CPAP vs. APAP

[jbn3boys]

Okay, so I know this has probably been covered before, but I am too brain-dead from lack of "good" sleep to find it.

To preface this, I have been diagnosed with SDB, I understand the difference in how the two machines work, and I have been given the choice of using either cpap or apap. (I have been on apap for about 3 months now, and am frustrated with how it's going--that's another tread)

What I'd like to know is what are the reasons you are using one or the other? I'd love to especially hear from people who have used both, and why they chose the one they currently use. What are the main reasons for using apap instead of cpap?

I don't want to get into a discussion of other variables, such as flex or ERP, humidity or not, I just want to focus on cpap vs apap, and why each is used/preferred. (Like I said, I understand the differences is HOW they work, but I'm looking for why each is used)

I'd love "real life examples" from users of either/both.

Thanks!

[Duckie]

I have an apap machine. The Dr. first used it to titrated me since my night for titration could not come up with a sweet spot. She then, based on the information from rescan put me on CPAP at 8. Thee would be one or two night a week I woke up feeling like I was suffocating. When I told my sleep Dr. this she put me back on APAP from 7 to 20 and I sleep great. No suffocating feeling. My pressure are around 8 most of the week but for some reason on a single night a week, I can go as high as 16. So I like APAP better for those nights.

[jmelby]

Reasons one might use APAP instead of CPAP:
- A good titration was not possible during the sleep study--in this case, it might just be used temporarily until an ideal pressure is found.
- The individual has positional apnea--worse on the back, for example, and also moves around a lot at night. The APAP can adjust as needed.
- Comfort on keeping lower pressure when higher is not needed.

Reasons one might use CPAP over APAP:
- Waking from changes in pressure.
- Keeping at a higher pressure to prevent apenas rather than letting the machine adjust when it detects issues.

Personally, I have been on APAP since I started. When I went to the RT (respiratory therapist) for my follow-up, she changed me to CPAP with a pressure of 11, but I found I slept horribly with that change to a constant pressure. I switched back to APAP (9 - 13) and found that works best for me.

[mayondair]

I originally started with a straight CPAP, at 8, even though I did not have a good tritation. So after lurking on this forum and finding a new doc, figured an APAP was cheaper than a new study. Also knew from my original study that my apneas were somewhat positional, more on right side, none while on my back(go figure). An APAP allowed me to tritate at home, and i found a range of 9-15 works, my 90% varies between 10 and 13, so this works for me, no time at higher, uncomfortable pressures if I dont need it, some nights not over 11.AHI usually between 1 and 2 now.

[DoriC]

In my husband's case, we found it less confusing to start with a straight pressure at or close to his titration while we battled with leaks, masks, flex, HH, etc. As he adjusted to his therapy and we solved those other problems we experimented with auto and found he didn't always need a straight pressure of 12cms, only when he turned on his back or was restless. So we now use a very narrow range of auto at 10.5-13 and his 90% pressure is usually 11cms. At a wider range the changing pressures disturbed his sleep. The titration is only one night of many. Hope that helps.

[Hawthorne]

I have tried both.

I am sticking with APAP at a very narrow pressure range (10.5 to 13 cm). I am almost always at 11 and 12 cm during the night. The majority of the time is at 11cm. AHI below 2 almost always.

The 2 biggest reasons for me to use APAP and not CPAP -(1) I sleep better in APAP mode, I guess because my pressure can go up if it needs to. The narrow range means it doesn't go crazy and maybe induce centrals or wake me with the constant pressure changes.

(2) In APAP mode I don't get bad gas pain and bloating (I can't spell the name for it so say gas and bloating instead), which I get with straight CPAP.

[GumbyCT]

For me the biggest reason is to have a lower pressure until you need more. But also if (as) things change or you just want to try CPAP - there is no need for an equipment change. Plus I think with APAP - you are sure to get a machine capable of FULL data, not just compliance.

Overall, APAP is more versatile and makes more sense. (We) I have (all) wondered why they continue to make just the plain vanilla cpap.

[jbn3boys]

Thanks, everyone, for all your personal experiences! Keep em coming!

Also, if you used an apap for self-titration, could you explain just how you went about that, and how many nights between changes? Again, personal experiences, please. I learn so much more that way, than just telling me what "should" happen.

Thanks!

[mayondair]

Here is how I went about tritating. Started with 6-12 on recommendation from new doc, did that for 3 weeks, noticed that 90% was 11 or 12, not much time spent below 8, snore index and REHRA high, AHI 3 -4. Next tried 8-15 for 2 weeks, -AHI 2-3, snore and REHRA still high. Then tried 10- 15 , only for 5 or 6 nights, gas was bad, and it was not comfortable, added a flex, still no good, then 9-15 with a flex and it worked very well. No gas, comfortable , lower snore and REHRA, AHI between 1 and 2 . I used the same nasal pillow mask all the time, humidifier was ok so no fiddling with it during this process.

[RipVW]

Certainly, in my view, if one has the choice, one should choose an APAP, since an APAP will always provide the option of using it in auto mode or as a straight CPAP.

[dtsm]

Certainly, in my view, if one has the choice, one should choose an APAP, since an APAP will always provide the option of using it in auto mode or as a straight CPAP.

Concise and right to the point...

[HoseCrusher]

I had to figure out what pressure to use by myself. I started on APAP with the pressure set wide open. I noticed that initially there was some sense of not having enough air, so I set the starting pressure up to 6.

I reviewed my progress with a pulse oximeter. The APAP machine gave me a pressure indication of 12. I then set the machine to CPAP with a pressure of 10 and continued to monitor for obstructions by reviewing my O2 saturation levels. I ended up with a pressure of 10.6. I use the ramp, set the EPR to 2, and set the starting pressure to 8. My ramp time is 10 minutes. The first 4 - 5 minutes of that are used to warm up the water in the humidifier.

When I was using APAP, there were several times when the machine went to full pressure and it seemed like it wouldn't come back down. I have also noticed that my numbers are lower using CPAP than when using APAP.

While it took almost a week to dial things in, it is rare for me to have a desaturation below 90%. My machines version of AHI ranges from 1 - 15, but this does not seem to correlate with O2 desaturations, or changes in pulse rate. I may have to pick up an EEG to figure this out.

Since I didn't feel bad prior to xPAP, the only indication I have that it is working is to look at my O2 saturation. In spite of the machines numbers, as long as my airway is not obstructed I think I am doing well.

[rosiefrosie]

Certainly, in my view, if one has the choice, one should choose an APAP, since an APAP will always provide the option of using it in auto mode or as a straight CPAP.

Concise and right to the point...

And so true.........

[Mimmie]

I was set at a flat 13 when I got my first cpcp machine. I used it for 4 years. I recently had a new study done and got my new machine. It was put on apap with a range of 8-16. That didnt work out too well because I felt like I was suffocating at 8 so it was reset to 12-20. Quite a few times I hit 16 or 17 so it's nice to know that it's there when I need it.

[jbn3boys]

Certainly, in my view, if one has the choice, one should choose an APAP, since an APAP will always provide the option of using it in auto mode or as a straight CPAP.

Concise and right to the point...

Concise and to the point, yes, but I'm not trying to decide on which machine to buy. I already have an apap.
I'm trying to decide how to run the machine, in apap or in cpap mode.

While it took almost a week to dial things in...

That doesn't seem like long at all! Did you make changes nearly every night?

I may have to pick up an EEG to figure this out.

wouldn't that be nice!

Thanks, and keep the advise coming, please!