Is my AutoPap working?

Hello Folks,

I've lurked for about 3 months here, thanks for all of the informative posts- To briefly sum up my experience: after trying to get used to a RemStar Cpap with Cflex machine set at a max pressure of 12, I experienced severe aerophagia for several weeks. After changing to a lower pressure of 9, the aerophagia disappeared, but I had terribly painful headaches and nausea in the a.m., with no theraputic benefits- I was still tired. Finally, my neurologists switched me to an Autopap (Remstar Auto M series) machine.

I have used the new machine for 6 nights; the first two nights were terrific, - my average pressure was 10.5 - and then I began losing benefits by the third day. Naps, sleep driving, the whole compliment. Strangely, when the tech printed out my results from the Smart Card, I received the most benefits the first 2 days - 10.5 avg. On the third day it fell to 9.0, and the fourth and fifth day fell to 7.00- it's almost a straight line. The tech said days four and five I must not have needed therapy at all! However, those were the days I received no therapy, and needed naps, etc. I certainly DID need it- I just wasn't getting it from the machine!

I did a little experiment last night, as I began to suspect the machine was not operating correctly- I turned it on, and tried to get the machine to bump up by holding the pillows closed. When I held the pillows closed for 3 minutes, the pressure changed from 7.0 to 8.0. When I clamped it closed for another 2 minutes it ramped up to 9.0. When I let the pressure on and off (clamping for thirty seconds, and releasing) it dropped back to 7.0. I woke up this morning with a big clanger of a headache, and my average again last night was 7.0.

My question (at long last!) is this: has anyone else had this problem NOT receiving enough pressure with an Auto? I'm so at loss here- the only thing I can think of is that during my initial titration study, I had more hypopneas than true apneas. So maybe a 'low' breather doesn't signal the machine to put out as much pressure? I just can't figure it out. Is it possible that folks with a similar machine could test out theirs in the same fashion - turn on the machine, clamp the pillows and time how long it takes for the machine to respond with a higher pressure?

BTW, I switched hoses, and checked the mask for leaks, and used a chinstrap, so as far as I could determine, there are no leaks...

Any thoughts?

What are the pressure settings (range) on your machine?

Den

Hi Ricebowl,

One possible explanation is that you sometimes mouth breathe. The machine would see that as a Large Leak, and then drop pressure to your minimum setting.

Any chance you woke up with dry mouth during the night?

Regards,
Bill

Well, I'll just repeat what was said before:

1) If you are not using a FF mask, your mouth may be dropping open when you go to sleep.

2) Your pressure range (min/max) covers too large of a span. Try 9-12.

..

Thanks for the replies - My range is set from 7.0 to 14.0. I don't believe I am mouth breathing, as I have no dryness in the morning. The tech mentioned that mouth breathing is usually noted during the sleep studies, and they didn't note that with me. Of course, that doesn't rule out the possibility! The thought of taping my mouth shut gives me the willies- has anyone had this "low" pressure problem and was it solved by taping?

RiceBowl wrote:Hello Folks,

I've lurked for about 3 months here, thanks for all of the informative posts- To briefly sum up my experience: after trying to get used to a RemStar Cpap with Cflex machine set at a max pressure of 12, I experienced severe aerophagia for several weeks. After changing to a lower pressure of 9, the aerophagia disappeared, but I had terribly painful headaches and nausea in the a.m., with no theraputic benefits- I was still tired. Finally, my neurologists switched me to an Autopap (Remstar Auto M series) machine.

I have used the new machine for 6 nights; the first two nights were terrific, - my average pressure was 10.5 - and then I began losing benefits by the third day. Naps, sleep driving, the whole compliment. Strangely, when the tech printed out my results from the Smart Card, I received the most benefits the first 2 days - 10.5 avg. On the third day it fell to 9.0, and the fourth and fifth day fell to 7.00- it's almost a straight line. The tech said days four and five I must not have needed therapy at all! However, those were the days I received no therapy, and needed naps, etc. I certainly DID need it- I just wasn't getting it from the machine!

I did a little experiment last night, as I began to suspect the machine was not operating correctly- I turned it on, and tried to get the machine to bump up by holding the pillows closed. When I held the pillows closed for 3 minutes, the pressure changed from 7.0 to 8.0. When I clamped it closed for another 2 minutes it ramped up to 9.0. When I let the pressure on and off (clamping for thirty seconds, and releasing) it dropped back to 7.0. I woke up this morning with a big clanger of a headache, and my average again last night was 7.0.

My question (at long last!) is this: has anyone else had this problem NOT receiving enough pressure with an Auto? I'm so at loss here- the only thing I can think of is that during my initial titration study, I had more hypopneas than true apneas. So maybe a 'low' breather doesn't signal the machine to put out as much pressure? I just can't figure it out. Is it possible that folks with a similar machine could test out theirs in the same fashion - turn on the machine, clamp the pillows and time how long it takes for the machine to respond with a higher pressure?

BTW, I switched hoses, and checked the mask for leaks, and used a chinstrap, so as far as I could determine, there are no leaks...

Any thoughts?

Go through your programming making sure it is set to below:
Enter Setup:
1. Hold down the <- -> buttons while plugging in the power
on the back, wait 2 beeps, release buttons.
2. Press the + key. <- -> buttons move to next field, -/+ keys decrement/increment
3. Check the following field(s):

Settings:
-Therapy Mode=Auto (CPAP/Auto)

-Auto:Max=12 (default=20.0cm)

-Auto:Min=6.5 (default=4.0cm)

-CFlex Setting=2 (options are off, 1, 2 or 3)

-AutoRamp Time=30 (options are 05 to 45 min)

-AutoRamp Pressure=6.0cm (4cm->AutoMin)

-Mask Alert Feature=ON (On/Off)

-Auto Off Feature=Off (On/off)

-Split Night Time = Off (off, 120, 180, 240)

-Show AHI/Leak Feature=ON (On/Off)

Press On/Off button to exit.

I would try the above, if the machine continues to run eratically, I would take it back as it may be defective.

The 12cm maximum pressure should cover your ideal 10.5cm pressure but not let it run wildly should your SDB pattern kick it off.

Make sure the machine is seated properly on the humidifier platform (lifting up on the front of the machine will remove it from the humidifier platform).

I'm not sure what you're defining as 'average pressure', but if you found that your best results were when you used the APAP with average pressure around 10.5, why don't you switch your macine to CPAP mode of 10.5 and try if for a night or two? That way you could rule out the possibility of the machine not responding to you properly when you're in APAP mode.

Just a suggestion.

SnoreNoMOre2005

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, APAP

Thanks to NightHawkeye, oldgearhead, Snoredog and SnoreNoMore; all of your suggestions were great, and I used them all. Special thanks to
Snoredog; I didn't know one could break into the apap settings mode until you showed me how. This, along with finding out I was a mouth breather (who knew?) has moved me into actually receiving some therapy. Just a quick wrap up for anyone else out there who may find this helpful:

After messing with my Autopap settings, I settled into a minimum pressure of 10 and a max of 14. I now average 11.2 of pressure each night; no more aerophagia with this new apap machine, and with my minimum set at 10 (instead of 7) I am getting some quality sleep. My AHI is now (drum roll please) 1.9!

This was not possible, however, until I began taping my mouth shut and even taping around the nose pillows because of air leaks. I suspect I was not receiving benefits early on (as you all indicated to me) because I was mouth breathing and there was alot of leakage from the pillows, although for some reason, it was difficult for me to acknowledge that I was a mouth-breather. One would think that after all this baloney, one more thing (taping it all shut!) wouldn't be another indignity but just another hurdle. It was another indignity, however, but I did get past it. It is taking some time for me to get used to all of this, but the trade-off is palpable, so I'm reluctantly moving forward..

I have an appointment next week to get fitted for yet ANOTHER mask; I'm going for a face mask style, as the Opti-Life I have now is hurting my ears, not to mention that perhaps I won't have to tape with a new type of mask. Onward and onward.