Question Concerning APAP

jrfoster · Post by **jrfoster** » Fri Oct 13, 2006 3:05 pm

I have recently switched to APAP from CPAP and hope that I will like it better. However, I notice when I wake up and lay in bed for awhile it does not lower the pressure but stays at 10.5 or whatever. I thought that an APAP machine would adjust according to my needs. When I am not asleep but am resting in bed shouldn't it return down to 4 where it started? How long does an APAP remain at the highest pressure before going down, or do I have to hit the ramp button manually to return it to 4? This is all new to me. Thanks.

Jeff

rested gal · Post by **rested gal** » Fri Oct 13, 2006 3:24 pm

Autopaps are designed to not yo-yo the pressure up and down abruptly. The machine is supposed to work its way down slowly when breathing seems normal. If you're awake and watching the display window, it can seem like it takes forever before it drops even a little.

If the waking up you're talking about was when you woke up for the morning, it's very likely you woke up from (or close to) the last long REM stage of the night. REM is when we're most apt to have events (apneas/hypopneas) and would be when the machine probably is using the most pressure it needs to use to prevent and/or deal with things.

So, even though you were awake, the machine likely had just finished warding off the last problems in REM. Would take quite awhile for it to work its way back down, testing to see if things are staying "ok" at each step of the way down.

You know you're awake. The machine doesn't know that. It's designed to move back down carefully and slowly.

People have also reported the reverse happening...laying in bed BEFORE going to sleep, and noticing the pressure going up some even though they were not using ramp. Sometimes the relaxation of the throat while laying in bed awake can be limiting the air flow a bit (or a lot) and cause the machine to begin to take preventive action to open the throat and improve the air flow.

Some relaxation of the throat after waking up in the morning but continuing to stay in bed could be happening.

What was the single prescribed pressure from your sleep study...the pressure you were put on for cpap before you got the autopap?

jrfoster · Post by **jrfoster** » Fri Oct 13, 2006 3:50 pm

rested gal wrote:What was the single prescribed pressure from your sleep study...the pressure you were put on for cpap before you got the autopap?

According to my sleep study the CPAP was to be set at 10. The APAP is range is set from 4-12.

I am also having trouble falling asleep with the mask on. I lay awake for hours not sleeping. When I take the mask off, I can fall asleep, and then during the many times I wake up at night I can put the mask on and leave it on the rest of the night. I don't know why I can't fall asleep with it on initially. Sure makes me tired.

Jeff

dsm · Post by **dsm** » Fri Oct 13, 2006 4:00 pm

jr

As Rested Gal has pointed out Autos are *not* designed to do rapid pressure changes (that would create more sleep problems that it solves).

Also setting your machine to such a wide gap seems to me a recipe for problems. 4 really is too low & already seems to be causing you difficulty in getting off to sleep.

If I were preparing the machine for you, I would set it to min 8 max 12 allowing for say a ramp start of 6 or 7.

If you are willing to try those settings & report back - am hoping you will be pleased by the result.

Good luck

jrfoster · Post by **jrfoster** » Fri Oct 13, 2006 4:22 pm

dsm wrote: If I were preparing the machine for you, I would set it to min 8 max 12 allowing for say a ramp start of 6 or 7. If you are willing to try those settings & report back - am hoping you will be pleased by the result.

Good luck

How do I go in and change the settings? And you say start the ramp at 6 or 7 and not 4, with the range of 8-12? I thought the range had to include the starting ramp pressure?

Snoredog · Post by **Snoredog** » Fri Oct 13, 2006 4:45 pm

jrfoster wrote:
dsm wrote: If I were preparing the machine for you, I would set it to min 8 max 12 allowing for say a ramp start of 6 or 7. If you are willing to try those settings & report back - am hoping you will be pleased by the result.

Good luck

How do I go in and change the settings? And you say start the ramp at 6 or 7 and not 4, with the range of 8-12? I thought the range had to include the starting ramp pressure?

dsm · Post by **dsm** » Fri Oct 13, 2006 4:58 pm

Yup,

Of course RAMP is off when in Auto modes

But too big a range seems to be problematic for many people & the getting to sleep issue looked like it could be related to the very low starting cms.

Cheers

DSM

jrfoster · Post by **jrfoster** » Fri Oct 13, 2006 5:05 pm

Thanks Snoredog,

I went in and changed the ranges as you suggested from 6.5-11cm. I will give it a try tonight. I am also struggling with a bout of sudden onset insomnnia since April which adds to my OSA even more.
I am looking forward one of these fine days to a good nights sleep!

Jeff

hairnet · Post by **hairnet** » Fri Oct 13, 2006 5:40 pm

I am curious. I too have the Remstar Auto with a range of 5-13. If I wake up and the pressure seems too high and I push the Ramp Button does it return to the 5 setting. It definitely goes down. Could someone explain. Thanks.

jrfoster · Post by **jrfoster** » Fri Oct 13, 2006 6:02 pm

hairnet wrote:I am curious. I too have the Remstar Auto with a range of 5-13. If I wake up and the pressure seems too high and I push the Ramp Button does it return to the 5 setting. It definitely goes down. Could someone explain. Thanks.

Yes, it should return to the lowest level that it is set on. In your case 5 cm. Then go up as you need it.

Jeff

Snoredog · Post by **Snoredog** » Fri Oct 13, 2006 6:22 pm

jrfoster wrote:
hairnet wrote:I am curious. I too have the Remstar Auto with a range of 5-13. If I wake up and the pressure seems too high and I push the Ramp Button does it return to the 5 setting. It definitely goes down. Could someone explain. Thanks.

Yes, it should return to the lowest level that it is set on. In your case 5 cm. Then go up as you need it.

Jeff

jrfoster · Post by **jrfoster** » Sat Oct 14, 2006 8:50 am

dsm wrote: If I were preparing the machine for you, I would set it to min 8 max 12 allowing for say a ramp start of 6 or 7.

If you are willing to try those settings & report back - am hoping you will be pleased by the result.

Good luck

I tried it last night and I did fall asleep with the mask on! In fact I kept the mask on ALL night, but kept waking up over and over again. I don't know if it is my arms falling asleep causing me to wake up and turn over or if it is something else. At least I did fall asleep with mask on. That is a first step! Thanks for the help!

Jeff