CPAPtalk.com

LI, I've noticed something interesting when looking at data using my Remstar Auto several ways, so I don't know if you can reallllllly compare running in "cpap" mode with running in "auto" by the tick marks that show up in the data for events.

If I run my machine in straight cpap mode (and c-flex OFF) at a straight pressure of 10, there are almost no events on the data.

If I run my machine in auto mode (and c-flex OFF) at a range of 10 for the low pressure and 10 for the high pressure (in essence, as if it were a straight cpap) there will be some events show up in the data. In effect setting the high and low the same is running at a single fixed pressure. But my data consistently reports a slightly higher AHI when run that way vs running same pressure in cpap mode.

Think about that for a minute. Running in auto mode at SAME pressure of 10 for low and high should give essentially the same data results as running in straight cpap at 10. Right? But it doesn't. At least not when I've tried it both ways repeatedly.

Of course there are going to be variations in the number of events on different nights, but I've tried switching back and forth that way enough times to see that "auto" mode using a "single" pressure lets more things be seen in the data results the next day, than running the same machine in pure "cpap" mode at that same single pressure.

My non-techie guess about the discrepancy is that in auto mode, the algorithms are still fully at work analyzing things, even though the machine's high/low pressure is set on the same number, so that it can't really make any pressure changes based on what it senses.

In cpap mode, perhaps it is designed to not even use some of its algorithms. Blind to some things, in other words.

Of course who's to say which data gives the truer picture? Was the auto set at high/low "single" pressure correct when it reported more things sneaking by? Was the straight cpap mode deliberately overlooking things autopap mode takes into consideration and reports?

The machine can only report what it senses in each mode. I have a feeling that when run in cpap mode, the "sensing" is done a bit differently. Apneas are a pretty cut and dry thing to report. But when it comes to hypopneas, I wonder if the two modes ("auto" mode and "cpap" mode in the same machine set for same pressure) are looking at hypopneas in quite the same way? I wonder if the machine brings slightly less sensitivity to identifying hypopneas when it's running in cpap mode as opposed to running in auto mode at same "fixed" pressure.

I wonder if Auto mode might be looking at the flow that gets so limited it qualifies as an hypopnea in a more sensitive way. Perhaps identifying more conditions that the machine finally regards as "HYPOPNEA!" than it would in cpap mode. Just a wild non-techie guess.

If not apples and oranges, it might be a comparison of tangerines and oranges...the way the two modes in same machine work -- at "same" pressure. I don't know.

My mouth leaks seem to come and go (mostly go ) - I've never attempted mouth guards or tapes....
I'm sometimes tempted.
Sorry I can't help you with the Encore leak data - I haven't the slightest idea...

O.

RG,

You are not the first person to bring that up. There was a post, perhaps about how to bring someone's AHI down lower, that included exactly what you were talking about, how APAP setting at a same high and low number as opposed to a straight CPAP number yields different readings. Yes, you're right, different nights, different data. And unless we were able to split the cable and record our data on two machines simultaneously (could you imagine that?), we won't know if we'd get two different readouts. I will try, in a few days, since I have only been on straight CPAP for a few nights, to do the APAP with both numbers at 10 and see what I get.

The only good thing here is, you said you were referring to hypops. I haven't seen a hypop recorded since CPAP started. And last night had only one apnea. No matter how you spin that one, I can't look et that in a bad light. Every if we tripled the number, it would still be a great night for me.

But it is strange that since I set the machine to straight CPAP, no reports of hypops OR snoring. I have had a zero for both of those. Could it be straight CPAP, the constancy of the pressure just provides better therapy? I was titrated by an RT who said this, almost verbatim. "I got your titration perfectly. Once you get on therapy, you won't ever have a problem sleeping again."

Of course, he was wrong. He didn't have to come home and get used to the masks for me and the hose being attached to a machine and me at the same time, but he felt the titration level of 10 would solve my problems. Maybe expecting an auto machine to be able to predict what you're doing and be stop it at all pressures set is too much to ask? I don't even know what I'm talking about anymore. This is all so perplexing.

But I will try the 10/10 auto mode soon. I just think turning off the CFlex, too, might have had something to do with the one apnea figure today. Hey, let me enjoy the memory of reading that data this morning, even if there's a chance it could be inaccurate!!!

I haven't seen a hypop recorded since CPAP started. And last night had only one apnea. No matter how you spin that one, I can't look et that in a bad light. Every if we tripled the number, it would still be a great night for me.

But it is strange that since I set the machine to straight CPAP, no reports of hypops OR snoring. I have had a zero for both of those. Could it be straight CPAP, the constancy of the pressure just provides better therapy?

It's really difficult to explain what I mean...and my theory could very well be completely wrong.

What I'm saying is that there may be a few "light" (for want of a better word) hypopneas happening that the machine set to "cpap" doesn't even see because it doesn't have to be very sensitive in "cpap" mode. A lot of its analyzing power is turned off, so to speak.

However, when set to autopap mode (but at same straight pressure) the autopap's algorithms go to work sensing and analyzying every little change in airflow....even if we have it set so that it can't do anything about it...pressure is "fixed" at same low/high. Some hypopneas might be so borderline or light (if there is such a thing) they might get toted up in auto-straight-pressure, even though they were ignored, or unseen, in cpap mode. Even though they got recorded and reported, they don't necessarily cause you a bit of problem - no more so than they do when they happen but don't even get noticed (or reported) by the machine in cpap mode.

I'm getting very close to "If a tree falls, but..." yadda, yadda. LOL!

I'm not trying to say that one "straight pressure" way or the other would give you, or me, or anyone better treatment. That's the beauty of an autopap - so versatile! We can run it in cpap mode if it works better for us that way, or with high/low the same, or with a range. Interesting to look at the differences.

More and more I'm coming to believe that a lot of people would do best if their autopap's low pressure were set up very close to, and maybe even on, their prescribed pressure. Only reason to set it a good bit lower (3 or 4 points or even lower) than the prescribed pressure would be if the prescribed pressure was very high.

If your auto were set with low right ON the pressure you're presently using in cpap mode, and the high set a few points above that, it would be interesting to see if you'd get the same subjective feeling in the morning that your treatment went well.

If you decide to try that (aren't these machines fun to experiment with? lol ) don't even look at your AHI the next day. It's easy to get hung up on "what's the AHI this time" and start trying to tweak every little decimal point instead of going by how we feel. Not saying that's what you do, but I sure caught myself doing that a lot. It's tempting to do with the "AHI" right there in front of us each morning.

Okay, you talked me into it, RG. I am going to try tonight with the 10/10 apap. I did move up the bottom number, as per your suggestion to me a while ago, and it seemed more worthwhile. I had something else on the subject relevant to say but just forgot totally. Am I relapsing???

Anyhow, we'll see tomorrow what it will show. I will try it for a few days and see what happens.

I also made the DYI mouth guard tonight. And let me tell you, until I figured out what position the "blob" in the middle is supposed to be to push your tongue in the right direction (checked by holding my nose to see if I could breathe with it in my mouth), it was quite some time. Also, to get the bended "U" piece to stick to the mouthguard, until I finally heated up a knife and burned them together, don't ask.

It's still in the eighties and humid here on Long Island at 9 PM and I don't have AC on in my kitchen, so I'm standing at the stove, over boiling water and one gas burner running to heat my knife...I tell you, the things we'll do to not tape our mouths.

Oh, wait. Now I remember what I was going to ask you. When they do the PSG, they must use some type of sophisticated auto machine that picks up on the slightest of algorhythms? I wonder what it is they use that is so right, so sensitive and so precise as to set our pressures with accuracy. Probably some computerized apap machine that costs about a billion dollars.

I wonder what it is they use that is so right, so sensitive and so precise as to set our pressures with accuracy.

It's called a very experienced, good sleep tech.

(No kidding.)

Restgal writes:

It's called a very experienced, good sleep tech.

Can I get one of those to go, please?

qrtylox, Thanks for the info on the mouthpiece. I will definately be looking into that one for sure! I am using a modified sports mouthpiece at this time and it is working ok but the one you linked to looks a lot smaller and more comfortable to use.

Also I've been on cpap for 2 years now and I have researched the lap band extensively and it is what I think would be best in my situation. Thanks for all the replies and god bless you all!!!!!!!