I switched from APAP to CPAP

[KatieW]

Edited June 3, 2010. When this post was written, I was using ResMed S8 AutoSet II. So all results are for this xpap.

My profile shows S9 AutoSet, because I switched March 2010. On the S9, I am back to using apap, with good results.


I've been reading the threads about APAP, with interest. Have been on apap therapy almost 2 months, and am doing well--numbers are good and I feel good. I'm now using the Mirage SoftGel with PapCap, and leaks are 0-low.

I have gradually increased my Minimum pressure to 8.4 cmH2O with good results, but don't want to go above a Maximum of 10 yet, because I experienced severe aerophagia at 11 cm. I'm doing ok at 10, if I take Gas X and watch what I eat in the evening.

Looking at my graph, my therapy pressure is 9.8 - 10 cm most of the time. So I'm wondering if I should I try a straight CPAP of 10 cm, with EPR 2. Any down side to doing this? Thanks.

[nobody]

There's no downside to do it, no. You can always switch back if it doesn't work out. I found that it's definitely a process of finding what works. I've also noticed that I get the best results by having the lower number closest to my needed pressure and keeping the top pressure just below what makes me swallow too much air.

[Wulfman]

Hi Katie.

In my opinion, the only "downside" would be in NOT trying it.
When a person has a multi-mode machine, I think it's always advantageous to explore some of the options that are available.
You've got some options with your "workable" pressures and some other options with regard to the EPR settings.


Den

[GaryG]

Katie, seems like you're working in a very small range, so I understand why you'd set the CPAP at 10. But why an EPR of 2? Why EPR at all? Why not 1?

[KatieW]

Katie, seems like you're working in a very small range, so I understand why you'd set the CPAP at 10. But why an EPR of 2? Why EPR at all? Why not 1?

Gary, I'm just guessing. I started with an EPR of 3, and decreased it to 2 a week ago, so see how I would feel--it wasn't noticeably different. My reasoning is--it's there for my comfort, so why not? I think I read somewhere that it's not therapeutic, rather just comfort. I'll go do a search.

ETA: Here's a good thread on the subject:

viewtopic/t47269/viewtopic.php?f=1&t=45 ... PR#p411937

[GaryG]

Katie, I just had an hour and 40 minute nap on CPAP, and had AI = 0.0. And alert? And I can't wait to bedtime tonight

Definitely give CPAP a try.

[KatieW]

Katie, I just had an hour and 40 minute nap on CPAP, and had AI = 0.0. And alert? And I can't wait to bedtime tonight

Definitely give CPAP a try.

That's great Gary! Yes, I already changed my settings:

- start cpap at 8.4 (my apap minimum)
- cpap 10
- ramp 5 minutes
- EPR 2, fulltime

And the next setting is interesting: EPR INHALE: (from the Clinical Guide) Sets the rate at which pressure returns to therapy pressure during inhalation. Only available in cpap mode. Options are Medium and Fast Response. Based on the EPR threads I read, I set it at Fast Response.

I think it's comical that I can be so excited about changing the settings.

[GaryG]

I think it's comical that I can be so excited about changing the settings.

Like a kid in a candy store. I know the feeling well.

[Autopapdude]

There is absolutely no upside to switch to cpap for a successful autopap user. First, a fixed pressure all night is rarely necessary. Pressure changes with conditions, and one's overall somatic condition. The autopap gives the flexibility to provide additional pressure on demand for those "bad nights." Cpap does not allow for that. Second, in terms of comfort, one can normally use a lower pressure for 90% of the night, and abort events as they come up, if the autopap is set up properly for your titration. Third, since your numbers will vary wildly from one night to another, a fixed setting makes no sense, unless your pressure demands are so specific, the only way to get satisfactory therapy is to have a fixed pressure. Some folks arouse easily on pressure changes, and those might benefit from straight cpap--then again, they may have trouble falling asleep on their titrated pressure.

[sagesteve]

I went from the original APAP to CPAP. Best thing I ever did! Worked SO much better.

[Autopapdude]

I went from the original APAP to CPAP. Best thing I ever did! Worked SO much better.

I find that hard to believe. Your pressure is the same EVERY night, under all situations? That is almost impossible. One has to have a bad night sometime, and that is where the autopap can do what a cpap can't.

[nobody]

The pressure changes on the APAP can disturb sleep for some people.

[Autopapdude]

The pressure changes on the APAP can disturb sleep for some people

So can a few nasty apneas that sneak past a fixed setting if you roll over on your back, for example. If you're stuck at 10 on a fixed pressure, and all of a sudden you need 13 for a few minutes, I guarantee that the apnea you get will wake you up more readily than the machine upping its pressure 2 or 3 cm.

[nobody]

I know a number of people on this forum have reported doing much better on a fixed pressure than on the APAP range. Even with an APAP range, you very likely won't be able to stop all apneas, it's just the way it is, unfortunately! But you can get it well enough to get a very good night sleep with a low AHI. For some people that is with a range and for others that is with a straight CPAP.

[Wulfman]

The pressure changes on the APAP can disturb sleep for some people

So can a few nasty apneas that sneak past a fixed setting if you roll over on your back, for example. If you're stuck at 10 on a fixed pressure, and all of a sudden you need 13 for a few minutes, I guarantee that the apnea you get will wake you up more readily than the machine upping its pressure 2 or 3 cm.

If you have an APAP set for 10 - 15 and you're sitting at 10 and you have a sudden apnea (which takes a pressure of 13 cm. to clear).......I can guarantee that machine will not stop them. I don't know of an APAP that will actually STOP an apnea in progress......and they have to have preceding events (snores, flow limitations or hypopneas) to give the machine a reason to increase pressure. If you normally have a 12 second apnea, that comes from out of nowhere, the machines can't get there in time.


Den