My data since hiring the apap

[mgaggie]

My pressure has not gone above 9 and my AHI has been under 5.0 for the six days I've been using the apap.

So much for the sleep centre saying I would need more than 17!

[Julie]

Amazing huh?!

[mgaggie]

Amazing huh?!

Yep.

I just wish I could say I wasn't feeling tired anymore when I wake up. But I'm hoping that will improve with time

[purple]

It might not be relevant to your situation. BUT, I once used a straight pressure of 11, had an AHI of less than 2.5, and did not feel rested. With the permission of the doctor I used it on auto, and by increasing the pressure up to over 15, then auto, I suddenly had an AHI of .2, and felt rested. I am not a fan of how auto works versus my breathing cycle. The only thing Auto did was give me a reason to increase the pressure, a notch at a time. Auto at first did not get up to 15, or 14, or 13. It took awhile.

Then I had serious aerophagia. SIGH. Now I have a VPAP, bi-level machine. I suspect that part of the issue is that my machine, on 11, while it kept the pressure at 11 during all my inhale time, did NOT provide enough air for me to fill my lungs. That is, I suspect, and the doc did not say it to be true, that I needed the higher pressure not to stent my airway open, but for me to fill my lungs. I suspect this is because of the small area which air has to go through to get to my lungs, I need to create a really high pressure to pull it in. With the higher pressure machine settings, like 15 plus, I could better fill my lungs. and the lower pressure on EPAP allowed me to evacuate my lungs better.

Not sure if what your APAP is telling you is the whole story, then again it might be for you.

[icipher]

What is an APAP?

[Pugsy]

What is an APAP?

Generic term for a machine that has the auto adjusting pressure mode.
APAP....Autoadjusting Positive Airway Pressure....single pressure that can auto adjust or vary as needed throughout the night
CPAP....Continuous Positive Airway Pressure.....fixed single pressure delivered throughout the night that might vary only with whatever exhale relief is being used...but still considered a fixed single pressure.
All machines with APAP mode available also have CPAP mode available...so like 2 machines in one.

I use a bilevel pressure machine but it also auto adjusts the pressure as needed so instead of a single pressure I have 2 distinct different pressures that auto adjust. I also have a fixed bilevel mode available plus a straight cpap mode available and I can also make it work like APAP if I wanted to. So 3 official modes but I can make it function like another mode to mimic APAP function.

[mgaggie]

Not sure if what your APAP is telling you is the whole story, then again it might be for you.

It might not be, so I'll be waiting until the month is up to see what it says before I go adjusting the other one. Surely I'll go into REM sleep at least once during the month?!

[Pugsy]

There could well have been any number of reasons why you didn't get into REM during the titration sleep study besides pressure needs.
Maybe it was a fluke night...maybe it was a combination of sleep stages and sleep position.
I do know that my OSA is worse in REM and sometimes I have seen pressures push 20 cm for brief periods of time.
If you are like me...all the more reason to just use APAP and let the machine find the pressure needed for whatever period of time it deems necessary. That's sure better than my using 18 to 20 all night long for maybe 30 minutes of stubborn events in REM.
Some nights my pressures never really vary very much at all and some nights they rock and roll all over the place....and that's why I just use auto adjusting pressures and let the machine do its job. I sleep right through the changes and never know they happen until I happen to look at a report.

Here's an example of a not very exciting pressure night...it's a bilevel report but just pretend the top line isn't there to compare it with your machine's report. And below it is a report showing some marked increase in pressure in response to some events and most likely they are occurring in my first REM cycle of the night. And before anyone wonders...that leak still didn't get a large leak flag in Encore...a good bit of that leak is vent rate increase associated with the higher pressures.