AutoPap pressure lower than CPAP pressure

Hi Everyone- I am new to this whole process and recently started using an autopap instead of my Resmed Elite CPAP. I had not been feeling very well on the CPAP and wondered if my pressure was incorrect since I did not sleep very well at my titration study. Here is the kicker: for the last two nights(my first with APAP) my pressure registered as 9.8 and 9.6. The pressure my Doc. had prescribed was 12. I had been using 12 on the CPAP for almost 8 weeks before using the APAP. Does this make sense. Could my pressure have been set too high on the CPAP? Could this have been what made me feel so "foggy,and generally crappy"? Iam going to use the autopap for about two weeks(a loaner) and then I guess my doc will make me go back to the CPAP. Using the APAP I feel a little better and will continue to use it for the next two weeks and hopefully begin to feel some improvement . On the CPAP my ears where stuffy and popped a lot and I felt almost like I had the flu. Since on the APAP I have not noticed the ear problems and I don't feel quite so rotten. I am SOOOO hoping for some good results. If I have to go back on the CPAP(insurance dictates) should I insist that she lower the pressure to about 10 if my results continue to show the 9.8 general pressure? Thanks for all your wisdom!!!! My results for the last two nights were: Press:9.8 , Leak: 0.14, AHI:3.6, AI:0.0,HI:3.6
the second night: Press:9.6,Leak: 0.18, AHI:3.0, AI:0.1, HI: 2.9. How do those results look. Could someone please explain to me what those "initials" mean and what the "ideal" measurements should be? My biggest complain is rainout in my FlexiFit 406 nasal mask. I wake up in the night with it dripping and I have to get up and wipe it out with a washcloth. Last night I wrapped my hose in tights but it didn't help a whole lot. Any suggestions???

That's the whole idea about APAP, to use only the pressure you need when you need it.

That said, you are using different machines and unless you are using software to download your data, you may be getting incorrect info or drawing incorrect conclusions. Also your needs change day to day. Jim

Hey Grumpy,
Great news that you got the APAP -- even if it's for 2 weeks. You can self titrate in that amount of time.
Yes -- your pressure could have been set too high on the other machine. It sounds like your pressure should be around 9.5 to 10, but two nights isn't really enough data to draw that conclusion. Is that a 90% number or the highest number, or ??? If it continues at that, then yes -- the pressure should probably be around 10....That said, I'm not a doctor!!!!!

Question -- who told you the insurance dictates a "CPAP" only??? The DME?? If the DME bills the insurance company correctly, you should be able to receive an AUTO CPAP machine and the insurance company won't complain. The billing codes for the low end CPAP machine and the higher end Auto CPAP machine are the same, so the insurance company pays the same for either one!!!!!! The difference dollar wise?? The DME will make more money if they can force you to continue the CPAP only. I had my doc write a model specific prescription for the Auto machine when the DME tried to tell me I couldn't have one!!!! I have an Auto CPAP!!!!
If the DME tells you the insurance company dictates, call the insurance company and verify or determine that the DME is being less than truthful....
Hang in there and keep fighting!!!! It's your health you're worried about, not the profits of the DME!!!!

Your numbers don't seem to be that bad.....
AI is the Apnea Index
HI is the Hypopnea Index
AHI is the addition of the two above -- anything below 5 is considered "normal" (whatever that really is) (Apnea/Hypopnea Index)

Rainout -- try to keep your machine below the level of the bed....the condensation should run back down to the machine.
Or you may need a "hose cover" to keep your hose a bit warmer than it is. There are numerous places to find them. If you do a search on the forum I'm sure you'll find all kinds of threads discussing hose covers....
Though it is pricey, the Australian heated hose is what quite a few folks use for rainout....Not onlhy is the hose covered but heated as well, so the outside cool air doesn't cause the condensation.

Hope this helps a little.....

Take care!
cheers
goose

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Hi. I went the two-week trial route also. Suggest that at some point during the trial you spend some time sleeping on your back as that's often when the events are worse. Unless you are already doing that, you very well could need a higher pressure for when sleeping in that position. You do want your cpap pressure to cover your worst case scenario.

When you were using cpap, were you using one with exhalation relief? That can make a big difference.

Best wishes in figuring it all out.

Kathy

I did the same as you in the beginning. Had cpap and the MD put me on apap to for a month to check pressures at home. When I told him how much better I slept and my dh also, he wrote me a prescription to change my cpap for auto. Fortunately, my insurance requires a 10 month rental and then the machine is mine, so all they did was change it out... during the 10 month time I also got it changed again to the Respironics auto with C-flex that I wanted for the exhale relief. (My first 2 were Resmed paps). So maybe if you are feeling much better with the auto, a change is possible.
However, I now have bipap auto and couldn't be happier.

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CPAP at my titrated pressure of 13 was uncomfortable. According to my sleep study, 13 cm brought my AHI down to 7.5. (My at-home CPAP did not have data capability, so this is the only benchmark I have for straight CPAP.)

I bought a REMstar Auto and discovered that a range of 10 cm (high enough to stop most of my snoring) to 14 cm gives me much better results. AHI is typically 3-point-something or lower. I spend 70% of my sleep at 10 cm, which is soooo much more comfortable. My 90% pressure is usually around 12.

I’m very happy with the move to APAP. But be aware the change to APAP doesn’t work for everyone. The saving grace is that an APAP will still work as a CPAP at fixed pressure.

Wayne

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