Moved From CPAP to APAP - Not Going Back

[95C4]

Over the weekend I moved from CPAP [ 10 minute ramp from 5.5 to 10 ], to APAP, [same ramp, which I found I don't need], with a range of 7 though 12.

I immediately noticed a difference in the breathing effort required on APAP compared to CPAP.
APAP feels more natural & smoother & requires less 'effort'.
I will be sticking with APAP from now on.

AHI - On CPAP it got down to an average of 1.9.

Have been on APAP 3 nights and the readings in order have been: 6.0, 4.7, 2.7

Am I correct in assuming the machine is 'learning' my breathing pattern & adjusting & that explains the reduction in AHI over 3 nights??

In summary, if you are on CPAP and your machine has the ability to go to APAP, I recommend you give it a try.

I am breathing easier in the mask & I feel more rested on APAP.

Wish I had done it earlier.

[Pugsy]

Am I correct in assuming the machine is 'learning' my breathing pattern & adjusting & that explains the reduction in AHI over 3 nights??

More likely your body is adjusting to the "new" breathing feeling pattern. The APAP mode doesn't learn anything or remember anything but your own body does.
Your body has been used to 10 cm...now you are using 7 cm (and letting the machine go up as needed)...7 is going to be more comfortable for a lot of people.

I would need to see the actual event graphs before commenting on AHI changes. Especially if a good bit of the AHI was clear airway events which could very well be awake event flags.

[95C4]

Am I correct in assuming the machine is 'learning' my breathing pattern & adjusting & that explains the reduction in AHI over 3 nights??

More likely your body is adjusting to the "new" breathing feeling pattern. The APAP mode doesn't learn anything or remember anything but your own body does.
Your body has been used to 10 cm...now you are using 7 cm (and letting the machine go up as needed)...7 is going to be more comfortable for a lot of people.

I would need to see the actual event graphs before commenting on AHI changes. Especially if a good bit of the AHI was clear airway events which could very well be awake event flags.

..........................
Thanks Pugsy
Glad to see you back at the keyboard

[PST]

I was given an APAP machine during an overnight hospital stay recently and I don't want to go back either. I loved it much more than I thought I would. I just wish I could have obtained data from the machine to be sure I was getting the same results that I do with CPAP. The respiratory therapist couldn't help (said it was impossible, if you can believe that), and I could only figure out how to get a week, month, or year average, which was certainly unhelpful since I'd only used it one night. I definitely had fewer leaks, though, when lying on my side waiting to go to sleep. I am almost five years into therapy for OSA, hard as that is for me to fathom, and perhaps will qualify for a new machine through insurance. I have a for real eye condition that isn't too serious but is exacerbated by leaking air, so it would make medical sense to move to APAP.

[penuel]

I was given an APAP machine during an overnight hospital stay recently and I don't want to go back either. I loved it much more than I thought I would. I just wish I could have obtained data from the machine to be sure I was getting the same results that I do with CPAP. The respiratory therapist couldn't help (said it was impossible, if you can believe that), and I could only figure out how to get a week, month, or year average, which was certainly unhelpful since I'd only used it one night. I definitely had fewer leaks, though, when lying on my side waiting to go to sleep. I am almost five years into therapy for OSA, hard as that is for me to fathom, and perhaps will qualify for a new machine through insurance. I have a for real eye condition that isn't too serious but is exacerbated by leaking air, so it would make medical sense to move to APAP.

Question,

Do you know the kind of machine and mask that you used at the hospital?

[penuel]

95C4, can you show Flow Limitation or UAR from that machine in which you get low AHIs? Very low AHIs could be a suspect for residual UARS.

Look, in my case I have almost zeroes for AHIs but I still have Flow Limitations which include UARS, it means that my treatment is NOT fully adequate. My S9 Autoset has a unique methodology dealing with UARS whereby it checks the flatness of the respiration waves shapes and acts accordingly, but it's not enough.




There are NO events left but the Flow Limitation is still not low. Flow Limitations (which include UARS) can indicate:

Table 1—Clinical Features Associated With UARS

Daytime symptoms Excessive daytime sleepiness
Fatigue
Morning headaches
Myalgias
Difficulty concentrating

Sleep disturbances Frequent nocturnal awakenings
Difficulties initiating sleep
Insomnia
Bruxism
Restless leg syndrome
Unrefreshing sleep

Autonomic nervous system Hypotension
Orthostasis
Cold hands and feet

Functional somatic syndrome associations Depression
Anxiety
Chronic fatigue syndrome
Irritable bowel syndrome
Fibromyalgia

Polysomnographic abnormalities Increased RERAs
Increased nocturnal arousals
Increased CAP rate
Alpha intrusion during sleep

--------------------------------------------------------------------------------
Do you have any of these?

[sleeplessinaz]

Adjustable pressure works so much better for me. So glad you switched - there IS is difference!

[PST]

I was given an APAP machine during an overnight hospital stay recently and I don't want to go back either. I loved it much more than I thought I would. I just wish I could have obtained data from the machine to be sure I was getting the same results that I do with CPAP. The respiratory therapist couldn't help (said it was impossible, if you can believe that), and I could only figure out how to get a week, month, or year average, which was certainly unhelpful since I'd only used it one night. I definitely had fewer leaks, though, when lying on my side waiting to go to sleep. I am almost five years into therapy for OSA, hard as that is for me to fathom, and perhaps will qualify for a new machine through insurance. I have a for real eye condition that isn't too serious but is exacerbated by leaking air, so it would make medical sense to move to APAP.

Question,

Do you know the kind of machine and mask that you used at the hospital?

It was a Philips Respironics machine, and the control knob looked like that on pictures of the current models. I didn't see anything that said PR System 1 or the like. It might have been an institutional version of the consumer product. I know Respironics machines are very common but I'd never seen one before in person. There was no humidifier. I used my own familiar mask (a Quattro).

[Double A]

I've been considering the move to an APAP.

I only recently found out what they were and I've been on a CPAP for 6 years, thanks Docs. I get really inconsistent results with my CPAP (S9 Elite), I've played around with pressures and the EPR but it never seems to help.

I have pretty bad allergies which causes some nasal congestion so I think based on what I've read the APAP would help. Just having to decide if it worth forking over the cash because I got my latest machine last year through insurance so I would have to buy it on my own.

[95C4]

Penuel
I have Sleepyhead s/ware & still getting to grips with it.
Need to get my head around your data.
Will review/consider your questions & get back.
It may not be until tomorrow.

[95C4]

I've been considering the move to an APAP.

I only recently found out what they were and I've been on a CPAP for 6 years, thanks Docs. I get really inconsistent results with my CPAP (S9 Elite), I've played around with pressures and the EPR but it never seems to help.

I have pretty bad allergies which causes some nasal congestion so I think based on what I've read the APAP would help. Just having to decide if it worth forking over the cash because I got my latest machine last year through insurance so I would have to buy it on my own.

........................
I had to dig into my own pocket to get the APAP machine & acknowledge I am fortunate to be able to do that.

All I can say is I consider it worth the outlay in terms of the improved sleep quality I am experiencing. I also have more energy during the day.
On the mask, airflow is a lot 'gentler' now, I don't get the 'punch' of air up my nose at 10, nor do I feel as though I am having to force air out when I exhale.
As I am settling down after putting on the mask when I retire for the night, it feels more like normal breathing & I drop off to sleep easier.

[Its a pity there isn't a pool of APAP machines out there that CPAP people can try]

If you decide to on to APAP, make sure you ask on the Forum for 'set up" advice by providing your current CPAP pressure, then the regulars will suggest a range to start with.

The allergy thing you mentioned is important - I do better on the mask if I can get the sinuses as unblocked as possible - helps being able to drop off to sleep.
I have a routine now at night that involves taking 1 Allegra 24 hr tablet, saline spray & saline Gel & I will use a Vicks nasal stick as well if necessary.
If I am still 'stuffed up', I have a steroid spray, but I try & keep use of that minimal.

[penuel]

Penuel
I have Sleepyhead s/ware & still getting to grips with it.
Need to get my head around your data.
Will review/consider your questions & get back.
It may not be until tomorrow.

The followings are my treatment results in SH. You can see the zero for AHI but the Flow Limitation (FL) graph shows that my treatment is NOT adequate. If you also have residual Flow Limitation like I do, then please don't panic b/c no one on this board could tell what to do about it. But the issue is that AHI = zero, is not enough. In my case, from the list of the symptoms that UARS could cause, and which I posted above, I probably have one or two but they are not serious.

[95C4]

Penuel
I have Sleepyhead s/ware & still getting to grips with it.
Need to get my head around your data.
Will review/consider your questions & get back.
It may not be until tomorrow.

The followings are my treatment results in SH. You can see the zero for AHI but the Flow Limitation (FL) graph shows that my treatment is NOT adequate. If you also have residual Flow Limitation like I do, then please don't panic b/c no one on this board could tell what to do about it. But the issue is that AHI = zero, is not enough. In my case, from the list of the symptoms that UARS could cause, and which I posted above, I probably have one or two but they are not serious.

.......................................................
I can see activity & spikes on your Flow Limitation graph, but I don't know the significance of that activity - what does 'Flow Limitation' activity suggest is going on??

[chunkyfrog]

Auto pap allows me to use lower pressures, reducing leakage across my eye lids.
Since most glaucoma meds have reduced eye moisture as a side effect,
I will be mentioning this fact to my eye doctor.

[Pugsy]

Don't try to compare flow limitation data between a ResMed S9 machine and your PR System One machine. They are not the same values and are not reported in the same manner....apples and oranges.

With the PR System One machine you must be in apap mode to even get flow limitation data flags....so any prior reports in cpap mode showing FLs 0.0...are meaningless.

You are welcome to try to understand how Penuel's S9 reports and works....but I think for now your time would be best spent understanding your own machine and how it reports stuff.