Sleep Doc no longer a Fan of APAP

[brazospearl]

pratzert, honey, if your doc "doesn't like" apap, he shouldn't use one. You, however, need to use what works best for you!

[Raj]

The problem I find with running APAP with an open upper range is an increase in centrals. I do best by limiting the range on both ends.

[pratzert]

pratzert, honey, if your doc "doesn't like" apap, he shouldn't use one. You, however, need to use what works best for you!

After reading some of the posts here, it looks like the response time may differ from machine to machine and perhaps his experience is with a machine that lags.

But I agree I shoul duse what works for me, and so far, the AutoPAP is the one for me.

The Tech at my sleep Docs office wants me to drop off my data card for her to D/L what's on it, so I have set my machine for CPAP for a week just for kicks.

I don't notice too much difference, but I want to get it set back to Auto and set the max all the way up to see what happens.

[mars]

Hi All

The testing I have done on myself indicates that there is negligible difference with my AHi between Cpap 12 and Apap 11 - 13.

A result of combined obstructive apneas and central apneas is usually around 3 AHi.

When I sort some other health stuff out I will probably try cpap again for a more prolonged period.

cheers

Mars

[Janknitz]

Hmmm, thought I'd posted here, but it seems to be missing. My point was that I am set for 9 to 15 cm of pressure. I hang out about 9 or 10 cm most of the night, but during REM sleep I often go up to 15 or so. When it was set lower, I had problems.

My numbers are great. My AHI is always under 1.0. But I'm certain that if I was set at a fixed pressure it would not be so good. Without APAP I don't think this treatment would be successful for me.

This is NOT positional, I almost always sleep in the same sidelying position except for the last hour or so of sleep when I turn on my back or other side. But that is not when my pressures go up.

If the pressures are too widely apart, there can be some problems with slow responses, but a carefully calculated narrow range can work very well for people like me who definitely need more pressure in REM sleep.

I love Brazospearl's comment and agree wholeheartedly.

[packer]

I agree with many of the posts- keep bottom high as comfortable - my personal experience is like this

I have moved bottom number up to 10.5 from 8 over 2 years in .5 increments leave top at 17 [ top very very seldom reached] I keep aflex set at 3 on PR1- I like the ease of exhale- but have moved bottom upward over last couple years

I am under 1 AHI consistently and this is backed up by oximeter reading once a month

biggest thing for newbies is compliance- if i had to use a leaf blower on 12 I would have quit after a week and end of story
so-- set bottom where you are comfortable to start- then move up a little- catch more events quicker- before they start in effect

as you get more used to mask and leaks etc and the whole cpap deal-- move bottom up a little at a time
anyhow- my two cents worth- packer

[Muse-Inc]

...he said he was no longer a fan of APAP becasue he thought the response time was not fast enough to stop an episode...

APAPs are preventative, responding to specific identifiable breathing irregularities that precede an event. If the initial pressure is much lower than your titrated pressure, it might take the APAP a bit of time to get to the pressure to stabilize your breathing and hopefully prevent the expected event. This may be why he is not a fan. For some of us, our initial pressure is sufficient to prevent apneas and reduce our HI as much as any device is able to.

If I were in your situation, I'd get a copy of the PSG results and determine what my current pressure range requirements are.

[Muse-Inc]

...set for 9 to 15 cm of pressure...

Hey Jan...many here consider that to be a wide range, not open (4-20) but wide, ie more than +2 and -2 from titrated pressure. I'm currenty set 9.6-15 as I'm back sleeping most of the night; when both shoulders fully heal I'll go back to 8-15.

[DoriC]

My husband was titrated at 12 cm water pressure. The DME was all set on selling us a S9 Escape; but hubby insisted on an Autoset,
because he had SO much trouble breathing during sleep study. The Dr's RX was to set it on CPAP mode at 12 with NO EPR.
Hubby set said machine for Auto 7-16 cm range RIGHT THERE! Guess what?--His 95th percentile pressure is consistently around 10--
and he wears it all night, every night--no complaints. Who knew that a sleep study could be so far off.
Makes you wanna go, "Hmmm."

Chunky, I'm curious, so what's your hubby's average AHI? It seems many people are titrated incorrectly, my hubby was one of the lucky ones with a good experience and a pretty accurate pressure. Remind me not to mess with your husband! Our machine was delivered to our home but at least I waited until she left before I changed the settings!