Talk to me about APAP settings...

Monday I go pick up my APAP and return my Elite to the DME. I am going to go in so I can get it sooner. They said it was the same billing code as the CPAP and insurance isn't going to buy another machine now (got new one 2mos ago) so it will be done as an exchange. That shocked me after how awful my last dme was... but anyway...

How should an APAP be set? I know my settings are going to be 7-11 but I suspect some tinkering needs to be done with it. Is there a guideline about setting it a certain # above and below your titration # from the CPAP study? I have ResScan so I can check the data and such.

I have a Respironics auto so I don't know if the same thing applies with Resmed.

On the Respironics autos, things seem to work well with the minimum pressure being at or just below the titrated pressure. The maximum pressure is not usually as important unless there is a reason for a narrow range.

You will be starting with one pressure range and, since you have the software and reader, you will be going from there. You mention that it will be set at 7 minimum and 11 maximum. I assume they are setting it at that range as a result of your recent sleep study. If your titrated pressure is 7 or 8 this is probably a good range to start with. it is a fairly narrow range. I do well with a narrow range. This is what you should go on until or unless the data tells you changes are needed. Certainly 7 is high enough for you to be able to breathe well and to deal with the CO2.

After about a week, unless data and the way you feel are not good after about 2 to 3 days, you may want to make some changes. It usually takes about a week for the body to adjust to a setting.

You will have some data to post, since you already have the software so people here will be able to help with any adjustments that may help things along.

As I said, I know next to nothing about Resmeds but, to me, it should be the same. Someone who knows more about Resmeds will correct this if I am wrong.

All the best!

I would set it at a higher range if I were you. You have been titrated at 10 and 14cm... so at some point during the night you may be needing 14 even if the titration was slightly faulty. I would set the minimum somewhere around 8 or 9 and leave the top wide open or limit to 15 if you're worried, and see how you do for a few nights. Do you have the software as well, or just the LCD info?

What I've read here suggests setting your minimum to 1cm or so below your titrated pressure or better yet your 90% pressure on the APAP. Maximum pressure is another story - some people complain about runaway pressure so they limit the top to just a few cm above the titrated pressure, but if I were you I'd leave the max higher to first see what kind of data you get. First thing to check will be your 90% or 95% pressure - if you consistently have roughly the same 90% pressure every night then you can set your minimum pressure 1cm below that, again based on what's been said here previously.

I hope you get it earlier rather than later

Well, they titrated me to 10 at my most recent titration and when they used the apap on me then it was set 7-11. 10 is where they think I need to be. 10 is not always working though... I may go ahead and use it as prescribed and then see how my data looks in ResScan after a week.

2girlsmom wrote:Well, they titrated me to 10 at my most recent titration and when they used the apap on me then it was set 7-11. 10 is where they think I need to be. 10 is not always working though... I may go ahead and use it as prescribed and then see how my data looks in ResScan after a week.

You will see after a few days whether the machine is bumping up against the maximum range #... if it does consistently then you need to bump up that number. Pure speculation on my part here... but I suspect you will find your machine bumping 11. But do go with the recommended settings and gather some data for a few days before making adjustments.

Don't be too quick to make changes... give the machine enough time at new settings so you can gather some meaningful data.

Be sure to set your "Settling" time for whatever time it takes for your breathing to settle down and be ready for sleep. During the "Settling" time the machine will not record any events. Events recorded when you are awake are meaningless.

Make sure your leaks are under control before attributing too much importance to the other numbers... as they will also be meaningless when leaks are out of control. The LCD data can give you a reasonable idea of how that is doing. As well, the software will show you the peak (spike) leaks during the night. Below is a chart as per Resmed rating leakage...

Leak (L/s) Rating
0.00-0.18 Excellent
0.19-0.26 Very Good
0.27-0.34 Good
>0.35 Poor

I would suggest in addition to reading the data with RESSCAN that you also record the numbers of your LCD:

Usage
Pressure
Leak
AHI
AI
HI

Setup a spreadsheet and record this every night... for me it provides a snapshot over a period of time of how I am doing and how adjustments are affecting the therapy.

My own settings are below. I usually spend most of the night hovering around 11 - 12. Rare times the machine does bounce against the 15 max limit but I never see an event associated with that.

Do you have the clinicial manual for the AutoSet?

Thanks Paul. I do suspect that I'll need to increase the top # but I'll be a good girl and use it as prescribed for a while.

I do not have the clinical manual for the Autoset but I know how to access the menu on the machine. Should I get the clinical manual?

2girlsmom wrote:Thanks Paul. I do suspect that I'll need to increase the top # but I'll be a good girl and use it as prescribed for a while.

I do not have the clinical manual for the Autoset but I know how to access the menu on the machine. Should I get the clinical manual?

If you want it (the clinical manual for the Autoset) send me a PM with your email and I will forward. Some good info in there.