I change EPR to 1 and AHI is now 2.0

[VikingGnome]

My AHI's had been creeping up to 6-7 on some nights. I decided to changed EPR from 2 to 1 to see if it helped. My AHI this morning is 2.0.

When I had my CPAP titration, the tech started at 10 and finished at 14. When my sleep doc saw me two weeks later, she said she wished the tech had gone up to 15 because at 14, my apneas who not totally gone. So she set my prescription at 15 although I was never at 15 on the study. It is possible I really need 16 but at 15 with EPR at 2, it drops to 13 on exhale. I really wish I had an AutoSet but my doctor doesn't "believe in them."

I'm on South Beach Diet now and have lost 12 pounds in 2.5 weeks. If I lose enough weight I'm going to need to have settings adjusted. I only needed 10 when I was 20 pounds lighter. If I had an APAP, I would be in fine shape. Sigh! My DME had never dispensed an AutoSet she said. That means all the sleep docs in this area are not prescribing APAP.

[Pugsy]

There are ways to get the S9 Autoset as a backup machine if you are willing to go out of pocket for the costs. I am sure you are aware of this. Could you or would you be comfortable doing it on your own?

Also...Just because your particular DME has not seen to dispense an APAP doesn't necessarily mean that all doctors and all DMEs in your area are stuck on CPAPs.

[VikingGnome]

No. My finances are such that purchasing an S9 Autoset on my own would not be possible. I see my sleep doc for 60 day follow-up on April 4. Maybe I can convince her that with my weight loss and continuing diet, that I really need an S9 AutoSet. If she wrote a new Rx, the DME could switch out the S9 Elite I have because I'm on Medicare.

[Pugsy]

The weight loss and possible variables in pressure could present a good argument for APAP.
Of course it could always be used in CPAP mode. While APAP isn't always the "best" thing for everyone it sure is nice to have it available. My doctor didn't/doesn't offer APAPs often either. I happen to need it for variable pressures in REM. I bought my own machine but when I showed my reports documenting that APAP was beneficial for my needs then APAP was added to my records. I do have a DME for masks and supplies but have never used my insurance for a machine. My DME always tries to offer me a new APAP now. I have since bought several machines on my own and everyone of them I got such a good deal that my out of pocket was less than my copays with my insurance (which is a Medicare Advantage plan now) but for cpap stuff it pays exactly like Medicare.

Good luck and good job on the reduction in AHI with a minor change in the EPR. That works for a lot of people.

[LSAT]

I think too much of an issue is made about autos..Yes it would be nice to have one, but a good machine like the Elite is adequate for most people.Many with autos set their machine to CPAP anyway. Pressures do not change that much. My pressure has been in the11-12 area for as long as I have been on my CPAP 'brick'. Any time I have checked my data with an autoset,my 95% figure has been about 11.5. I rarely check my AHi, but when I do it averages about 4-6. I'm happy with that. I feel good...I sleep good. What would I gain by driving myself nuts trying to lower my AHI?...Nothing!

[josh73]

LSAT, i completely agree with you on the AHI thing. There are mornings i look at my machine and my AHI is 2.0 or lower and i feel OK, but not great. And there are days that my AHI is 5 or 6 and i feel GREAT.

Also, I asked for an APAP when i was first diagnosed with sleep apnea and my doctor wouldn't prescribe one since my titration was successful and i didn't have any other problems besides my AHI of 15. My sleep tech told me that an APAP rental is available if changes are made, ie: weight loss. I started in mid January and have lost around 20 lbs so far but i'm not going to worry about seeing about a APAP rental until next January at the earliest.

[Papit]

. . . Of course it (your Autoset) could always be used in CPAP mode. While APAP isn't always the "best" thing for everyone it sure is nice to have it available. My doctor didn't/doesn't offer APAPs often either. I happen to need it for variable pressures in REM. I bought my own machine but when I showed my reports documenting that APAP was beneficial for my needs then APAP was added to my records. . . . Good luck and good job on the reduction in AHI with a minor change in the EPR. That works for a lot of people.

I'm using an Autoset in CPAP mode since I began three months ago. Please help me understand better when it might make sense, if ever, for someone to switch their Autoset machine from CPAP over to Auto mode. What are the most common reasons to do that?

Also, you might explain how the Autoset is useful, and why you need it, for "variable pressures" in REM. What was it in the printouts you brought in that showed that the Autoset set for Auto was beneficial for your needs? --thanks, Mike

[Uncle_Bob]

I'm using an Autoset in CPAP mode since I began three months ago. Please help me understand better when it might make sense, if ever, for someone to switch their Autoset machine from CPAP over to Auto mode. What are the most common reasons to do that?

someone using an AUTO in CPAP mode may switch to APAP mode in an attempt to self titrate themselves to see if a changed CPAP pressure may be needed.

[Pugsy]

Also, you might explain how the Autoset is useful, and why you need it, for "variable pressures" in REM. What was it in the printouts you brought in that showed that the Autoset set for Auto was beneficial for your needs?

Rather than hijack this thread with my reports and stuff I answered your questions here.
Look on last page if you don't want to read my whole boring story of how I went to bilevel.
viewtopic/t71442/viewtopic.php?f=1&t=71 ... te#p656179

[LSAT]

I'm using an Autoset in CPAP mode since I began three months ago. Please help me understand better when it might make sense, if ever, for someone to switch their Autoset machine from CPAP over to Auto mode. What are the most common reasons to do that?

Also, you might explain how the Autoset is useful, and why you need it, for "variable pressures" in REM. What was it in the printouts you brought in that showed that the Autoset set for Auto was beneficial for your needs? --thanks, Mike

If you are using CPAP mode and your AHI is low, but you feel crappy, you might benefit from a titration with an auto...or...
If your AHI is high and you don't know why.

[teachcsg]

Just from experience as an RT. Auto cpap's are great but dont think they will solve all your problems. I have seen many patients on auto cpap's where their AHI was still >5. So dont feel like if you dont get an auto cpap your therapy is not any good. There really is not one size fits all in sleep apnea land.