apap setting and sleep study question

LarryJ · Post by **LarryJ** » Thu Mar 03, 2005 5:42 pm

I am switching from a cpap to an apap this week and would like to know what I should set it for. Right now on my cpap they have me set at a pressure of 10 cm with a ramp up. Based on my sleep study info below what should my settings be? Also how does my study compare to others here?

First half of study without cpap for 3 hours 27 min:

119 apneas
Oxygen desaturation went to a low of 75%
AHI 78.45

Second half with cpap at 10 cm for 3 hours 3 min:

12 apneas
Oxygen desaturation went to 92%
AHI 8.99

Thank you for any info,
Larry

rested gal · Post by **rested gal** » Thu Mar 03, 2005 6:25 pm

I'm not a doctor, or anything at all in the health care field. Just an autopap user. If it were me, I'd probably set the range at 5 or 6 or 7 for the low (whatever I felt was giving me enough air for comfort) and 12 for the upper pressure, to give a little head room should there be occasional times when the titrated pressure of 10 wasn't quite enough to deal with an event.

Autopaps don't use "ramp", so be careful that you or whoever sets it up has ramp set for "0" zero, if it's a Respironics Remstar auto. Setting "ramp" on that machine when it's also set for "auto" would cause it to operate in "split night" mode. That would mean the machine would steadily use only its very lowest pressure, and not begin using your treatment range until at least an hour (or up to 4 hours!) had gone by.

Since I've never wanted to use "ramp" and always kept it turned off with any machine I've used, it was news to me the first time someone told me that "ramp" (as we think of it for plain cpap users) can't even be enabled when using the Remstar autopap. Sure enough, they were right. The Remstar auto will start out at whatever low you've set, or whatever you set for "starting" pressure, so ramp really isn't even needed in auto mode. Trying to set a "ramp" time in auto mode would result in a split night mode - not good.

LarryJ · Post by **LarryJ** » Thu Mar 03, 2005 6:43 pm

Thanx for the info. I think my ramp starts at 4 then goes to 10 in about 20-30 min

rested gal wrote:I'm not a doctor, or anything at all in the health care field. Just an autopap user. If it were me, I'd probably set the range at 5 or 6 or 7 for the low (whatever I felt was giving me enough air for comfort) and 12 for the upper pressure, to give a little head room should there be occasional times when the titrated pressure of 10 wasn't quite enough to deal with an event.

Autopaps don't use "ramp", so be careful that you or whoever sets it up has ramp set for "0" zero, if it's a Respironics Remstar auto. Setting "ramp" on that machine when it's also set for "auto" would cause it to operate in "split night" mode. That would mean the machine would steadily use only its very lowest pressure, and not begin using your treatment range until at least an hour (or up to 4 hours!) had gone by.

Since I've never wanted to use "ramp" and always kept it turned off with any machine I've used, it was news to me the first time someone told me that "ramp" (as we think of it for plain cpap users) can't even be enabled when using the Remstar autopap. Sure enough, they were right. The Remstar auto will start out at whatever low you've set, or whatever you set for "starting" pressure, so ramp really isn't even needed in auto mode. Trying to set a "ramp" time in auto mode would result in a split night mode - not good.

wading thru the muck! · Post by **wading thru the muck!** » Thu Mar 03, 2005 8:42 pm

Larry J,

First, I would listen to rested gal. She puts a lot of thought and effort into finding effective treatment for herself.

I would set the auto at 6cm min 14cm max. I recommended a little higher at the top end than rested gal because your AHI was a little high at 10cm. An AHI of 5 or below is what your goal should be. The only caveat would be if some of those apneas were central apneas. If so, the higher pressure may make that worse. I'm assuming this is not the case though.

You won't need the ramp on the auto because it stays at the minimum pressure until it anticipates an event and then increases the pressure as required to prevent it.

Which auto machine are you going to get?

loonlvr · Post by **loonlvr** » Thu Mar 03, 2005 8:57 pm

I learned about the ramp thing the hard way. If you see my topic further down. I had the ramp on with the auto and it stayed at the bottom setting(5.5) for 2hrs even tho i was having LOTS of apneas. So i switched it of.

LarryJ · Post by **LarryJ** » Thu Mar 03, 2005 9:08 pm

I'm getting the 420E w/ humidifier and software from cpap.com

wading thru the muck! wrote:Larry J,

First, I would listen to rested gal. She puts a lot of thought and effort into finding effective treatment for herself.

I would set the auto at 6cm min 14cm max. I recommended a little higher at the top end than rested gal because your AHI was a little high at 10cm. An AHI of 5 or below is what your goal should be. The only caveat would be if some of those apneas were central apneas. If so, the higher pressure may make that worse. I'm assuming this is not the case though.

You won't need the ramp on the auto because it stays at the minimum pressure until it anticipates an event and then increases the pressure as required to prevent it.

Which auto machine are you going to get?

wading thru the muck! · Post by **wading thru the muck!** » Thu Mar 03, 2005 9:16 pm

Larry J,

That machine was my first choice when I got mine. You will be very happy with it.

gailzee · Post by **gailzee** » Thu Mar 03, 2005 10:19 pm

I have the PB 420E. I am set at autopap 5-14. I have the software, I"m averaging about a 10.0-10.5 max. Your study sounds like mine. was yours a split study in one night. I had to go 2 nights.

I went from 133 ''episodes" to 19. I thought 19 was high, dr. never really commented yes/no when I asked him.

I only had the straight cpap/ramp in the study. Very uncomfortable. Do be sure to get the heated humidifer, it's a must, even set on low.
with the software, I follow my own progress, and my AHI's have been around 1-2. So quite a difference from the ''41" I had on the diagnostic study.
Hope this helps.

LarryJ wrote:I am switching from a cpap to an apap this week and would like to know what I should set it for. Right now on my cpap they have me set at a pressure of 10 cm with a ramp up. Based on my sleep study info below what should my settings be? Also how does my study compare to others here?

First half of study without cpap for 3 hours 27 min:

119 apneas
Oxygen desaturation went to a low of 75%
AHI 78.45

Second half with cpap at 10 cm for 3 hours 3 min:

12 apneas
Oxygen desaturation went to 92%
AHI 8.99

Thank you for any info,
Larry

apap setting and sleep study question

apap setting and sleep study question

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