CPAP to APAP

snorestats · Post by **snorestats** » Mon Jan 08, 2007 2:31 pm

I'm currently set for straight CPAP at 13 with a ramp of 5 for 20 minutes.

If I want to be adventurous in the near future, what settings should I use in APAP mode?

DreamStalker · Post by **DreamStalker** » Mon Jan 08, 2007 2:36 pm

Since you have the software, collect some data and that will help guide you adventure setting in APAP mode.

Wulfman · Post by **Wulfman** » Mon Jan 08, 2007 2:41 pm

snorestats wrote:I'm currently set for straight CPAP at 13 with a ramp of 5 for 20 minutes.

If I want to be adventurous in the near future, what settings should I use in APAP mode?

What do the "numbers" look like on your reports now?
Do you really need a Ramp for that long? (or at all?)
Are you using C-Flex?
HOW DO YOU FEEL?

Den

oldgearhead · Post by **oldgearhead** » Mon Jan 08, 2007 2:52 pm

If I want to be adventurous in the near future, what settings should I use in APAP mode?

8 -14 CM/H2O...No Ramp..

snorestats · Post by **snorestats** » Mon Jan 08, 2007 2:53 pm

What do the "numbers" look like on your reports now?

They've been good. Real good with the HC431 mask, but with the hybrid (2 nights so far), too many leaks and my AHI is up. Yesterday it was at 7.5, although I've been averaging about 2.5 with 431.

Do you really need a Ramp for that long? (or at all?)

I'm not sure... that's simply what was prescribed. Not sure why it's set for that so long. I'd rather know if I have a leak BEFORE I go to sleep.

Are you using C-Flex?

yes I am. It's currently set to 3

HOW DO YOU FEEL?

Not bad... some days better than others.

neversleeps · Post by **neversleeps** » Mon Jan 08, 2007 2:55 pm

The ramp function doesn't work in APAP mode on the original Remstar APAP, so if that's something you love, then you might want to stick with CPAP mode.

If you don't mind losing the ramp function, and your AHI is consistently under 5.0 at 13cms, then I suppose you could try an APAP setting at 10-15 and see what happens. Whatever you try, give it at least a couple weeks at the new setting to get a good average of what it's doing to your AHI before you make any changes.

OTOH, there's the logic, if it ain't broke don't fix it.

snorestats · Post by **snorestats** » Mon Jan 08, 2007 2:55 pm

8 -14 CM/H2O...No Ramp..

So is 5 below and 1 above the general consensus?

neversleeps · Post by **neversleeps** » Mon Jan 08, 2007 3:08 pm

snorestats wrote:So is 5 below and 1 above the general consensus?

There are a couple different theories on that. Some say it is prudent to have the low end of the range closer to your titrated pressure and the high end a few cms. over it. The logic behind that is if your titrated pressure is correct, the closer the low end is to it, the less likely you are to have apneas while it zooms up to nab them. With the high end of the range a few cms. over your titrated pressure, you will get those errant apneas that occur due to position changes, alcohol consumption, congestion, etc.

Others ascribe to the notion the low end should be a lot lower than the titrated pressure, because if you don't need it, you aren't getting it unnecessarily.

The only way you'll know what works best for you is to start playing around with it, keeping in mind to hold it at the new setting for a couple weeks before you consider the stats significant.

Wulfman · Post by **Wulfman** » Mon Jan 08, 2007 3:09 pm

neversleeps wrote:The ramp function doesn't work in APAP mode on the original Remstar APAP, so if that's something you love, then you might want to stick with CPAP mode.

If you don't mind losing the ramp function, and your AHI is consistently under 5.0 at 13cms, then I suppose you could try an APAP setting at 10-15 and see what happens. Whatever you try, give it at least a couple weeks at the new setting to get a good average of what it's doing to your AHI before you make any changes.

OTOH, there's the logic, if it ain't broke don't fix it.

I'll "DITTO" this one. If you want to see if your present setting is about right, this is the range I'd use.

You could also tweak your (fixed pressure) setting down or up a point at a time and see what happens, too. Also try C-Flex at 2. Works for me.

Best wishes,

Den

DreamStalker · Post by **DreamStalker** » Mon Jan 08, 2007 3:14 pm

There are several factors that would help you to decide how much above and how much below your titrated CPAP pressure you should set your APAP.

If your PSG showed central apneas, some will advise you not set your max APAP above your titrated CPAP value and only lower your min pressure in increments of one.

If you have no issues with centrals, you can up your max pressure setting in increments of one. Same can be done for min APAP pressure setting in reverse direction. Try to change only one variable at a time and try for a week or two for representative average in order to understand how the changes are affecting your treatment.

You may want to get James Skinner’s Encore Pro Analyzer (do search) and use the AHI vs. pressure trend plot to find the “sweet spot” settings … keep in mind that it may take a few months of data collection and analysis to find it.

snorestats · Post by **snorestats** » Mon Jan 08, 2007 3:37 pm

Thanks for everyone's help.

I do have the card reader, software plus Encore Pro Analyzer.

I guess the consensus is to try 10-15.

So, by going apap with my machine, I lose the ramp function? No biggie if that's the case.

neversleeps · Post by **neversleeps** » Mon Jan 08, 2007 3:42 pm

snorestats wrote:So, by going apap with my machine, I lose the ramp function?

Yep. No ramp function in auto mode on the original Remstar APAP.

BTW, if you're accustomed to using C-Flex, it's actually the AFLE mode that you want.

snorestats · Post by **snorestats** » Mon Jan 08, 2007 3:45 pm

it's actually the AFLE mode that you want

Right... thanks!

Wulfman · Post by **Wulfman** » Mon Jan 08, 2007 3:57 pm

And, if your Auto has never been used in APAP/AFLE mode before, be sure to check the "Ramp Time" setting and make sure it's set to 0's (zeros)......otherwise it could be in a "Split night" setting if there's any time set in the values.

Den

zzzzzz!! · Post by **zzzzzz!!** » Mon Jan 08, 2007 5:20 pm

neversleeps wrote:The ramp function doesn't work in APAP mode on the original Remstar APAP, so if that's something you love, then you might want to stick with CPAP mode.

Do you mean "original" as in "not the M-Series"?

(sorry, I'm new at this... will introduce myself soon in another post!)

Mask

Mask

Mask

Mask

CPAP to APAP

CPAP to APAP

Re: CPAP to APAP