Can anyone use APAP?

Can anyone use an APAP machine? My pressure is set at 8....would I be able to use one? It sounds like the newest technolgy to help facilitate compliance. Will I have to battle with my insurance company for it? Does the dr. need to write a prescription specifically for APAP? I am so thankful for the education here.....didn't get much when they gave me my machine.
Does it matter what the patient wants in terms of a machine? Do we have any say in the matter if insurance is paying for it?
Thanks!

Are you thinking APAP would be easier to exhale against?
Minimum pressure on these machines is 4 cm. If you only need 8 cm...in theory you could probably get by with 4 cm minimum and maximum near your 8 cm. Most people find that 4 or 5 cm pressure to be rather stifling and not comfortable anyway.

You might want to read some information that one of our forum members has written down about insurance and cpap machines and apap machines.
http://maskarrayed.wordpress.com/what-y ... me-part-i/

thanks for the link.........I am going to read it now.
Do you think APAP would be uncomfortable because my pressure is low?
It is the exhalation part that is difficult for me.......can't breath out against the pressure. Thanks again!

Three years ago I started out at 6 min and 8 max I tolerated this very well with a nasel mask . You can see by my profile how my pressure has changed over time and you can not do this as easy with CPAP.

APAP is not a miracle cure for exhale relief problems. How come you are thinking APAP now? Not that APAP is bad because it isn't but if you used any APAP without exhale relief you are going to be in the same position you are in now. APAP is a variable pressure in the sense that the machine will increase the pressure in response to events..it doesn't vary the pressure greatly while you are awake when you are having difficulty exhale. APAPs will do whatever exhale relief that the brand will do but when using APAP...the minimum pressure is constant (within whatever exhale relief it has) and doesn't change until the apneas try to happen.

Now BiPaP machines will greatly help people with exhale relief problems because they can be set to have one pressure for inhale and one much loser pressure for exhale....BiPap machines do require another RX for sure and your 8 cm pressure needs is going to make it difficult to justify the expense. Now if you used 16 cm pressure...might stand more of a chance.

You really need to try a machine that offers real exhale relief to see how you do with normal exhale relief before going down the other roads.

APAPs are nice...2 machines in one and if you can get one...great..but APAP alone may not fix your exhale relief problem. APAP with 6 minimum would be more comfortable and close enough to your 8 cm needs to treat well.

Thanks for your help. I really don't know what I need. When I went to pick up my machine, the DME guy took out the machine, showed me how to turn it on, and all the "nice" features (alarm clock, humidity, etc.).
When I went back to tell them I was having exhalation problems and explained it to the nurse practitioner, she told the DME guy "she's done some research", as if indicating I wasn't a complete no-brain.
I am really trying to be prepared for my next visit on Tuesday, when I will be given a different machine. The DME guy told me today they were looking at something with EPR for me.
I want to make sure I am educated and that I get the best machine for me and my sleep apnea. I had over 80 events per hour. That is about all they told me when I went back after my sleep study. I do not feel very informed about anything at this point, but I am pretty medically savvy. I have been reading alot, and I really appreciate the link on the DME.....that was GREAT!
So, I feel like I have a lot resting on my shoulders. That is why I am trying to figure out what I think will work for ME. Sorry to say, but the DME people I saw were clueless. They wanted me to try a heated hose to see if that helped with the exhale. I got home, and the hose leaked all over the place. I called them and told them there was a problem. Seems they forgot to give me the adapter piece for the heated hose....YIKES! That is unexcusable if you ask me. I am just trying to be prepared. I will be happy if I find a machine that allows me to exhale more easily. Thanks again for all your help, and any further suggestions are greatly appreciated.

imsleepynomore wrote:Three years ago I started out at 6 min and 8 max I tolerated this very well with a nasel mask . You can see by my profile how my pressure has changed over time and you can not do this as easy with CPAP.

What does it mean Additional Comments: APAP 10-16 in the above post signature line? Is it either 10 cm OR 16 cm? In the two APAPS that I am familiar with (S9 APAP, and the Respironics comparable one which both have three degrees of exhale pressure reductions either by EPR or Flex) ) if you set the machine on 16 cm max or even 13 cm max then you'll be exhaling into at least into 13 cm or 10 cm which is a lot to exhale into.

We all know that a BiPAP cpap is the only answer when the problem is exhaling pressure.

BTW, APAPS are not suitable for certain ailments. For those involved with heart conditions and also APAPS are worst when hi blood pressure treatment is involved.

One of several sources:


http://chestjournal.chestpubs.org/conte ... /1393.full

Between now and Tuesday really study up on what machines will do full data and offer you the exhale relief you need. Avoid anything with "Escape" in the ResMed name.

I have used both the ResMed S9 and the PR S1 machines. I am thinking that you might like the S9 EPR exhale relief better than the Flex relief of the PR S1 machines. I could be wrong but the drop in pressure during exhale is a significant drop which you most likely will find very easy to exhale against. EPR would be available on either the straight cpap machine or the autoset.

Respironics machines have the various "Flex" exhale relief options. These reductions are smaller and based on your own breath. If you are having trouble exhaling against 8 cm pressure then your breaths may not be very forceful and thus the exhale relief reduction in pressure with the Flex options may not be as apparent.

Your best option would be to try a machine with some sort of specific exhale relief at your pressure and see what feels better to you.

avi123 wrote: What does it mean Additional Comments: APAP 10-16 in the above post signature line?

This typically means that the minimum pressure setting is 10 and the maximum pressure setting is 16. When the machine is first turned on, the pressure starts out at 10cm. As the machine detects flow limitations, snoring, OAs, and hypopneas, the machine raises the pressure setting. But it will not raise the pressure above 16cm regardless of whether the machine continues to detect flow limitations, snoring, OAs or hypopneas.

---And the further apart the low and high settings, the longer the machine will take to reach the higher pressure, should you need it.
Place the two values far enough apart, and apnea gets a head start, rather than being prevented.

I been using a S9 Autoset for almost a year but my obstructive apnea index is still rising. That my AHIs are rising too it's self explanatory, the AHI value contains the Hypopneas and we all know that Resmed's chief scientist who developed the S8 and S9 Autosets said to ignore all Hypopneas i.e if so, also ignore all AHIs.

My last PSG from a year ago prescribed a plain CPAP set at 5 to 7 cm. However, since it had no effect on my treatment I kept raising the pressure continuously and gradually up to my present 16 cm as max pressure. However the APAP is still asking to raise the pressure further. This can be seen by having the pressure graph still hugging the max pressure line. BUT, since the AASS specified a BIPAP machine for persons who need pressures above 15 cm, I am due for a new PSG Sleep Study which would verify my case and also advice the optimal set pressures by doing a titration (assuming that the attending Tech is not amongst those a morons).

In my opinion, I should have insisted on a BIPAP machine right from the start. All those EPRs and Flexes used on CPAPs and APAPs are causing instability in the respiration system, which is bad. This is besides the lack of these machines to provide a comfortable low exhalation pressure.

I might come back and post some graphs showing my battle with my APAP.