2 nights on APAP and wondering - 3rd night is in now -

jules · Post by **jules** » Wed Dec 06, 2006 11:40 am

I have been on cpap (Pro 2) for just over a year. I tended to use 8.5 or 9 with swift and 10 with CL2 as I found I needed higher pressure with CL2. My AHI was always a little higher with CL2 (averages around 3 versus swift around 2) but it is so much quieter.

I set the new auto for 7 to 10 with cflex of 3 (had been using cflex of 3 with Pro 2). I was never titrated but I have a years experience and data for my previous "experiment" This is now starting a new experiment and I expect to reset the machine for 8 to 11 and use CL2 tonight. My 90 % was 10 night one and 9 last night.

I have used the CL2 these two nights. It is maxing out at 10 as expected and I am seeing a higher AHI than expected (still under 5). That isn't worrying me as much as I am waking up a lot more which I hadn't done on a straight pressure.

My question -- I am wondering if I am waking up responding to air pressure changes and if so how soon will that go away?

My goal is to get the machine set so I can switch masks and not have to change pressures on the machine (something I had to do with the Pro 2), as well as keep the apneas under control. After I get a range for the CL2 I will see how well it works for the swift.

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CPAPopedia Keywords Contained In This Post (Click For Definition): cflex, swift, CPAP, AHI, auto

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CPAPopedia Keywords Contained In This Post (Click For Definition): cflex, swift, CPAP, AHI, auto

rested gal · Post by **rested gal** » Wed Dec 06, 2006 12:04 pm

With as tight a pressure range as you have set, Jules, (7 - 10) I kinda' doubt that it's pressure changes that are waking you. But anything's possible.

You might try setting the new machine to straight cpap for a few nights at your old "straight" setting and your usual C-Flex setting, just to see if you still experience the wake-ups. If so, perhaps it's partly just the temporary excitement (LOL!!) of having a new machine.

Another experiment you might try is using it in AFLE mode, as you are now... but with a range of 9 - 14. Perhaps you're one, like me, who does well with the lower pressure set pretty much on the "prescribed" pressure. I use autopap primarily for the benefit of more pressure being available for the brief times it might be needed....not so much for using "lower" pressures.

Each person is different, so different ways of setting the range might work better for you. Or, you might find that you do, indeed, sleep better with one steady pressure and C-Flex to make exhalation more pleasant, the way you had it with your Pro 2.

For now, I'm betting the awakenings are... "'cause it's new."

curtcurt46 · Post by **curtcurt46** » Wed Dec 06, 2006 12:13 pm

I would set min pressure to 9cm and the max to 14cm. Make sure you are controlling leaks. My experience says your minimum pressure should be close to the best single pressure if using straight cpap.
I have done this for myself and my avg for the last 30 days is 0.7 AHI. When the machine was wide open 5-20cm I was around a AHI of 5. I have actually gotten a 0.0 in the last 30 days, but at the same time I had a bad night and got a 9.7 AHI.

Yes, pressure changes can wake you. If you think air pressure changes are waking you then you should see this on the daily details report. You could also go to a single pressure for a week to see if it makes a difference. As you know this OSA is very complex in nature and many things can cause waking.

TerryB · Post by **TerryB** » Wed Dec 06, 2006 12:23 pm

I am convinced that I sleep better at a more constant pressure and that the auto's response time allows hyponeas to develop and raise the numbers although apneas are very few and far between.

TerryB

jules · Post by **jules** » Wed Dec 06, 2006 12:36 pm

I don't have a leak issue. I have both masks tweaked to death with elastic bands and don't seem to be a mouth breather.

My leaks averaged 23 l/min these two nights which is better than the upper 20's I get with swift at 8.5.

I am seeing more hypoapneas and also with the APAP get a time in apnea in Encore Pro report. I had needed My Encore to get that before and don't have it installed on this computer. I believe this time I am getting is higher than when I was using old computer and using My Encore but I am not certain. I need to install My Encore on this computer.

Interesting TerryB as I am wondering if that is where I am these two nights. It is a new experience. I know I still have a few more nights of experiements.

I hesitate to set min at 9 as I do better at 8.5 over 9 with the swift and my goal is to get a range that will work with both masks. I am working on the "harder" mask first.

Wulfman · Post by **Wulfman** » Wed Dec 06, 2006 12:38 pm

Jules,

I'm "one of those".....who also started with a Pro 2 (in May of '05) and after over a year, tried an Auto with a fairly narrow range of 10 - 15 and found that I didn't sleep as well even though it only got to 15 for a minute and a half on one night and spent most of the time between 10 and 12. So, I set up all of my machines for straight pressure and C-Flex of 2 and sleep like a rock.
I also had more "recorded" apneas and hypopneas on the Auto, too.
But, it DID prove that I "guessed" at a better pressure than my sleep doctor did.

The nicest thing about Autos is that they're a "multi-mode" machine....you can choose which therapy works best for you.

Best wishes,

Den

jules · Post by **jules** » Thu Dec 07, 2006 11:11 am

Well I set the machine fo 8 to 11 last night and I spents most of the night at 8 and 9. I hit 10 for under 10 minutes and hit 11 twice for a total of 2 minutes.

The AHI last night was under 1.0 and one of the apneas was scored corresponding to a mask adjustment. I did download My Encore and it seems to be running fine. I guess I need to check for spyware as when I had downloaded it a year ago my spyware detectors went wild.

I did wake up more than I would like but less than the previous two nights. I will give this range a few more nights to see if it is the right one and then switch to the swift and see how it works.