CPAP vs APAP

After a long time on a CPAP machine I have finally upgraded to a ResMed S10 APAP. I thought this was bound to be a major improvement - automatic adaptive titration, sounds the bees knees!

But I find a disadvantage - I don't really care about apneas, I seem to have survived 30 years at least with no ill effects, my primary concern is killing my snoring so I can sleep with my wife.

Now presumably if a CPAP is titrated correctly it is *proactive* and will smother ALL snoring. The APAP however is *re-active*; examining my Sleepyhead graphs I find that it detects an event, and THEN increases the pressure some way into the event - so this no doubt prevents a string of subsequent events but it doesn't prevent the first one. It appears that I snore for about 10 seconds before it is stifled, repeating 7 or 8 times per night. Unfortunately this is long enough to wake up my wife (and this of course applies to other events as well). So one is never going to get zero events, which one would with a CPAP.

Any comments?

If the CPAP was set to a pressure of 10 and you had mostly no events until for example you rolled to your back then you'd need more pressure to correct this. This is where the APAP shines. You set it to a pressure range of say 10 minimum and the max at 20 and the machine will be at 10 and prevent most events. Then when something changes in your sleeping that requires more pressure it is available.

If you set the apap setting up optimally...it becomes pro active instead of reactive and will prevent those first events you don't want to happen.
It's just a matter of optimizing the settings.
APAP mode can do the same thing cpap mode does if you set it up right.

Yep - I see increasing the max and min is one solution - indeed the ResMed S10 can be used in pure CPAP mode, but then why did I buy an APAP? I was titrated at 12, looking at the Sleepyhead readouts I never go above 8.5 - to be honest I found 12 a bit of a strain and 4 to be very welcome. I suppose I could try setting it at 7 to 12 and see what effect that has.

Just thought I ought to make the point, because it is not that obvious.

Wolstan Dixie wrote: ↑

Wed Jan 16, 2019 10:55 am

why did I buy an APAP?

Well....I have no idea...Only you can answer that question.

But let me share with you why I did.
My OSA is worse in REM...so much worse that I often need pressures 6 to 8 cm higher in REM than in the other sleep stages..and REM makes up about 20 % of the night.

So I often need up around 18 cm during REM...and other parts of the night I do well with around 9 ish.
Now I could set it in cpap mode and kill everything...but I would need 18 cm all night long to do. If you think 12 is a bit much...try 18 all night long.
And to use it all night long just to cover what is needed during REM...way over kill and not very comfortable over kill.
These machines react to more than just a flagged apnea...they don't always wait until something happens that gets a flag before they think about doing anything. There's a lot more to that auto adjusting algorithm than just reacting to OAs and hyponeas.

Wolstan Dixie wrote: ↑

Wed Jan 16, 2019 10:55 am

Just thought I ought to make the point, because it is not that obvious.

Actually if you spent more time here you would see that we talk about it all the time...it is very obvious and discussed frequently and in great detail.
Maybe you don't think it is obvious but most of us here do.

All you need is a good optimal minimum pressure in apap mode to hold the airway open for the bulk of the time and prevent that first whatever that bugs you or your wife...and then let it maybe have a little room to roam around if it needs to for some reason.
It won't go anywhere without a good reason. It's not really all that difficult to grasp if one just uses a little logic and common sense.

Or just use cpap mode and be happy....bemoan the apap mode not being needed...but it is what it is and you can't do much about it now. It's there if your situation should ever change and it might be useful later.

Wolstan Dixie wrote: ↑

Wed Jan 16, 2019 6:48 am

It appears that I snore for about 10 seconds before it is stifled, repeating 7 or 8 times per night. Unfortunately this is long enough to wake up my wife (and this of course applies to other events as well). So one is never going to get zero events, which one would with a CPAP.

Any comments?

Your minimum pressure is too low.

Wolstan Dixie wrote: ↑

Wed Jan 16, 2019 10:55 am

why did I buy an APAP?

Not interested in your introspectives, honestly.

Wolstan Dixie wrote: ↑

Wed Jan 16, 2019 10:55 am

I suppose I could try setting it at 7 to 12 and see what effect that has.

Unless you have a compelling reason, don't lower the max setting from 20.

You fail to get the picture, Snoring is just one symptom of Sleep Apnea, not the main reason to use either manhine. CPAP & APAP, can help snoring, but it's real use is to keep your airway open, so you won't die from not being able to get needed O2 by breathing normally. Although if you can't breath, you will stop snoring in time. (Dead)

APAP is better that CPAP because it can be set as CPAP, options are good if used correctly. Neither unit will work the best unless it's set to your needs. Jim

why did you buy the machine did you have a test done or because you snore?

Because my previous machine was a 23 year old Sullivan IIID and I thought it was time for an upgrade - and I discovered that something unpleasant was happening to the foam lining. I obviously hadn't thought about it deeply enough - I presumed you just left the minimum on 4 and the machine dealt with the rest up to your titrated pressure - I don't think that is an unreasonable assumption for someone not familiar with APAPs. So actually you set it to act as a CPAP for the majority of the time, with the capacity to deal with unusual peaks.

Yes - my primary concern is the snoring - that is what is socially isolating. It is the only effective treatment. I'll chance the rest.

Wolstan Dixie wrote: ↑

Wed Jan 16, 2019 10:55 am

but then why did I buy an APAP? I was titrated at 12, looking at the Sleepyhead readouts I never go above 8.5 - to be honest I found 12 a bit of a strain and 4 to be very welcome.

Didn't you just answer your own question???? You were titrated at 12 which causes you a "bit of a strain". Now with the APAP, your machine "never goes above 8.5". The knowledge gained from APAP can eliminate "the strain".

Wolstan Dixie wrote: ↑

Wed Jan 16, 2019 6:48 am

It appears that I snore for about 10 seconds before it is stifled, repeating 7 or 8 times per night.

Your posts do not clearly state what pressures you are using. But, it sounds like you set the minimum too low.

Wolstan Dixie wrote: ↑

Wed Jan 16, 2019 5:14 pm

I don't think that is an unreasonable assumption for someone not familiar with APAPs.

Like *any* tool, one should familiarize oneself with the proper operation thereof.