A note to the new user

Grabraham · Post by **Grabraham** » Tue Sep 27, 2005 6:00 pm

As you read through things at CPAPtalk.com and other places please do NOT think that because you have a CPAP instead of an APAP that treatment will not work for you unless you some how get an APAP. I bring this up because it is easy to come to the conclusion that a CPAP is a poor choice when you read about everyone getting info from their software and all of the importance that is placed on this here and in other forums. I am not going to try and say that being able to monitor your own treatment is not valuable, I just want you to know that if you can't it in NO WAY means your treatment cannot be successful. Sometimes online forums, no matter what the topic is - Brewing beer, making model rockets, CPAP ETC - can focus on the advanced or higher end of the subject and can leave the new user feeling that because they don't have the "best" machine or all the bells and whistles that they will fail.

derek · Post by **derek** » Tue Sep 27, 2005 6:32 pm

Absolutely! After purchasing an APAP, I am now back on CPAP - and getting better treatment. To me the auto mode was useful in demonstrating that I was over-titrated, and pointed to the appropriate CPAP pressure, but I have no intention of going back to apap.

Sleepless on LI · Post by **Sleepless on LI** » Tue Sep 27, 2005 6:34 pm

Grab,

What a nice gesture that post was. You were really thinking outside the box on that one. I would never have thought to write such a thoughtful thread.

If I'm not mistaken, the Remstar Pro 2 is not auto, but it does give you the capability to monitor your events with Encorepro software and a card reader, and ALSO has Cflex. So even if you are on straight CPAP, you can still monitor your progress. And for all I know, there may be other machines out there that can do the same from other manufacturers. Just trying to state that you can monitor your events and still be on straight CPAP and not APAP.

And to quote WillSucceed...well, maybe not quote him, but he believes if you can tolerate the straight pressure, it is the "gold seal standard" of treatment IF your sleep study was done correctly as that is the pressure they found that will best either eliminate or drastically reduce your episodes. Many people are more compliant, though, on auto because they don't have to put up with the high pressure that they were titrated at all the time unless the machine detects the need to raise it up there. So they can be more comfortable at a lower pressure unless the need arises for it to be raised, thereby possibly causing one to be more compliant.

Once again, Grab, nice thinking on this one. Very thoughtful.

rock and roll · Post by **rock and roll** » Tue Sep 27, 2005 6:45 pm

I agree, in fact I run straight cpap mode versus auto most of the time.

I don't have trouble at 10 0r 12 on straight cpap, I wonder at what pressure most feel they can't take it?

Sleepless on LI · Post by **Sleepless on LI** » Tue Sep 27, 2005 6:55 pm

Hey, old buddy, good to see you back in the action. Hope your clean up is going or has gone well. Didn't pull the back out, I hope.

I have no problem on 10 cms, either. I did have a problem with the aerophagia, for sure, so I tried the auto. Either way, it's not much of a huge difference with AHI's and the like. But 10 cms guarantees a zero snore rate and usually the lowest possible AHI I can get.

I would imagine, though, once you start getting past the 12 mark, or for people who have other conditions that have to do with the respiratory or pulmonary systems, breathing can be a bit of a hard task. For those in that situation, I'm sure auto AND Cflex is a blessing. I guess we should thank the Man Upstairs for one less problem to contend with, that of not having to worry about breathing at our titrated pressures. I'll take whatever positives I can get.

dsm · Post by **dsm** » Tue Sep 27, 2005 6:59 pm

Grab...

Good call - I have been wanting to say similar for a while. I have an APAP device and am pleased I bought it but I am currently using a straight CPAP machine and it is working very well & it plus my f/f mask & I are currently very happy together. I will probably settle on one of the APAPs (RemStar, Spirit or Vantage) but then again I may stay with one of the CPAPs (F&P221LE, PB420S, Polaris ISP9800, ResMed S8 )

The times I have problems is when I experiment & that is the price I am willing to pay.

Also am not yet using any software - probably will soon but am spending that money of alt xPAP machines to trial (along with a couple of others in our Lab Rat team).

Again, a good comment.

DSM

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ProfessorSleep · Post by **ProfessorSleep** » Tue Sep 27, 2005 6:59 pm

Excellent post, G! And very insightful. I certainly can understand how the impression you anticipate some "newbies" having could be created. It would be easy to feel like you've got second-class or el cheapo treatment with all this high-tech talk on the board. Software? What software? But, hey, there's a reason for everything, and your clarification is appreciated and very nicely stated. Very kind of you.

Wulfman · Post by **Wulfman** » Tue Sep 27, 2005 8:44 pm

Grab,

Thanks for a GREAT post!
I agree that you can get equally fine treatment on a straight CPAP machine. I doubt that in my case, an APAP could do much better. A "straight" machine can still be tweaked to provide what works best for its user.
Over the last month, my average AHI is about half of what's listed below. Additionally, all of the rest of my indexes have dropped dramatically since I started on this therapy.

Best wishes,

Den

lindas88 · Post by **lindas88** » Tue Sep 27, 2005 9:09 pm

I also bought an apap machine but had better luck using it as a cpap...so now I am straight cpap....

Colorado Jan · Post by **Colorado Jan** » Tue Sep 27, 2005 11:33 pm

Well, I guess I'm still pretty much a newbie---I think I've had five weeks of CPAP now---and although I like gadgets, I'm not particularly skilled with them.

I have a basic DME-provided CPAP, set at 9cfm, and I've been 100% compliant since I've gotten it. Never even get in bed to READ without the thing on. And I really like it. I like the noise. I like the steady pressure. I have no problems exhaling against it. Can't stand the ramp feature, I like that pressure STEADY. I get myself to sleep by listening to myself breathe in and out, kind of like a meditation or something. And I've always slept with a fan directed right at my face (was this an attempt at home-made CPAP????? lol), so I like all that air blowing around everywhere. So that ole basic CPAP thing is doing great.

At some point when I purchase a machine though, I'll probably go the fancy route for the tracking ability and for occasional home "sleep studies", just to make sure I'm still at the right pressure. That argument for auto-pap does make sense for the long-term. But I really have no doubt I'll still basically use it as a straight CPAP. Works for me and I'm the type that thinks if it ain't broke, don't fix it!

Jan in Colo.

Jan in Colo.

4Katie · Post by **4Katie** » Wed Sep 28, 2005 7:00 am

Excellent point. When I was trying to get used to using my CPAP, I spent a lot of time wondering if I should have an APAP. But my pressure is only 6, so I realize that wouldn't really make much of a difference.

Same with ramping. I used it, cuz it was there and seemed like a good idea. But I don't need it at all.

The key, as with everything else, is to find what works for you.

Grabraham · Post by **Grabraham** » Wed Sep 28, 2005 7:40 am

As you all have noticed, when you take a big step back and look at the forums, a

walking in could get the impression that they are fighting a losing battle because some of us have taken their treatment to levels that they cant begin to imagine. I just want to assure new hose heads that in 90% of the cases that the person who's post they just read that has the latest and greatest equipment would sleep just as effectively on the equipment they "got stuck with from the DME".

WAFlowers · Post by **WAFlowers** » Wed Sep 28, 2005 8:04 am

Grabraham wrote:I just want to assure new hose heads that in 90% of the cases that the person who's post they just read that has the latest and greatest equipment would sleep just as effectively on the equipment they "got stuck with from the DME".

Excellent point. I have an APAP and with almost no exception my treatment would be every bit as successful if I just had a "normal" CPAP set at my titrated pressure.

But I don't regret the extra expense. And all too commonly reported here people don't receive a good laboratory titration for whatever reason (and there are lots of them). If I hadn't received an excellent titration study then the APAP would have gone from a luxury to a necessity, as I fine-tuned my treatment.

Sleepless on LI · Post by **Sleepless on LI** » Wed Sep 28, 2005 8:25 am

Grabraham writes:

I just want to assure new hose heads that...

(LOL) And, just to clarify that a bit, "hose heads" is not a derrogatory remark referring to newbies, but rather a term that has been used to describe those of us on therapy who use our machines.

ProfessorSleep · Post by **ProfessorSleep** » Wed Sep 28, 2005 8:36 am

Excellent points, everyone. And as one of those "newbies," I appreciate the discussion (and the candor). There is another reason for going with basic equipment, too, at least for me anyway. I'm a techie at heart, and the idea of not having the software and tracking ability does make me feel like I might be missing something. Combine that with inherent skepticism of health care and, gee, I'd like to manage it myself. But I also know that such capabilities can take over your life (at least I don't think I'm alone in allowing the technology and the numbers to take over. I've been known to do that type of thing - grin). In this case, I think I'm better of with the "plug and play" variety... like Jan, if it ain't broke.... But I still think my next machine will be an auto just so I CAN do it myself - if I want to, that is

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