Want to change to APAP

[rottyjohn]

Hello All

I am currently using a PR CPAP C-Flex (insurance machine I am stuck with) set on 13cm my currently prescribed pressure. I am convinced that my apnea is very positional. When on my side 13cm is fine to keep my AHI well below 5 averaging below 3 and I feel great. When I roll onto my back I start snoring and AHI goes through the roof! I literally tied one of my arms down to prevent rolling onto my back. It is effective but after 3 months I no longer am interested in tying myself down anymore. I pull so hard on the restraints that my arms /wrist/elbow go numb which wakes me up too. Not to mention probably not the smartest maneuver. I've played with pressure going a high as 15 and low as 12. I will say 13cm does work if I'm off my back and sometimes even when I do roll over. Stopped using restraint 1Jan AHI numbers are coming up often over 10 average. As high as 20 one night! Ugh!

My only experience with APAP was the DME/Sleep Dr. gave me PR APAP for a week set wide open which was awful. Was to slow to react literally went from 4 to 20 on two of the nights! Other nights barely above 10. I have learned much and feel if I get an APAP and set it at 12-20. Sure would be nice to know it would work before sinking $100's in buying my own machine. My DME/Dr. are big whopping "0's". Insurance company bought machine outright instead of renting. Retired military health care difficult and breaucratic at its best. I am in process of getting my prescription loaded into CPAP.com so I can buy my own machine if that's the route I go. Supposedly they faxed a copy of my prescription to my wife's work. I am very skeptical. Won't know until Monday.

Sure would appreciate any help or ideas you may have?
My frustration level is quite high...

Thanks,
John

[jamiswolf]

Why don't you just raise your cpap pressure to what you need on your back? Like you mentioned, the auto feature isn't all that smooth and some people find the changing pressures wake them up.

And if you're determined to get an apap, check out Craigslist. Some good deals there if you don't mind a used machine. Or Secondwind cpap.
J

[Namlehse]

My issue, they made me sleep on my back for Titration. My AHI on my side is 24 (Where I normally sleep) on my back it's 81. So while on my back, they cranked me up to 18, then sent me on my way with a CPAP RX of 18.

I got lucky.. My DME gave me an AutoSet. After showing my doctor I was watching my Data, I set mine to a range of 12-18. I've actually dropped my AHI since doing this. I was averaging around 4.5, whith a bad night hitting 6.5. Last night I hit an AHI of 2 with a 95% of 13.4. It's a lot eiser to sleep if you don't feel like a dog hanging his head out of a car window.

Something to consider would be selling off your machine after you buy the other. I think the auto is worth it's weight in gold. I've been watching Craigslist lately. Depending on where you live, you may see quite a few come up. I'm shooting for another full AutoSet setup as a spare, at around $350-400, should be fairly easy to find, just might take time!

[Sheriff Buford]

Keep in mind if you get a Phillips Respironics (PR System One REMstar APAP Auto with Bi-Flex) or a resmed s9 autoset, you can use the machine in either straight cpap mose or in the autoset mode. The machine provides both modes. I started out on the autoset mode, but found I felt better on straight cpap mode. Some folks swear by the autoset mode. It's a personal and comfort thang.

Sheriff

[archangle]

Far too many people, including DMEs and doctors don't seem to realize that APAPs can be set to something other than 4-20 pressure range.

[Pugsy]

Are you wanting to stay with PR S1 brand so you can use your original humidifier? Or are you wanting to change brands?

While my OSA has never been particularly worse on my back it is worse in REM stage sleep. I used APAP 10 to 20 range. Some nights I saw mainly 12 cm and some nights I saw times when I went to 16 to 18 cm.
I was lucky that the pressure changes never bothered me but then I never tried minimum of 5...and with your needing at least 13 that is a recipe for disaster in more ways than one. You might just find that APAP with a smaller range works quite well but of course no one can guarantee it will.

[-tim]

Is your mask leaking when your on your side?

As far as CPAP vs APAP, it seems like compliance is higher with APAP than CAPA for new users. CPAP will provide a more aggressive treatment.

A Doctor at St Vincent's was looking at blood pressure it seems that sleep apnea patients had less flexibility with their blood vessels. I wonder if APAP helps increase that flexibility.

[rottyjohn]

Thanks all,

tim I never have had much trouble with leaking. Currently using FF mask and leak rates are very close to specs. When I was put on CPAP initally with nasal mask couldn't keep mouth closed losing all pressure.

Pugsy I wouldn't be shocked if I found that I have some form of the REM issue you describe too. My bad days come as clusters of Apneas usually 30 minutes long and 3 hrs after falling asleep. Then calm period with another volley of apneas.

Archangle couldn't agree more...Why not narrow the range.

John