Move from CPAP to APAP

I am now about 90 days into CPAP. My Sleep Dr., after my in lab sleep study set my CPAP pressure at 14. Had severe SA with over 70 AHI's. I now avg. 3.2 or so AHI on CPAP, sleeping around 9 hrs but still wake up several times per night. Actually was so worn out that I have adapted very well! Considering change to auto. What have others experienced by doing this? I have a friend that just went back after 5 yrs & his Dr. put him on auto @ 8 & 12 right at the start. Is there a reason that I was not placed on auto? Everything that I have read talks about how much more comfortable auto is. Please give me some feedback. Thanks!

This blog is very informative!!

F or some people it may be comfortable...for others they may be disturbed by the changing pressures during the night. If during the titration your pressures varied greatly, an auto may benefit you. If your pressures were in a narrow range, fixed pressure will work just fine. Your friend may find that with the pressure range of 8-12 that he averages 9 or 10. In that case a fixed pressure will work fine for him. Personally I have my range set at 11/14. If I set my pressure to 12 I average about the same AHI as the range setting. You have an autoset machine...why don't you try a pressure range and see if you like it????

RedRooster wrote:I am now about 90 days into CPAP. My Sleep Dr., after my in lab sleep study set my CPAP pressure at 14. Had severe SA with over 70 AHI's. I now avg. 3.2 or so AHI on CPAP, sleeping around 9 hrs but still wake up several times per night. Actually was so worn out that I have adapted very well! Considering change to auto. What have others experienced by doing this? I have a friend that just went back after 5 yrs & his Dr. put him on auto @ 8 & 12 right at the start. Is there a reason that I was not placed on auto? Everything that I have read talks about how much more comfortable auto is. Please give me some feedback. Thanks!

This blog is very informative!!

Some people do better on auto. Some people do better on straight cpap. The nice thing about auto is that you can go back to straight cpap if you want.

The main reason to use an auto machine is if you have different pressure needs during the night. For example, when I sleep on my side, I can get by on 11 or 12 just fine. But if I roll onto my back, I will have multiple events, even at 12 or 13. I will get spikes to 15, and sometimes, spikes to 17. They are very short. I probably spend less than half an hour a night above 13, but I do need that added pressure if I am on my back. Now, I have an added benefit that when the pressure goes up, I tend to roll back onto my side. So, with cpap, I sleep on my back a lot less than I would without cpap. So, if were to use a straight 12 or 13 pressure, I would probably sleep on my back more and have a lot of apnea events that would destroy my sleep. In order to get a decent ahi with straight cpap, I would need to be at 15 or 16 all night, yet I really only need that for half an hour. So, for me, it is a huge benefit to use apap.

That said, there are many people who don't have changing needs through the night. Or they are disturbed by the changes in pressure. The changes don't bother me until they get high, and then I just roll over. Yet slight hissing from a leaking mask will drive me crazy. It really depends on what you can sleep through easily, and what bothers you. Some people who have auto and good ahi numbers have tried a straight pressure to see if they sleep better, and some do. They just didn't realize that the changing pressures were causing them a problem.

xxyzx wrote:

RedRooster wrote:I am now about 90 days into CPAP. My Sleep Dr., after my in lab sleep study set my CPAP pressure at 14. Had severe SA with over 70 AHI's. I now avg. 3.2 or so AHI on CPAP, sleeping around 9 hrs but still wake up several times per night. Actually was so worn out that I have adapted very well! Considering change to auto. What have others experienced by doing this? I have a friend that just went back after 5 yrs & his Dr. put him on auto @ 8 & 12 right at the start. Is there a reason that I was not placed on auto? Everything that I have read talks about how much more comfortable auto is. Please give me some feedback. Thanks!

This blog is very informative!!

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cost
they try to use the cheapest solution so insurance will pay for it
they dont care about comfort or how well it works
as long as you are compliant with use
and it sort of treats the problem

auto is absolutely best
your needs change constantly
sleep position, stage of sleep, congestion, ...

The OP has an autoset...

I was titrated around 3 cm too high, and sold an S9 Elite.
After 9 months, I bought an Autoset, and have never gone back.
Too much pressure gave me GAS!

I have used both for extended periods, and don't have a preference. My pressure needs during the course of a night didn't vary enough to make auto a big bonus for me. My range was so tight. If I remember correctly it was set at 9-12. Autos have gotten a bad rap in some circles when the issue wasn't necessarily the mode of delivery, but failure on the part of those who prescribed them in a generic wide open range rather than specific to patient needs. For the person whose treatment at a fixed pressure is not problematic, I wouldn't feel cheated by not using auto. Others may have cause to want that option.

I dont see how auto is more comfortable unless you cannot sleep with your current pressure? The change of pressure may be uncomfortable? Your mask fits nice and tight at 8cm and then when it bumps to 15 it starts leaking

The benefit of auto is that the machine may find a better setting for you than what you have now but 3.2AHI is real good.

A lot of people are sold autos online by internet doctors doling out prescriptions.. autoset 4-20 range and you are all set

and yes, most doctors prescribe the least expensive solution that will hopefully solve your problem .. which they should since that is the ethical thing to do.

If your pressure leaks at 15 then you should try adjusting your mask fit with the pressure at 15.

chunkyfrog wrote:I was titrated around 3 cm too high, and sold an S9 Elite.
After 9 months, I bought an Autoset, and have never gone back.
Too much pressure gave me GAS!

Froggy...Even with the Elite, by using Sleepyhead you could have made a pressure adjustment that would have kept your AHI at a reasonable level.

Nobody knows if I had gas, opened my mouth, or kicked off the covers.
There may be standards in sleep clinics, but these bozos did not get the memo.
At the time, I was so sleep deprived, just SLEEPING was huge.
For the first few months, I struggled to get a mask to fit.
Gas, if there was any, was not an issue---yet. I had bigger problems to address first..
I was new--and had not yet become adventurous.
I was on cpap for 90 days before I even knew about Sleepyhead; and my events DROPPED like a rock when I got my Autoset.

xxyzx wrote:

LSAT wrote:

xxyzx wrote:
========

cost
they try to use the cheapest solution so insurance will pay for it
they dont care about comfort or how well it works
as long as you are compliant with use
and it sort of treats the problem

auto is absolutely best
your needs change constantly
sleep position, stage of sleep, congestion, ...

The OP has an autoset...

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he said he had a Cpap

He shows an AUTOSET in his profile

I have used my machine set on a range of pressures since I started treatment. I was first prescribed 20 - 25 cm H2O with 5 cm pressure support. After a few months , I noticed my pressure was staying at 20 all night long. I tried using lower pressure settings, both fixed and variable with mixed results. Some settings decreased obstructive or hypopneas, but raised my centrals. Others led to higher flow restrictions. After many months of trying different settings, I have settled on a straight pressure of 20 with 3 cm pressure support. My AHI normally stays under 1 most nights with occasional nights slightly over one. The only way to know if a variable setting will help you is to try it. If you don't like it, go back to what you have now.

xxyzx wrote:

LSAT wrote: The OP has an autoset...

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he said he had a Cpap

No. The OP said he was using cpap and thinking of switching to apap. HIs equipment list shows an autoset. So, he is using an autoset in cpap mode.