APAP settings

[SleepyCabeza]

Hi all. Newbie here so please excuse the dumb question. My in-lab titration was a waste. Didn't sleep a wink. I have a appointment with the sleep specialist in a couple days and I'm going to try to convince him to not have me another do titration but to prescribe me an APAP machine instead. But since the in-lab titration didn't produce results, how will we know what range to set the APAP machine to? I have mild apnea, but severe during REM(AHI=31).

[Pugsy]

You start with a generic range of pressures and monitor the results and tweak pressure settings based on those results.
So you make sure you get a machine that has easy to obtain and use software....and that would be ResMed or Phillips Respironics and make sure that the machine is the latest in the model series...S9 for ResMed and PR S1 60 series for Respironics.

Usually start out with minimum pressure of 4 with maximum open to 20. Many people can't use 4 cm comfortably though. Just from lack of a lot of air moving it can feel stifling. Feels like suffocating but we aren't..but feels like it so I usually suggest start with 6 cm minimum pressure if 4 or 5 feels like you can't get enough air.

If your pressure needs never go above 10 cm...that 6 cm minimum pressure will probably do quite well but if you happen to need pressure in the higher teens then the minimum likely will need to be a little higher so as to give the machine a better head start. The minimum pressure is the most critical pressure setting when using APAPs.
Anyway...easy to see what is going on and decide where to go by using the software reports.

Pressure needs have no correlation to severity of the OSA. People can have "severe" OSA and only need 5 cm to keep the airway open and someone might have "mild" OSA and need 20 cm.

It is common to see OSA worse in REM stage sleep. Mine is. It is also common for pressure needs during REM stage sleep to increase. Also common for supine sleeping. APAP machine in auto mode would likely be a good fit for someone who needs more pressure in REM stage sleep...that way the pressure can stay lower during the other sleep stages and only increase when needed..maybe in REM. I see this myself.

[nelamvr6]

I started out with a very low pressure, but than ks to this great forum, and especially Pugsy, I was able to get my settings dialed in really well.

I ended up with a starting pressure of 10, a max of 16. I usually never go above 11.

Make sure you get the SleepyHead software so you can track your progress.