Fixed vs Auto mode

[Katerific]

Why would fixed pressure be used when auto is available on the machine? I think it makes more sense to let the machine work for you instead of tying its hands. I had a sleep study at the hospital that was nothing more than a titration study and I came away with a fixed pressure recommendation. If Auto is preferable, then titration studies would seem to be unnecessary. They are also costly. I had to pay $1000 deductible. I switched my machine to auto and I don't want to get scolded by my medical provider for changing it. Thank you for your help.

[jnk...]

Why would fixed pressure be used when auto is available on the machine?

Some users actually prefer fixed pressure. Some claim they sleep better. It may be that they have very sensitive chemoreceptors that react to changes in pressure in a way that disturbs sleep for them. Others, for example those who have had UPPP or those with nonstandard patterns of breathing, may not give off the standard biological signals used by autos to sense the best pressure at any given moment. In other words, the APAP algorithms just plain don't work well for them. For those patients who fall far outside the middle ranges of the bell curve with how they breathe, straight CPAP may be the best option. Fortunately, all APAPs can also run in CPAP mode.

I think it makes more sense to let the machine work for you instead of tying its hands.

In the majority of circumstances, that is indeed the most logical and practical approach, as long as the minimum is set within a cm or two of what is needed to prevent actual apneas.

If Auto is preferable, then titration studies would seem to be unnecessary.

The beauty of lab titrations is the screening for other comorbid sleep issues that can be unmasked once OSA is gotten out of the way. Limb movement problems and underlying conditions that make one prone to centrals can be exposed during lab titration and addressed as reaction to pressure is noted. Is that necessary for every plain vanilla OSA sufferer? Probably not. But you don't know whether you are plain vanilla or not until reaction to pressure is observed and documented. So the payoff of titration is in the eye and wallet of the sleeper, depending on circumstances.

I switched my machine to auto and I don't want to get scolded by my medical provider for changing it.

The ideal is supposed to be teamwork. You are supposed to have the final say on your team as long as you are in your right mind, which your post makes obvious that you are. Scoldings are for children, so if anyone on your team tries that approach, show them your I.D. with your date of birth on it. Then fire the scolder. You can always politely inform your team of your chosen approach and ask for their comments at any time, if you want to be proactive about keeping things cooperative--but that is your choice, not theirs. They work for you.

[Katerific]

Jnk, thank you for the response. It is very informative and really helped!

[jnk...]

Jnk, thank you for the response. It is very informative and really helped!

You are most welcome.

Great question.

Hopefully the wording provided some small fodder for further research, education, and discussion.

I love this place.

[TonyG]

Why would fixed pressure be used when auto is available on the machine? I think it makes more sense to let the machine work for you instead of tying its hands. I had a sleep study at the hospital that was nothing more than a titration study and I came away with a fixed pressure recommendation. If Auto is preferable, then titration studies would seem to be unnecessary. They are also costly. I had to pay $1000 deductible. I switched my machine to auto and I don't want to get scolded by my medical provider for changing it. Thank you for your help.

In my experience with this treatment I have found that fixed pressure gives me better number results and better quality sleep. My recent experience with a new machine and apap convinced me that it is best to use whatever works best for YOU just like when choosing a mask. The purists might not agree but they probably haven't had any problems and good for them. If you can tolerate both equally with similar results then forsure I would use apap. However it is not for everyone.