CPAP? APAP?

Hawthorne · Post by **Hawthorne** » Sat Mar 15, 2008 10:12 am

I have had my new machine for just a month now. I am having pretty good numbers most of the time. I have a fairly tight range (9-13). I've changed it a couple of times and come back to this setting. My titrated level at my sleep study (5+ years ago) was 10. Late last year I had a loan of an auto pap for 5 nights. It showed that I was at a pressure of 11 for 90% of the time. My old machine was reset to 11. It's my backup for now.
Is it advisable to leave my machine set at a range in auto mode all the time or is it good or better to set it at a set CPAP pressure for most of the time and use the auto mode to reset if the smart card data, or the way I feel, indicates a change in pressure might be needed? Maybe there is no one answer to this question but thought I would ask you folks.
I have an appointment with the Sleep Specialist at the end of this month (had to wait 5 months for the appointment - that's why I bought the auto). I will probably do a sleep study if he suggests it, since I need to know if anything else is going on with my sleep.

rwalther · Post by **rwalther** » Sat Mar 15, 2008 10:21 am

Take a look at the thread I just started on this subject.

It's orthogonal to your topic. (I just love it when I get to use that word.)

I'm trying to figure out if the Auto feature induces a change during breathing events that actually does more harm than good, and ends up waking me up.

The answer will probably be the same as it is for virtually every question posed on this board ... "It's different for different people".

Rusty

mindy · Post by **mindy** » Sat Mar 15, 2008 10:32 am

I agree with the "different strokes for different folks" theme. I have an auto and used it in auto but finding a good pressure range was like playing a game of whack-a-mole. I've since changed to cpap mode with c-flex and I wake up less often (perhaps fewer arousals due to pressure changes?) and am doing better. It's still good to have the auto so I can recheck periodically or as things change.

One other item: there is a *small* study which showed that with heart failure straight CPAP helped but APAP did not. However, it was only a small study and the APAP was set at something like 4-16. There's no way to know if a tighter range would have produced different results.

Mindy

Slinky · Post by **Slinky** » Sat Mar 15, 2008 11:50 am

I do think that your leak rate, whether due to mask leak, mouth breathing or lip flutters, can have more effect in auto mode than in straight CPAP mode. These newer CPAPs can compensate quite nicely for leaks but I think auto mode allows for a greater rise in pressure than straight CPAP mode. Just my thoughts on the subject w/no research to back it up.

rested gal · Post by **rested gal** » Sat Mar 15, 2008 1:30 pm

mindy wrote:One other item: there is a *small* study which showed that with heart failure straight CPAP helped but APAP did not. However, it was only a small study and the APAP was set at something like 4-16. There's no way to know if a tighter range would have produced different results.

Mindy

Right, Mindy. There's no way to know if a higher minimum pressure would have produced results showing APAP helping just as much (perhaps more) than straight CPAP.

I don't think it's so much a matter of "tightening" the range (as in bringing the maximum pressure down) as it is a matter of RAISING the lower pressure (regardless of how how wide open the top is set) that can make an autopap work effectively and smoothly for many people.

If I had to bet on what pressure range would work best for most people using an autopap, I'd bet 10 - 20. Or at the very least, 8 - 20.

mindy · Post by **mindy** » Sat Mar 15, 2008 2:14 pm

Thanks for the clarification, RG. I phrased it too imprecisely when I referred to tightening the range. I've never had a problem with the top pressure set too high, only with the bottom pressure set too low!

Mindy