CPAP vs. APAP

WindFlyer · Post by **WindFlyer** » Sat Apr 02, 2005 8:11 pm

I've been reading a lot on the boards about how APAP rules, and I'm not disagreeing with that, but I have a question: Right now I use a CPAP (11cm) and I don't feel uncomfortable at all. In fact, believe it or not, I've had 100% compliance. It seems like the major reason everyone wants to go APAP is because they feel uncomfortable exhaling against pressure. For me personally, though, I'm not bothered by it in any way. Is there any drawback to just staying with CPAP in my case since I'm able to handle the max needed pressure all night long?

Thanks in advance...

nodding off · Post by **nodding off** » Sat Apr 02, 2005 8:28 pm

No problem, in my opinion. After 9 years I went on APAP 2 months ago because I thought it would make a difference by providing the pressure levels I needed. I had not revisited the sleep lab in those years and wanted to be sure I was getting the therapy I needed. My apap titrates me at between 12-13 most nights, which is higher than my prescribed pressure of 10. I just had another sleep study, so we'll see if the results are the same. As far as comfort goes, I had to adjust the lower end to 9 PSI to reduce the number of Hypopneas I have, so I am experiencing more on the higher end. However, if that is what my body needs for restful sleep, so be it. That makes apap worthwhile for me. If you are comfortable and rested with straight cpap my advice (I'm not a doctor, so take it for what it's worth) would be.. If it isn't broken, don't try to fix it!

rested gal · Post by **rested gal** » Sun Apr 03, 2005 12:43 am

I agree with nodding off - if cpap suits you fine, no need to change to another type of machine.

I've often said I'm probably just a plain straight cpap'er at heart. I can breathe out fine against any pressure up to about 14. My autopap usually goes no higher than 12 or so. Probably if I were titrated for one pressure it would be 11, maybe 12. And I'd do fine there.

So, why did I get an autopap anyway? I wanted a machine that would vary the pressure just in case I ever needed more. I also liked the idea of having less pressure delivered any time less pressure would do the job....less pressure going, usually less change of mask leaks. I also wanted to use software to see my overnight data.

I could do fine without all those bells and whistles. I do like the idea of not having to bother with a sleep study - now or in the future - with the autopap finding the best pressures for me all night, every night.

But if a person is comfortable with their cpap and are getting good treatment, there's really no compelling reason to go to something else. Good treatment is good treatment.

littlebaddow · Post by **littlebaddow** » Sun Apr 03, 2005 3:29 am

rested gal wrote: But if a person is comfortable with their cpap and are getting good treatment, there's really no compelling reason to go to something else. Good treatment is good treatment.

I think the key is 'getting good treatment'
If your pressure need changes to a higher setting, then the effectiveness of treatment on a CPAP is then presumably reduced somewhat, whereas the APAP will adapt. If the 'brain fog' and other symptoms then creep up on you gradually so you don't immediately notice, then I guess it's a question of whether you might be doing any damage to your health.
Perhaps consider changing to an APAP when the machine is next replaced - it can't do any harm to have the flexibility it offers.

Marie · Post by **Marie** » Sun Apr 03, 2005 6:19 am

I have the same question.So far,I am satisfied with cpap,I am also on 11 pressure.I just can't believe all the trouble so many people are having.I feel so lucky.I have the respironics comfort classic nose mask.Good results with that also.Been on both since September of 04.
Have used them every night without fail.
Still getting about 4-5 hours of sleep on average,and I don't fall asleep every afternoon as I did in the past.

But,I'm beginning to wonder that since I don't really dream that often,if my cpap is set at the right pressure.And I am still a very light sleeper.

So far,no one has suggested that I have another sleep study.Or even mentioned it.Do they(RTS) just wait till you have a problem?
Should the sleep study be done every so often on a regular basis?

Marie

rested gal · Post by **rested gal** » Sun Apr 03, 2005 3:28 pm

Marie, I'm not a doctor, but here's my take on dreaming.

You said, "since I don't really dream that often"...

Dreaming is a healthy part of the process of sleep. Not remembering dreaming doesn't mean you weren't dreaming.

It's possible (probable even, imho) that you are really dreaming along just fine. You're just not waking up in the midst of a dream. REM sleep, when most dreaming occurs, is also when the muscles are mostly in a paralyzed state of relaxation and when most "events" - apneas and hypopneas - are likely to happen. If treatment is not preventing apneas and hypopneas very well, I'm of the opinion that we are likely to have our REM sleep disturbed - more likely for an apnea or hypopnea to wake us up in the middle of REM. If it wakes us up sufficiently, we're more likely to remember the dream or at least the fact that we were dreaming.

If the cpap machine keeps you sleeping peacefully through REM like you should, you won't even remember having dreamed. An exception might be if you're awakened in the morning during the last dream of the night - during the much more extended periods of REM that happen as morning draws nigh. An alarm clock, people stirring around in the house, dog wants out, neighbor starting a car, etc.

So, I think not remembering dreams is a good thing. It might very well even be a sign of cpap treatment doing exactly what it's supposed to do. Just my two cents. I rarely remember dreaming and feel very rested each morning.

littlebaddow · Post by **littlebaddow** » Sun Apr 03, 2005 5:10 pm

rested gal wrote: So, I think not remembering dreams is a good thing. It might very well even be a sign of cpap treatment doing exactly what it's supposed to do. Just my two cents. I rarely remember dreaming and feel very rested each morning.

I'm also not a doc but I'm with rested gal on this. Before diagnosis, and particularly during the period when my symptoms were most evident, I was aware of unusually vivid and disturbing dreams. Now, with treatment working well for me, I rarely remember dreaming.

Newsgrouper · Post by **Newsgrouper** » Sun Apr 03, 2005 6:07 pm

I'm still awaiting my Respironics CPAP with C-Flex. The more I read here the more afraid I become that I will not be well served by the prescribed machine and that I should have an APAP instead. Are my fears founded?

rested gal · Post by **rested gal** » Mon Apr 04, 2005 12:22 am

A lot of people are no doubt using straight cpap just fine and getting great treatment. Just because a lot of us on the message boards choose to use autopaps, it doesn't mean you have to worry that you're not going to get "as good treatment" from a straight cpap machine.

LittleBaddow made a good point in favor of using autopap - being...if the pressure you need changes in the future (or wasn't found correctly during the sleep study titration) the autopap can find what you need, night after night, month after month.

Autopap can be set to operate as a straight cpap, if that's what your doctor and you prefer. Two types of machine in one, for not really much more money. A lot of flexibility, as LittleBaddow said. Convincing a doctor and an insurance company and a DME of that can be another matter.

But as far as getting effective treatment, Newsgrouper, a straight cpap can give you that, too. After you try it for awhile, if you don't feel that you're getting good results, perhaps you can get your doctor to let you have a trial on an auto with C-Flex to see if an autopap makes any difference.

If you can get the order switched to the Respironics Auto with C-flex, I'd do that. But if you can't, I wouldn't worry.

billionzz · Post by **billionzz** » Mon Jul 17, 2006 2:46 pm

Any suggestions on what to tell your primary care doctor, sleeep doctor or sleep study center so you can get an apap?

Thanks

oldgearhead · Post by **oldgearhead** » Mon Jul 17, 2006 2:56 pm

I think the biggest reason is body position. Most people, myself included require different pressures for different body positions.

snoregirl · Post by **snoregirl** » Mon Jul 17, 2006 3:01 pm

I also have an apap. Not because the CPAP didn't work. Right NOW the pressure setting (13) is fine. I find that a lot of the night I am on 10 my low setting and my ears (stuffyness from pressure), stomach (swallowing air), and mask (leaks) are happier with the lowest possible setting that will do the job. APAP gives me this lower pressure for part of the night.

ALSO I did not enjoy my sleep studies at all nor did I enjoy the expense that I incurred having them. (my copay for the studies was more than an outright APAP purchase)

ALSO I tend to change weight, and while weight MAY not affect apena, it very well may for me and I want to make sure when I lose or gain that the machine adjusts WITHOUT the expense of a sleep study.

All this considered (comfort and expense) since I have to foot the bill for some of this (copay) I decided that an APAP would serve me best. Not everyone would agree for themselves.

I decided that if I don't feel that APAP is good on a regular basis, I can easily turn it into CPAP.

But it is all about choice for me.

billionzz · Post by **billionzz** » Mon Jul 17, 2006 3:38 pm

So do you think the doctors will listen to this common sense reasons for having an apap?

If you have to wait 5 years between machines it only makes sense.

rested gal · Post by **rested gal** » Mon Jul 17, 2006 4:39 pm

billionzz wrote:So do you think the doctors will listen to this common sense reasons for having an apap?

Just depends on the doctor's attitude toward autopaps. With a bit of luck, your doctor will be one with commonsense and will not be one who responds with a kneejerk "NO" response when a person asks for something the doctor didn't think of first.

Here are a couple of topics with interesting discussions about doctors who won't prescribe autopaps:

Feb 19, 2005 subject: "Sleep Doctor" doesn't like autopaps

Jul 25, 2005 subject: DOC WOULD NOT PRESCRIBE AUTO C-FLEX

billionzz wrote:If you have to wait 5 years between machines it only makes sense.

Yes, I think you're right.

harikarishimari · Post by **harikarishimari** » Mon Jul 17, 2006 4:48 pm

I have been using an APAP for about 8 months now. I have noticed that the AUTO titration pressures drift between 8 and 11 cm. This seems to be most closely related with mild allergies, which I am just becoming aware of. I have always lived in a humid climate where it rains almost every day, and now I live in a desert area where the air is dry (hate it!) and the winds bring pollens and allergens depending on the season. It could be my imagination, but I can almost predict my pressure setting on the APAP by reading the pollen report. I suppose one could do that with a CPAP if you had the data card and the software and LOTS of spare time with nothing better to do. Otherwise I think it would be very hard to keep up with the drift in pressures. The nice thing about the AUTO is that it adjusts AUTOMATICALLY. I don't need the data to change the pressures, I only look at it to see what is happening. I find it very informative. Only a guess, I would guess that there are a lot of people using CPAP and don't even suspect their 90% titration values drift all over the map. How would they know? Especially without data.

-HKS

(right now it is 107 deg, and 16% humidity. ARRRRRRRRRRRRRRGH!)

CPAP vs. APAP

CPAP vs. APAP

Good results with cpap

seasonal changes in pressure requirements

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