Sleepyhead, CPAP, APAP, and BIPAP

[CzechCzar]

[CzechCzar]

Thanks very much Pugsy... I guess what is confusing me is that I am still having OAs, even though I am on therapy. I thought the purpose of CPAP therapy was to eliminate the apneas. Still, I will defer to your expertise!!

To expect the machine to never record any apnea events is generally considered an unrealistic expectation.
While AHI of 0.0 does happen to some people on occasion and some more often than others...it really isn't the primary goal. Primary goal is good sleep and elimination or greatly reduce any sleep apnea symptoms..not a perfect math score.

I saw one overall graph showing AHI of 1.something. That's usually considered an excellent number.
It usually accepted that AHI of less than 5.0 is considered acceptable therapy when on the cpap machine when people report they are sleep well and feeling decent.

Your pressure is only 6 cm ...is that correct? You could try a little 0.5 increase just to see if the OAs or hyponeas reduce a little but there is no real urgent need to do so and it might not make any difference anyway.

[Pugsy]

Even people without the OSA diagnosis will have an occasional apnea event of some kind. It just happens.
So an occasional random thing is not really a problem. The problem comes up when the apnea events become numerous, cause frequent awakenings, stress on the body and drops in oxygen levels.

Hold your breath for 10 seconds...that's a central apnea. Not a big deal is it? We do it all the time while awake and don't even notice it. Well while asleep our airway tissues will collapse and block off the airway to some extent and when it lasts for 10 seconds or more....it earns a flag for some sort of apnea event. One of these events every hour or so is no big deal. Now when they start happening in large numbers then it becomes a problem....the body goes under stress...sleep quality gets totally messed up...stress on the heart occurs, etc.

So the medical community had to come up with some sort of numerical evaluation to make some sort of criteria for the OSA diagnosis. It was determined that 5 of these events per hour would be their dividing line.

Finally...these machines are super sensitive and they don't know if we are awake or asleep and sometimes they flag awake breathing "events" by mistake. So they aren't 100% perfect and there can be false positives. Especially in the central (clear airway) category. Hold your breath for 10 seconds and the machine will likely flag it as an apnea event and most likely a central.
For these reasons we don't make our goal total eradication of all apnea related events. We instead have an acceptable range of numbers that we can live with. No different really than a range of "normal" numbers for any blood test a person might have.

If it bugs you too much...talk to your doctor about it and see what he says.

[CzechCzar]

Thanks so much Pugsy... I really appreciate you taking the time to answer a question I am sure you have been asked before.

Even people without the OSA diagnosis will have an occasional apnea event of some kind. It just happens.
So an occasional random thing is not really a problem. The problem comes up when the apnea events become numerous, cause frequent awakenings, stress on the body and drops in oxygen levels.

Hold your breath for 10 seconds...that's a central apnea. Not a big deal is it? We do it all the time while awake and don't even notice it. Well while asleep our airway tissues will collapse and block off the airway to some extent and when it lasts for 10 seconds or more....it earns a flag for some sort of apnea event. One of these events every hour or so is no big deal. Now when they start happening in large numbers then it becomes a problem....the body goes under stress...sleep quality gets totally messed up...stress on the heart occurs, etc.

So the medical community had to come up with some sort of numerical evaluation to make some sort of criteria for the OSA diagnosis. It was determined that 5 of these events per hour would be their dividing line.

Finally...these machines are super sensitive and they don't know if we are awake or asleep and sometimes they flag awake breathing "events" by mistake. So they aren't 100% perfect and there can be false positives. Especially in the central (clear airway) category. Hold your breath for 10 seconds and the machine will likely flag it as an apnea event and most likely a central.
For these reasons we don't make our goal total eradication of all apnea related events. We instead have an acceptable range of numbers that we can live with. No different really than a range of "normal" numbers for any blood test a person might have.

If it bugs you too much...talk to your doctor about it and see what he says.

[CzechCzar]

Would you guys recommend switching to an APAP if the price is reasonable? Are there likely any improvements to be gained?

[lebowski8]

I have two machines that I use. My main machine is a Respironics APAP that I got in 2011. My older machine is a Respironics CPAP that I got in 2009. I use the CPAP machine now for travel-- I have permanently packed luggage that includes the machine, hose, mask, and 8' extension cord. I use the same full face mask model when i travel.

I like the APAP more because it is more comfortable-- the AFLEX makes breathing easier and the hose never gets so full of moisture that i have to drain it (newer generation humidifier). Also, I never have problems with air blowing out my tear ducts with this machine.

The CPAP is louder (but it's also a machine generation older). I have problems with the constant pressure causing air to blow out my right tear duct. But-- my AHI numbers averaged somewhat better overall with the CPAP!

All in all, I like the APAP just a bit more. I can't tell a physical/emotional/psychological difference when the average AHI only varies by 0.5 or so.

Would you guys recommend switching to an APAP if the price is reasonable? Are there likely any improvements to be gained?

Would you guys recommend switching to an APAP if the price is reasonable? Are there likely any improvements to be gained?

[palerider]

Would you guys recommend switching to an APAP if the price is reasonable? Are there likely any improvements to be gained?

with a pressure as low as yours, and as few incidents as you're having, it likely wouldn't be worth the extra $$.

also, when you post a screenshot, it's better if you post the whole image, with charts showing flow, pressure, leaks, first. (you can rearrange them by dragging in sleepyhead) the ahi chart can be amusing, but it doesn't tell anybody anything, the whole image, with charts and the summary data on the left, like the example that was given