Personal observation

About 6 weeks ago I decided to change from APAP to CPAP. All my data was saying the my best pressure should be 12 (that is what my Rx was from a sleep study done several years ago) I set the APAP to run in CPAP mode and am using a C-flex setting of 2.

Since I have been doing this my morning blood sugars have been running about 20 points lower than they were on APAP. My AHI is usually between 1.5 and 0.7. It was running as high as 3.4 on APAP. I am staying asleep longer before I wake up for a bathroom break and have slept all night a couple of times. That NEVER happened when I was on APAP.

I didn't have my APAP set very wide, only 11 / 13, but I'm seeing a noticeable difference running straight CPAP. I read where other people have had similar results, but I wouldn't have belived it if I hadn't experienced it myself.

FWIW...

Hi Jeff.

So glad to hear about your success (read that "health benefits") with your therapy.
I won't say that it surprises me.

Best wishes,

Den

Jeff, congrats! Excellent results!

While some people find that the auto-pap's ability to deliver lower pressures during most of the night is a plus for them, others find the varying pressure actually causes them to be more wakeful and/or to have more apneas. Just goes to show that everyone is different.

For the last two months, I have been running my auto in straight cpap mode, using the pressure info gathered from more than a year in auto mode. My apneas were always low (.1 to .2), but the hypopneas were averaging 3.2 I've found over the last two months that my apneas have not changed, but the hypopneas have gone down, now averaging 2.

If things deteriorate, I would go back on auto to re-titrate for a month or so, then use the new figure for straight cpap.

Isn't it great to have a machine that allows you to switch modes as needed?

Good luck with your therapy!

Jeff, you've discovered what several of us have....that straight CPAP works better than APAP. I found that out about 4 months ago. WOWZERS!

But, I noticed about a week ago that I wasn't feeling as good as I had been. I decided to go back to APAP and it seems to be helping. Go figure!

I'm wondering if my body adjusts to whatever form I'm using and after a while, it isn't as effective.....kind of like excercising where you have to vary the routing every so often to get maximum results.

*shrug* Dunno, but I'm still feeling good and it sure is nice to have the option of running in either APAP or CPAP!

Kajun

Good for you, Jeff. Now I don't feel so bad about sticking with my ultra-low-tech cpap. It works for me--just fine.

I decided to switch my auto to straight cpap, too. I'm a light sleeper and it seemed to work slightly better that way. I had a very narrow range for a while before I made the switch.

I'm very glad to have had the auto in the first place, since my titration study was so inaccurate. I'm sure I'll use it again if anything seems amiss with my therapy and it seems pressure related.

The most important thing for me on the machine is its data capability. It has helped me see what's going on each night and spot problems then solve them.

Glad to hear that, JeffH. I have a straight cpap and will be changing machine next year when my 5 years are up. Last year, I had been allowed a 2-week trial of an apap because I didn't believe the pressure (11) at my follow-up sleep study was good enough. I was correct because the apap said I should have 13.8. However, it was the most miserable sleepless 2 weeks of my life. I swear that every time the pressure changed, I woke up. I felt so weird because everyone in this forum seems to find that apap's are absolutely wonderful machines.

However, that being said, I'm truly hoping to be able to get an apap when I change machines so that I can test it out in apap mode occasionally when/if there are issues. Otherwise, I plan to keep it in cpap mode.

France

[quote="JeffH"]About 6 weeks ago I decided to change from APAP to CPAP. All my data was saying the my best pressure should be 12 (that is what my Rx was from a sleep study done several years ago) I set the APAP to run in CPAP mode and am using a C-flex setting of 2.

Since I have been doing this my morning blood sugars have been running about 20 points lower than they were on APAP. My AHI is usually between 1.5 and 0.7. It was running as high as 3.4 on APAP. I am staying asleep longer before I wake up for a bathroom break and have slept all night a couple of times. That NEVER happened when I was on APAP.

I didn't have my APAP set very wide, only 11 / 13, but I'm seeing a noticeable difference running straight CPAP. I read where other people have had similar results, but I wouldn't have belived it if I hadn't experienced it myself.

FWIW...

frapilu wrote: <snip>

However, it was the most miserable sleepless 2 weeks of my life. I swear that every time the pressure changed, I woke up. I felt so weird because everyone in this forum seems to find that apap's are absolutely wonderful machines.

<snip>

You are not alone in thinking that 'everyone thinks Autos are wonderful', that is fostered here by some among us but enough people here are honest enough to have reported that changing pressures from an Auto do not always improve their xPAP therapy. Many people who have doubts just don't say so for fear of seeming to be missing the boat.

Autos do seem to work well for a while. For many there is a slow deterioration & a feeling of going backwards. Change to some other mode & therapy boosts again. Then if that does the same after a while (even CPAP mode does this) then switch back to Auto mode.

I would like to gather as much evidence as possible as to if it is just Auto mode that causes the slide (I actually think it is both CPAP and Auto) but we need as much honest feedback as we can get.

If anyone else has any input on experiencing an xPAP therapy slide please do add details.

DSM

For several years I used my old Sullivan straight CPAP and never thought a thing about it. No data, no breathing relief, no nothing but 12 cm of air up the snout every nite and that seemed to be working great until last year.

I think my deviated septum got worse, and I started mouth breathing.

Got my nose fixed, started mouth taping, went back to straight CPAP, use three drops of Clear Pur-sleep every nite and things are going better than they have been in a long time.

I too am a pretty light sleeper and the pressure change was almost worse than the apnea as far as arousals go.

Any one with a APAP and still having trouble, keep an open mind to this solution. I really wanted the APAP to do more than it is able to do.

JeffH wrote:About 6 weeks ago I decided to change from APAP to CPAP. All my data was saying the my best pressure should be 12 (that is what my Rx was from a sleep study done several years ago) I set the APAP to run in CPAP mode and am using a C-flex setting of 2.

Jeez louise... People are going to start thinking we're the same person now!

Except I prefer Cflex of 3. And I can't test my blood sugars in the morning.

Welcome to the club!

LOL,
B.

With Den's (wulfman) invaluable help a while back I went from Apap to Cpap and have had teriffic results. He read my charts, made suggestions and with a little experimenting I hit the sweet spot and have been having consistant AHI of .5 or lower. That's the beauty taking charge of your therapy and having the help of a friend from this forum rather than rely on a RT. I can only imagine where I would be with out his help!

Bonnie wrote:With Den's (wulfman) invaluable help a while back I went from Apap to Cpap and have had teriffic results. He read my charts, made suggestions and with a little experimenting I hit the sweet spot and have been having consistant AHI of .5 or lower. That's the beauty taking charge of your therapy and having the help of a friend from this forum rather than rely on a RT. I can only imagine where I would be with out his help!

Hi Bonnie.

Glad to hear your therapy is still doing well. Do you realize it's been almost a year?

Best wishes,

Den

Just adding some feedback re upping my own Ipap CMs from 13 to 14. That seems to have worked ok as today I was running on all 6 cylinders and no tiredness after lunch as happened in the two previous days.

A doctor I spoke to about this jokingly said well if you have a V8 engine & cut back the oxygen (air) intake it is going to sag a bit too

So for me, keeping that air flowing at a good rate is all important.

I have come to believe that a change as little as 1 CMS can make the difference between a good day and a 'slow' day.

I have not learned to trust Autos as being the best vehicle to constantly deliver the needed pressure. The theory behind Autos is wonderful and full of obvious common sense except, the reality for many of us is that the lower CMS start setting may be ok by the Auto but not for our daily well being. It seems to me that Autos can only do their best at deciding what they think is the ideal pressure but too often it isn't & thus we see so many examples of people who excitedly start out with their machine in Auto mode - bouyed by the wonder stories they read here, often with loads of enthusiasm even from from trusted members, but who then see the good feelings slip away and wonder why.

Having tried various BiLevels (incl Bipap Auto) for almost 2 years I am in no doubt that they too have issues and my observation here is that if the Ipap Epap gap is too big (I no longer will set mine at greater than 4 CMS gap) *and particularly* if the Ipap is set to 14+ CMS, then the user may well experience hyper-ventilation regularly and this can then cause waking up sweating & with pulse racing. However, for some people the Auto Bipap may solve more problems than it creates, if they are needing very high Ipap pressures.

As a general comment, if anyone has nightly data showing breathing rates greater than say 25 Breaths Per Minute, then the pressure setting & gap may be suspect (too high). *But*, only if they are not COPD patients of have some other debilitating lung disorders.

The Servo Ventilation machines thus far seem to be able to solve all the problems mentioned above but even they are still all too new for any safe conclusions to be reached.

DSM