Why return to CPAP from auto-CPAP?

ozij wrote:Everything Den said, except for:

Autos can only respond to an event and they raise pressures rather slowly.....

Some companies' autos raise the pressure sooner and faster than Respironics. And while all Autos attempt to pre-empt events, how will they manage to do it depends very much on a person's breathing pattern. But that theoretical point doesn't change the fact that too wide a range, or any pressure change, may bother some people.

If you're renting an Auto and like it, you can buy any automatic machine you want from CPAP.com with your original cpap prescription - you do not need Auto Rx to buy an Auto online, CPAP on the Rx is enough. Check out the prices and do some comparison shopping, buying online frequently turns out cheaper than getting it from your DME through insurance.

And you will find that some insurance companies will reimburse you for buying the machine online, escpecially if you write to show them the incredible money they will save if they let you do it.
O.

And, I agree with SOME of that. Mainly the part about some Autos responding to events in different ways. Leaks and snores seem to be what they respond to, faster.

The Autos use "algorithms" (basically, computer programs) and sensors to do what they do. They can't necessarily "think" too far ahead. They sample breathing patterns and depending on what their sensors detect ("events" or "conditions")), they react to whatever they detect according to what their algorithm (program) tells them to do.

Den

Opinion is clearly divided on APAP v CPAP, and that might be a good argument for cautious experimentation to determine the most favorable mode and pressure setting or range.

I liked my CPAP, but I love my APAP (w AFLEX). I learned here that for many folks, the lowest AHI (and the best q of life) via APAP comes from setting the lower pressure value high enough to keep the machine from fiddling with the APAP algorithms, and just behave like a CPAP. In other words, my lower pressure is equivalent to my titrated pressure. (Actually, I learned from some clever and observant folks here that AFLEX functions better for many if the lower pressure is a tad higher than one's titrated pressure. IIRC, it has to do with preventing occlusions at the end of exhalation.)

Also, as Wulfman Den says, if the machine starts chasing some higher pressures, that can interfere with your sleep. So, (again, for many, probably not all) a fairly tight range between lower and upper pressure works best.

Why then even have an APAP if the lower pressure is set to the cpap titrated pressure, and the pressure range is narrow? Good question.

Let's say you have a cold or a glass or two of wine in the evening. Or, say you sleep in an unusual position for a night. You might just need an extra cm or two. My data shows that I do on occasion, and that is the principle reason I use and APAP. (Having the ability to use AFLEX is the other.)

I would venture a guess that somewhere down the line, one of the equip manufacturers will build a "tweener". A CPAP with the capability to boost the pressure 2 or 3 cms if needed. That would be a winner.

Good luck - - Capt M.


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