CPAP to APAP?

[Muse-Inc]

Would appreciate any insights from those of you who started on CPAP and went to APAP: why and benefits, please.

Thanks all who posted re APAPs and lower morning-fasting BGs in the 'Diabetes & Apnea' thread...will discuss with sleep doc @ Monday appt. My BGs are resistant to lowering; I've been blaming my excess wt or some undiagnosed cardiac prob and generally feeling bad that my wt loss stalled at 50#s. Now, recognizing that I've been having events, usually multiple every night that wake me up, that I haven't awakened feeling refreshed in wks (mos?), that others see me sliding back into the horrible behavior I had pre-CPAP, that I have the dark circles & tired appearance of my pre-CPAP days, it sure seems like my apnea is not being treated effectively right now. Sure wish I knew what my sat O2s have been during these nightly events.

I have lots to discuss with my doc as my current situation is unacceptable when I could be in charge of my daily apnea therapy. I was thinking a data-capable CPAP with EPR might be sufficient but maybe I really do need an APAP. Wish me luck in dealing with my doc, my insurance co, finding the $ for my co-pays living on unemployment.

Thanks all for any insights!

[billbolton]

Would appreciate any insights from those of you who started on CPAP and went to APAP: why and benefits, please.

I used non-data capable Resmed S7 and S8 Lightweight CPAPs for several years, before acquiring a data capable Resmed S8 Autoset Vantage APAP from a fellow CPAPtalker a couple of years ago.

I tried various APAP setting approaches but with all of them I ended up feeling less well rested than I had on straight CPAP. So now I use the APAP in CPAP mode, with EPR enabled (which is a nice-to-have but not strictly necessary).

The big differnce for me was the data capability, not the auto capability. The availablity of nightly data plus analysis software has enabled me to fine-tune my treatement, which I discovered needed some adjustment between seasons (in terms of mask/hose fittings) to remain at optimum efficacy.

Cheers,

Bill

[mthomtech]

Bill,

What kind of things did you adjust ... different masks, etc?

I'm currently using a straight CPAP (F&P HC234) and I'm happy with it. But as fortune would have it, I'm getting ready to be laid off from my job, and have a bunch of flex spending account money to spend ... so I figure I might as well spend it on a top of the line machine and accessories here at cpap.com.

I was considering the F&P SleepStyle 608 with the heated tube, but the more I read I'm leaning toward the s8 AutoSet II. I like the idea of the data capabilities, amd the APAP functionality sounds good ... but I think I'll be like you and end up really using the CPAP setting. But just think of how much I could learn from the data analysis from both modes. Then I was thinking the S8 Elite II may be an option since it is cheaper, but without the APAP functionality.

One last question ... I noticed the S8 asks you to select the mask used, and of course they are ResMed masks. I use a mask similar to yours ... I use the F&P Zest ... used to use the HC 407.

Any thoughts would be appreciated.

Michael

[kteague]

I'm with Bill on the data being the most important feature. I have used cpap then apap and now cpap again for over a year. I was getting good numbers on apap, but my doctor wanted me to use cpap since my sleep is so fragile and pressure fluctuation was a variable I could eliminate from the list of possible contributing factors. My numbers are equally as good on cpap (AHI between 0.0 - 1.9). If money allows and you want more options, go for it. But I wouldn't feel I had "settled" by getting a data capable cpap. I will say the air in my belly wasn't a problem on apap. Don't know if that issue arose because of cpap at a consistently higher number or cflex.
Kathy

[mthomtech]

I wish that the F&P's had data capabilities. I'll probably go with the AutoSet, just becuase the I have the use the flex spending money or I lose it anyway.

[billbolton]

What kind of things did you adjust ... different masks, etc?

I found that I needed to adjust the headgear fitting between summer (looser) and winter (tighter), and also started using a SleepZone heated hose over winter. With those changes I could hold my better (summer) efficacy results pretty much all year round.

Cheers,

Bill

[mthomtech]

Thanks for the reply. Last year, I added a snuggle hose cover to my hose, and that really helped in the winter to stop the rainout.

I just ordered the S8 Auto Set II w/ humidifier. I also ordered the software from cpapaustralia.

Does you version of the S8 have a mask setting? And if so, what do you use for the FlexiFit 405?

[billbolton]

And if so, what do you use for the FlexiFit 405?

I just use "Standard"

Cheers,

Bill

[Paul56]

Would appreciate any insights from those of you who started on CPAP and went to APAP: why and benefits, please.

I am the opposite. I started on APAP and went through the pains of narrowing down my range but after a few months switched over to CPAP where I spent another few weeks dialing-in the settings.

My numbers are much better on CPAP and I feel that I sleep better. I never wake up with pressure changes or with the machine blowing at maximum and seemingly never going to drop.

It is nice to have the AUTO machine as that gives you options, but I would have no problems using a straight CPAP. In fact I'm considering purchasing a backup/travel machine and will be getting a CPAP for that purpose.

[Wulfman]

Put me down for another vote for "data-capability takes precedence over Auto functions".
I have nothing against Autos/APAPs.....I have several, myself......but I hardly ever use any of them in a range of pressures. In the first place, the changing pressures disturb my sleep. In the second place, the Autos can't respond fast enough to head off events, so many of the events occur anyway. They're not as "automatic" as some people think. (My AHI is usually higher when I use one in a range of pressures.) For them to be truly "effective", the minimum pressure has to be set high enough to prevent the vast majority of events......so, once you have THAT pressure, you usually don't need much above that pressure and a single pressure will usually suffice.
If a person is prone to mask leakage (as many of us are), APAPs can make for disastrous sleeping with the pressure changes. And, when it increases pressure, the leaks can become worse and it then becomes a "feeding frenzy" between leaks and pressure changes.


Den

[BeanMeScot]

The reason, to me, to have an APAP is if your pressure needs truly change. If you don't like the changing pressure of APAP, change it to CPAP and use it that way but if your AHI goes up and nothing is working, you can go to APAP mode and find out if your pressure needs have changed.

Many people on here talk about getting better therapy with CPAP. I tried that and I didn't like it. I didn't sleep as well and my AHI was basically identical so I went back to APAP with ranges. People are different. Having an APAP gives you versitility a straight CPAP doesn't give you.

[Yoda]

I am in the middle of a trial on APAP. I have been on CPAP for about 2 months and finally got to what I think was a pressure that kept me sleeping. I think the APAP disturbs my sleep. I had mostly RERA's on my sleep study and the auto can read the flow limitations. (so that is good) My data is about the same for CPAP at 15 or APAP 10-20. If there is any difference, I am a little better on the CPAP. So, I will probably keep the CPAP machine. If you are unsure and can afford it, the APAP gives more flexibility. You can run it either way.

Good luck with the decision.

Cecile

[RipVW]

I switched for CPAP (S8 Elite) to APAP (M Series Auto w/AFLEX) more than a year and a half ago, and I've used it in auto mode ever since. The pressures adjust every night to meet my needs, yet the changes never disturb my sleep. And, in auto mode, my AHI averages 0.4. Love my M Series Auto!

[mthomtech]

Thanks for all the feedback!

I went for the AutoSet II mainly so I could analyze the results of the auto mode ... just like was mentioned here ... to see if/when my pressure needs change. I have no issues with my current machine (HC234), so I'll be using it as a backup too. My original objective was to get a second machine for backup / travel, but the sized (with humidification) were not much different than my HC234 ... so I opted to go for the data capabilities. Plus, if I ever do get used to no humidification when I travel, the AutoSet is small without the humidifier.

In general, I've had no issues with compliance ... in fact, I can't really even nap without using the cpap. I still can't believe I functioned without it. Without the cpap, I had an AHI of 59. And even though my pressure is relatively low at 8cm ... I can't believe the sleep is so good. I guess I never knew what I was missing. All I thought I had was heartburn at night ... and always knew I snored loudly. Luckily my wife noticed some serious apneas / arousals and we got it checked out.

I wonder why they don't make sleep studies a regular part of a physical these days ...

[Muse-Inc]

Thanks all for your input, will post what doc says after tomorrow's visit.