Auto better than fixed CPAP? total newbie question

graygables · Post by **graygables** » Sun Jul 06, 2008 9:32 pm

when I mentioned it to my sleep study therapist, she said that auto CPAPs were "too expensive" and "don't work all that well". Long story, but I had to buy mine OOP and opted for the GoodKnight since it was the most affordable. Now that I'm a month into it, I'm beginning to have buyer's remorse. Should I try to sell this one and get the auto or should I just wait until I need a new machine?

I don't know how they can possibly do a titration when I was barely able to sleep w/ a mask that kept slipping off and having to be adjusted, but maybe I don't know that much about it...

Gray

ozij · Post by **ozij** » Sun Jul 06, 2008 9:52 pm

Any auto can be run as a fixed pressure machine.

No fixed pressure machine can be run as an auto.

Different autos have different algorithms, and for some people, one machine's auto can be great and the other machine's auto can be terrible.

Some people do much better with autos. Let's assume than only about 1% of cpap users need an auto to get proper therapy. If you belong to that 1%, you need it, 100%.

Should you buy an auto? If your present machine is a 420G - a machine that doesn't even track your data - (and you can afford it) then I would say yes.

If your present machine is a 420S, I would say: Buy the Silverlining software first, and use it to track your results. If it turns out you feel well and have a low AHI - then you don't need an auto.

If, on the other hand, you don't feel well, and you can't get both a low AHI and a feeling that the therapy works - then yes, that might mean you will do better on a self adjusting machine, and the Silverlining software will be there for you to read results off a GoodKnight 420E - which is Puritan Bennett's automatic (i.e. self adjusting) machine.

Should you decide to buy a 420E, be sure to read these instructionabout setting it up - the majority of DMEs do not know how to set it up properly.

Welcome to the forum, and good luck
O.

Snoredog · Post by **Snoredog** » Sun Jul 06, 2008 10:21 pm

auto is MORE flexible than a CPAP.

-auto can give you reports on how you did the night before
-auto can be set with a lower starting pressure and still address your OSA to normal limits
-being the auto can be set lower it will be quieter, when it increases pressure you are most likely asleep so you won't notice it
-auto can reduce the number of trips and expense to see the sleep doctor (real reason they don't want you to have one)
-have difficulty with therapy the auto will be what most likely gets you past it

difference in cost between the CPAP and Auto is minimal, over 5 years it is nothing.

-auto has a greater resale value should you decide to sell it.

Wulfman · Post by **Wulfman** » Mon Jul 07, 2008 5:55 am

graygables wrote:when I mentioned it to my sleep study therapist, she said that auto CPAPs were "too expensive" and "don't work all that well". Long story, but I had to buy mine OOP and opted for the GoodKnight since it was the most affordable. Now that I'm a month into it, I'm beginning to have buyer's remorse. Should I try to sell this one and get the auto or should I just wait until I need a new machine?

I don't know how they can possibly do a titration when I was barely able to sleep w/ a mask that kept slipping off and having to be adjusted, but maybe I don't know that much about it...

Gray

When it comes to "too expensive"........how much is your health worth? The difference between a data-capable CPAP and the Auto is about one visit to the doctor's office.
As far as "don't work all that well".......that's partially true but REALLY true if they're not configured properly. A pressure range that's too far apart from the "needed" pressure is not efficient and will give you sub-standard therapy because it has too far to go and will take too much time to get to where it needs to be.

I put my first priority in data-capability. Set to a range of pressures, an Auto isn't the "end-all be-all" therapy for everybody......but like the others have said, they're flexible because they can also be set to straight pressure (CPAP mode).....and virtually all of them are data-capable.

If you should decide to get another machine, there would be nothing wrong with keeping your existing machine for a backup. Many, many folks will tell you that it's GOOD to have a spare machine sitting around.

Den

TerryB · Post by **TerryB** » Mon Jul 07, 2008 11:57 am

I have an auto and seldom run it in auto.
I look at my reports every Sunday morning and adjust as I see fit.
You could make minor "educated guess" adjustments to your single setpoint machine if you get the software. You might not really need the auto adjustability.

My $0.02

TerryB

DreamStalker · Post by **DreamStalker** » Mon Jul 07, 2008 12:31 pm

Everyone is different but I'm one who does signficantly better with APAP -- and I have tried most of what is available ... cpap w/exhalation relief, cpap w/o exhalation relief, apap w/o exhalation relief, and apap w/ different kinds and settigns of exhalation relief and on different brands of machines.

It's not that much more to get a machine with all of the options and then experiement to see what combination of options works best for you. Its all about options and when it comes to health, I think more is better.

Needsdecaf · Post by **Needsdecaf** » Mon Jul 07, 2008 1:39 pm

I think the software is the most important thing. I am monitoring my results and am running an average of about 2.0 AHI, and am on straight CPAP. To me, combating mask leaks is a bigger issue than the pressure.

My pressure has been adjusted up 1.0 CM since I was titrated. I found that bumping it up 0.5 significantly reduced my AHI down from around 5 to around 1.75, and then between the longer hose and full face mask it popped it back up. A kick up another 1/2 cm brought it back down.

Of course, my pressure is relatively low, 9, and as always YMMV.

sleepngo · Post by **sleepngo** » Mon Jul 07, 2008 2:05 pm

I agree with everything that has been said so far, but I would like to add that for me it was a matter being able to tolerate the machine or go off Cpap, due to a bad case of GERD and Aerophagia.

I tried straight Cpap, auto with Cflex, auto with Aflex and Bileve auto with Biflex and the gold standard for me is Bileve auto with Biflex. I did very well on all four machines, but could only control the aerophagia while on the auto's. Bileve being the best for me because I can fine tune the Ipap and Epap to get the best pressure to control aerophagia while achieving a low AHI. The Apap auto also gave good relief but the Bilevel gave me the most natural breathing while controlling aerophagia.

Even if I had-den suffered form GERD and from what I now know about the Auto's I would still prefer the auto's over straight Cpap. Almost forgot to add how important it is to be able to monitor you data, with the ability to do that I was able to achieve a good trade off between AHI and aerophagia and still wake up feeling great.

Dan

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CPAPopedia Keywords Contained In This Post (Click For Definition): cflex, CPAP, AHI, auto, APAP, aerophagia

Auto better than fixed CPAP? total newbie question

Auto better than fixed CPAP? total newbie question

Re: Auto better than fixed CPAP? total newbie question