I switched from APAP to CPAP

[DreamOn]

Just in; Strange man in black suit with mirror attached to riding Helmut leads thousands in attacks against alleged devious DME suppliers and health insurance companies. Reports of cats, monkeys, and various strange beings forcing a new policy of issuing data capable machines only and training of self dosing are unconfirmed. It is recommended that normal people should stay in their homes for their own protection. President Obama is recalling all overseas military to put down the riot. Details at 11.

ROTFL!!!

[DreamOn]

Yes, he found his data card in his Resmed bag, so we downloaded all his data onto my laptop. He was fascinated. We discovered his monthly average AHI has been around 5, but in the past few days, the leaks are way up, and his AHI last night was 15. He realized that he is getting a leak from the elbow of his mask, and is going to replace it asap. He's also got a shopping list now--papcap, heated hose, card reader, software. It was fun to help him.

Fantastic, Katie!!!

[jnk]

Just in; Strange man in black suit

Well, naturally, any educated patient active in his own therapy would be considered "strange" to most.

[GaryG]

Yes, he found his data card in his Resmed bag, so we downloaded all his data onto my laptop. He was fascinated. We discovered his monthly average AHI has been around 5, but in the past few days, the leaks are way up, and his AHI last night was 15. He realized that he is getting a leak from the elbow of his mask, and is going to replace it asap. He's also got a shopping list now--papcap, heated hose, card reader, software. It was fun to help him.

How does it feel to be the expert now?

[Autopapdude]

Just in; Strange man in black suit

OH NO! Not a man in a black suit? You know what that means? MIB--"Men in Black" That means that the entire board is inhabited by aliens, trying to subvert us into thinking we have OSA.

[DoriC]

Gary, I'll be interested in the results of your experiment. We've been doing the opposite(cpap to apap) the last few weeks, narrow range of 11-13, and it seems that Mike is sleeping at the lower pressure most of the nights with occasional spikes to the max if he's restless or turns onto his back but not often. His AHI is the same in both modes (0.5-1. but his leak rate seems better on apap at the lower pressure??

[GaryG]

Gary, I'll be interested in the results of your experiment. We've been doing the opposite(cpap to apap) the last few weeks, narrow range of 11-13, and it seems that Mike is sleeping at the lower pressure most of the nights with occasional spikes to the max if he's restless or turns onto his back but not often. His AHI is the same in both modes (0.5-1. but his leak rate seems better on apap at the lower pressure??

Dori, it seems like my AI's are lower on CPAP so far, but my sample is only 5 nights. If leak rate is better, could be due to lower pressure. You put question marks on the end there, but I think it is a reasonable outcome to observe lower leaks at lower pressure. When I started the CPAP, I was thinking, let me just try this for a week, then I'll just narrow my APAP from 6-12 to 8-12, but after 5 nights of CPAP, 4 of them with "good numbers" (AI = 0.5, on a ResMed I don't even worry about HI's), I'm thinking maybe another week....I was getting AI's of 1.0 or lower on APAP, but now I'm getting AI of 0.5. Yes, only a few nights. (Let me tweak it... oh no no no. Gotta get stats for longer period of time....)

[Autopapdude]

Dori, it seems like my AI's are lower on CPAP so far, but my sample is only 5 nights. If leak rate is better, could be due to lower pressure. You put question marks on the end there, but I think it is a reasonable outcome to observe lower leaks at lower pressure. When I started the CPAP, I was thinking, let me just try this for a week, then I'll just narrow my APAP from 6-12 to 8-12, but after 5 nights of CPAP, 4 of them with "good numbers" (AI = 0.5, on a ResMed I don't even worry about HI's), I'm thinking maybe another week....I was getting AI's of 1.0 or lower on APAP, but now I'm getting AI of 0.5. Yes, only a few nights. (Let me tweak it... oh no no no. Gotta get stats for longer period of time....)

____

Good strategy, Gary. I think two weeks (or at the very least, one week) shows a trend, as opposed to one or two nights. My cpap trial is over--with all the discussion going on I set my autopap for cpap, and used the titration prescription (which was gotten from two sleep studies). AHI over a 4 night period rose to 3, and I was very restless, as opposed to my usual one "bathroom break" in the middle of the night. So, I am back on my 8.5 to 14 for tonight, and I will probably be more comfortable. I bet the AHI goes back down to the .8 to 1.2 range that it usually is. So, all in all, quite interesting. If you do go back to autopap (and that is entirely your decision, obviously), I would tighten the settings, by bringing up the lower. The upper makes less of a difference than the lower,obviously, as it is the sensor for the events. I think 8-12 is ideal for you from my NON-MEDICAL background. Remember, I suggested 8-11.5 originally, I think (or was it 7-11.5)? At any rate, if you go autopap, do raise the lower limit.

[GaryG]

Dori, it seems like my AI's are lower on CPAP so far, but my sample is only 5 nights. If leak rate is better, could be due to lower pressure. You put question marks on the end there, but I think it is a reasonable outcome to observe lower leaks at lower pressure. When I started the CPAP, I was thinking, let me just try this for a week, then I'll just narrow my APAP from 6-12 to 8-12, but after 5 nights of CPAP, 4 of them with "good numbers" (AI = 0.5, on a ResMed I don't even worry about HI's), I'm thinking maybe another week....I was getting AI's of 1.0 or lower on APAP, but now I'm getting AI of 0.5. Yes, only a few nights. (Let me tweak it... oh no no no. Gotta get stats for longer period of time....)

____

Good strategy, Gary. I think two weeks (or at the very least, one week) shows a trend, as opposed to one or two nights. My cpap trial is over--with all the discussion going on I set my autopap for cpap, and used the titration prescription (which was gotten from two sleep studies). AHI over a 4 night period rose to 3, and I was very restless, as opposed to my usual one "bathroom break" in the middle of the night. So, I am back on my 8.5 to 14 for tonight, and I will probably be more comfortable. I bet the AHI goes back down to the .8 to 1.2 range that it usually is. So, all in all, quite interesting. If you do go back to autopap (and that is entirely your decision, obviously), I would tighten the settings, by bringing up the lower. The upper makes less of a difference than the lower,obviously, as it is the sensor for the events. I think 8-12 is ideal for you from my NON-MEDICAL background. Remember, I suggested 8-11.5 originally, I think (or was it 7-11.5)? At any rate, if you go autopap, do raise the lower limit.

Yes you did suggest that range of 8-11.5. Current plan is to get CPAP data for a period, then try APAP from 8-12 or possibly 9-11 (note 11.5 not possible on ResMed Autoset, as odd tenths not available). I'd see 9-11 as a tweak from CPAP 10. . Anyway, with the encouragement from you and others, I am proving my sleep doc wrong by improving on my numbers.

[KatieW]

How does it feel to be the expert now?

I'm no expert, but I knew more than him. My husband was impressed also, he said something like "you've learned alot from all that time on the internet".

House guest asked if there was a book that he could get on all this stuff. I said no--I learned it all from reading cpaptalk.

[DoriC]

Autopapdude, So it seems to me after having this interesting discussion that my husband's therapy does follow your pattern except that his AHI is really the same on cpap=12 or auto=11-13 (0.5-1.. The difference I find as the "observer" is that on auto at the lower pressure he is less restless, has no or at most 1 bathroom break/night,lower leak rate and in general his breathing is quieter. But thinking back to when we were newbies and didn't understand data, 90%, leaks,etc, the auto settings left me confused,impatient,at a loss, and it wasn't until Den suggested cpap at a pressure at or close to Mike's titration that the situation stabilized and I slowly learned how to interpret data and make small gradual changes and now doing well on auto mode. I guess what I'm saying, based on my experience,is that newbies might do better starting on cpap with less guesswork to deal with and sort of "graduate" to auto when they feel comfortable with adjusting minimums,maximums and really understand the data. Does that make sense?

[engransan106]

Katie, I'm no expert but when I reviewed your data it seems that your Apap has been so limited by the 10 cm upper pressure setting that it is not working properly as an Apap and in fact is more like a Cpap. Your results aren't bad but without some additional pressure your Apap cannot respond to those apneas. I realize that you are concerned by the aerophagia but you may adapt given more time. You might also try adjusting the data range settings of your chart to get a better view of the tracking.
Regards
Engransan

[Autopapdude]

Autopapdude, So it seems to me after having this interesting discussion that my husband's therapy does follow your pattern except that his AHI is really the same on cpap=12 or auto=11-13 (0.5-1.. The difference I find as the "observer" is that on auto at the lower pressure he is less restless, has no or at most 1 bathroom break/night,lower leak rate and in general his breathing is quieter. But thinking back to when we were newbies and didn't understand data, 90%, leaks,etc, the auto settings left me confused,impatient,at a loss, and it wasn't until Den suggested cpap at a pressure at or close to Mike's titration that the situation stabilized and I slowly learned how to interpret data and make small gradual changes and now doing well on auto mode. I guess what I'm saying, based on my experience,is that newbies might do better starting on cpap with less guesswork to deal with and sort of "graduate" to auto when they feel comfortable with adjusting minimums,maximums and really understand the data. Does that make sense?

Yes, to a degree. I think cpap has its problems also, as the titration better be right, or there is no error correcting. What that autopap gives is a margin for error. I think you said the key in the middle of your post. "less restless and more relaxed." To me that is the key. As long as the numbers are in an acceptable range (AHI<5, and there are no weird patterns on the numbers), whatever makes the person treated feel more comfortable is the key. Some folks love the fixed pressure, as there aren't changes. Some love the pressure relief, and the ability to adapt to changing situations. I think it is an individual basis thing, and I am beginning to back off from my "everybody needs an autopap" attitude. I think "everybody needs the best treatment for themselves they can get." Personally, as I have said many times, I really like the autopap, and had no trouble with the "learning curve." Sometimes, I think we all overthink things, in the quest for the "perfect AHI." I dunno.

[GaryG]

What's better? A Democrat or a Republican? Broccoli or Squash? Mash potatoes or Baked potatoes? Today's music (ycch) or our music (yay!). Red or Blue? Vanilla or Chocolate (I don't think there is an argument here, oh wait.).

A personal choice. Important thing is they both exist, one or the other seem to work better, and whichever works best is the better choice for the individual.

[Muse-Inc]

Vanilla or Chocolate...

Are you nuts? Chocolate of course, the darker the better!