Going from APAP to CPAP

Hi all,
I had a visit with the sleep doc today. I had changed my own settings from 4/8 to 5/8.2. He seemed okay with my changing them, but he was sooooo surprised. He said no one else had ever done that before. When I asked if it bothered him that I did that, he said "No, after all, it is YOUR treatment. " So I was pretty happy with that. But from all he said, it sounds like no one ever thinks much for themselves (his other patients). He kept saying "How did you know how to make the changes?" I just kept saying "I just learned it". haha
I asked him if my autopap was perhaps waking me up too much, and so he said to try out the CPAP. He chose to start at 8, since my information from the machine showed that I spend 95% of the time at 7.8 or less.
Does that make sense? I guess I would rather start at something like 6 and work up to 8 over a week......or am I just being silly?
He said "give me your card and I'll program it for you". I told him I could do that myself, but he preferred to do it. I'll give it a try, but if it doesn't work out, I'll just change it back myself.
Their printout said that my worst leak was .35l/sec, but I know for a fact that one time it was .45. I asked him what was considered an acceptable leak for my swift nasal mask and he laughed and said they can't really know that, and that he never looks at the leak rate anyhow. ???? Was his answer a little curious??
He was also totally flabergasted when I told him that patients can buy the software. But he also said that if I did get the software, it would be fine for me to print out the info, bring it in, and we'd talk about it ......which is good. But I'm not sure he knows enough to appreciate what would it be saying.
Do you think going from an APAP of 4/8 (spending 95% of my time at 7., to a CPAP of 8 will be real noticeable to me? Thanks for your help.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): swift, CPAP, APAP

I would think you'd sleep a lot better.....and will probably improve your therapy.
If your bottom pressure was really at 4 or 5, that's pretty low and would take too long for it to get up to where it needed to be.

Glad to hear that there ARE some doctors that realize whose therapy it really is.

Den

8's really not very high. I would think it would be easy to get used to.

I changed from APAP to CPAP, (with help from this board.) It made a huge difference for me. I now have very low AI , HI and AHI. It seems the pressure changes were causing some events.
I had really bad leaks with the Swift and changed to a nasal mask. I have almost no leaks with the Activa .
This week , I started using the Ultra Mirage II nasal mask and have had ZERO leaks with it.
I think it's wonderful that you have taken charge of your own therapy. I find it appalling some of the the Doctors know less that we do.
All the best to you,
Lee Ann

My doc wanted me to try CPAP instead of APAP in case the pressure changes were causing some of my frequent awakenings. Can't say that made a difference one way or the other. My stats have been very good on both.

For you to start at 8 seems reasonable, I mean, why use a pressure less than effective unless you have already found a higher pressure absolutely intolerable? If getting used to it is what you are concerned about, the ramp feature should help you with that. I think you'll be surprised at how quickly 8 will feel comfortable and you'll be wondering if the machine's even on.

Best wishes, and congrats on your doc's attitude.

Kathy

Country

From the above, it seems quite common for folks to switch from APAP to CPAP, especially once they have defined the "sweet spot" precisely.

I went the other way, and for me, it works better.

My CPAP setting was at 8 cm, and I have better results with an APAP set to a range of 7.5-9.5, and my AFLEX setting at the middling value of 2.

So, with the lower range at 7.5, I'm within the therapeutic range from the get-go, but if I need a "boost" (like if I sleep in an odd position, or I have a cold), the machine is free to bump up the volume.

Good luck with the xPAP settings.

Regards all - - Tom

Ditto to all of the above.

O.

Ditto to ozij's "ditto." Or...is "tritto" a word?

I'd try cpap mode at 8, with and without EPR turned on.

I'd try cpap mode at 10 with EPR at 3.

I'd also try auto at 7 - 16.

I'd try auto at 8 - 20.

See what various settings show on your data each morning, giving yourself 3 or 4 days at each change.

I'd try several different ranges in auto mode; and several different straight pressures with EPR turned on in cpap mode. As your doctor (good for him!!) said, "It's your treatment."

What he said about how he doesn't bother to look at the leak rate, though...well.... he should start taking an interest in that. Treatment air escaping out into the bedroom does nothing to hold the throat open.

Thanks everyone!

I'm sure glad you all helped me know how to change the settings myself.....otherwise, finding the right spot would take months, and many dollars in visits to the doctor.

Last night went well for me, but I was already very tired from not having used the mask the night before. But I was sort of amazed how easy the transition was. Its hard to believe that the slow increase in pressure of the autopap would wake me up.......but just about anything wakes me up, so its not out of the realm of possibility. I think what's more possible though is being awakened by not being able to breath, if the autopap isn't opening me up fast enough.
I'm still in search of the perfect chinstrap though.....
I bought some tights yesterday, so I'll try to work on those.........hopefully not from jail (if you read my other post).
Thanks again for all your help!

Maybe what you should do is set your Auto Pap low end to 8cm (which is what you've been prescribed) and the upper end at 13cm for those times your sleeping in an odd position and need slightly more pressure. If your Resmed has a ramp feature, then set that also to 20 minutes to start from 4 or 5cm

My 2 cents worth

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): auto