CPAP vs APAP - one sleep doc's view

Hawkeye · Post by **Hawkeye** » Sat Jul 01, 2006 5:01 pm

Re the Doctor's comment about straight CPAP being better than APAP, I've wondered about this myself. Being relatively new to using a machine, and starting out with APAP, CFlex I find myself trying to sync my breathing to the machine and when I slow my breathing I feel the machine trying to anticipate the change in my exhalations. Or, at least that's how it seems.

I've wondered if swithing to straight CPAP would help eliminate this.

Wulfman · Post by **Wulfman** » Sat Jul 01, 2006 7:04 pm

Hawkeye,

Give it a try and let us know.

Den

Darth Vader Look · Post by **Darth Vader Look** » Sun Jul 02, 2006 12:11 am

Hawkeye wrote:CFlex I find myself trying to sync my breathing to the machine and when I slow my breathing I feel the machine trying to anticipate the change in my exhalations. Or, at least that's how it seems.

If you found you were trying to keep up with the machine then simply turn the C-flex down or off. Some people have done this with good results. That is why for some people C-flex is unimportant in the grand scheme of purchasing an xPAP and rightfully so.

Some people do respond better to one set pressure while others do not. This is just the advantage to having an APAP. You can run it both ways.

alsarnac · Post by **alsarnac** » Mon Jul 03, 2006 7:44 am

I'm currently using an auto adjusting CPAP (PB420E). When my pressure goes up, I get awakened. I've asked my respiratory therapist if I could switch from APAP to straight CPAP, and in reply she said, "x x x the reason that APAP was suggested for you (referring to myself) is that you are definitely positional meaning you will require higher pressures on your back then on your sides. You were titrated according to your needs on your back. A lot of patients find that their pressure requirements change despite being in the same position on various nights. This can be attributed to your level of fatigue, position of your head, alcohol, sleeping tablets, colds etc. Most patients stated that they too awoke to high pressures and that it took a few months for them to get used of it. If you opt for the CPAP of 8cmH20 versus the APAP you may find that you are only comfortable sleeping on your back. What I (my RT)have seen in a lot of patients is that when they turn to their side with the higher pressure they frequently get an increase in EEG arousals as the pressure is too high and they pressure release through their mouth. This will certainly not harm you the way apneas will, but you will find you feel more tired. If you want to continue to have free reign in your bed then you are best to keep it on the APAP. You could always try the CPAP for comparison, but do try to stay on your back."

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Darth Vader Look · Post by **Darth Vader Look** » Tue Jul 04, 2006 3:37 am

alsarnac wrote:I'm currently using an auto adjusting CPAP (PB420E). When my pressure goes up, I get awakened. I've asked my respiratory therapist if I could switch from APAP to straight CPAP, and in reply she said, "x x x the reason that APAP was suggested for you (referring to myself) is that you are definitely positional meaning you will require higher pressures on your back then on your sides. You were titrated according to your needs on your back. A lot of patients find that their pressure requirements change despite being in the same position on various nights. This can be attributed to your level of fatigue, position of your head, alcohol, sleeping tablets, colds etc. Most patients stated that they too awoke to high pressures and that it took a few months for them to get used of it. If you opt for the CPAP of 8cmH20 versus the APAP you may find that you are only comfortable sleeping on your back. What I (my RT)have seen in a lot of patients is that when they turn to their side with the higher pressure they frequently get an increase in EEG arousals as the pressure is too high and they pressure release through their mouth. This will certainly not harm you the way apneas will, but you will find you feel more tired. If you want to continue to have free reign in your bed then you are best to keep it on the APAP. You could always try the CPAP for comparison, but do try to stay on your back."

Not sure if you are having a run away condition with your P&B 420E but just to let you know that there is a simple fix for that if you are.

Snoredog · Post by **Snoredog** » Tue Jul 04, 2006 12:20 pm

alsarnac wrote:I'm currently using an auto adjusting CPAP (PB420E). When my pressure goes up, I get awakened.

you can fix that by setting a limit to the high pressure value and leaving it in the apap mode. That value should be the pressure found when you were in the supine position during your last titration.

if you find that machine is awakening you, you might want to have them try changing the 1FL feature. It is best to have the manual and do it yourself so that if it doesn't work out, you can switch it back. You might want to ask your doctor about it the next time you see them about getting the clinical manual (very small manual) that came with the machine, then you could do it yourself.