Auto Cpap better for sensitive users?

[sickwithapnea17]

I'm curious in some patients does auto cpap work better than bipap or even asv? maybe due to sensitivity of the sleeper interrupting their sleep continuity?
it seems that the change in pressure in a bipap could result in arousals for sensitive sleepers and sleep fragmentation
isn't sleep continuity more important than AHI?

[LSAT]

You would have a similar change of pressure in an auto. Probable better to have a fixed CPAP pressure.

[cre8vmynd]

I personally was prescribed an auto machine but found that the changes in pressure disrupted my sleep too much. I switched to straight cpap and do much better on that. I can't comment on ASV or Bipap though.

Casey

[Mary Z]

I'm curious in some patients does auto cpap work better than bipap or even asv? maybe due to sensitivity of the sleeper interrupting their sleep continuity?
it seems that the change in pressure in a bipap could result in arousals for sensitive sleepers and sleep fragmentation
isn't sleep continuity more important than AHI?

AHI is debated as being the best predictor of therapeutic success when measured at home. I don't believe you can say sleep continuity is more important because very few of us know actually how much absolutely uninterrupted sleep we have. I prefer CPAP to AUTO or Bilevel because I don't like the pressure changes. ASV is prescribed for certain types of sleep disordered breathing so for those folks CPAP is probably not an option.

[Pugsy]

isn't sleep continuity more important than AHI?

Depends....are we talking about an AHI of 2 or an AHI of 20?

[jonnybee]

I personally was prescribed an auto machine but found that the changes in pressure disrupted my sleep too much. I switched to straight cpap and do much better on that. I can't comment on ASV or Bipap though.

Casey

Same here. I paid $300 out of pocket to upgrade to an S9 Auto from a straight S9 cpap and found the pressure changes very disruptive. Am back to straight cpap. Wish I had my $300 back, lol.

[Guest]

I had one really good night on Auto Cpap when I took some restoril, but on my bipapst I can only get about 2 hours of night and the graph that I see on Encore viewer is always really fragmented, I'm only sleeping 1 hour at a time and I keep on waking up with the mask off even at lower settings like 11/7. maybe I just need to tape the mask on.

[HoseCrusher]

My experience on this suggests that once you get your pressure dialed in, CPAP will work most of the time. However, you can set a narrow window of APAP and optimize your treatment.

In my case my optimum CPAP pressure is 10. If I set APAP to a wide range, the machine pressure changes during a leak caused by rolling over in bed will wake me up. Been there, done that, had to shut the machine off to get it to reset to a pressure that didn't feel like it was blowing the mask off of my face.

I find that if I limit the upper pressure, I can get even more effective therapy using APAP over CPAP.

I am using APAP and have my pressure range set on 9 - 13. When I review my data, I see that my median pressure is 10, but the pressure does fluctuate between 9.5 and 12. Some nights I need a little more than 10 and other nights I need a little less.

Using APAP over a narrow range and paying close attention to my data, I have improved my therapy and the machine is able to adjust for my good nights and my bad nights, and it doesn't wake me up with sudden pressure changes running wild.

[sickwithapnea17]

sometimes I feel much better when I awake with an AHI of 3 or 4 on bipap than with a higher pressure and lower AHI.

[LSAT]

sometimes I feel much better when I awake with an AHI of 3 or 4 on bipap than with a higher pressure and lower AHI.

An AHI of 3-4 is great. Worry more about how you feel than the AHI number. If you feel good an AHI <5 is great.

[Pugsy]

sometimes I feel much better when I awake with an AHI of 3 or 4 on bipap than with a higher pressure and lower AHI.

You use a lower pressure, sleep better and get an AHI of 3 to 4 and wake feeling very decently?

You use a higher pressure, don't sleep as well, get a lower than the 3 to 4 AHI?? and wake feeling crappy?

AHI lower than 3 or 4 is going to be a very minor lower number simply because 3 to 4 is considered effective therapy and it can't go much lower. I thought from what you had mentioned in other threads that your lower pressure was not very effective and you needed the higher pressures to get the AHI down.

Higher pressures will and can disrupt some people. It is simply easier to adjust to a lower pressure range.
So we will sleep with less disruptions at lower pressures and if we sleep more soundly...we feel better.

Now if your use of lower pressure gave you a greatly increased AHI (double digit) when compared to the higher pressure results then you need the higher pressure but if the lower pressure gives AHI less than 5 consistently then I would be using the pressure that gave me good AHI AND let me sleep better. AHI of less than 5 is not high enough to worry about using higher pressures. I would be using the settings that gave me effective therapy (less than 5 AHI) AND let me get some good restful sleep.

If some one has an AHI of 1.0 and slept horribly, restless, etc at the higher pressure
but I could feel quite decent with good sleep at lower pressure that gave me an AHI less than 5 then that would be the one I would use. Sacrificing good restorative sleep by using higher pressures to try to reduce an AHI of 4 down to 1 is over kill. Sleep quality is extremely important on how one feels the next day. An AHI of 0.0 isn't worth anything if sleep quality is poor. It isn't the events making someone feel crappy with an AHI of 0.0.... it would be the poor sleep quality.

[Guest]

I can only sleep well 2 nights in 7 months now.
The Auto Cpap on 8/15 seems to work ok for me. The good night I had on bipapst the average settings for IPAP/EPAP were 11/8. This was one of the only nights I had continuous sleep. It seems that the real rest and repair that your body does occurs in deeper stage 3/4 sleep and you can't reach that unless you sleep more than 1-2 hours continuously

[Paul56]

At the outset of my treatment I spent a good long time, several weeks, experimenting
with slow changes with my AutoSet to get it working for me.

Eventually I had the pressure adjusted down to a fairly narrow range; however, I get my
best results with the machine in CPAP mode.

There were a few times when I would wake up with the Auto blowing at max and seemingly
no intention of lowering itself other than me resetting the machine.

So, I'm one of those folks who doesn't do well on an Auto. I'm not an overly sensitive sleeper
given I've been known to sleep through huge thunderstorms that wakes everyone else.

Next machine will be a straight CPAP unless the price differential is low.

[2 B Sleeping Soundly]

Pugsy wrote: Sacrificing good restorative sleep by using higher pressures to try to reduce an AHI of 4 down to 1 is over kill. Sleep quality is extremely important on how one feels the next day. An AHI of 0.0 isn't worth anything if sleep quality is poor. It isn't the events making someone feel crappy with an AHI of 0.0.... it would be the poor sleep quality.

Amen! Couldn't be said any clearer or better!!

[feeling_better]

My experience about 3+ years: Auto presicribed; found out too many arousal on pressure changes, as indicated by HI, AI. Switched to fixed at the maximum needed (sometime 0.5 or 1.0 below max reached by Auto may better), and I sleep much better and my AI, and HI are much lower. Has been using Fixed only for the last two years.