I switched from APAP to CPAP

[-SWS]

For reader comparison, here are AASM's current practice parameters for Auto-CPAP:
http://www.aasmnet.org/Resources/Practi ... Update.pdf

And AASM's current practice parameters for CPAP and BiLevel:
http://www.aasmnet.org/LearningCenter/P ... Pparam.pdf

If most doctors currently prescribe exclusively APAP, that's a trend I am unaware of.

[carbonman]

For reader comparison, here are AASM's current practice parameters for Auto-CPAP:
http://www.aasmnet.org/Resources/Practi ... Update.pdf

And AASM's current practice parameters for CPAP and BiLevel:
http://www.aasmnet.org/LearningCenter/P ... Pparam.pdf

Is this required reading .....and will it be on the midterm??

[-SWS]

The midterm has been indefinitely suspended based on sagging popularity.

Hmmm... It never occurred to me that most people would find the above two documents inordinately boring... By golly, I think you're onto something fairly concrete there, Carbonman.

[mars]

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.

Autopapdude

I do wonder why you are so definite in telling others that their experience is wrong.

I also doubt the logic of your postings, you say on the first line above -There is absolutely no upside to switch to cpap for a successful autopap user.

And you say on the last line above - Some folks arouse easily on pressure changes, and those might benefit from straight cpap

So apart from providing entertainment, how are you helping?

Is belittling other peoples experience what you think your place in this forum should be?

I have read some helpful posts from you, then off you go and vent again - to no good purpose.

You sure are pissed off about something, it would be better to get a baseball bat and beat the hell out of a pillow than keep insulting people.

Hi All

If you want to read what I found out about different pressures and cpap and apap - from personal experience -which no one can deny then you can go to -

viewtopic.php?f=1&t=47236&p=425980#p425980

And if you don't fall asleep reading the introduction you will find some interesting figures.

cheers

Mars

[Autopapdude]

SWS, those are good articles. I can't say that all doctors prefer autopap (as previously stated, a lot of the "old school" ones might not be up on the research). However, every one of the doctors I have seen over the past 11 years for treatment and diagnosis of OSA have advocated strongly for apap, as they feel it treats the "rogue" apneas in a superior manner. As was said before, a sleep study is often not representative of ongoing treatment pressure, and can be frequently inconclusive of a really accurate titration. My current Internal Med doctor is a graduate of Mayo Medical College, which is part of the Rochester Minn. clinic complex. He stated unequivocally that he prefers apap for its ability to "change with the circumstances." He'd disagree with Link in that autopap doesn't allow the majority of events to be untreated--that it reacts quickly enough to a "flagging event," and adjusts accordingly. My ENT doctor, who is rather famous in the field, states that titrations done in a sleep lab are frequently too high or too low, and need to be adjusted anyway. So, he likes autopap for those reasons. The doctor who did my re-titration in 2005 is a sleep expert (did his residency at Columbia Presbyterian) also advocates for "variability of treatment options." That is what I go on, and it makes sense--sleep is not a uniform situation nightly, but is variable and fluid. The apap is good at adapting to said situations, as long as it is adjusted properly. I had originally stated that apap isn't for everybody--those who have pressure sensitivity or centrals are in a whole different situation, and must be dealt with appropriately. My experiences with autopap have been extremely positive, and I will continue to advocate for them over cpap for the reasons stated above. I AM NOT disparaging cpap--merely stating that it is an old technology, and that the better autopaps help to improve compliance and treat as well or better in most cases.

Autopapdude

I do wonder why you are so definite in telling others that their experience is wrong.

Never said that. I said that for many, autopap is superior, due to comfort factors, and variability options. If something works for someone, so be it. A lot of people jump to change too readily, and don't give their prescribed treatment a chance.

[KatieW]

Autopapdude and LinkC....guys, I think you're both right--in that whatever works for you, is the best way to go...for you. I appreciate you both! And you've made me laugh.

It seems that cpap is working best for me though. For now anyway.

[KatieW]

For reader comparison, here are AASM's current practice parameters for Auto-CPAP:
http://www.aasmnet.org/Resources/Practi ... Update.pdf

And AASM's current practice parameters for CPAP and BiLevel:
http://www.aasmnet.org/LearningCenter/P ... Pparam.pdf

If most doctors currently prescribe exclusively APAP, that's a trend I am unaware of.

Thanks for the articles. I've printed them, and will read them over my morning coffee.

[Autopapdude]

Katie, I am glad it is working. If it ain't broke, don't fix it. If your numbers are good and you feel good--hey, I am happy for you.

[mars]

[Sagesteve quote] I really don't have bad nights. My AHI is a consistant 0.5 to 0.9. [/quote]

Autopapdude Quote

Of course you do. EVERYBODY who is on xpap therapy has had or will have bad nights--doesn't matter what your AHI is. Don't get hung up on the numbers alone. If you say you haven't had a bad night, I just don't buy that one bit. Cpap/Apap therapy is difficult, and an adjustment for everybody. Perhaps your recent AHI is consistently below 1 (doubt it), but that alone doesn't mean that you won't have a night that is sleepless, and where there are many awakenings. Numbers change over the years as well--how long have you been on 'pap therapy?[/quote]

Quote Mars

I do wonder why you are so definite in telling others that their experience is wrong.[/quote]

Quote Autopapdude

Never said that. I said that for many, autopap is superior, due to comfort factors, and variability options. If something works for someone, so be it. A lot of people jump to change too readily, and don't give their prescribed treatment a chance.[/quote]

What can I say. If you cannot acknowledge what is plainly there for all to see, then having any kind of discussion with you serves no purpose. I dunno I really think a good baseball bat session before you post would do you a world of good. Of course, as you are so ready to give others your advice, you won't be complaining about mine

But for me, you cannot blatantly lie, and then expect to be taken seriously.

cheers

Mars

[Sleepy Taz]

Autopapdude wrote "Numbers change over the years as well--how long have you been on 'pap therapy?"

For me, I have been on Cpap therapy for 21 years with a constant pressure of 17. In that time I have had 4 sleep studies and each produced the same results. Maybe those bad nights you speak of have to do with pressure changes causing arousals?

[Autopapdude]

What can I say. If you cannot acknowledge what is plainly there for all to see, then having any kind of discussion with you serves no purpose. I dunno I really think a good baseball bat session before you post would do you a world of good. Of course, as you are so ready to give others your advice, you won't be complaining about mine

But for me, you cannot blatantly lie, and then expect to be taken seriously.

You're taking yourself and this discussion too seriously. Relax!

For me, I have been on Cpap therapy for 21 years with a constant pressure of 17. In that time I have had 4 sleep studies and each produced the same results. Maybe those bad nights you speak of have to do with pressure changes causing arousals?

And, your pressure is dead on consistent for 21 years, every single night? It NEVER changes? That would be unique, as most folks have some change from night to night.

[GaryG]

Hate to be redundant, but my takeaway is that CPAP/APAP is hard work. Nothing is easy. And so we all have to experiment and figure out what works best for us.

And when one finds a solution, one can get shall I say, a bit overenthusiastic about sharing with others. Cos everyone knows how hard it is to get this working optimally.

Ok, now I'll let the discussion go on.

[Autopapdude]

Hate to be redundant, but my takeaway is that CPAP/APAP is hard work. Nothing is easy. And so we all have to experiment and figure out what works best for us.

Exactly. Agree 100%. All I was doing was sharing my expertise as an autopap user. Am I enthusiastic about autopap, after using cpap for many years! YES. IMHO is it a better treatment! YES. Do doctors agree with me? YES, in my experience, and in many studies. Universally so? No, but increasing approval. Is it for everybody? Obviously not, as lots of folks here prefer cpap. So, let's leave it at that.

Also, let's face one fact. A lot of the flaming comes from one person, who has had vehement POLITICAL disagreements with me, and responds negatively to virtually everyone. Let's keep personal dislikes out of cpap therapy, if we can possibly do so. DO I respond to his negativity? Yes, and do I provoke him? Of course! No denials, and the apology I made before was to a female member who was offended. He continues "to stir the pudding" instead of acting like an adult and ignoring me, when he disagrees.

[mars]

Quote Autopapdude

You're taking yourself and this discussion too seriously. Relax! End Quote

Autopapdude

OK mate, I am taking myself too seriously. Obviously I should treat your posts as a joke.

How serious are you when you tell people that their experience is wrong, and you pontificate ad nauseum about your view of how things should be done?

So.......serious when you have something to say, but when you are proven wrong...then its "relax".

What a hypocrite you are

Mars

[Wulfman]

Hi Katie.

Nice looking report.

Hope everything continues to go well and you're feeling good, too.'

Like I said in my first post on Page 1........"In my opinion, the only "downside" would be in NOT trying it."

We're all different and consequently, our therapy can be, too. What works for one, may or may not work for another. (especially when it comes to masks)

Good luck.


Den