My machine is telling porkies

[DeeNJai]

My machine is telling porkies

[QUOTE=Alleycat;22164]I take it you have a respironics? Which model is it? If it is the new 60series then you can set a minimum and maximum pressure support.

If you have zero pressure support it will effectively be an apap rather than bi-level. Do you notice the difference or is it just what you have seen on your download? The pressure is set between 4 - 20cmh2O System One RemStar Auto with A-Flex (561P). I feel a lot better the day that it been on Bi-Level as I am more awake and not so sleepy in the afternoon. The AHI is mostly lower than when on APAP also the pressure, RERA and my snoring is down to under 10 and Vibrarory snores down 0 most of the time. So I think that I do better on Bi-Level.

Does it look the same on the clinic download?

They download the data in another room and never say anything other than what the leak level is. Next time I see them I will ask them to show me what is going on with the machine and what is happening with my sleep apnoea.

If it continues I would ask your clinic to swap out your machine. It sounds like a potential software fault (which the 50 series have had a lot of).[it is a System One RemStar Auto with A-Flex (561P) I dont know if it is a (561P). here is the serial number P06783059A4C1 Is this a 50 series or another model

I will ask them to swop the machine over and also when I go to the clinic I will take my friend with me so if I get stuck then she will prompt me in what I want to say as I struggle when I am with professional people because of the way I was treated as a child and young adult. It took me over 8 years to be able to talk to my Urologist frankly. I cant let this be the same as this is such much more serious than my bladder one. /QUOTE]
Dee

[Sleep2Snore]

Always good to take someone with you but put pen to paper. This way you will not miss anything. Nothing worse when you have just left and remember something else.
Even if your friend has the notes and prompts you.
Best just to hand a letter to the specialist, but have a copy so if he skips over any question you can pick up on it.

[DeeNJai]

My machine is telling lies

Hi
I also write out questions that I want to ask even when I am going to see my GP as then I know what I am going to talk about and I always print of a copy for him. My friend Pat always telling to do this so that you know what you want. I will start planning what I want to ask at the Sleep Clinic to the Technician and ask for a new machine and also say I feel more awake during the day if I am using Bi-Level whereas I am normally quite sleepy the rest of the time.

I have noticed since October I am starting to feel very tired again and struggle to stay awake some of the days. I am getting only a couple days where I am fine if I don't have to have a nap but if I try not to take the nap during the day it catches up with me within four or five days I end up crashing where I end up sleeping for days and days.
Dee

[DeeNJai]

my machine is telling porkies

Again the machine changed it mode on New Years Eve and I had a great night sleep. The mode was on Bi-Level. I didn't have a nap yesterday because I wasn't tired in the afternoon. i was more sleepy in the evening but I am always tired in the evening. Last night it was back on APAP and by 1130 today I was feeling quite tired and I ended up with a three hour nap which isn't good. I will look again on Sunday to see what is going on. I am marking the days where it is on Bi-Level so I can see what is going on.

I keep a daily diary which is divided into four sections so that i can monitor what is going on. I am also making down the quality of my sleep, pain levels and fatigue. Hopefully it will help with explaining to the Sleep Unit that there is a problem with the machine.
Dee

[Sleep2Snore]

Hopefully what you tell them will also be confirmed by the card in the machine. Looks as though you may have a lot of central apnoeas going on, that is why you will be feeling better on bipap. It may be wise for them tom test this in hospital and if this is the case have a machine set up for you on the correct pressures.

[DeeNJai]

My machine is telling porkies

Hi
I have just read on Respironnic site say this about the system one machine:

"Our advanced System One sleep therapy system has been carefully developed to know when, why and how to provide you with just the right therapy and continuous comfort to help you enjoy restful sleep and more productive days.

Through advancements in software algorithms, humidification management, and the marriage of proven technologies, System One thinks for itself, carefully monitoring and recognising when your therapy needs are changing. It knows how to maximise your comfort and provides your clinician with the essential information they need to manage your CPAP/BiPAP therapy."

Not sure if this is why my machine keeps changing from APAP to Bi-Level.
Dee

[Sleep2Snore]

I would not think it should change modes by itself.
Pressure yes, but not modes.

[Alleycat]

The mode should not change itself. The 561 is the 60 series APAP the Bi-level is the 761. So if you have an APAP it can't be working as a bi-level. I'm still not clear how you know it has changed modes? I think the details that you read on the website are from some of the features on the newer 60 series like optistart, which if turned on monitors you for a few days and if you immediately start having apnoeas when you fall asleep it will increase your starting pressure to try to eliminate these. There are also a few other self adapting modes when it is set in fixed pressure mode -that will increase or decrease the fixed pressure by +/- 3 cmH2O depending on the airway events (seems to me a redundant mode in a APAP).
If you have a bi-level device you either need more support with your breathing (if you have hypoventilation underbreathing such as caused by obesity, lung disease , a curved spine or neuromuscular problem). Sometimes bi-level can also help with mild central apnoeas but usually this will require a different machine called adaptive servo ventilation.

I would go back to your clinic, explain the problems you are having and ask to see your download so you can compare the results with your diary.

[DeeNJai]

My machine is telling porkies

here is the stats from Sleepihead:
First Last Days AHI FL Machine Mode Pr. Rel. EPAP IPAP PS
04/01/2014 04/01/2014 1 3.57 1.41 PRS1 Auto None 4.50 20.00
03/01/2014 03/01/2014 1 5.90 0.58 PRS1 Bi-Level None 4.50 20.00 15.50
01/01/2014 02/01/2014 2 5.39 0.92 PRS1 Auto None 4.50 20.00
31/12/2013 31/12/2013 1 3.56 1.04 PRS1 Bi-Level None 4.50 20.00 15.50
24/12/2013 30/12/2013 7 4.67 1.06 PRS1 Auto None 4.50 20.00
23/12/2013 23/12/2013 1 5.30 0.85 PRS1 Bi-Level None 4.50 20.00 15.50
21/12/2013 22/12/2013 2 7.04 0.85 PRS1 Auto None 4.50 20.00
20/12/2013 20/12/2013 1 5.91 0.66 PRS1 Bi-Level None 4.50 20.00 15.50

Dee

[Alleycat]

This doesn't really make too much sense. If it is an APAP then you can only have EPAP not IPAP. If it is a bilevel the maximum ps is 8. The 15.5 seems to be a calculated difference between the 4.5 (probably the minimum EPAP) and 20. The PR1 biflex has a maximum IPAP of 25 and maximum EPAP of 17 to 25 depending on the PS (if PS is zero IPAP =EPAP). The APAP has a maz pressure of 20. Does your device say Aflex or Biflex on it? (I mean physically written on the box below the screen.)?
I have never used sleepihead so have no idea how it works.

[DeeNJai]

My machine is telling porkies

Hi
It says REMStar System One APAP with A-Flex. I am going to ring my unit today and ask for an appointment because of this problem. Also I am struggling again with feeling tired all the time and my depression has increased which I am not happy about as it was getting better. I know that I have SAD but that normally doesnt get this worse. I will let you know how I get on getting an appointment.
Dee

[Sleep2Snore]

This doesn't really make too much sense. If it is an APAP then you can only have EPAP not IPAP. If it is a bilevel the maximum ps is 8. The 15.5 seems to be a calculated difference between the 4.5 (probably the minimum EPAP) and 20. The PR1 biflex has a maximum IPAP of 25 and maximum EPAP of 17 to 25 depending on the PS (if PS is zero IPAP =EPAP). The APAP has a maz pressure of 20. Does your device say Aflex or Biflex on it? (I mean physically written on the box below the screen.)?
I have never used sleepihead so have no idea how it works.

I don't know what is going on with her machine but if Dee says it is changing modes then Dee is noticing something. It may be going from one mode toOu the other or taking to long to respond when on APAP, I don't I had two machines that changed during the night and the first time they started it and stuck a guage on it and said it was ok. They said it couldn't change during the night.
I refused to take it back the second time and was provided right when they ran it on saturated test.
So I don't doubt something must be going on.
In any case Dee has to get them to look at the problem.

[DeeNJai]

My machine is telling porkies

Hi
I have an appointment next Friday at my Sleep Unit. Hopefully they will be able to explain what is going on with the machine. I will write some questions that I want to be answered. Also I went to see my GP today and he has increased my dose of Mirtazapine to 30mg per day as he said the higher the dose of this medication the less sedative effect. I also mentioned that on some forums it says that isnt good to be on this medication if on CPAP he looked up the medication and didnt show any cautions.

I will keep you posted on how things are going.
Dee

[DeeNJai]

My machine is telling porkies

here are the questions so far i am going to ask the Tech

Questions to ask the Tech
1. Why is the machine changing modes between APAP & Bi-Level as this machine is a series 60 (561 P) model so it’s not Bi-Level as this would be (761 P).
2. I am feeling a lot more tired again as I feel the treatment isn't working as well as did at the beginning.
3. At times I have problems with large leaks.
a. Currently I am swooping masks every couple of days to protect my skin as I was getting a lot of eczema around where the mask was touching the skin.
4. When it is on Bi-Level mode I feel a lot better and I don't always need a nap during the afternoon which is a good thing.
5. I would like to have a new machine as I don't trust the machine I have at the moment.
6. What is the difference of APAP against Bi-Level machines as I have said in question 4 I feel better when on Bi-Level.
7. Would it possible to have a trial on Bi-Level to see if I get a better nights sleep for three months and then review it.

Please do feel to correct anything you think needs to make them better.
Dee

[Sleep2Snore]

Hi
I have an appointment next Friday at my Sleep Unit. Hopefully they will be able to explain what is going on with the machine. I will write some questions that I want to be answered. Also I went to see my GP today and he has increased my dose of Mirtazapine to 30mg per day as he said the higher the dose of this medication the less sedative effect. I also mentioned that on some forums it says that isnt good to be on this medication if on CPAP he looked up the medication and didnt show any cautions.

I will keep you posted on how things are going.
Dee

I don't know about this one, but it might depend on how old his/her bible is.
There was a tablet I was on that had a strong side affect, but it was not in the book, but I found it on the leaflet that came with some tablets that was meant for a market abroad and took the leaflet up to him. I was put straight on to something else!

Just saying that's all.