10-11. Could it be that when I wake it is up to 16 and that is why it is louder and uncomfortable? When I first got my machine it was set for 16 and I couldn't even get to sleep in the 45 min ramp time. Then it would almost blow my mask off. The sleep dr. told me to use the Remzz's and then the auto setting and I was at least able to get to sleep.

Quote:I do not have software and from what I am reading my Philips Respironics Remstar Auto A flex machine does not work well with any free soft ware.

SleepyHead should work just fine with your machine. If you use a Windows machine, you can just download SleepyHead 0.9.3 from sourceforge.

If you use a Mac, you will also need to download a patch if you are using a Series 60 System One machine. You can figure out which kind of System One you have by taking the water tank out of the humidifier and turning the whole thing upside down. The model number on the blower unit will have a three digit number in it. It will most likely be a 550 or a 560. If it's a 550, you don't need the patch; if it's a 560, you do need the patch. Should you need the patch, there is a link to it in the SleepyHead Software Download Link thread in the Private Files and Links area of the Apnea Board Forum pages that is accessible only to registered members. If you have trouble finding this link, PM me and I'll send you some detailed instructions on how to get there.

It is 560P, but my computer is 64 and software is 32. Can I still download? Then do I put the SD card into my computer?

Quote:My DME provider has recently changed due to Medicare coverage and I haven't had good response in contacting them. I don't see the sleep dr. again until June. I understood that the auto setting should increase the pressure as needed but does it also decrease? Not feeling rested, ready to quit!

First, yes, the pressure DOES decrease---if the decrease in pressure does not lead to a worsening in the shape of the inspiratory part of the wave flow. In other words, the machine is tracking a whole lot of variables that affect how your inhalations actually look on graph paper. And when it decreases the pressure, it checks the shape of inhalations as they show up on graph paper. And if it detects subtle changes that indicate the airway may be becoming less stable, the machine will not decrease the pressure any further than the current pressure setting.

Next, since you are having problems and you are not getting much response from your DME, it's time to start calling the sleep doc's office. Yes, you have an official follow up appointment, but it's not until next June. And that's not good enough since you're ready to quit NOW. So it's quite reasonable to call the doc's office NOW to let them know you're not doing well in terms of adjusting to CPAP therapy.

When you call the sleep doc's office you need to tell the receptionist that you are really struggling and that you've had no real luck in contacting the new DME. Tell the receptionist that you are frustrated to the point where you are seriously thinking about just giving up and quitting. And that at this point you NEED to have the doc or a nurse or a PA call you back and talk about the problems you are facing in your adjustment.

It will help if you can give the doc/nurse/PA some hint as to what your major issues are. Since you say you're waking up multiple times each night uncomfortable due to the pressure and you are repeatedly hitting the ramp button, start there. But try to tease apart what it is about the pressure that's bothering you to the point where you are waking up. Is it air in the stomach? Is it air blowing in your eyes? Is it simply that it becomes way to hard to exhale comfortably?

Once the doc/nurse/PA knows what kind of problem you're dealing with and how much this is affecting you and close you are to just quitting, they'll give you some suggestions on what to try AND they may just move that next follow up appointment up a whole lot closer to NOW rather than waiting for another 7-8 months before seeing you.

(11-25-2013, 04:27 PM)spc23 Wrote: ramp starts at 4 and it takes 45 min to increase. I assume that is 5 and keeps on going as is needed.