apap to find your ideal pressure?

[sleepyhead63]

Is using the autoset mode with my vantage machine a good way to tweak and find your ideal pressure?

[track]

In my case apparently not. My pressure always goes to 13 regardless of my sleep position...it spikes a little up and down but that is where it spends most of the night. For side sleeping I do better at a pressure considerably below 13 and for back sleeping I do better with a pressure considerably above 13.

[sleepyhead63]

I ask this question because according to my sleep study my doctor reccommends a pressure of 14 but for the past few nights in apap mode it was at 10 when I checked my numbers in the morning.

[Flying_Norseman]

You should get a week's worth of data before making any changes. I also have to watch out for the machine "chasing snores" or raising the pressure for leaks.

[billbolton]

Is using the autoset mode with my vantage machine a good way to tweak and find your ideal pressure?

If your are certain your Sleep Disordered Breathing issue is simple Obstructive Sleep Apnea, it's probably workable.

If your SDB is anything more complex, or you are on any medication etc, it's probably not a great idea.

Cheers,

Bill

[Bytor]

Are you supposed to use APAP to find your ideal pressure and then set that pressure in regular CPAP? I was planning on just leaving my machine in APAP mode all the time.. is that wrong?

[billbolton]

I was planning on just leaving my machine in APAP mode all the time.. is that wrong?

If it works you, its fine.

It doesn't work well for everyone, as the changing flow rate can be a disruptive sleep element for a non-trvial numbers of users. who find a more constant flow rate preferable.

Also, for users with CSA (complex sleep apnea) which involves central apneas, the variable flow rates range needs to be very tightly controlled, and there are also other SDB conditions which APAP doesn't suit well.

Cheers,

Bill

[stevoreno]

I was planning on just leaving my machine in APAP mode all the time.. is that wrong?

If it works you, its fine.

It doesn't work well for everyone, as the changing flow rate can be a disruptive sleep element for a non-trvial numbers of users. who find a more constant flow rate preferable.

Also, for users with CSA (complex sleep apnea) which involves central apneas, the variable flow rates range needs to be very tightly controlled, and there are also other SDB conditions which APAP doesn't suit well.

Cheers,

Bill

[Michael Holloway]

I really am new to this (1 month) and struggling with keeping the mask on for any good length of time. However... I can report that I had my machine set for auto 6-14 (the orig 'script' was 11) and I couldn't cope with the thing going off during the night. It is hard enough with coping with the interface (the mask) with small and inconsistent leaks etc and then the machine gong off with high pressures, not because of my breathing, but I think because of leaks - I had no sleep at all.
I re-programmed the machine to CPAP with no ramp to 11 cm and it was much easier to cope. Ramp caused me to feel the 'not enough air' syndrome at low pressures.
I STILL have problems with sleeping on my side and leaks, and then after ripping off the mask (Mirage 2) after 3 hours. I wake up (because of thrashing about with OSA after another 1-2 hours and try to put the mask back on. However SOME times, I get the overwhelming feeling of not being able to breath, ie being suffocated so then I do NOT put it back on... then to wake up in the morning exhausted. I'm sure I'm not alone in this experience.

Does anyone have any suggestions for that period at night, when you wake, having kicked off the mask an hour or so earlier? How do you cope with this feeling of not being able to breathe freely?

[billbolton]

new pressure will have to be increased from 16 to 18 so are you saying someone who has to have a machine set to my high pressure would do better on straight CPAP rather than APAP or would I do better on BIPAP rather than straight CPAP?

For that sort of flow rate, BiPAP is often recommended.

Cheers,

bill

[EdAPAP]

Bill and Steveoreno,

My situation is very similar to Steveoreno's. Titrated to 14 cm; started on APAP at 9-17 cm; at 17 cm still had AHI = 15+; recently increased to 10-18 cm.

I wake up every night between 1:00 am and 4:00 am with the machine blasting away at max 18 cm. I can't tell whether I am waking up because of continuing AHI level or because of the varying pressure levels. Also wonder if I might be among the 15% who have CSA. My wife says I often stop breathing (when on the machine) for ~10 sec without even attempting to initiate inhalation

I will see the Sleep Lab folks on Mon Dec 3 for 30 day follow up.

Do you think a BiPAP with fixed inhalation/exhalation pressures in a tighter range would help?

Ed

[Wulfman]

I really am new to this (1 month) and struggling with keeping the mask on for any good length of time. However... I can report that I had my machine set for auto 6-14 (the orig 'script' was 11) and I couldn't cope with the thing going off during the night. It is hard enough with coping with the interface (the mask) with small and inconsistent leaks etc and then the machine gong off with high pressures, not because of my breathing, but I think because of leaks - I had no sleep at all.
I re-programmed the machine to CPAP with no ramp to 11 cm and it was much easier to cope. Ramp caused me to feel the 'not enough air' syndrome at low pressures.
I STILL have problems with sleeping on my side and leaks, and then after ripping off the mask (Mirage 2) after 3 hours. I wake up (because of thrashing about with OSA after another 1-2 hours and try to put the mask back on. However SOME times, I get the overwhelming feeling of not being able to breath, ie being suffocated so then I do NOT put it back on... then to wake up in the morning exhausted. I'm sure I'm not alone in this experience.

Does anyone have any suggestions for that period at night, when you wake, having kicked off the mask an hour or so earlier? How do you cope with this feeling of not being able to breathe freely?

You didn't say what machine. I'm guessing that mouth-leaking may be part of your problem if you have a nasal mask (and it sounds like you do have one). As far as what to do when you wake after taking off the mask.....put it back on and go back to sleep. Depending on what machine you have, there may be a setting that shuts your machine off when having a large leak.....if so, you need to turn that feature OFF......so it keeps blowing. Does your machine have either C-Flex or EPR (breathing relief)?

Den

[Wulfman]

Bill and Steveoreno,

My situation is very similar to Steveoreno's. Titrated to 14 cm; started on APAP at 9-17 cm; at 17 cm still had AHI = 15+; recently increased to 10-18 cm.

I wake up every night between 1:00 am and 4:00 am with the machine blasting away at max 18 cm. I can't tell whether I am waking up because of continuing AHI level or because of the varying pressure levels. Also wonder if I might be among the 15% who have CSA. My wife says I often stop breathing (when on the machine) for ~10 sec without even attempting to initiate inhalation

I will see the Sleep Lab folks on Mon Dec 3 for 30 day follow up.

Do you think a BiPAP with fixed inhalation/exhalation pressures in a tighter range would help?

Ed

If you don't have it......get some software so you can tell what's going on.
I'm guessing mouth-leaking for you, too.
And, if you were titrated at 14.......why do you have your bottom pressure so much lower than that?
Without the software, you can't tell what's causing the pressure to go up.....could be leaks (or other things), too.

With an Auto and no software......you're "flying blind". You'd be better off to set that thing in CPAP mode at your titrated pressure of 14 and look at the numbers in the LCD.

Den

[EdAPAP]

Den,

I do not think mouth or mask leaking is the problem. I will purchase tracking software after next week's meeting with the CRNP who is the sleep lab's compliance expert.

Ed