I do seem to sleep better with straight CPAP over VPAP

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
space45
Posts: 189
Joined: Thu Apr 03, 2014 6:40 pm

I do seem to sleep better with straight CPAP over VPAP

Post by space45 » Sat Apr 19, 2014 9:34 am

after awhile with straight pressure you do not even feel it, or at least I do not.

no inrush of air as the machine ramps up to jam air into you. feels like normal breath. I think I may get a better and longer nights sleep with just plain CPAP. will have to see what the numbers say but as for how I feel, it feels good.
I think all the changes in pressure was waking me in the morning when I was not sleeping as hard.

anyways, I am sure some have posted similar things in the past. one of the guys that responded to one of my threads had mentioned straight CPAP being better and feeling better, so I tried it and liked it. I am sure with time I would get used to the pressure changes, but for now the straight CPAP seems to be a good option and I can see what the other guys was talking about

just reporting what I found that seems to work better for me.

User avatar
SleepWrangler
Posts: 156
Joined: Mon Mar 03, 2014 9:10 pm
Location: Ontario, Canada & New York

Re: I do seem to sleep better with straight CPAP over VPAP

Post by SleepWrangler » Sat Apr 19, 2014 10:25 am

space45 wrote:after awhile with straight pressure you do not even feel it, or at least I do not. just reporting what I found that seems to work better for me.
I'm glad you are finding the settings best suited to fix your breathing Stan! Get better pal.

Country4ever
Posts: 1373
Joined: Wed Oct 31, 2007 6:22 pm

Re: I do seem to sleep better with straight CPAP over VPAP

Post by Country4ever » Sat Apr 19, 2014 10:50 am

The same thing happened to me when I first started using cpap. The doc set it on autopap and I kept waking up all night long.
I finally changed it to straight cpap, and started sleeping through the night. I think some of us are just very sensitive to changing pressures.
I'm glad you found what works best for you!

_________________
MachineMask
Additional Comments: Resmed HumidAir 11 for humidifier

xyz
Posts: 407
Joined: Fri Dec 07, 2007 1:38 pm

Re: I do seem to sleep better with straight CPAP over VPAP

Post by xyz » Sat Apr 19, 2014 12:46 pm

> one of the guys that responded to one of my threads had mentioned straight CPAP being better and feeling better

It's difficult for me to imagine how that could possibly be true. Well, I can think of one, which I'll mention below (it was set up wrong).

> I am sure with time I would get used to the pressure changes

It has to be set up properly to work well. If apap worked less well for you than cpap, my guess is that the apap setting was wrong.

See the thread titled "Am I Missing Something." See zoocrewphoto's post ("your apap is set wide open").

Some machines have a tendency to "run away," meaning keeps using higher and higher pressure. Eventually that causes leaks. Which then cause higher pressure.

The "cure" for this is apap, set up properly.

Experiment. Try apap with a min starting pressure of 2 (or 3) under your prescription and a max of 2 (or 3) above your prescription.

> will have to see what the numbers say

Good point. Experiment, look at your numbers, adjust as indicated. Let us know how it goes.

Wulfman...

Re: I do seem to sleep better with straight CPAP over VPAP

Post by Wulfman... » Sat Apr 19, 2014 1:17 pm

space45 wrote:after awhile with straight pressure you do not even feel it, or at least I do not.

That's the idea!

no inrush of air as the machine ramps up to jam air into you. feels like normal breath. I think I may get a better and longer nights sleep with just plain CPAP. will have to see what the numbers say but as for how I feel, it feels good.
I think all the changes in pressure was waking me in the morning when I was not sleeping as hard.

Yep! As you go through various sleep stages, your breathing changes and the machine may interpret those changes as reasons to increase pressure.......consequently, you may get bumped out of the needed sleep stages. You need pressure to splint your airway open and get some decent sleep and not chasing Flow Limitations and Snores.

anyways, I am sure some have posted similar things in the past. one of the guys that responded to one of my threads had mentioned straight CPAP being better and feeling better, so I tried it and liked it. I am sure with time I would get used to the pressure changes, but for now the straight CPAP seems to be a good option and I can see what the other guys was talking about

Was probably me. I've tried both and prefer straight pressure. In even a small range of pressures, I found myself frequently waking up at the pressure bumps. And, this is from a person who could sleep through events that would wake the dead. Lots of others on the forum prefer straight pressure and have found the same thing about the pressure changes waking them up.

just reporting what I found that seems to work better for me.
Lots of others seem to do fine with ranges of pressures. I've always been an advocate of a person HAVING an APAP because they have more options. (I have several myself) But, the user needs to figure out for themselves what works best for THEM.
Too many users THINK that just because they paid more for the APAP and that it's supposed to be "better", but that's not necessarily the reality for everyone.

Glad to hear you found something that seems to work for you.


Den

.

Stevoreno_55
Posts: 369
Joined: Tue Jan 14, 2014 10:28 pm
Location: MS Gulf Coast

Re: I do seem to sleep better with straight CPAP over VPAP

Post by Stevoreno_55 » Sat Apr 19, 2014 1:39 pm

Is it pretty much the norm for many who participate on this board to mess with the pressure settings on their machines without first consulting with their sleep doctor? I've never messed with my machine's pressure settings. My DME's in the past would never agree to change the pressure settings on my machines until they received a Rx from my doctor stating a pressure change order. Maybe that's a Mississippi Rx law; idk.



Stevoreno_55
MS Gulf Coast
04/19/14

_________________
Mask
Additional Comments: Newly diagnosed pressures as of June 05, 2014 are 22cmIPAP and 18cmEPAP; first diagnosed with OSA in 1999.

User avatar
Pugsy
Posts: 63942
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: I do seem to sleep better with straight CPAP over VPAP

Post by Pugsy » Sat Apr 19, 2014 1:44 pm

Stevoreno_55 wrote:My DME's in the past would never agree to change the pressure settings on my machines until they received a Rx from my doctor stating a pressure change order. Maybe that's a Mississippi Rx law; idk.
DMEs are like pharmacists...they can't alter a doctor's RX without doctor's okay. That's not just a Mississippi law.
There's no such "law" pertaining to patients changing things...be it how or when they take their pills or the cpap machine.
I don't advise people to change anything if they aren't comfortable with doing so and understanding why they are doing it.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
Todzo
Posts: 2015
Joined: Tue Apr 24, 2012 8:51 pm
Location: Washington State U.S.A.

Re: I do seem to sleep better with straight CPAP over VPAP

Post by Todzo » Sat Apr 19, 2014 2:03 pm

space45 wrote:after awhile with straight pressure you do not even feel it, or at least I do not.

no inrush of air as the machine ramps up to jam air into you. feels like normal breath. I think I may get a better and longer nights sleep with just plain CPAP. will have to see what the numbers say but as for how I feel, it feels good.
I think all the changes in pressure was waking me in the morning when I was not sleeping as hard.

anyways, I am sure some have posted similar things in the past. one of the guys that responded to one of my threads had mentioned straight CPAP being better and feeling better, so I tried it and liked it. I am sure with time I would get used to the pressure changes, but for now the straight CPAP seems to be a good option and I can see what the other guys was talking about

just reporting what I found that seems to work better for me.
Years ago I was reading research looking into the effectiveness of several kinds of PAP. What really struck me was that CPAP always yeilded the least arousals. Always.

I decided back then to stick with CPAP if at all possible. I am glad I made my decision.

In recent years they have been looking into the nonanatomic causes of Sleep Apnea.

In a recent study[1] they found that:
-----------------------------
36% of patients with OSA had minimal genioglossus [tongue] muscle responsiveness during sleep

37% had a low arousal threshold

36% had high [respiratory control] loop gain.

28% had multiple nonanatomic features.

Although overall the upper airway was more collapsible in patients with OSA (Pcrit, 0.3 [−1.5 to 1.9] vs. −6.2 [−12.4 to −3.6] cm H2O; P <0.01), 19% had a relatively noncollapsible upper airway similar to many of the control subjects (Pcrit, −2 to −5 cm H2O). In these patients, loop gain was almost twice as high as patients with a Pcrit greater than −2 cm H2O (−5.9 [−8.8 to −4.5] vs. −3.2 [−4.8 to −2.4] dimensionless; P = 0.01).

A three-point scale for weighting the relative contribution of the traits is proposed. It suggests that nonanatomic features play an important role in 56% of patients with OSA.
-----------------------------

Now the only thing that CPAP pressure can help is collapsibility. It can raise the pressure above the critical closing pressure (Pcrit). But it tends to raise the respiratory control loop gain. And all the noise and extra stuff on the face cannot be good for arousal threshold.

And indeed if you try to compensate for variability in the critical closing pressure by raising the pressure to respond to an event, well it might work. However, if the respiratory control system gain (already a bit higher due to the stress hormone release during the event) is pushed above one by the raise in pressure you are likely to cause more apneas than less. And indeed arousal threshold is likely lowered by the same stress hormones so the extra pressure may bring an arousal into the picure. Any event tends to raise respiratory control loop gain and lower arousal threshold.

I am suspicious that the current trend to try to control things mechanically is not a good direction.


[1] Danny J. Eckert, David P. White, Amy S. Jordan, Atul Malhotra, and Andrew Wellman "Defining Phenotypic Causes of Obstructive Sleep Apnea. Identification of Novel Therapeutic Targets", American Journal of Respiratory and Critical Care Medicine, Vol. 188, No. 8 (2013), pp. 996-1004. doi: 10.1164/rccm.201303-0448OC

[2] Sairam Parthasarathy M.D., Emergence of Obstructive Sleep Apnea Phenotyping. From Weak to Strong! American Journal of Respitory and Critical Care Medicine VOL 188 2013
-- critical closing pressure [Pcrit] - Arousal Threshold - ventilatory control Loop gain - and genioglossal Muscle responsiveness. Pcrit, Loop, Arousal, Muscle (PALM)--
May any shills trolls sockpuppets or astroturfers at cpaptalk.com be like chaff before the wind!

Wulfman...

Re: I do seem to sleep better with straight CPAP over VPAP

Post by Wulfman... » Sat Apr 19, 2014 2:59 pm

Stevoreno_55 wrote:Is it pretty much the norm for many who participate on this board to mess with the pressure settings on their machines without first consulting with their sleep doctor? I've never messed with my machine's pressure settings. My DME's in the past would never agree to change the pressure settings on my machines until they received a Rx from my doctor stating a pressure change order. Maybe that's a Mississippi Rx law; idk.



Stevoreno_55
MS Gulf Coast
04/19/14
The reason that is probably true is because most of us no longer have "sleep doctors" and/or have determined that WE are our own best advocates for proper therapy. NOBODY is going to be more concerned about OUR therapy than WE are.

At some point, the doctors tell the users that they're on their own, or the office visits become few and far between. The problems that the users encounter are brushed off by the doctors, DMEs and RT. This is why many users give up on their therapy (if they don't find one of the support forums).

Some people aren't "comfortable" with becoming familiar with their equipment, and I guess that's OK. But, the sooner they DO become familiar with it, the better off they'll be.

There are NO laws governing how the "owner" of the equipment can or cannot adjust/tweak the settings.......ANYWHERE.
As noted, the folks who sell and make adjustments to the equipment (DMEs, RTs, etc.) can't do it without a doctors order, but those regulations don't have any governance over the owners.


Den

.

User avatar
BlackSpinner
Posts: 9745
Joined: Sat Apr 25, 2009 5:44 pm
Location: Edmonton Alberta
Contact:

Re: I do seem to sleep better with straight CPAP over VPAP

Post by BlackSpinner » Sat Apr 19, 2014 4:36 pm

Stevoreno_55 wrote:Is it pretty much the norm for many who participate on this board to mess with the pressure settings on their machines without first consulting with their sleep doctor? I've never messed with my machine's pressure settings. My DME's in the past would never agree to change the pressure settings on my machines until they received a Rx from my doctor stating a pressure change order. Maybe that's a Mississippi Rx law; idk.



Stevoreno_55
MS Gulf Coast
04/19/14
Would you make the same suggestion to a diabetic? Don't change your insulin level until your doc has seen all your data?

_________________
Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: Hybrid Full Face CPAP Mask with Nasal Pillows and Headgear
Additional Comments: Quatro mask for colds & flus S8 elite for back up
71. The lame can ride on horseback, the one-handed drive cattle. The deaf, fight and be useful. To be blind is better than to be burnt on the pyre. No one gets good from a corpse. The Havamal

User avatar
Todzo
Posts: 2015
Joined: Tue Apr 24, 2012 8:51 pm
Location: Washington State U.S.A.

Re: I do seem to sleep better with straight CPAP over VPAP

Post by Todzo » Sat Apr 19, 2014 5:44 pm

Stevoreno_55 wrote:Is it pretty much the norm for many who participate on this board to mess with the pressure settings on their machines without first consulting with their sleep doctor? I've never messed with my machine's pressure settings. My DME's in the past would never agree to change the pressure settings on my machines until they received a Rx from my doctor stating a pressure change order. Maybe that's a Mississippi Rx law; idk.



Stevoreno_55
MS Gulf Coast
04/19/14
So which will give more reliable results. A so called “titration” done over a single night in a lab. Or to adjust your pressure a small amount, monitor your data for ten days and decide on the next change until you have clearly arrived and the optimal pressure.

We do not sleep in a laboratory. Well, only for testing. It is not the same air, sound field, or even bed. It is unlikely there will be the same air temperature range or humidity. We changed our evening schedule to be there. We are in the company of strangers. The whole thing is costing a ridiculous amount of money and so we only get one shot in this night (or part of a night).

It is all so upsetting that they may need to administer a sleeping aid just so we can sleep!!!

So we have stress from the new surroundings and personal exposure. We also have stress from the financial issues. Stress from the “one shot” characteristic. Likely we are stressing about the results. We do have stress.

Stress affects inflammation levels so the critical closing pressure is likely to be affected!

Stress affects respiratory control system gain!

Stress affects the arousal threshold.

Any sleeping aids used move everything as well.

It is unlikely an accurate titration will be obtained. From what I have read here often the result is unusable.

I feel assured with results obtained in my own home over a period of 60 or so days. It also reduced my average AHI by about a factor of three. A recent change resulted in half of what I was running.

Perhaps the industry could learn a few things from what we find ourselves needing to do.
May any shills trolls sockpuppets or astroturfers at cpaptalk.com be like chaff before the wind!

Stevoreno_55
Posts: 369
Joined: Tue Jan 14, 2014 10:28 pm
Location: MS Gulf Coast

Re: I do seem to sleep better with straight CPAP over VPAP

Post by Stevoreno_55 » Sat Apr 19, 2014 6:23 pm

BlackSpinner wrote:
Stevoreno_55 wrote:Is it pretty much the norm for many who participate on this board to mess with the pressure settings on their machines without first consulting with their sleep doctor? I've never messed with my machine's pressure settings. My DME's in the past would never agree to change the pressure settings on my machines until they received a Rx from my doctor stating a pressure change order. Maybe that's a Mississippi Rx law; idk.



Stevoreno_55
MS Gulf Coast
04/19/14
Would you make the same suggestion to a diabetic? Don't change your insulin level until your doc has seen all your data?
I most certainly would; I'm a type 2 Diabetic myself but I do not have to take shots; just 2 pills a day to control my blood sugar.



Stevoreno_55
MS Gulf Coast
04/19/14

_________________
Mask
Additional Comments: Newly diagnosed pressures as of June 05, 2014 are 22cmIPAP and 18cmEPAP; first diagnosed with OSA in 1999.

Stevoreno_55
Posts: 369
Joined: Tue Jan 14, 2014 10:28 pm
Location: MS Gulf Coast

Re: I do seem to sleep better with straight CPAP over VPAP

Post by Stevoreno_55 » Sat Apr 19, 2014 6:36 pm

I guess I'm a member of the old school but the only setting that I have messed with on my machine is the humidifier's setting; either turned it up or down; I have never messed with the pressure settings on my machine because I never bothered to learn how because my RT told me not to do it. If my RT told me not to do it then it must have been true. Those of you who do mess with your machine's pressure settings; do you also own a manometer so you can check your machine's pressure from time to time to confirm that your machine's pressure is what it says it is?


Stevoreno_55
MS Gulf Coast
04/19/14

_________________
Mask
Additional Comments: Newly diagnosed pressures as of June 05, 2014 are 22cmIPAP and 18cmEPAP; first diagnosed with OSA in 1999.

User avatar
lliann
Posts: 372
Joined: Wed Jun 20, 2012 6:33 pm
Location: upstate new york

Re: I do seem to sleep better with straight CPAP over VPAP

Post by lliann » Sat Apr 19, 2014 6:50 pm

I think its quite possible to educate oneself to know as much as sleep technicians etc. I believe there are several people here with incredible intelligence, diligence and committment that have done so. I believe I have a responsibility to make sure I am getting the care I need. I am the most important person to me when it comes to my health. For me, I stopped believing in the invincibility of dr suggestions or the medical system when ..well there are a lot of whens. After I worked in a doctors office. After I worked in a hospital. After I understood insurance companies have made victims of both patients and doctors. After I learned about overbooking. And for me, after I learned that my medical treatment is a we program. My ignorance or willingness to accept without question doesn't serve me best. Just sayin.

_________________
Mask: AirFit™ N20 Nasal CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Sleepyhead for Mac s9 auto settings 11-16

space45
Posts: 189
Joined: Thu Apr 03, 2014 6:40 pm

Re: I do seem to sleep better with straight CPAP over VPAP

Post by space45 » Sat Apr 19, 2014 6:55 pm

when I switched over to CPAP I started at 12 cmH2o the number recommended by IRS (not the tax guys) for my CPAP and got up at nights to piss again (one time, not the multi ones with out any machines) and did not feel near as good as VPAP so I upped it to 15 and that was way better, but I will try it higher starting tonight as I think it could be better, my numbers are good but am getting hypopnea events. not bad and very slight but will play and see if I can get rid of them