Clinical indications for A-SET vs. CPAP?

Finally had a titration study, after living on a 560 Autoset machine for a year. Originally 4-20 then based on chip readings and sleepiness, the DME's respiratory therapist recommended I move it up to 7-20. Still sleepy, and insurance running out before obamacare kicked in, so I quickly scheduled the titration study.

The DME/sleep MD has now Rx straight CPAP at 12 in. pressure. I knew that 7-20 wasn't cutting it and am glad I finally have a better answer. Plus I can finally sleep on my back if I wish. Why the machine couldn't figure it out after a year with OptiStart turned on, I don't know, but that's a whole other discussion.... Now generally less tired on 12, but I now absolutely have to use the ramp feature to fall asleep, and my new Simplus has problems with leaking at the nose at the higher pressures with movement, which I'm working on adjusting.

The sleep center person said they Rx'd straight CPAP because a single pressure reduces the chance of waking me up if the machine attempted to adjust. I have now re-set the machine to 12-20 APAP and have not yet gone to straight CPAP, however. Waking up much more refreshed.

Are there any clinical indications for ordering straight CPAP vs APAP? As a previous poster had stated, and others answered, CPAPs get billed at the same rate as APAPs but with higher retained profits by DMEs. Could that be a reason for the Rx for CPAP only or am I being too suspicious? There must be good, medical reasons for doing one type or the other, right?

I may try setting the 560 machine for 'split night' operation and see if it shows any better sleepyhead numbers while it runs in CPAP vs APAP mode.

Some people are disturbed (while sleeping) by the pressure adjustments, and only you can determine that by experimenting, but having an Autoset machine gives you both options, so you can do just that. However, I personally might also experiment a bit - for a few days at a time per setting - with using autopap at e.g. a low pressure of 8 and a higher one of 15, which tends to give you more precise numbers on readouts of your 90-95% plateaus on most nights - i.e. you'll see if you actually spent most of your time at e.g. a level of 11, or 14, or just 9.5, and then if you're more comfortable with Cpap regardless, you'll have a self-titrated pressure to try.