CPAP vs APAP settings

[lynninnj]

Along with depending on good healthy food and good healthy exercise and good healthy water and good healthy relationship choices, you will come to depend on good healthy sleep and good healthy breathing. And then you will hopefully enjoy all the benefits to your life so much that you will be deeply proud of all the good healthy choices you have made and will continue to be glad to benefit from in combination. And people will wonder what your secret is. And maybe you'll choose to tell them, and maybe you won't. But you'll laugh to yourself knowingly, because you'll know how you put the work in to learn the secret weapon for yourself that pulled it all together for you: optimized PAP therapy.

Mark my words, Ms. KittyMom22. Mark. My. Words.

I like your approach lazarus. lol

sorry to be all doom and gloom.

You said you nearly lost a job due to the brain fog. It may well have been long covid or it could be OSA.

Give it time.
You’ve got this.

[lazarus]

like your approach

Thank you. Maybe my knowing that will help distract me from all the ones in the forum who are rolling their eyes again at me right now for being so over the top.

(You know who you are.)

[KittyMom22]

I'm concerned that if I should need to stay over with a friend, or want to go camping, or maybe even possibly have sex one day, or if the power goes out, I won't be able to sleep at all without the machine, as someone else just posted. It's one thing to use glasses - it's not an electrical aid and I have multiple pairs as well as contacts.

It's just really hard to give up all spontaneity and independence.

Edited: I know you're all feeling very sage about this but it's new to me and I deserve to be able to process and grieve. I am struggling to accept this permanent disability. I am a person who requires mechanical assistance to breathe.

[KittyMom22]

You said you nearly lost a job due to the brain fog. It may well have been long covid or it could be OSA.

It was definitely Covid. It was temporary, acute, and terrifying. I couldn't process words. Actually I've heard what I experienced called "Medium Covid" which seems more accurate.

[ozij]

Edited: I know you're all feeling very sage about this but it's new to me and I deserve to be able to process and grieve.

You do.
We're trying to show you that the view from the top of the mountain is worth the struggle. We're not "feeling sage". We're remembering our own grief and struggle and what came afterwards.

I am a person who requires mechanical assistance to breathe.

No you're not. Your brain and muscles are working perfectly as far as breathing is concerned. When you sleep, your perfectly functioning brain wakes you up when your breathing is interrupted because of an obstruction. It commands your muscles to breathe, and they do, and then you go on breathing perfectly OK as long as you're awake.
You a person who needs assistance in keeping her upper airway open when she's asleep. It's the sagging tissues that have to be kept from sagging.

The continuous positive airway pressure is there to keep the tissues from obstructing your upper airway. That's all.
There are many changes in our lives when we start using CPAP. There are reasons to grieve.

But if you focus on being as factual and informative as possible with friends (and strangers, and yourself) it will be much easier for all of you.

Don't say: "I am a person who requires mechanical assistance to breathe." Say "I'm not too good at sleeping and breathing at the same time, so I use this machine that helps me do that." Or something to that effect. "That's why I'm bringing my machine along, that's why I need an electric outlet in the room I'm sleeping in, and why I bring along an extension cord."

You'll find may great threads on the forum about using a cpap when camping; there was an excellent one not so long about using cpap on a canoeing trip.

[robysue1]

I'm concerned that if I should need to stay over with a friend, or want to go camping, or maybe even possibly have sex one day, or if the power goes out, I won't be able to sleep at all without the machine, as someone else just posted.

APAPs are highly portable: If your friend lives in the same town, driving to pick it up is not that difficult.

Many of us regularly camp with our xPAPs: They can run on battery power. Heck there are even some people who have found ways to do backpacking trips into the backcountry with small sized travel units and solar powered batteries. Is it cheap? No. But it beats being crabby and short tempered and tired on the whole trip because your sleep is disrupted by lots of apneas.

As for sex? A lot of us are married and our sex lives have not deteriorated. And any potential mate who can't stand the idea that you need to put your mask on after finishing sex and wanting to sleep doesn't really care about what is in your best interests.

As for power outages? Well, yeah, they can be difficult. If your power only goes out for a short while, staying up is an option. But in a prolonged outage? Yeah, that means either putting up with a whole lot of not very good sleep OR being prepared with a battery pack and a way of charging the battery pack. So if you live in areas that are prone to lots of power outages, particularly long ones, it's worth preparing for one.

It's one thing to use glasses - it's not an electrical aid and I have multiple pairs as well as contacts.

It's just really hard to give up all spontaneity and independence.

Yeah, it seems like you have to give up all spontaneity and independence. But its not really like that at all. Unless you are asleep, you are not tied to a machine. And you are owned by two high needs cats, so you already have to do a lot of planning to do something spontaneous---in other words you already have to plan on who's going to take care of those kitties and how long can you safely leave them before you've got to get back to them.

Edited: I know you're all feeling very sage about this but it's new to me and I deserve to be able to process and grieve. I am struggling to accept this permanent disability.

It's ok to grieve. And we've all been through that.

But it's not ok to think of needing a CPAP as a "permanent disability." Having OSA and needing CPAP is much more like having high blood pressure and needing to take BP meds. Or being a diabetic and needing to use an insulin pump. OSA is a chronic health condition and CPAP is the treatment for that chronic health condition. When you use CPAP, your OSA is treated and you become healthy because the OSA is controlled and no longer destroying your body.

I am a person who requires mechanical assistance to breathe.

NO. You do NOT need mechanical assistance to breathe---if you needed mechanical assistance to breathe, you would be on an actual ventilator.

Rather---your upper airway needs a bit of support---in the form of some very gentle pressure to keep it open. You are doing all your own breathing for yourself when you are using your CPAP. You are initiating the inhalations and you are initiating the exhalations. Your muscles are doing all the work of breathing all night long.

All CPAP does is prop your airway open so that your brain can get some sleep instead of having to be constantly vigilant of the need to arouse just enough to unobstruct a collapsed airway over and over and over all night long. Once you learn how to sleep well with the CPAP, CPAP allows your body to once again enjoy normal sleep that is uninterrupted by constant sleep disordered breathing events.

Yes, in the early days it seems as though CPAP is just as bad, if not worse than, the disease. But that's not unique to OSA: Many other chronic medical conditions have treatments that have side effects that cause problems with people complying with the therapy. Many diabetics have real trouble adjusting to the diet they need in order to help control their diabetes along with dealing with the insulin injections. Many people with high blood pressure find it difficult to cut back on salt and many BP medications have side effects. Many people with debilitating migraines spend years trying to find a drug regime that they can tolerate in terms of side affect that will also control their migraines.

[robysue1]

I think apap is more comfortable myself. Do you prefer cpap?

No, I don't, I'm just curious because I thought I was being prescribed CPAP but realized it's not actually that. Someone said APAP is often used in place of a titation study, which I did not have, so I was just curious if people ever stay on APAP or if it's only used for titration purposes. I definitely think I would like CPAP full time less!

The only advantage I could see is not waking up with a higher pressure than what I fell asleep with. Perhaps if it stayed the same pressure I wouldn't wake up as much.

There are people who do prefer CPAP to APAP. They are in a minority around this forum, but they do exist. And one reason is that a constant pressure can mean less sensory stuff waking you up all night long. It's not just waking up because of pressure increases---some people find that they have significantly few problems with leaks when they use CPAP rather than APAP: If the pressures aren't moving all over the place all night long, that takes one variable out of the puzzle of how to keep the mask from leaking: Not only do pressure increases sometime wake people up, pressure increases can also cause a mask seal to spring a leak, and then the leak can wake the person up even if the pressure increase would not have.

I would suggest that if you want to try straight CPAP for a few nights, that you think about switching your APAP into CPAP mode. The usual advice is to set the CPAP pressure to your 95% pressure setting from the APAP because that setting will clearly be enough to prevent almost all of your obstructive events from happening in the first place.

The downside to straight CPAP is that you will be at that 95% pressure setting all night long. Whereas in APAP, you might only need that 95% pressure setting for as little as 5-10% of the whole night. And having the machine be at a lower pressure for most of the night can increase comfort.

But you won't really know if CPAP or APAP is more comfortable for your until you try at least a night or two using CPAP.

[KittyMom22]

Thanks for all the encouragement. You're being very kind. I know I'm just feeling very discouraged right now.

Facing one's mortality is never easy. I have to tell myself I have a disability to get myself to use the machine. That's why I used that term. Otherwise I'm tempted to think I don't really need it.

As far as relationships go, of course if you're already married or have a long-term partner CPAP shouldn't interfere. I am well aware that ship sailed for me long ago, so this is just my last feeble protest.

[KittyMom22]

I think apap is more comfortable myself. Do you prefer cpap?

No, I don't, I'm just curious because I thought I was being prescribed CPAP but realized it's not actually that. Someone said APAP is often used in place of a titation study, which I did not have, so I was just curious if people ever stay on APAP or if it's only used for titration purposes. I definitely think I would like CPAP full time less!

The only advantage I could see is not waking up with a higher pressure than what I fell asleep with. Perhaps if it stayed the same pressure I wouldn't wake up as much.

There are people who do prefer CPAP to APAP. They are in a minority around this forum, but they do exist. And one reason is that a constant pressure can mean less sensory stuff waking you up all night long. It's not just waking up because of pressure increases---some people find that they have significantly few problems with leaks when they use CPAP rather than APAP: If the pressures aren't moving all over the place all night long, that takes one variable out of the puzzle of how to keep the mask from leaking: Not only do pressure increases sometime wake people up, pressure increases can also cause a mask seal to spring a leak, and then the leak can wake the person up even if the pressure increase would not have.

I would suggest that if you want to try straight CPAP for a few nights, that you think about switching your APAP into CPAP mode. The usual advice is to set the CPAP pressure to your 95% pressure setting from the APAP because that setting will clearly be enough to prevent almost all of your obstructive events from happening in the first place.

The downside to straight CPAP is that you will be at that 95% pressure setting all night long. Whereas in APAP, you might only need that 95% pressure setting for as little as 5-10% of the whole night. And having the machine be at a lower pressure for most of the night can increase comfort.

But you won't really know if CPAP or APAP is more comfortable for your until you try at least a night or two using CPAP.

Thanks! Yes I've figured out most of that stuff already. I'm just trying not to mess with the settings too much until after my next appt with the pulm. If he's using this for titration, I don't want to skew the data.

I managed about 5.5 hours last night, though I was awake for a portion of that time. Apparently every mask adjustment registers as an event, as well as crying and exhaling hard against the flow of air in frustration! It says I had 4.8 events per hour and I was awake for 2.5 of those hours. It registered 10 events during my first hour of awake use and those were all mask adjustments or me holding my breath against the flow. It's really hard not to hold my breath - like when the wind is blowing in your face. Anyway, I'll explain that to him when we talk.

I did request the F30 instead of the F30i, and they're going to send it. Thank goodness!

PS One of the great things about cats is they don't actually need me all the time, and if I have a glass of wine too many, am trapped by bad weather, or whatever, they're fine without me for a day or two. My neighbors have a key also. I really don't miss having dogs for that reason!

Of course the kitten needs TLC right now. She got her 2nd set of shots yesterday and she was so good.

[lynninnj]

I'm concerned that if I should need to stay over with a friend, or want to go camping, or maybe even possibly have sex one day, or if the power goes out, I won't be able to sleep at all without the machine, as someone else just posted. It's one thing to use glasses - it's not an electrical aid and I have multiple pairs as well as contacts.

It's just really hard to give up all spontaneity and independence.

Edited: I know you're all feeling very sage about this but it's new to me and I deserve to be able to process and grieve. I am struggling to accept this permanent disability. I am a person who requires mechanical assistance to breathe.

It is fair concern, mainly with so many unknowns.

I think folk here manage to do all these things you mentioned but I understand that sensebof vulnerability, I really do.

Once you start optimizing your therapy you may feel differently about it.

[palerider]

Thanks for all the encouragement. You're being very kind. I know I'm just feeling very discouraged right now.

Facing one's mortality is never easy. I have to tell myself I have a disability to get myself to use the machine. That's why I used that term. Otherwise I'm tempted to think I don't really need it.

As far as relationships go, of course if you're already married or have a long-term partner CPAP shouldn't interfere. I am well aware that ship sailed for me long ago, so this is just my last feeble protest.

Trust me, your prospective bed partner would much rather you strap on a CPAP and are quiet at night than listening to your snoring and choking and gasping for air all night long.

[chunkyfrog]

You can bring it along for a "sleepover",
because it could help weed out the shallow ones.

[palerider]

Oopsie.

double post.

[KittyMom22]

Trust me, your prospective bed partner would much rather you strap on a CPAP and are quiet at night verses listening to your snoring and choking and gasping for air all night long.

Ha! I couldn't get a date when I was ten years younger, more fit, and didn't have OSA. Online dating is just a meat market. I gave up in 2015.

[lazarus]

Thoughtful human beings are generally impressed by fellow human beings who take their health seriously. PAP and dating are no exception to that.

Although, I'm not really sure how all that works over in the hypochondriac forums.

I would go see, but reading those forums always makes me feel a little sick to my stomach.