Switching from APAP to CPAP

[WillieRioli]

Trying to get back into the routine of using my ResMed Airsense Auto 10 and not sure whether to keep using APAP.

Or

Evaluate the data from that month and a half I used the APAP to switch to a CPAP pressure.

My memory of using APAP was my AHI was averaging 1.5 with little leakage though my daytime sleepiness was still pretty bad.

Any opinions on this? APAP or CPAP?

[LSAT]

Why not just make the switch and see how you feel. It's really no big deal. If you know your average pressure on APAP, use that as your fixed pressure on CPAP setting. Personally, I would always take APAP with a pressure range. Some people dislike the feeling of pressure changes and prefer a fixed pressure.

[WillieRioli]

Why not just make the switch and see how you feel

That's a fair point

If you know your average pressure on APAP, use that as your fixed pressure on CPAP setting

Is it median pressure or the P95 pressure that it should be set to? There has to be an article somewhere on how to use APAP for titration to a CPAP.

I would always take APAP with a pressure range

You prefer APAP because you've tried CPAP and it didn't work for you? Just curious. I know LankyLefty recommends CPAP long term. but like you said it all depends on how you feel not general consensus.

[lazarus]

It's a popular recent position among the YouTube personalities to claim that CPAP has some fundamental advantages over APAP. I believe this is based on their personal assumptions and on scant anecdotal "evidence" from a few rare cases. But that stated position if theirs still gets clicks and captures views and extended eye time, which is too often the real point, I'm afraid.

There's nothing wrong with straight CPAP (or with turning off EPR, for that matter). However I would recommend most modern users first try raising an APAP minimum to within one or two cm of what is needed to prevent apnea (and playing with EPR) for ultimate comfort and therapy success. Then experiment with CPAP later, if one wants, and choose whatever gives one the lowest AHI and best subjective sleep quality over time.

[Pugsy]

I know LankyLefty recommends CPAP long term.

He doesn't walk on water and often recommends stuff that a lot of others don't necessarily recommend. It's his opinion and that's fine but it is just his opinion and he isn't God.

Is it median pressure or the P95 pressure that it should be set to? There has to be an article somewhere on how to use APAP for titration to a CPAP.

Use the median pressure if you are wanting to try fixed pressure.
Don't use the 95% number unless it happens to be extremely close to the median pressure.
95% numbers (for pressure or leak or whatever) just means you were at OR BELOW that number for 95% of the night.
That "or below" part of the definition is critical. Besides the 95% number is too easily skewed to the high side, with a relatively short period of time of being there, to be a good starting point.

[Pugsy]

Side note....if you are someone who sees rather dramatic changes in pressure needs because of positional issues or REM stage sleep issues (both which can cause marked increases in pressure) then fixed mode may not be a good choice for you.

I am a prime example....in REM stage sleep my OSA is hugely worsened (like 5 times worse than non rem) and I often see pressures 6 to 8 cm more in probable REM. If I were to use a lower pressure and fixed then my OSA wouldn't be well treated and if I were to use fixed at 8 cm more...it sure wouldn't be much fun to use 16 cm all night just to take care of REM sleep which amounts to maybe 20% of the night...that other 80 % of the night 9 cm does a great job for me.

[dataq1]

One of the side effects of Cpap mode is that the impact of Flow Limitations index is neutered.

[Max46]

One of the side effects of Cpap mode is that the impact of Flow Limitations index is neutered.

Do you mean that the Cpap does not react to flow limitations?

[Pugsy]

One of the side effects of Cpap mode is that the impact of Flow Limitations index is neutered.

Do you mean that the Cpap does not react to flow limitations?

Fixed cpap mode does NOT have the ability to auto adjust the pressures in response to flow limitations....so it CAN'T do anything except maybe flag them if a person is having them.

Not a big deal if a person doesn't have many flow limitations or a problem with them but a potentially big problem if someone is having a lot of FLs and/or they are disturbing a person's sleep.

There are other ways to deal with FLs besides the auto adjusting pressure feature in apap mode.
So even if a person has some problematic FLs they can usually be dealt with using other measures if needed.

[Max46]

There are other ways to deal with FLs besides the auto adjusting pressure feature in apap mode.
So even if a person has some problematic FLs they can usually be dealt with using other measures if needed.

That might be useful to talk about, unless you already have a link to some place else in the forum. I could start a new thread so as to not go off topic here.

My brother is on CPAP, with low AHI but significant FLs, claims that the FLs which are sporadic through the night does not cause him a sleep disturbance. But obviously something is happening. Maybe he can improve his sleep!

[ozij]

"Anecdotal evidence" is a term relevant to when you're trying to formulate a rule.
The rule you have to formulate is the one that fits you, and only you. Basing decisions on a single night would be using anecdotal evidence. Basing your decisions on consistent observations of you own singular response to CPAP therapy, be the pressure fixe or automatically adjusted by your machine will teach you which type of therapy is best for you.
Despite medicine's adage of "if you hear hoof beats don't first think of zebras" you may well be hearing zebras. The only conditions relevant to you those you are in. Observe them carefully.

[MYRESPCO]

As a Respiratory therapist working in sleep medicine, all MD's are switching to APAP.
why?
Apap changes pressure as your needs change, If you gain or loose weight the machine adjusts to you.
If you turn and toss in your sleep, APAP changes pressure adjusting to your sleeping position.
APAP is basically smart CPAP that will change pressure to remove the obstruction in your airway.

You would be going backwards if you are going to CPAP (just 1 steady pressure)

Yash B RRT

[dataq1]

As a Respiratory therapist working in sleep medicine, all MD's are switching to APAP.
If you turn and toss in your sleep, APAP changes pressure adjusting to your sleeping position.

It does ????

Pressure changes (with APAP) are generally initiated by the machine's perception of a flow limitation or restriction.
That perception is significantly influenced by the shape of the inhalation flow rate curve. What seems to be ignored is the volume flow of the inhalation.

[lazarus]

It does ????

Yes, it does. Of course. Among other things.

As for the nonsensical nature of the rest of your post, may I suggest that it may be time for you to consider mamboing dogface to the banana patch?

[Tec5]

RE: "APAP changes pressure adjusting to your sleeping position."

It does ????

Yes, it does. Of course. Among other things.

Pray tell how does the APAP machine measure sleeping position ?
Is it also reported in a secret OSCAR file?