Caveats to using APAP in CPAP mode?

[chance]

Hi all

I'm considering getting the newer Respironics PR System One APAP. I'm used to using a CPAP and I'll probably use the machine in that mode mostly, but I've used an APAP from time to time from my doctor and DME.

Are there caveats to using an APAP mainly in CPAP mode? Are there any differences in how one might operate in comparison to the straight CPAP in the same model line?

I figure, the difference in price of the new APAP from the CPAP Pro version are slim; why not go ahead and get the APAP version.

[cinco777]

I run my APAP at a constant pressure by setting Min & Max to the same pressure value. I use this approach so that my machine will report Flow Limitations that I find interesting now and hope some day may prove useful in improving my sleep therapy.

Initially, I ran my machine in APAP modality with a range of pressures and tried different ranges with the hope of achieving a more restful sleep. I'm a technical guy but I couldn't, with all my past experience, including multiple regression analysis, figure out what was making things better or worse. After one month running APAP, I switched to straight CPAP and finally could determine what changes helped and what changes didn't.

Since my switch five months ago, I have returned to APAP mode on two occasions, both times to conduct an experiment. Both experiments failed to improve my sleep, both in restfulness and lower sleep event #s, so I switched back to my constant pressure APAP with Min & Max equal to the same pressure value.

I'm glad that I purchased an APAP machine (actually two as my backup is the same exact model) since it allowed me to determine that APAP ranges are not for me (at least with my current level and distribution of sleep events). If, in the future, something requiring APAP turns up and looks promising, I will switch to APAP ranges and give it a try. Having an APAP allows me the freedom to experiment and the additional cost of my APAPs was insignificant when I realized that I am going to be hooked up to a machine for 7 - 8 hours/night for the rest of my life. FYI, my BMI is 21 so losing weight and possibly reducing my need for CPAP is not going to happen. Good luck in figuring out what works best for you.

[chance]

cinco, with your M-Series APAP do you know if it is possible to select a straight CPAP mode instead of reducing the range in APAP?

I've found from experience I sleep best with a straight CPAP, specifically the Respironics M-Series models. I have a Resmed S8 Escape II now, and it's like I have to really work to inhale on it (it's the only one I've used and I kinda wonder if it may be malfunctioning). Sleep quality aint the best with it. When I use EPR, I'm a complete mess the following day.

The M-Series on the other hand, I sleep like a baby and the C-Flex makes no/little difference in how I feel the next day, just a bit more comfortable. Comparing to the S8, even without C-Flex enabled, inhaling is MUCH easier - it seems to give way when I breath in. I managed to get my machine full of something, either dust or .. ? Attached are pictures. What I want now is a machine that acts similarly to the M-Series CPAP without the trouble I had with the last, the PR System might be what I'm looking for. The APAP feature would be nice if it doesn't detract any from using it as a CPAP.

Now that I'm looking for it, Respironics mentions active inhalation detection as part of the built-in features of their machines, here's the marketing page: http://autotrak.respironics.com/ .

[rested gal]

with your M-Series APAP do you know if it is possible to select a straight CPAP mode instead of reducing the range in APAP?

Yes, you can select straight cpap mode in the M-series APAP (that's the machine I use much of the time.)

I run my APAP at a constant pressure by setting Min & Max to the same pressure value. I use this approach so that my machine will report Flow Limitations that I find interesting

The few times I've set my APAP to operate like a CPAP, I've done the same thing cinco did, for the same reason -- I've set the min and max to the same number in order to continue gathering "flow limitations" data. If set for straight CPAP mode, the machine records only apneas, hypopneas and leak info. In auto mode with min/max set the same, it gathers those same things, plus noting "flow limitations" (less airway collapse than with hypopneas.)

But yes, you definitely can set any autopap to "cpap" mode. All autopaps have a "cpap" operating mode available for use, as far as I know. That's what an "autopap" is, anyway ... it's first and foremost a "CPAP" machine that just happens to also have a mode for "autotitrating" if a person wants to use autotitration.

[Autopapdude]

Definitely no caveats. Some individuals have a preference of having a fixed pressure to try and curtail all events, if possible. Others prefer the comfort aspects of the autopap doing the selection for the user. It is strictly a matter of that which works best for the user.

[cinco777]

chance wrote

cinco, with your M-Series APAP do you know if it is possible to select a straight CPAP mode instead of reducing the range in APAP?

Yes, and thanks to RestedGal for answering your question before I had a chance. I actually ran straight CPAP for two days before learning on this forum that I could run my APAP with Min & Max set to the same pressure and see Flow Limitation events (something not possible in straight CPAP mode).

BTW, I've learned from reading & participating in this forum since March '09 that RestedGal's answers, tips, recommendations, "you name it", etc., are always right on the money. I claim to be a technical person (my interest, training, and experiences) and I trust her responses more than anyone else's on this forum.

[rested gal]

oh gosh...

I'd send you a list of how many times I've been wrong, cinco, but it would take months of typing!

[Autopapdude]

oh gosh...

I'd send you a list of how many times I've been wrong, cinco, but it would take months of typing!

I somehow doubt that you are often wrong, Rested. You've clearly done your homework and understand your condition quite well. We would all be so smart to emulate that desire to be well informed. Most people take the sleep doc's word as gospel and never question him/her, or the DME. Those are huge mistakes, as one can be one's best clinician. Of course, there is some use for doctors--perhaps we could use them as lab rats for new equipment?

[chance]

Thanks guys for your input! Adjusting your therapy based on flow limitations.. that's really awesome.

It's such a breath of fresh air in comparison to the low level of care I'm getting from my sleep doctors, all the money I've spent, the downtime.. ugh.

I bought the PR System One Auto now knowing there isn't software yet available. I found this: http://respironicsremstars.respironics.com/ . It appears the straight System One Pro and the Auto give flow limitation data. I can't remember if the reports from my M-Series Pro gave FL or not.

[Babette]

No caveats. I'm currently using my M Series APAP at straight cpap 12cm, no flex, no ramp, and no problems.

Keep us posted on the new machine. Love to know whether I want to upgrade or not.

Cheers,
B.

[KatieW]

I run my APAP at a constant pressure by setting Min & Max to the same pressure value. I use this approach so that my machine will report Flow Limitations that I find interesting now and hope some day may prove useful in improving my sleep therapy.

This is very interesting. Does anyone know if this would apply to the Resmed S8 Autoset II?

I just made a typo...Res Mend....that's a good name for it, eh?

[LinkC]

Let me join the chorus of APAP-used-as-CPAP users. Although I actually switch between CPAP and APAP. I have two SmartCards with the different prescriptions on them, so the switchover is as easy as pulling one out and sticking the other in.

I use APAP for a week every 6 mos or so to "home titrate". Then back to CPAP at the 90% pressure. And I DO notice an upward trend in my numbers while on APAP. (Maybe I'll try APAP @ 16/16 tho after reading about the FL thing. Makes sense.)

Sadly, I gained some weight this summer (I blame the cruise line and an evil dessert-pushing waiter named Carlito!) and my pressure jumped up a notch.

Your machine doesn't care at all whether it's set in CPAP or APAP.


"If you cannot decide, Sir, I can bring you the Oreo sundae AND the flaming Baked Alaska." --Carlito

[Babette]

Could you send Carlito over to my house, please?

Me too. I use the Auto function now and then to re-titrate. But lately I just seem to like sleeping with straight cpap. In the past, I've used the spread, and played with different spreads, but I've been doing straight 12cm now for nearly a year.

Cheers,
B.

[LinkC]

Now I'm wondering...if I run APAP @ 16/16, will there be any difference at all between c-flex and a-flex? I would think not...

[LinkC]

Not a chance! I'm keeping Carlito for myself! No, wait...that's not...I mean...that sounds bad...it's the desserts, I tell ya!

(Not that there's anything wrong with that...)