CPAP versus APAP

RickinNH · Post by **RickinNH** » Mon Jun 11, 2007 9:46 am

Since my REMSTAR Plus machine did not have the software capability I complained to get the Pro model and they finally agreed to replace the Plus model. however I have found out that they are giving me an APAP instead of the CPAP. Is this better for my therapy? Do most of us need an APAP or a CPAP...or does it matter?

Goofproof · Post by **Goofproof** » Mon Jun 11, 2007 10:21 am

Steak vs Hamburger, which is better? Considering the DME gave you Roadkill, both would be better than the orgional, The APAP is a CPAP too, So is more better, Yes most of the time. When you get the A-1 (Software), you will be ready for a Meal. Jim

RickinNH · Post by **RickinNH** » Mon Jun 11, 2007 10:52 am

I know it costs more but what advantages will APAP have for me? I thought the APAP is for those who can not attend a sleep trial, since the pressure varies based on feedback from apnea events. Why doesn't a sleep doc prescribe the APAP if it is better therapy.
Sorry to ask so many questions, I just don't trust the DME. They don't seem to have my best interest at heart.

snoregirl · Post by **snoregirl** » Mon Jun 11, 2007 10:58 am

Advantages for an apap vs cpap are (but not limited to)

Reduction in air being swallowed as you run at lower pressure when higher pressure is not necessary. Most of us have varying needs during the night and from night to night, the apap if set for an appropriate range can give you what you need at the time and not more.

You can use the APAP to recheck your sleep study results, now or in the future, thereby avioding costly retitration studies

I am sure others can think of more, but those alone are enough.

Take it and run!

If you find you do better on straight CPAP, some do, then you can set up the APAP to be just that, and down the road when you feel the urge, you can set a range and do your own mini sleep study to see where your are.

Slinky · Post by **Slinky** » Mon Jun 11, 2007 11:02 am

Yup. SnoreGirl said it all. Count your blessings, thank your lucky stars, IF you REALLY ARE getting an autoPAP. Grab it and run whilst you can.

dsm · Post by **dsm** » Mon Jun 11, 2007 5:44 pm

Rick,

If you have the choice and don't have to pay the difference the Apap is without doubt the best choice.

- It can run in cpap mode

- Autos have the best data collection capabilities of almost all machines on the market

I think you can say you are lucky on this

DSM

TXKajun · Post by **TXKajun** » Tue Jun 12, 2007 8:22 am

Hi, Rick. I've had an APAP (PB 420E) for about 2 1/2 years now. For the first 2 years and 3 months, I ran it in APAP mode, doing some regular monitoring using the Silverlining Software. It worked pretty good. Most of my symptoms went away (excessive sleepiness at work, falling asleep during movies or travelling, total lack of energy, etc). But it was only in the last couple or 3 months, since I switched over to CPAP mode, that I've really felt "back" to normal.

I was titrated at 16 cm, AHI of 105 during sleep study. Running under APAP mode (pressures from 8 to 15 cm), my AHI was consistently 2-3, maybe up to 4.5 once in a while. Using CPAP mode at 14 cm, my AHI is 1.7 or less, with all of it coming from hypopneas.

So, for me, CPAP is da bomb!

Like everything these days, YMMV.

Kajun

Guest · Post by **Guest** » Tue Jun 12, 2007 8:55 am

Make sure that they're giving you a NEW machine (whether it be a "Tank"/"Classic" or M Series) and not something that's been sitting back in their inventory for several years.....or one that somebody else used for a couple of years. If it's an M Series, it SHOULD be a new one although they've been available since about this time a year ago.
I would make them verify the "blower hours" (which should be less than 20 or thereabouts) and document that.
The "user hours" can be zeroed out, but the "blower hours" can't be.
If it's a REMstar Auto, make sure it has C-Flex.
If they give you a ResMed S8 Vantage (APAP), it won't have exhale relief (EPR) in Auto mode. REMstar's do have C-Flex in Auto mode.

I own two Autos and a REMstar Pro 2 (CPAP) and use them all in fixed-pressure mode at 12 cm. After starting with the Pro 2 and the Encore Pro software, I was able to "dial in" my pressure, but then about a year ago, after I got my first Auto, I ran it in a range for a week and verified my pressure......and that the pressure my sleep doctor had prescribed (18 cm.) was much higher than I needed.

Den

Guest · Post by **Guest** » Tue Jun 12, 2007 1:55 pm

Thanks Wulfman,

I was wondering how to keep them honest about whether the machine was new. Do you know how to check the "blower Hours"?

Guest · Post by **Guest** » Tue Jun 12, 2007 2:39 pm

Anonymous wrote:Thanks Wulfman,

I was wondering how to keep them honest about whether the machine was new. Do you know how to check the "blower Hours"?

I BELIEVE (I don't have a machine where I'm at) that it either flashes it on as you plug it in or when you hold the two < > user buttons and plug it in (to enter the setup mode) and is one of the first things to be seen in the setup mode. (I think it's in Setup mode)
User hours are shown on the display screen any time the machine is plugged in (doesn't have to be running) and will be in a format like NNN.N (whole numbers with a decimal number). These can be zeroed out by selecting an option upon entering Setup mode.....but the blower hours can't be (without being sent back to the factory).

Also, if it's a "Classic", another clue to tell how old/new it is would be by the firmware version......which is also seen briefly in one of those previously mentioned startup modes. All of the newer "Classic" machines would have version 2.7 level firmware. I don't know if they've gone higher than that, but that's what my newest Auto and Pro 2 (which went back to the factory last September) have in them. If you see a 2.7 (or whatever) briefly come on the screen, that would be the firmware version.

FWIW, when my Pro 2 went back to the factory, they upgraded the firmware (from 2.5 originally), zeroed out the user hours but did not zero out the blower hours.

Den

RickinNH · Post by **RickinNH** » Tue Jun 19, 2007 6:08 am

I just received the Auto RemStar with a smart card. The DME did not enable the screen to view HI and leaks but I was able to change this with info from this forum. They set the machine up as the doctor prescribed, 12.0 cm H20 and as a CPAP with Cflex. Is there some software that I need in order to view additional information or is it enough to see the Hypopnia index and leak info? The machine has a card but I would have to bring this to the sleep center to read it.

Should I set a range around the 12 cm H2O and try the unit as an APAP?

ufo13 · Post by **ufo13** » Tue Jun 19, 2007 9:32 am

Rick:

I would definitely try this machine in AUTO mode at a range of say 10 cm to 14 or 15 cm's. Also try it with(setting 1,2,or 3 c/flex) and without c/flex and give it a try for a few days and see what you like and how you FEEL! Then give it a try in straight CPAP mode at your titrated 12 cm! See what works best for you! As far as the software goes I don't think it's available for purchase anymore in the normal pipeline, but maybe Den (wulfman) or one of the other Respironics experts on this forum can give you better information on the software!

All the best!

Steve,
ufo13

rested gal · Post by **rested gal** » Tue Jun 19, 2007 10:40 am

Rick, please check your PM's. Button at upper right of this page.

CPAP versus APAP

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