from AUTO to CPAP... an experiment

Well, after operating my AutoSet in AUTO mode for 960 hours I have decided to experiment operating it in CPAP mode for the last few nights.

Titrated pressure was 8 but is was as much as admitted on the sleep study documents that a higher pressure would be needed. 95th centile pressure in AUTO mode has been around 12 to 13 for months.

I decided to start the experiment with operating the CPAP at 10. Turned out that was too low as per the numbers. For the last few nights I have been operating in CPAP at 11 with excellent results so far... AHI reporting in the 3 to 4 range with AI always zero.

I am encouraged by the results so far and will continue to operate in CPAP mode and monitor. I know it is early going to draw any conclusions... but if early results are an indicator I may actually do better on CPAP than in AUTO mode.

You never know until you try. I do better on Apap, and my wife does better on Cpap.

Here's what I did and it worked great. I ran my machine on auto. Ramped up from 4 to an 8. All that week I looked at my run up and down (which ran between 8 and 15 on auto). I kinda took the average for that week. I now am on CPAP straight at 9.5 with a 2 humidifer and a 2 Flex. My AHI is at 1.4 now ( it was running at 3.9 when I had it on auto). Hope this helps.

I did the same and had a CPAP session of 2.0 AHI (about 8 3/4 hours sleep), and with APAP I was getting 5.0. Very limited data, but it seemed to me that APAP was waiting 'til some horses got out of the barn before closing the door. An APAP fix would be to set the minimum on my titrated CPAP setting, but being a programmer I'm a bit wary of software algorithms and the seemingly random fashion in which APAP seems to be chasing ghosts. I'm sure that's just abject ignorance on my part, but as long as I've got a comfort zone in CPAP and it is keeping my AHI down, then I'll hold off playing around with it for a while...

Paul56 wrote:Well, after operating my AutoSet in AUTO mode for 960 hours I have decided to experiment operating it in CPAP mode for the last few nights.

Titrated pressure was 8 but is was as much as admitted on the sleep study documents that a higher pressure would be needed. 95th centile pressure in AUTO mode has been around 12 to 13 for months.

I decided to start the experiment with operating the CPAP at 10. Turned out that was too low as per the numbers. For the last few nights I have been operating in CPAP at 11 with excellent results so far... AHI reporting in the 3 to 4 range with AI always zero.

I am encouraged by the results so far and will continue to operate in CPAP mode and monitor. I know it is early going to draw any conclusions... but if early results are an indicator I may actually do better on CPAP than in AUTO mode.

Doesn't surprise me at all.
Too many people who buy APAPs think they HAVE to run them in a range of pressures (for various reasons).
If a person has a "multi-mode" machine, they need to experiment to see what gives them the best results.
Changing pressures can disrupt a person's sleep during the night.

Den

It's pretty simple a APAP set to run in CPAP at the correct pressure, is bound to operate closer to your needed pressure than a APAP set to too wide a range or a range higher than you really need, or a incorrect ramp setting. If things are not set so they can preform their function, they won't. Also some people do better on CPAP. APAPs work better when they have time to get to treatment pressure faster by using a 3 cm range. Jim

Paul56 wrote:95th centile pressure in AUTO mode has been around 12 to 13 for months.
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I decided to start the experiment with operating the CPAP at 10. Turned out that was too low as per the numbers. For the last few nights I have been operating in CPAP at 11 with excellent results so far... AHI reporting in the 3 to 4 range with AI always zero.

I am encouraged by the results so far and will continue to operate in CPAP mode and monitor. I know it is early going to draw any conclusions... but if early results are an indicator I may actually do better on CPAP than in AUTO mode.

I'm not surprised at all that you're getting better AHI numbers in CPAP mode at 11, compared to your previous APAP usage with Range: 8-15

If you want to continue experimenting, try this:

APAP mode, range 11 - 20 (or 19, 18, 17, 16, 15..whatever you want to set for the max pressure... won't matter since it will presumably be a pressure than never gets used anyway, so go with 20 )

I'm betting you get as good an AHI with the APAP minimum set for 11 as you do using CPAP mode at 11.

I've always felt that the minimum pressure on an APAP is the important one to "set right". To me, setting the minimum pressure right means setting the minimum up high enough to prevent most events right from the get-go. The usefulness of APAP to me is not to see how low I can set the minimum pressure. The usefulness of an autopap to me is having the minimum pressure set high enough to be "like CPAP", but with additional pressures up above available if ever needed. A margin of unused pressure up above takes care of the possibility of needing more pressure occasionally or briefly sometimes.

Paul, did I miss your AHI results from the APAP mode? What is it that you are comparing to?

I am sure you know if you set an APAP to 4, you are destined for a higher AHI.

GumbyCT wrote:I am sure you know if you set an APAP to 4, you are destined for a higher AHI.

In Paul's Additional Comments: AHI ~60 / Titrated @ 8 / Range: 8-15 / Settling: 20 min / ResScan 3.5

I assumed he was using APAP at 8 - 15, but sometimes people change things without changing their Profile's "Additional Comments."

rested gal wrote:

GumbyCT wrote:I am sure you know if you set an APAP to 4, you are destined for a higher AHI.

In Paul's Additional Comments: AHI ~60 / Titrated @ 8 / Range: 8-15 / Settling: 20 min / ResScan 3.5

I assumed he was using APAP at 8 - 15, but sometimes people change things without changing their Profile's "Additional Comments."

Exactly - which is why I asked. We tend to forget what we have in our own comments

Edit: Actually 60 is more like Dx from the PSG nite, w/o cpap.

OOOOOOOO Laura, thanks so much for that valuable information, I think you are right on about the lowest setting number. I'm now wondering after all these years if that wasn't my problem with the auto mode.
And your pix is fabulous.
Ellen

Yes, the profile is accurate in terms of how I was operating the APAP. I seemed to be doing well with that range and my thoughts were to keep the pressure low as possible while still getting good therapy.

It would seem 11 is my pressure sweet-spot on the CPAP side. Having discovered that I may give the CPAP a few more days and then switch back to APAP and adjust the minimum pressure to 11 there to see how it goes... but I have to say that I feel I'm doing pretty well with a pressure of 11 on CPAP.