CPAP vs APAP Pressure Settings

After 2 sleep tests, my sleep doctor prescribed a CPAP with a pressure setting of 6 for OSA. A complete PSG titration test showed at pressure of 6 I had and RDI of 10.

My local DME got me a ResMed S8 Elite II and it was set pressure 6 and EPR lelel 2. After the first 3 nights my AHI averaged 12.0. I thought it should be lower so I requested to try an APAP.

My DME then gave me a ResMed S8 AutoSet II and it was set with a pressure range from 5 to 10 in APAP mode. We turned EPR off.

The first night using the AutoSet II the AHI came back at 5.6. But what surprised me is that the pressure settled in at 10.0. How could the pressure of 6.0 prescribed by the sleep doctor be so different from the pressure of 10.0 that the APAP selected.

Is it possible that the complete PSG titration test was wrong at recommending a CPAP pressure of 6.

My DME said they could only increase the pressure by 1 in CPAP mode, without getting approval from the sleep doctor. But it seems that the DME has more leeway when setting the APAP pressure range (which in my case was set from 5 to 10).

Should I be concerned if the AutoSet II sets my pressure to 10.0. It seems my AHI, AI, and HI are in the normal range with this setting. If this is the case, then why did the sleep study not pick up on this?

To really offer the best advice, I think we would need to see a nights data so we can look at how & when the pressure varied.

Sleep studies are mostly accurate but don't always take into account the anxiety factor of being wired up in a lab.

DSM

I probably will take my AutoSet II in to my DME to hook it up to the ResScan software and print off a report. I'm hoping this report would have more details than what I could get off the display on the AutoSet II.

joeb989 wrote:I probably will take my AutoSet II in to my DME to hook it up to the ResScan software and print off a report. I'm hoping this report would have more details than what I could get off the display on the AutoSet II.

Absolutely, But make sure the DME or whoever, downlaods the 'detailed' data & not 'summary' data as ResScan 3.7 defaults to 'summary' & what you need is the 'detail'.

Good luck

DSM

It is more than possible that your one night's sleep in the lab was not representative of your normal sleep.

O.

It doesn't surprise me at all that your sleep study and your "in home" auto study are different.

If you get several nights the same on the auto test at home (and I think you will), I would trust that more than one night (in lab sleep study), under very different circumstances than your usual sleep circumstances.

joeb989 wrote:I probably will take my AutoSet II in to my DME to hook it up to the ResScan software and print off a report. I'm hoping this report would have more details than what I could get off the display on the AutoSet II.

Shouldn't you be able to use the smart card to download the data and bring that to the DME instead of lugging the entire machine?

JRI wrote:

joeb989 wrote:I probably will take my AutoSet II in to my DME to hook it up to the ResScan software and print off a report. I'm hoping this report would have more details than what I could get off the display on the AutoSet II.

Shouldn't you be able to use the smart card to download the data and bring that to the DME instead of lugging the entire machine?

Yes.

Thanks everyone for your input !

I reason I brought in my machine to my DME was in case they wanted to change the settings, which they did. They updated the pressure range to be 5.0 to 15.0 (before it was 5.0 to 10.0).

The DME also didn't know how to download the detailed data. I told 2 technicians that there should be a detailed report, but neither knew how to bring it up. So they gave me a report with summary data, which wasn't any different than the data I could get off the LCD panel. I think I will get ResScan 3.7 and print the detail reports myself.

I'll continue to monitor my numbers carefully, especially since my first sleep study showed that most of my apneas were central. After the first night with APAP pressure settings of 5.0 to 15.0 my 95th percentile pressure was 10.8

I understand now that the ResMed AutoSet algorithm prevents central apneas from causing run away pressure above 10.0. If my pressure remains around 10.0, it may add more weight to my theory that most of my remaining apneas are central and not obstructive. Perhaps the pressure was driven up to 10.0 by my centrals apneas, which may mean that my obstructive apneas could really be managed by less pressure. Originally the sleep doctor prescribed a fixed pressure of 6.0 in CPAP mode.

joeb989 wrote:I reason I brought in my machine to my DME was in case they wanted to change the settings, which they did. They updated the pressure range to be 5.0 to 15.0 (before it was 5.0 to 10.0).

At this point I was about to suggest using the data card also for bringing back the new settings but

joeb989 wrote: The DME also didn't know how to download the detailed data.

This gives me the idea they don't know how to put new settings onto the card.

I'm curious about what you find out about the discrepancy between sleep test and apap reading, and what you end up doing.
I have a similar situation. Sleep test indicates a 7. But apap machine indicating 10.

Thanks.

There are two steps to getting detail data.

First, on the download screen, you have to select the All Available Data radio button.

Then, you have to click on Detailed Graphs tab at the top of the page to display the data.

Hi joeb989,

Curious what you eventually end up doing ? Are you still using the Apap feature ? And at what setting ? I have a similar situation.

Many thanks in advance.