Why so sluggish on APAP????

[grumpygirl]

Hello All- Just wondering if anyone out there had a theory as to why I feel less rested when using my machine on APAP mode? My range of pressure is 8.0-12.0 and I'm trying to deal with the aerophagia issues and GERD that have plagued me for a while now. Sometimes I think I wake up more often on APAP but go back to sleep very quickly, but I haven't actually compared the wakings on APAP to how many I have on CPAP. Any other ideas?? All I know is that when I use APAP mode I feel more tired and sluggish all day.

[Country4ever]

Hi Grumpy girl,

I was on apap for many months and I woke up all the time. Then I read that some of us are so sensitive to the pressure changes, that it can wake us up.
So I changed to straight cpap and it made a huge difference for me! I would never have guessed that such subtle changes in pressure would disturb some of us, but they do.
Were you ever on straight cpap?

[JeffH]

I too didn't do well on APAP. One pressure all night is more tolerable for some, in fact, I would venture to say most.

[Sergey45]

I also was not able to get use to very sophisticated BiPap, so I have switched back to simple CPAP.
You can check my CPAP machines’ experience here:
http://www.sleepapneasymptom.medgrip.co ... chine.html

Many people find my CPAP masks’ experience very helpful as well:
http://www.sleepapneasymptom.medgrip.com/cpap_mask.html

[Guest]

Same for me. I changed to CPAP, and my numbers improved drastically.
I still wake up all the time, but it's not CPAP related. I have other health issues. But CPAP makes the other issues easier to deal with.
I have a machine that has EPR , and I have that set on one. It's really very comfortable.
APAP pressure changes were definitely disturbing my sleep.
Good luck, and I hope you get it right!
Lee Lee

[DreamStalker]

[quote="grumpygirl"]Hello All- Just wondering if anyone out there had a theory as to why I feel less rested when using my machine on APAP mode? My range of pressure is 8.0-12.0 and I'm trying to deal with the aerophagia issues and GERD that have plagued me for a while now. Sometimes I think I wake up more often on APAP but go back to sleep very quickly, but I haven't actually compared the wakings on APAP to how many I have on CPAP. Any other ideas?? All I know is that when I use APAP mode I feel more tired and sluggish all day.

[Snoredog]

Autopap on that machine is NOT going to respond to any apnea above 10 cm pressure.

If you put it in CPAP mode at 11.6 then you have your answer.

But using it that way won't do much to relieve aerophagia. Which to use is a decision only you can make.

[dsm]

Snoredog is partly correct on this in that the machine mentioned will not try to treat a flow block but will continue to treat flow limitations above 10 CMs.

There is one other possibility with your therapy - this is that the Resmed machines (I have tried almost all their recent models of the S7 S8 & Vpap family) can be quicker to change pressure that the Respironics & other brands & while this is very helpful to some people it disturbs others.

I too am a GERD sufferer & take a tablet morn & another at night as GERD does create annoying side effects such as nasal congestion (triggered by reflux reaching up to the throat). GERD greatly contributes to aerophagia. It also causes a sore throat (same reflux effect). Snoredog posted an excellent item about the effects of silent GERD & it is worth readin (Snoredog, can you repost that here ? - it is an excellent writeup).

I am on 10/13 CMs (11/14 on a Respironics) pressure & since moving to a Bipap SV have had the most satisfying therapy I have ever experienced. Even when I have a full night of mask leaks (black bar right across the Encore Pro readout) I will still come in with a total AHI under 1.0.

Apap just didn't work for me & neither did cpap. I could get the AHI numbers down low but tended to feel that the therapy wasn't working. Went through lots of periods of feeling something wasn't right - not getting enough air. The Bipap SV is now my best ever machine (dream machine) as I get such great nights sleep compared to any other I have ever used.

I no longer get that feeling I am not getting enough air - because it can adjust the ipap pressure breath by breath & does so in a way that is very smooth & easy to take, it makes sure I am maintaining a healthy peak volume.

Good luck on your therapy & I hope you soon get it to a point that you feel really good about it.

DSM

[roster]

Count me as another who does better on straight cpap than apap.

[grumpygirl]

Snoredog- I don't understand why you say that APAP won't respond to any apnea above 10 cm pressure. Please explain that one to me again. I know we've been through this one before but I can't remember what you said. I have tried it on CPAP mode at 11.6 and felt better except for the aerophagia. I KNOW I need to get my GERD under control but just can't seem to get there yet. My normal pressure on CPAP is supposed to be 12 but I can't tolerate it that high. Thanks for your patience!!

[grumpygirl]

Just another question. Do any of you think my pressure range is not good? My doc prescribed 8-12 on APAP. Is that too short a range, should I have a range of about 7-12 or 8-14 something like that? I know the lower ranges will help my aerophagia but was wondering if that might have anything to do with why APAP makes me feel sluggish. What would happen if I raised the upper pressure to 14-more aerophagia and GERD or better sleep???

[dsm]

[quote="grumpygirl"]Just another question. Do any of you think my pressure range is not good? My doc prescribed 8-12 on APAP. Is that too short a range, should I have a range of about 7-12 or 8-14 something like that? I know the lower ranges will help my aerophagia but was wondering if that might have anything to do with why APAP makes me feel sluggish. What would happen if I raised the upper pressure to 14-more aerophagia and GERD or better sleep???

[Snoredog]

[quote="grumpygirl"]Snoredog- I don't understand why you say that APAP won't respond to any apnea above 10 cm pressure. Please explain that one to me again. I know we've been through this one before but I can't remember what you said. I have tried it on CPAP mode at 11.6 and felt better except for the aerophagia. I KNOW I need to get my GERD under control but just can't seem to get there yet. My normal pressure on CPAP is supposed to be 12 but I can't tolerate it that high. Thanks for your patience!!

[grumpygirl]

Snoredog- THANKS for the detailed info. You must be very informed about all this stuff!!! I have gotten my AI down very low lately on the APAP, and my HI also, although it seems my HI is always higher than my AI. My AI has been less than 1 for weeks now. I think I am understanding you-hopefully and I will try to raise my minimum pressure tonight to 8.5 and my higher pressure to 13 and see how that works. All this is so complicated and every apnea patient is different so I must say that I am truly grateful for your knowledge and patience. I hope the changes in pressure don't complicate my GERD or aerophagia but I'll give it a shot for a couple of days. I'm going on a short vacation this week and would love to have more energy to enjoy the "sand and surf". Wish me luck!!

[grumpygirl]

Ooops meant to say 8.6-12.6. I'll be conservative for the first few days and see what happens.