CPAP and APAP Question

[Wulfman...]

Very true. I think I was hoping to wake up and see some really low pressure numbers. I also thought I would feel better after using the APAP. I actually felt more tired when I got up.

Your experiences are not surprising
Along the lines of what Pugsy said, you've been on a fixed pressure for a lone time and now the pressures are changing all night long. I found the same thing after being on fixed pressure for a year......and my AHIs were higher when I used a range of pressures. The pressure changes have to be REactive instead of PROactive......based on breathing characteristics.
Ranges work for some, but not for everyone. Certain breathing characteristics (mostly Snores and Flow Limitations) are what drive pressure increases. In some cases (the criteria varies according to the manufacturers' algorithms), the machines will respond to apneas, but it's pretty "iffy".
Look at your reports for the Flow Limitations and Snores and you may see why it went to 15.

With your fixed pressure, you might try a slightly higher setting than 12, too. How long did you try the setting of 11? It may have been a fluke, if it was a short-term experiment.

Nothing wrong with getting an additional machine......and an APAP......they have more options for settings if you feel the need to experiment. Also, you could try experimenting with the "Flex" settings. They're not supposed to make THAT much difference, but after years of using a C-Flex setting of 2, I turned it off altogether (in 2013) and my annual AHI average dropped even more.....from 0.4 to 0.2 and 0.3.


Den

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[Janknitz]

I do want to try to get an APAP. My current CPAP is 4 years old and I don't think my insurance will let me get another one til after 5 years and I don't know if they will let me get the APAP or not. I think after this 30 days trial, if my pressure does fluctuate allot during the night, they may consider it.

Just so you know, your insurance company DOES NOT CARE IF YOU GET AN APAP OR A CPAP. The APAP can be used in CPAP mode if you prefer, so if you want one just to experiment as you are now, that's fine. Insurance companies pay by HCPC codes (billing codes) and it's the SAME billing code for APAP or CPAP. The fight is with your DME (who will tell you your insurance won't cover an APAP, but that's not true).

As you near the five year mark, your best bet is to choose the make and model of machine you want (Currently the best ones are Resmed Airsense Auto or Philips Respironics Dream Station Auto). Then ask your doctor to specify exactly what you want on your new prescription and also write "Dispense as written". The insurance company won't care because they pay one amount no matter what you get. The DME won't like it (because it cuts into their profit margin), but they have to follow the prescription and in general (with some exceptions) they cannot charge you a penny more for an auto over a CPAP.

Don't get stuck with another CPAP for 5 more years if you really want/need an APAP.

[lzicc]

Thank you Pugsy for that explanation. It makes allot of sense. I am going to see if they can turn the minimal number up to about 8 or 9 just to see. It seems obvious that I don't need anything less than that. I talked to my therapist and they are going to remotely chance the lower pressure to 8 to see if that works better for me.

I also agree with the change from CPAPA to APAP. It feels weird now when I put my mask on and the pressure starts that low. It's almost too low to be comfortable when I go to sleep.

Wulfman, I only had it set at 11 for about a week and a half. I did try going to 13 a while back, but it didn't seem to make a difference in my AHI and with the pressure that high, I had to tighten the mask more which I keep it fairly tight as it is since I move around so much when I sleep.