Never Use CPAP When You Have APAP Capability (?)

[RipVW]

Resmed re the Autoset Advantage:

According to Resmed--

Autoset technology provides the most comfortable and sensitive treatment for flow limitation, snoring and apnea. Since most obstructive apneas occur during REM, that's when the greatest pressure is required. Conventional machines (CPAP) set the pressure at that highest normal level needed, even though you will not need that pressure all night.

When you have a cold, blocked nose, or allergy, a higher than normal treatment pressure will be required (same when taking certain meds or consuming alcohol). That higher than normal treatment pressure might not have been evident during one's titration study. It is normal for our needs to vary night to night as well as throughout each night. The CPAP pressure established during a titration study might well not be adequate to open one's airway under these circumstances. I would never consider running my APAP machine in CPAP mode—doing so defeats the primary purpose of APAP technology which is to provide responsive pressure, responsive to normal variances in pressure needs.

Source: http://www.resmed.com/en-us/clinicians/ ... 40x380.swf

[rested gal]

I would never consider running my APAP machine in CPAP mode—doing so defeats the primary purpose of APAP technology which is to provide responsive pressure, responsive to normal variances in pressure needs.

Some people do better using one straight pressure than varying pressures. For some people "CPAP" is better; for others "autopap" is better. I don't think it's necessary, or even advisable, to use an autopap in auto mode IF a person finds that he/she does better using the autopap in "cpap" mode.

Some like to use their autopap in auto mode just to spotcheck things every once in awhile, and otherwise get very good treatment running their auto in cpap mode. Others, like you and I, get good treatment using a range of pressures.

Whatever works best for a person who has an autopap is the best way (imho) to use the machine...whether that's "cpap" mode or "auto" mode.

[jrfoster]

I would assume that all auto-cpap's offer the same treatment as the "AutoAdvantage" by Resmed. The question is...does the machine wait until you have an apnea to increase the pressure or can it tell that an apnea is about to happen and increase the pressure before the event?

I have as you can see below a remstar auto. But I use it now on straight CPAP because I can tolerate a pressure of 12cm without any problem.
I tried the Auto setting on different occassions but have not noticed much difference in lowering AHI.

Jeff

[rested gal]

The question is...does the machine wait until you have an apnea to increase the pressure or can it tell that an apnea is about to happen and increase the pressure before the event?

I think that could depend greatly on how hard and fast an apnea hits.

With most people there are probably some "before it happens" indications that an apnea situation is a'brewin'. Some lessening of air flow starting to happen. In those cases, the machine would respond to the lessening air flow and increase the pressure before the actual "event" (the apnea or hypopnea) had a chance to happen.

[Guest]

The question is...does the machine wait until you have an apnea to increase the pressure or can it tell that an apnea is about to happen and increase the pressure before the event?

I think that could depend greatly on how hard and fast an apnea hits.

With most people there are probably some "before it happens" indications that an apnea situation is a'brewin'. Some lessening of air flow starting to happen. In those cases, the machine would respond to the lessening air flow and increase the pressure before the actual "event" (the apnea or hypopnea) had a chance to happen.

The goal then is to find that "magic" number that will keep my airway open all the time so that apenas can't even form! I don't know if that number is out there!

I can't see how some in this forum get their AHI down constantly under 1. What are they doing that I am not?

Jeff

[rested gal]

I can't see how some in this forum get their AHI down constantly under 1. What are they doing that I am not?

Jeff

Why, they're wearing pantyhose tights and tape, of course! (j/k)

I dunno. What matters is getting an AHI under 5.0. Trying to get it lower and lower and lower isn't really going to make much, if any, difference to most people. If my AHI is well under 5 and the leak line is nice and low, I wouldn't worry about trying to tweak the AHI down more. I feel exactly the same -- equally well rested -- after a night with AHI of 4.0 as I do after a night with AHI of 0.4.

[goose]

Interesting topic and so timely for me......

I've been running my APAP in CPAP mode since July because the range that I was using 7-15 was causing a lot of unexplained NR's at the top end.

Let me digress a bit.
My titrated pressure was 5.....I can barely breathe at 5, so was set to 7. My AHI wouldn't go below 11 with that pressure, so I pressured my DME (pun intended) to provide me an APAP (with a little help from the doc).

After a few nights of "testing" and doing a lot of reading of the historical posts here from RestedGal, SWS, dsm, and others I came to the conclusion that I am one of those people that has an adverse reaction to the pressure change algorithm in my RemStar M Series APAP machine.

Using my original sleep test and my titration test reports I decided to set my pressure at a CPAP of 10. Viola!!! My AHI almost immediately lowered and leveled out at about 2.5......So it appears that 10 is my "magic number".
But I got greedy a month ago and set it to 11, looking for a lower AHI.
I have yet to see my average AHI go below 3.1, so from that I would postulate that 11 is too high. I also don't feel as good as I did at 10 with the lower AHI -- so getting greedy and going for a lower AHI kind of backfired on me.

What makes this whole discussion timely for me, is that today (about an hour ago) I reset my machine into APAP mode with a range between 9 and 11....It could be that 9 will be better than 10, but 10 was doing the job.
So for the next week or so I'll be "testing" the waters again --

How do I feel?? Does it seem like it's working?? Should I set it at 9 and leave it?? Only the reports will tell, so I'll be waiting until mid next week to pull the reports again (daily doesn't give me trends really....and that's what I look for).....

Anyway -- I have to echo RG's comment that there are some of us that don't do well with a moving pressure, so setting the APAP machine to CPAP mode and using APAP mode for "testing", is quite appropriate!!!

cheers
goose

[Goofproof]

I can see why Resmed would say that, seeing that their APAP doesn't record data in the APAP mode, and we know they don't like seeing mere mortals having useful data. So keep them on APAPm and data dumb. Jim

[RiverDave]

Goof,

Mine records data in APAP mode. What data are you referring to?

[Goofproof]

Goof,

Mine records data in APAP mode. What data are you referring to?

My mistake, I got my wires crossed between data and EPR, it's epr that doesn't work in APAP, the data does work. Jim

[kteague]

I watched the linked video, and the question that comes to my mind is, if the auto is so clearly superior, as their sales pitch presents, why do they even include a cpap mode and why do they continue to sell cpaps by the boatload? I would think that if they really consider autopap to be an advance in technology they would be phasing out the cpaps as outdated technology.

[mindy]

[quote="ted] I would never consider running my APAP machine in CPAP mode—doing so defeats the primary purpose of APAP technology which is to provide responsive pressure, responsive to normal variances in pressure needs.

[/quote]

There is currently debate in the medical community about APAP vs CPAP. The following abstract is about the lack of help with cardiovascular risk factors when using APAP compared to CPAP. I strongly doubt that this is anywhere near a definitive study but it is certainly provocative.

http://tinyurl.com/2f2te7

So one of the benefits of an APAP machine when one wants/needs to use CPAP is the ability to run on CPAP for medical reasons and periodically use the APAP to retitrate (as some are already doing).

Mindy

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, APAP

[Wulfman]

The ResMed Auto machines don't have EPR (exhale relief) in Auto mode, which (to me) would be a reason NOT to use their Autos.....especially at relatively higher (or high) pressures.

To Auto, or not to Auto.....THAT is the question.....
I firmly believe this is something for each user to decide. And, one NEEDS software to interpret the data from an Auto.

One thing I like about using single pressure is that with "all things being equal", you can look at variations in AHI over time. Since some nights/weeks/months are better or worse than others, you can try to figure out what made the difference.

Den

[RiverDave]

RiverDave wrote:
Goof,

Mine records data in APAP mode. What data are you referring to?


Full data and charts like you download in Encore pro, not scribbles on a lcd. Jim

With AutoScan or ResScan software you get similar graphs. EncorePro does appear to have resmed beat on the tables. It's a lot more than scribbles, though.

[Goofproof]

RiverDave wrote:
Goof,

Mine records data in APAP mode. What data are you referring to?


Full data and charts like you download in Encore pro, not scribbles on a lcd. Jim

With AutoScan or ResScan software you get similar graphs. EncorePro does appear to have resmed beat on the tables. It's a lot more than scribbles, though.

My mistake, I had data confused with EPR, It has data but no EPR in APAP. I must need more coffiee. Jim